Medical Tourism - Destination - United States of America

American medical tourists travel to Latin America (38%), Thailand (44%) and other countries, such as India, in smaller proportions (18%). The main reasons for American citizens opting for treatment in a foreign country are cost savings, higher quality, availability of treatment and reduced waiting times. Cost saving is the most important reason as, out of the 370 million US residents, 14% are uninsured and 7% are underinsured. In addition, the mother tongue of around 34 million inhabitants is Spanish. These reasons combined lead to many Americans seeking treatments in Latin America, accounting for 500,000-750,000 medical travellers annually. Americans are now the largest outbound flow with the number of medical tourists being expected to double annually. As a result of this growing market, insurance plans covering medical tourism have been introduced and the US based ‘Medical Tourism Association’ was established.

General Culture

The culture in the US used to be mainly influenced by the Europeans and to a certain extent also by the native inhabitants. Nowadays, there is an Americanisation of the world. The country has a proud military history and national pride is important. Even though English is the official language, Spanish is also the mother tongue of an estimated 34 million (2007) According to a 2002 study, the US was the only developed nation in the survey where a majority of citizens reported that religion played a “very important” role in their lives, an attitude similar to that found in its neighbours in Latin America. The cuisine is well known for its fast food but other types of cuisines such as Soul Food, traditionally eaten by African-Americans in the South, are popular, especially in the Southern states. All immigrants have provided their influence on the country’s cuisine as well. Traditional ingredients are various meats, potatoes, corn, wheat and seafood.

Safety

The US ranks 83 on the GPI. Despite the rather high crime rate in the country, it is generally safe to travel in the US. Due to recent terrorist attacks, security levels are high. Furthermore, in many states it is legal to carry a concealed weapon.

There is an extensive road infrastructure in the US, however, if one does not own a car, public transportation is only available in the major cities. The country has 73 international airports catering to destinations worldwide. There are intercity buses, for example the Greyhound’s Buses offering 3,700 stops all around the country, but also to destinations in Canada and Mexico.

Health Care Providers

In the US, ownership of the health care system is mainly in private hands, though federal state, county, and city governments also own certain facilities. There are 5,708 registered hospitals in the US counting 945,199 staffed hospital beds. The majority includes 4,897 community hospitals, from which 2,913 are private non-profit hospitals, 873 for-profit hospitals and 1,111 state and local government hospitals.

Insurance

Health care insurance in the US is not compulsory. Health insurance is primarily provided by the private sector. There are more than 2,000 different types of health insurance available. Concerning Americans under the age of 65, 14% are uninsured and 7% are underinsured. Private insurance is held by 54% of the population and 25% have public insurance. More money per person is spent on health care in the US than in any other nation in the world. A US citizen would only be partly covered by his insurance in most cases of medical treatment.

Uninsured Americans may experience problems such as long waiting lists, high deductibles and limited physician choices. Companies such as Aetna, WellPoint and Blue Cross Blue Shield Association are also offering medical tourism pilot programmes.

Reforms/Policies

The president’s budget and health reform called “Stability and Security for all Americans” is being discussed. “It will provide more security and stability to those who have health insurance. It will provide insurance to those who do not. And it will lower the cost of health care for our families, our businesses, and our government.” This will be done by setting aside a deficit-neutral reserve fund of USD 635 billion (€ 424 billion) over 10 years to help finance reforms of the health care system to bring down costs, expand coverage, and improve quality. It is expected that this measure will decrease the number of uninsured, but increase the underinsured.

General Medical Tourism Information

During 2008 a total of 63.6 million people left the country for tourist and business reasons. The main destinations were Mexico, the United Kingdom, Canada, Germany and Japan. Figures show that between 500,000 and 750,000 Americans left the country for medical tourism during 2007 spending around USD 2.1 billion (€ 1.4 billion). This makes the US the largest outbound country for medical tourism. The difference is due to many Americans going to Latin American countries that require no visas. The US has been the trendsetter within the medical tourism industry and was the first country to show interest to undergo medical treatment in less developed countries whereas, before that, the tendency was the opposite.

Facilitators/Cooperation

There are a few large medical facilitators operating in the US including Healthbase, Premier Med Escape, Planet Hospital and many more providing and helping patients find the best solutions abroad. The Medical Tourism Association (MTA) is the first international non-profit association comprised of the top international hospitals, health care providers, medical travel facilitators, insurance companies, and other affiliations. The MTA is currently working with 21 facilitators around the globe, with the majority situated in the US.

Flows

American medical tourists tend to travel to Latin America (38%), Thailand (44%) and other countries, such as India in smaller proportions (18%).

Reasons

• Cost savings: many procedures are cheaper outside the US, especially if one does not have suitable medical insurance. For this reason, 11% of US based companies offer employees the option to go overseas for treatment. In addition, most Americans going abroad choose elective treatments that are not covered by medical insurance.
• Quality: many countries offer better health care than in the US with lower infection rates.
• Availability: some treatment that is not yet allowed in the US is available elsewhere, e.g. stem cell treatment
• Waiting times: these can vary significantly depending on one’s place of residence.

Conclusion

Out of the 370 million US residents, 14% are uninsured and 7% are underinsured. Alongside this, around 34 million speak Spanish as their mother tongue. These reasons together mean that out of the 500,000 to 750,000 Americans who leave the US annually, many look to the Latin American countries, such as Mexico. Americans were the medical tourism pioneers and are now the largest outbound flow. The number of medical tourists is expected to double annually. This growing market has resulted in insurance companies, such as Aetna, releasing pilot medical insurance coverage plans and the establishment of the US based ‘Medical Tourism Association’.

Note: All prices are estimates, and may vary widely from source to source depending on services included in the estimate (i.e. doctor’s fees, hospitalisation, administration costs or the patient’s age and medical history). Due to non-disclosure strategies of the various locations, it was not possible to make a clear separation between those factors. All prices given for the specific facilities have been provided by the hospitals/clinics themselves via email or telephone contact. The prices are given in Euros (€).

N/A means either that treatment are not available in the specific hospital, that a price estimation cannot be found or that the medical facility did not disclose the information. For the average prices, printed literature has been used before researching sources on the internet.