http://www.azstarnet.com/allheadlines/234116
U.S. patients turn for care to Mexico (with poll)
Hospital price difference 'obscene' — and insurers are taking notice
By Gabriela Rico
Arizona Daily Star
Tucson, Arizona | Published: 04.13.2008
advertisementWhether you need a hip replacement, gastric bypass or heart surgery, you may find yourself seriously considering going under the knife South of the Border.
Mexico is poised to capitalize on the rising trend of U.S. patients shopping the globe for high-quality, low-cost health care. Its hospitals are upgrading their equipment and training doctors in English while private companies are building state-of-the-art hospitals to cater in part to Americans.
Those efforts are directed at people like former Tucsonan Katharine Frey. In December, she spent 18 hours on a flight to India for hip-resurfacing surgery.
The $45,000 to $60,000 estimate to have the procedure done in the United States was out of reach for the uninsured former ballet dancer. In India, the price was $8,000, which included doctor's fees and a week in the hospital.
"The difference in price is obscene," said Frey, 52, who now lives in Phoenix.
Beyond the cost savings, the attention to patients was remarkable, she said.
"These people are still into the Hippocratic oath," Frey said. "Their idea of service is just different from ours."
Mexico has fewer world-class providers than countries such as India, but Mexican hospitals have the advantage of proximity to the United States' $2 billion medical-tourist market.
At the urging of employers clamoring for lower health costs, some U.S. health insurers have begun referring customers to facilities in Mexico.
Private companies have noticed the growing demand. More than 20 private hospitals are in various stages of development, both in border cities and resort communities in Mexico. One is planned for Puerto Peñasco, the Sonoran port four hours southwest of Tucson.
Big potential for Mexico
For Mexico to take full advantage of its geography and gain in the medical tourism industry, the country must have as many accredited hospitals as such nations as Brazil and Singapore, must keep costs low even as quality rises and must design a mechanism for handling malpractice cases, said Russell Bennett, vice president of Latino health solutions for Minnetonka, Minn.-based UnitedHealth Group Inc. Those factors are beginning to converge, he said.
"I think that we're not more than three to five years away," Bennett said. "Depending on how it plays out, it could move quickly."
Investors are looking to supply what they expect will be a growing demand from U.S. patients.
"This is a great opportunity not only for Mexico, but also to reduce health costs in the U.S.," said Marco Antonio Slim Domit, son of Mexican business tycoon Carlos Slim and CEO of his Mexico City brokerage, Grupo Financiero Inbursa SAB. The firm has an undisclosed stake in Star Medica, a privately held hospital chain.
Star Medica in September opened a 53-bed facility in Ciudad Juárez, about four hours southeast of Tucson, and plans others in Tijuana, Mexicali and Puerto Peñasco.
Dr. José Julio Chávez León, director of the Puerto Peñasco General Hospital, said it is welcome news for the seaside community, also known as Rocky Point.
The small general hospital with no in-patient beds is not equipped to handle the 45,000 permanent residents of the town, much less the additional 25,000 seasonal U.S. residents who occupy the beachfront condominiums that dot the shoreline, he said.
Staffed by an orthopedic surgeon, a general surgeon and a pediatrician, the hospital simply stabilizes patients, then sends them by ambulance to either Hermosillo, Sonora, or Tucson, each four hours away, Chávez said.
He sees big potential in a private hospital that caters to American patients because many already reside in resort communities in Mexico.
"The market is there," Chávez said. "And we can count on that market to grow."
Accommodating foreigners
Dallas-based International Hospital Corp. will open its fourth hospital in Mexico this year in the central Mexican state of Puebla. Its hospital closest to Tucson is in Hermosillo.
Opened to provide medical care to underserved communities, the hospitals saw an increase in foreign patients about five years ago, said Dr. Joseph Barcie, the corporation's president of centralized services.
"We never intended to be a destination for American patients," he said.
The company operates the CIMA and VITA chain of foreign hospitals using U.S. standards and doctors who receive U.S. training, Barcie said.
Last month, the company opened a department in Monterrey, Nuevo León, for international patients to visit before and after their procedures.
The most sought-after services are cosmetic and orthopedic surgeries, Barcie said. The majority of U.S. patients are from Florida, Texas, Arizona and Southern California.
Dr. Gilberto Ungson, who works out of the CIMA hospital in Hermosillo, said he sees hundreds of patients each year from both the United States and Canada.
The bariatric and general surgeon said the cost of various obesity treatments is $11,000-$12,000 in Mexico, compared with $30,000 in the United States.
Ungson said his surgery team members all speak English and make personal visits with the patient at least three times a day after the surgery.
"My business is growing by word-of-mouth," he said. "Patients like to feel the warmth from us, the personal touch. It makes them feel better."
Insurers consider Mexico
More American employers see medical tourism as a way to beat rising health-care costs, and they are letting health insurers know.
Major insurers so far aren't offering medical tourism benefits to Arizona policyholders, but several have pilot programs in other states. Health Net has a program in California. Blue Cross Blue Shield has one in South Carolina, and Aetna Health has a pilot program in New England.
Cigna Healthcare and Aetna are the two Arizona insurers exploring medical tourism coverage. Their preliminary evaluations are taking into account such issues as safety and malpractice.
Aetna is considering evaluations of certain hospitals in Mexico, said the company's national medical director, Charles Cutler. Quality of care, not cost savings, should be the first question for insurers, he said.
The cost savings are substantial: as much as $50,000 for a hip replacement or $72,000 for an angioplasty, in which a surgeon uses a tiny balloon to open a blocked coronary artery.
The reason medical care is cheaper is that salaries and supplies are 40 percent to 80 percent lower, said David Boucher, an assistant vice president for health-care services at Blue Cross Blue Shield of South Carolina, in Columbia.
The Joint Commission, a non-profit accrediting agency, has certified only two hospitals in Mexico, both in Monterrey.
Patient interest growing
In the past six months, inquiries for referrals to Mexican doctors have doubled because of the downturn in the U.S. economy, said "Mexico" Mike Nelson, who runs the Web referral service mexicomike.com.
The satisfaction with medical care in Mexico is about more than just lower prices, the McAllen, Texas, man said.
"American doctors are fine people, but because of the health-care industry they don't have time to talk to you," Nelson said. "It's the human connection that's missing."
That's what impressed Jackie Beltrand, a resident of Gold Canyon, just east of Mesa.
Her husband, John, receives dental treatment in Mexico and last year flew to India to undergo heart surgery.
A U.S. provider would have charged between $35,000 and $40,000 for the angioplasty he needed, she said. The procedure was performed in India for $9,000, and the price included five days in the hospital.
Jackie Beltrand and her husband were matched up with their doctor through an Internet service called Healthbase. The Boston company offers everything from doctor referrals to help with airline flights and has representatives accompany patients from the airport to the hospital when they arrive in a foreign country.
"Even though the hospital is crowded and the doctors have more patients than U.S. doctors, they explain every procedure and they lack the arrogance," Jackie Beltrand said. "The level of care was exceptional.
With a laugh, she added: "My friends, of course, wanted to have me committed."
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