EVIDENCE BASED MEDICAL TOURISM

United States is frequently projected as a pointer in the journey of modern Medical Tourism. Over a span of past few decades US has transformed from a nearly exclusive inbound country for modern healthcare to an outbound country making a prestigious market for cropped up non-US Medical Tourism destinations. This is true due to not only significantly increasing outflow of US patients but also for the reason that US dominatingly governs patients’ confidence in universal standardization of quality of healthcare. The JCI, a US based accreditation arrangement organization, powerfully holds supremacy for all Medical Tourism destinations. Almost all the non-US Medical Tourism hospitals make a point of reference of US patients’ inflow to their organization as an achievement. US certified medical professionals engaged in healthcare provider team are considered as point of superiority over others. This scenario does not make United States of America to be ultimate as US government is far behind to manage affordable healthcare services to all its own citizens leading to ample dissatisfaction in US population. “Healthcare Management” still plays leading decisive role in US presidential elections.

“Outbound Medical Tourism” is so crucial for US government that recently in April 2011 President Barack Obama pushed for an affordable health care arguing that he would not like his countrymen to travel to countries like India and Mexico for cheaper treatment. Obama’s such call reflects US concern over government’s failure to control spiralling health care cost. Nonetheless President Obama dreams to achieve reduction in healthcare cost for which he as allegedly initiated the steps. I strongly use the word “allegedly” for Obama’s healthcare Bill (March 2010) due to contentious reaction of US citizens and that it has a long way to go to prove its worthy. It sounds to me that President Obama’s distress, as evident in his call to avoid visit to India, Mexico for want of cheaper but qualitative healthcare, indicates towards the occult incompetency in US Federal Government’s Bill to appreciably reduce the healthcare cost that could prevent patient outflow as US citizen’s choice in a natural way. Nonetheless Obama’s long debated bill has potential to extend Medicare umbrella to additional 32 million citizens to commence from year 2014. This may possibly put a check on some US outbound Medical tourists in “Due course of time”.

President Barack Obama’s March-2010 Healthcare Bill (BOB) is continuation of United States’ ongoing long journey recorded from 1930 when US citizens used to pay nearly 80 percent of the nation’s medical costs from their own pocket. Insurance was barely in the picture almost till June, 1966 when President Lyndon B. Johnson (LBJ) launched government health insurance for the elderly with three simple words, as if flicking a switch: “Medicare begins tomorrow.” BOB claimed to be the biggest changes to healthcare 45 years after LBJ. Barack Obama describes that, “This (Obama’s bill- March 2010) isn’t radical reform but it is major reform.”

Figure 1: BARACK OBOMA BILL: KEY ISSUES

Figure 2: US PRESIDENT BARACK OBAMA’S 10-YEAR 940 BILLION $ BILL (BOB):

SALIENT FEATURES AT A GLANCE

“CHALLENGING FACTORS” NEUTRALIZING PROFICIENCY OF BOB ON US OUTBOUND MEDICAL TOURISM

1. RESULTANT UNISURED POPULATION:
   Depending upon how regulators turn the law’s broad provisions into specific rules and how individual Americans respond to the law there will be significant fallout of uninsured population even after BOB is in its full effect. According to a Congressional Budget Office (CBO) estimate 23 million Americans will lack insurance in 2019, after key provisions of the law are at its climax. The uninsured fallouts shall include
   1. Illegal immigrants,
   2. People opting to pay penalty for avoiding the law’s mandate to buy insurance and
   3. Some middle-class families who show inability to afford coverage despite proposed subsidiary under the law.
2. UNCOVERED MEDICAL CONDITIONS:
   Despite the fact that BOB contains a proposed check on insurance companies restraining them from denying insurance in case of pre-existing disease there will be many uncovered medical conditions like Dental and cosmetic surgery etc. Such situations will not be effected by BOB as far as Medical Tourism is concerned.
3. OTHER IMPORTANT ISSUES:
   Broad-spectrum factors sweeping whole America are bound to specifically influence the desired result of both BOB end-result and tapering down the healthcare cost negatively. These fulminating factors are:-
   1. Economic recession,
   2. Increasing unemployment,
   3. Baby boomers aging for Medicare,
   4. Private health spending lethargy and
   5. Rising health share of GDP in United States.

Greater the influence of challenging factors lesser will be the impact of Obama’s call to avoid his country men to travel abroad for cheaper qualitative options. This resultant plausibility of Obama’s call been defeated to stop the US outbound Medical Tourists may conceivably provoke the governing machineries to manipulate citizens’ mindset to obviate the US outbound Medical Tourism.

From other parts of the world like UK the controversial anecdote like strange bacterias such as NDM-1 in India may perhaps be a biased tactic to create panic and turmoil in Medical Tourists’ minds to shun values of Medical Tourism like cheaper quality healthcare! To eradicate panic of such seemingly misguiding public statement it is now socio-medical & moral obligation of medical scientists to unambiguously spell out the authenticity of NDM theorem along with justification of its taxonomy with unprejudiced honest transparency.

REFERENCES:

[1]Americans need not visit India for cheap health care: Obama- PTI – Wed, Apr 20, 2011http://in.news.yahoo.com/americans-not-visit-india-cheap-health-care-obama-063100035.html.

[2] Mark Trumbull; Obama signs health care bill: Who won’t be covered? http://news.yahoo.com/s/csm/20100323/ts_csm/289835_

[3]USA; Dr. Anil Khare ; LEGISLATIVE ASSITANCE TO MEDICAL TOURISM  http://www.medicaltourismmodel.com

[4]Dr Anil Khare M.B.B.S; M.S.; M.N.A.M.S(I) Evidence Based Medical Tourism (forthcoming book)