Best known countries for medical tourism

Saturday, October 27th, 2007

HEALTH CARE Seven Golden residents are glad they spent thousands of dollars going to India for hip replacements rather than sit in pain on waiting lists here


Dentist Jeff Dolinksy ( right) went to India for hip surgery, as did six other Golden residents in the past few years.

Jeff Dolinsky, a dentist in Golden, travelled to India in the spring — and he didn’t go to sightsee, meditate or contort his body in front of a yoga master. Dolinsky’s goal was more prosaic — hip surgery.

When Dolinsky went under the knife in a hospital in Chennai ( formerly Madras), he felt reasonably confident he had made the right decision.

After all, six other residents from the Rocky Mountain town of Golden had also undergone successful hip surgery in the same hospital with the same physician during the previous three years.

The patients from Golden are among the small but slowly growing number of Canadians flying to foreign countries for treatment — a for- profit phenomenon known as medical tourism.

The medical tourism industry earned revenues of $ 20 billion in 2005 and that figure is expected to double to $ 40 billion by 2010, according to a recent report by Frost and Sullivan, a U. S. business research firm.

The same study found that Asian countries such as India, Thailand, Singapore and Malaysia view medical tourism as important sources of revenue.

Canadians who “ outsource” their treatment overseas are doing so because of frustration over the list of 875,000 people waiting for surgeries and other procedures.

Dolinsky, 48, had spent many m o n t h s i n s eve re p a i n f rom osteoarthritis. He sought treatment and was told that hip resurfacing — a less invasive alternative to hip replacement surgery — was his best option. He was also told that he might have to wait a year if he wanted it done in B. C.

A long pain- ridden wait would have forced Dolinsky to scale back his dental practice and temporarily give up downhill skiing and mountaineering, the sports that drew him originally to the Golden area.

But instead of waiting, Dolinsky flew to India. The hospital picked him up and ushered him into what it called its “ platinum ward,” which was more like a posh hotel, with its marble floors, big- screen satellite TV and laptop computer with WiFi.

“ And from the time I woke up from surgery until now, I haven’t had to take more than a couple of painkillers,” recalled Dolinsky recently.

North Vancouver’s Gloria Creighton is similarly pleased with her decision to forgo treatment in Canada and fly to Chennai. Doctors here told her she needed a hip replacement. She feared this would end her career as a dance specialist with the Burnaby school district.

Her husband learned about the less invasive hip resurfacing from the Internet. He also learned that the procedure could be purchased at the clinic in Chennai. They decided to fly to the subcontinent and many months later, they have no regrets about the $ 15,000 cost.

“ When I came home I started walking around the park down the street and going swimming,” said Creighton.

“ It’s a miracle. Before that, I’d thought that I was gone, done- in. Now I can keep teaching and not have to go on disability and be a burden to the government.”

There are about 15 medical tourism companies based in Canada. Their clients are seeking elective surgeries for such things as joint replacement ( knee/ hip), cardiac surgery, dental surgery, cosmetic surgery, cancer and transplant surgery.

These firms arrange treatment in Latin America, Europe and Asia.

Critics have said it’s morally wrong for these developing countries to foster a private health care sector for wealthy westerners when the majority of their own citizens have poor access to health care.

That hasn’t stopped the governments of many Third World countries from trying to attract western patients.

The website of the Royal Thai Consulate in Vancouver gives an overview and pricing for its medical tourism sector, which attracted 600,000 foreign patients in 2004.

Many of the Canadian medical tourism companies are based in B. C., including Surgical Tourism Canada, which brokers surgeries for Canadians in affiliated high- tech private health facilities in India, Mexico, the United States and Abu Dhabi.

Yasmeen Sayeed, chief executive officer of Surgical Tourism Canada, said her client list has steadily increased since she opened in July 2005.

But Sayeed acknowledged that medical tourism is far less significant in Canada than in the U. S., where 500,000 Americans went overseas for treatment in 2005.

The reason for the difference is cost. Americans are used to paying for medical care, said Sayeed. Canadians aren’t because of their country’s universal publicly funded health care.

But for millions of Americans who are either uninsured or underinsured, purchasing medical care overseas can be cheaper than buying it at home.

Another obstacle in Canada for medical tourism, added Sayeed, is the refusal so far of provincial governments to reimburse people who receive treatment abroad.

While medical tourism in Canada is on the increase, the number of people going abroad for care appears to be insignificant.

Sayeed’s Surgical Tourism Canada is one of the largest medical tourism firms in the country, but it has sent only about 100 people abroad since its inception.

Leigh Turner, a McGill University biomedical ethics professor, recently wrote that little is known about how many Canadians do go abroad but that the number is probably relatively modest.

Also modest is the number of Canadians heading to the United States to avoid long waiting lists. There was a flurry of media reports a few years ago about Canadians heading south for private care, but a 2002 study by health care researchers at the University of B. C. found surprisingly few Canadians travelled to the U. S.

The report, Phantoms in the Snow, said Canadian travel tourism to the U. S. was “ more myth than reality” and that the numbers involved “ appear to be handfuls rather than hordes.”

Dr. Michael Rachlis, who has written extensively about the Canadian health care system, said the number of Canadians going overseas “ is of trivial significance.”

Rachlis recalled attending a conference in Toronto on medical tourism where most of the companies involved were only sending about six people a month abroad.

There seemed to be a jump in recent years in the number of Canadians, mostly ethnic Chinese or South Asians, going to Asia for organ transplants.

Ken Donahue, a spokesman for the B. C. Transplant Society, said 136 British Columbians have received transplants overseas since 1990.

But Dr. David Landsberg, medical director of transplantation at St. Paul’s Hospital, said the number of Canadians seeking organs overseas is on the wane because many countries have recently placed restrictions on the practice.

“ I haven’t had any patients who have gone away and come back in the last six months.”

Dr. Brian Day, head of the Canadian Medical Association, is a big fan of a reverse form of medical tourism — he wants the tourists coming here.

Day believes Canada could eventually make billions of dollars off mostly American medical tourists.

The CMA head believes B. C. could attract many medical tourists from Asia. Day said he visited an orthopedic hospital in Cuba that generates $ 20 million in revenue annually treating medical tourists.

But Day’s opponents in the debate over the future of Canadian medicine are less enamoured of the prospect of medical tourism in Canada.

Rachlis, a sharp critic of private medicine, said: “ Do we really want the administrators in our system spending their time luring Americans? Or do we want them to fix the problems faced by Canadians?”

Rachlis said the money available from medical tourism would only amount to tens of millions of dollars — minuscule compared with the $ 150 billion spent on health care annually in Canada. “ It’s just a complete diversion.” Day dismissed Rachlis’s criticism, saying that Canada should only promote medical tourism once waiting lists are eliminated in Canadian hospitals.

“ We are losing all of that potential trade and the only reason we are losing it is because we have wait lists.”

He also said that Rachlis seriously underestimates the revenue available to Canada from medical tourism — money that could be injected back into the system here.

Day believes Canada could make “ tens of billions or more” from medical tourism based on the sector’s projected growth worldwide.

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