Globalization + Health Care Crisis = Medical Tourism

An interesting article came "across the wire" today about outsourcing some medical procedures globally. The gist of the article is that, considering factors such as the 46 million uninsured Americans, options such as getting medical procedures performed overseas are starting to look better and better.

The article talks about the positives and negatives (e.g., risk) of medical tourism. It goes on to mention the tale of a 60 year old Oklahoma woman who needed a hip replacement ($40,000 in the states) for which her employer (Coldwell banker) supported her in selecting an alternative option: surgery in India. According to the article:

"In addition to saving thousands — the three-week trip totaled about $12,000, including the surgery, travel and lodging for two and a tour of the Taj Mahal — she also underwent a new technique just approved this year in the U.S."

There seems to be more and more reporting on this subject. This article follows a recent article in Business 2.0 about the same topic. This article affirms that, "This year alone, upwards of 500,000 Americans are expected to travel overseas to get their bodies fixed, at prices 30 to 80 percent less than at home."

According to testimony given before the senate in June of this year, the savings for procedures performed in countries such as India can be substantial. For instance, heart bypass surgery costing between $55,000 and $86,000 in the U.S. would approximately $6,000 in India. Obviously, there are risk issues that need to be considered, but the aforementioned Oklahoma woman's comments are noteworthy, "It's either that, or do it in the States for $28,000 to $40,000," she said. In the U.S. do you not sign forms? They're not responsible. The risk of it didn't really weigh on me."

All of this really, makes one stop and consider where this could all go. What this tells me is that the players within the current U.S. health care system (e.g., hospitals, doctors, etc.) drag their feet (in addressing the health care crisis) at their own peril.

There are a lot of issues to consider with respect to medical tourism and there is no shortage of websites and blogs that address these such as:

Surber's Old Columns
Global Surgical Solutions Blog

What's your take on this?

Getting up to speed on health care reform

Dr. Mike Magee has an excellent blog on his Health Politics website where he ably discusses topics related to the current and future U.S. health care system. He also has a series of podcasts which are extremely well done and informative.

For instance, one of these discussed the history of our health care system and how it came to be mostly employer funded. Nevertheless, I want to mention the one entitled "Building Tomorrow's Health Care" which touches on the coming transformation of the U.S. National Health Care system. Dr. Magee specifies two characteristics of the coming transformation, mentioning that it will be:

1) Home Centered - Educational Empowerment and behavior modification.
2) Influenced by Information Technology - communication between patients and caregivers.

What's interesting according to Dr. Magee is that the typical power players (e.g., insurance companies, hospitals, etc.) are not calling all the shots. Non-traditional players could play a very strong role in the future. These include:

1) Technology Firms - Intel, Phillips
2) Banks - Offering Health Savings Accounts (HSA)
3) Governmental municipalities - San Francisco, Philadelphia, Chicago, Boston

Hope you tune into this website, podcast, blog and let me know what you think.

Public Health: The impact of social networks

Dr. Tom Valente is doing some interesting work investigating the effect of social networks in influencing behavior from a Public Health perspective. This relates to the study of doctor behavior when prescribing treatments (heavy influence from peers) as well as patient behavior. I was listening to some interesting podcasts from the University of Washington School of Public Heatlh.

Thomas Valente is Associate Professor and Director of the MPH Program, Preventive Medicine, Keck School of Medicine, University of Southern California. In his talk, he touched on collaborative diffusion of behavior and the key influencing factors. What I really liked was his introduction on the topic of social networks.

For instance, one hears much about social networks related to the Internet and sites such as MySpace and Facebook. Nevertheless, Tom makes an excellent point that the study of social networks dates back many decades.

Tom talked about the fact that, in order to promote change, social networks and, what he calls “collaborative diffusion,” are of paramount importance. What makes this so interesting within today’s context is that today’s Internet technologies (e.g., collaborative networks) can pretty much turbo-charge the exact factors which Tom highlighted as key to promote a more relationship-based healthcare and wellness system.

You can download the podcast by right clicking here and selecting to “save target” to your hard drive. You can then listen to this with your computer or your portable MP3 player.

The University of Washington has an excellent series of podcasts listed here.

Health information you can rely on

The Pew Internet Project just released a study concerning the way consumers search for health information on the Internet. Even more important, is the surprising data point stating that although health topics are one of the most popular searches by US users, only 15 % of consumers who search for health information "always" check the source of the information that they find.

A full copy of the report can be downloaded by clicking here.

Some other interesting answers given by those surveyed concerning their experience searching health topics on the Net:

• 35% said that the information affected their decision about seeing a doctor.
• 74% said that they felt reassured that they could make appropriate health care decisions.
• 51% said that they were eager to share their new health or medical knowledge with others.

The last point about sharing information is key because this is where web 2.0 technologies (upon which today's Internet is built) can be most effective. What's interesting about all of this is that this information lends credence to the thesis that web 2.0 technologies have a place within a new, people centered vision for health care.

The astonishing part is that users don't really check the source (or date) of the information that they're looking at. Nevertheless, I've gotta believe that, given options, users will value information provided by alternate sources. Specifically, wouldn't it be great to get different points of views on specific health conditions which aren't all based on purely scientific or "traditional" medical points of view? Even more, how about if users could get some type of "evidence-based" research to back it up?

I mention these because they are all possible using current web 2.0 techniques. I really wonder whether there is any interest in applying these technologies to such a problem when so few people seem to investigate the sources of the information they find. If you can, please let me know your opinion.

Wouldn't it be nice?

Though I’m not involved professionally with Health care, I’ve always been around conversations concerning this topic. It helps that my father and brother (twin) are Docs. With the entire web 2.0 stuff exploding in the consumer market, I’ve wondered whether the social networking technologies that are currently evolving wouldn't be excellent tools to unite people with a new vision of a stronger and more effective health care system.

I wanted to write this blog, not so much because I have any particular expertise here, but rather, because I'm interested in becoming a part of conversations focused on answering the question:

Does today's web and it's associated technologies (e.g., collaboration, social networking) offer an avenue to developing (and promoting) a vision for a more sensible health care system?

After reading an article in the last issue of Newsweek on “Fixing America’s Hospitals,” I decided to find out more about health care and why everything is so screwed up so I tried to find some objective info on the web. I didn’t realize how tough this is. Sure, there’s some info, but I never know, because of Big Pharma sponsorships, if some of the information is skewed one way or another.

I’m sure there are a lot of studies on improving the health care system, but I found one in particular from the Rand Corporation, which states, “On average, Americans receive about half of recommended medical care processes.” Of note is the end of the report where they offer conclusions or recommendations on how to "fix" the current situation:

What can we do to break through this impasse? Given the complexity and diversity of the health care system, there will be no simple solution. A key component of any solution, however, is the routine availability of information on performance at all levels. Making such information available will require a major overhaul of our current health information systems, with a focus on automating the entry and retrieval of key data for clinical decision-making and for the measurement and reporting of quality.49 Establishing a national base line for performance makes it possible to assess the effect of policy changes and to evaluate large-scale national, regional, state, or local efforts to improve quality.


It’d be cool to have a vision of what a more “sane” system would actually look like. The closest thing to this vision that I came across was something called “People-centered Health care” or “People centered heath care” (not sure of the correct spelling ‘cause it’s spelled both ways). It seems to describe a health care experience 180 degrees different than the institutional experience one must currently endure. .

I found one definition of “patient-centered health care” from the Institute of Health care Improvement stating the following:

Enable health care providers to reliably meet the needs and preferences of patients. We believe that health care that is customized based on patient needs and preferences will make tremendous strides toward improving patient-provider relationships, sharing knowledge, and putting patients in control. Customization of care also helps to eliminate unwanted, unneeded, and wasteful services; and increase the effectiveness of care delivered.

Enable fully informed, shared decision-making. There is increasing evidence that patients and families who participate fully in care decisions help to improve the quality of medical decisions and reduce overuse of aggressive surgical treatments without worsening health outcomes. (Annette O’Connor)

Include patients and their loved ones on health care improvement and design teams. Doing so has transformed the improvement experience for the health care organizations that have embraced this challenge.

Currently, social websites such as Myspace are making headlines because of their ability to connect people. The technologies employed in such sites go by a number of names: Web 2.0, the social web. It occurs to me that these are precisely the type of tools that could ably address the areas (communication, collaboration, etc.) that "experts" highlight as problem areas within the healthcare system.

Wouldn’t it make sense to get patients, caregivers, and others to hook up in a Myspace-type environment all with the same vision (people-centered health care)? Employing such tools aren’t solutions bound to emanate?
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