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    High Costs in U.S. Is Driving Some Patients to Seek Treatment in India and Elsewhere

    Reviewed by Louise Chang, MD

    WebMD Health News

    More Americans Seeking Surgery Abroad

    Oct. 18, 2006 -- Dismayed by high surgical costs in the U.S., increasing numbers of American patients are packing their bags to have necessary surgery performed in countries such as India, Thailand, and Singapore.

    "This is not what is sometimes snootily referred to as 'medical tourism,' in which people go abroad for elective plastic surgery," says Mark D. Smith, MD, MBA, president and chief executive officer of the California HealthCare Foundation in Oakland.

    Today's "medical refugees," the term Smith uses in an article published in the Oct. 19 issue of The New England Journal of Medicine, are going to foreign countries for lifesaving procedures such as coronary bypass surgery and heart valve replacement, and also life-enhancing procedures such as hip and knee replacementknee replacement.

    "People are desperate," Smith tells WebMD. "This illustrates the growing unaffordability of the U.S. health care system, even to people who are by no means indigent."

    The report by Smith and his colleague, Arnold Milstein, MD, MPH, documents the case of a self-employed carpenter who couldn't afford private health insurance and would have faced financial ruin if he had surgery in the U.S. It also shows how some insured workers are being steered toward receiving less-expensive procedures outside the U.S.

    Indian Hospitals Booming

    Vishal Bali, chief executive officer of the Wockhardt Hospitals Group in Mumbai, India, says there has been a 45% increase in the number of American patients seeking care at his 10 Indian hospitals during the past two years.

    "Cost is a major factor," Bali tells WebMD. Some examples: Wockhardt Hospitals usually charge $6,000-$8,000 for coronary bypass surgery, $6,500 for a joint replacement, and $6,500 for a hip resurfacing, which represent a small fraction of the typical costs at U.S. hospitals.

    "Another major factor is what we call 'the Indian advantage,'" Bali says. "At some point, most American patients have been treated by an Indian physician in the United States and they have tremendous faith in Indian clinicians."

    Partly because of the influx of foreign patients, not all of them American, Bali plans to open 10 new hospitals in India during the next two to three years.

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