The pending implementation of the Affordable Care Act, aka Obamacare, will not stop or even slow down the moving train that is medical travel and tourism, say experts in the field.
Just days before the Supreme Court’s June 28 ruling giving a thumbs-up to most of the Affordable Care Act, David Boucher, president of Companion Global Healthcare, commented that regardless of the court’s decision, the major factors driving medical tourism would continue.
“The escalating cost of (U.S.) medical care and the continued decline in quality is ensuring the future of medical travel,” Boucher said during a presentation at the recent Well-Being and Medical Travel Conference.
In the wake of the Supreme Court’s ruling, Travel Market Report asked Boucher and other medical tourism experts for their perspectives on the impact of the Affordable Care Act on the future of medical travel.
If, as the Affordable Care Act promises, almost all Americans are covered by health insurance, will fewer people travel to save money on medical procedures?
Josef Woodman, publisher of Patients Beyond Borders medical travel guides: The answer is yes, no and neutral. On the one hand, those who are currently uninsured – a huge component of medical travel – will gain access to covered healthcare. Some may be able to stay in the U.S. for an orthopedic procedure that they were previously not insured for. Some of this will take away from medical travel.
On the other hand, you can’t have 30 million Americans (the currently uninsured who are expected to gain coverage) entering our already broken system without a tradeoff in the form of longer waits for specialty care.
If you look at Canada and the U.K., where there are long-established healthcare systems, this has been the case. So the people who can afford to travel for specialty care to places like the Cleveland Clinic or Sloane-Kettering will do so. Those who can’t will be stuck with long waits.
Boucher: Americans and Canadians will continue to travel abroad and domestically for healthcare, whether it’s to a Cleveland Clinic, Johns Hopkins or other facility. They are looking for safety and service, which are both leading motivators to travel for healthcare. Price is only the third consideration.
Most employers indicate that they continue to be interested in the right services for their members at the right place and right price. If that means changing their benefit plans to cover travel to the Cleveland Clinic, they are increasingly open to it. Nothing in (the Affordable Care Act) will change this.
We will see more companies following in the path of Pepsico and Lowes in this regard.
(See story, PepsiCo Med Travel Benefit Expands Market for Agents, December 22, 2011
Kiana Bright, vice president, Thailand Medical Travel and Tourism: More Americans will travel overseas for healthcare. Accessibility of care will be a long-term problem if more people are brought into the healthcare system. Canada has universal healthcare and is a perfect example of this. Many Canadians have to wait up to seven months or more to receive knee replacement surgery.
In addition, the healthcare cost will be increased for employers. This will drive them to find creative options to save money. Medical tourism can be the answer for that.
Are there areas of medical tourism that will not be impacted by the Affordable Care Act?
Boucher: It should have no impact at all on dental coverage and therefore dental tourism. In fact, a lot of Americans are dropping their dental coverage. Even if you are covered, most dental premiums have a $1,500 or $2,000 a year maximum at best. So if you need $15,000 worth of dental work and you are only covered for $1,500, it still pays to travel for dental care.
Woodman: There is a vast landscape that will not change at all. Dentistry is not covered (under the Affordable Care Act), neither are cosmetic surgeries and some bariatric procedures. Dentistry and cosmetic surgery comprise over half of all medical travel – and if you add in elective surgery, that’s about 75%.
What other factors beyond cost and insurance coverage are driving the future of medical tourism?
Boucher: With the increasing shift toward greater transparency and consumer awareness, there will be an increase in Americans traveling for healthcare as they learn more about the high quality care available overseas.
There’s so much more information out there on the safety, quality and service provided by medical institutions. More consumers are sharing their experiences. It’s no longer just what the medical facility wants to tell us. People will increasingly be able to make educated decisions.
Woodman: Global options for healthcare will be something that more people are comfortable with. People are growing savvier about these options already – there are people who are getting off a cruise ship and getting an MRI while in port.
We haven’t yet reached a critical mass on healthcare transparency but it is coming. More patients will be rating their experiences online. It will be like hotels on TripAdvisor.
Hospitals are offering packages and special deals, but not enough yet and they are not posted on their websites. The next phase is to pry all this information loose and aggregate it. It will be easier to shop and compare.
The global potential for medical travel is huge – and increased global activity will lead to improvements in healthcare. There’s a huge growth of the middle class in other countries, which means more people can travel for healthcare. Hospitals will be forced to compete.
For another viewpoint on how healthcare reform could impact medical tourism, see "Analyst Eyes Impact of Health Reform," December 12, 2011.