Paper by Maryam Khan

Author presents various arguments for medical tourism specifically cost savings of up to 90%, where not only individuals but employers and insurance companies are considering providing medical tourism as an option to their employees or insured. She mentions the Blue Shield of California Access Baja Plan that offers people living close to the border option to get treated in Mexico. The article mentions that according to International Federation of Health Plans  almost 11% of US employers are currently offering medical tourism and about 73% of US companies might offer Consumer Driven Health Plans that allows for a medical tourism choice. It states that medical tourists typical take a companion and half get their information off the internet. Again half used a medical travel facilitator and were mostly happy with their experience.

The paper mentions extra options hotels are providing including private entrance, floors with nurse stations, wheelchair accessibility etc.

The paper also indicates that there are many hurdles to medical tourism including coverage by their insurance policies, visas, post surgery complications, language barriers, sanitation, and lack of legal recourse. Issues with the long travel itself are also discussed.


http://scholarworks.umass.edu/cgi/viewcontent.cgi?article=1371&context=refereed

Disruptive Innovation Article by Clayton Christensen

Clayton Christensen's book "The innovator's prescription" talks about solutions to the healthcare crisis.  Its primary premise is that the hospital system of today contains 3 mutually exclusive and competing business models.  In order to create efficiencies, increase quality and reduce costs, it is important for the healthcare system to recognize this, and split the models.  We have already started to see this happen in some cases, with some hospitals focusing on integrated cancer treatment, while offshore clinics providing value-based, fixed cost for routine procedures.  This article is a good summary of the book and talks about matching clinician skills to the difficulty of the medical problem.

http://hbr.org/web/extras/insight-center/health-care/will-disruptive-innovations-cure-health-care

World Health Organization Bulletin on movement of patients across borders

This article referes to the need for the uninsured to seek medical tourism from the US, and that insurance companies have started to offer options to seek medical procedures abroad.


http://www.who.int/bulletin/volumes/89/1/10-076612/en/

Paper on impact to providers and plans by Mark S. Kopson

A very broad summary of the medical tourism market including key statistics from the Deloitte and McKession studies.  Also includes specific and detailed examples of US plans and their actions in relation to offering options outside the US.


http://www.healthlawyers.org/events/programs/materials/documents/am09/kopson.pdf

Article on Industry reaction to Medical Tourism by Candace Gwaltney

Author mentions that inurance company WellPoint announced a pilot program for Medical Tourism which prompted the Indiana Legislature (Bill 1084) to take a protectionism stance by Rep. Craig R. Fry and echoed by Dr. Richard Feldman.  The points made by Feldman around his concern are valid in that forcing frail patients to travel abroad is not desirable, however, he did not have objection to patients going abroad on a purly elective basis. This is actually the case in the Wellpoint program as described in the article. The insurer mentioned that is providing medical tourism as an option to a select company is Aetna. BCBS SC's new initiative is also mentioned.

The author also cites a facilitator stating that they are seeing more cases for carida, spinal, orthopedic and dental procedures.

http://www.bizvoicemagazine.com/media/archives/09mayjun/MedicalTourism.pdf

The actual Bill 1084 mentioned in the article can be found here:
http://www.in.gov/legislative/bills/2009/HB/HB1084.1.html

Gallup Poll

The poll shows that the likelihood of using a foreign option increases to above 50% if the person surveyed did not have insurance, was told the quality would be equal or better and the costs would be lower.

Considering there were 48 million americans without insurance in 2009, this is a significant number that, if requiring treatment, might be likely to look abroad for options.

http://www.gallup.com/poll/118423/americans-consider-crossing-borders-medical-care.aspx

Deloitte paper on Medical Tourism by Paul Keckley and Howard Underwood

Detailed analysis by the authers includes Medical Tourism pilot programs and their details. It mentiones state legislation including the West Virginia bill that encouraged covered employees to seek medical care in foreign JCI accredited instituations and to waive copayments and deductables and which died in committee. IT also mentions the Colorado bill that was postponed.

The article projects almost 1.6 Million US outbound medical travelers by the year 2012.  Key point here is that the article includes the more than half of the US workforce which will be of second of third generation foreign decent in the next 25 years which would likely seek medical procedures abroad if given the option by their provider.

http://www.deloitte.com/assets/Dcom-UnitedStates/Local%20assets/documents/us_chs_medicaltourism_111209_web.pdf