By Dr Tomislav Meštrović, MD, PhD
Various financial and legal hurdles have overwhelmed and pushed companies of all sizes to pursue innovative solutions and new strategies to get the most out of every dollar invested in their employee healthcare benefit plans. That is the reason why employers and insurers across the USA (but in the other parts of the world as well) have begun to explore various medical tourism programs.
Medical tourism can be a path to greater transparency of price and quality of what may have once been considered unconventional solution for those employers who self-fund their health insurance offerings. Projected costs of sending employees and customers abroad are definitely lower, thus such plans can be offered at a lower cost to the insured. As a result, employers could offer various incentives, as reimbursing travel expenses and participating in the medical bill.
It is said that this practice could relieve an overburdened public health care system and save a great deal of money. Some estimates say that if just 1 out of 10 patients traveled abroad to receive treatment, the United States could save more than one billion dollars per year.
Since California legislation bill passed in 1999 allowed insurance companies from that state to reimburse authorized providers in Mexico, several insurance models that already exist incorporate medical tourism as a viable option. Blue Shield provider networks in California offers less expensive premiums that encompass traveling to certified hospitals in Mexico.
In 2007, US Health insurer Aetna saw medical tourism as an important emerging trend and launched a pilot plan, partnering with Singaporean hospitals for expensive procedures. Hannaford, grocery chain based in Maine, New England, used this insurer to offer their employees the option of traveling to Singapore for hip and knee replacement.
Other companies are also including various cross border health plans. Florida's United Group Programs (UGP) has special packages for surgeries and other medical tourism services in Thailand hospitals. WellPoint introduced a pilot program in 2008 in which their members have a possibility to carry out certain procedures in India.
Corporate Synergies Group Inc. that advises other companies on worker benefits says they say an increase in the number of clients that consider adding medical tourism programs. Employers considering offering medical tourism as an option are starting to consult with various medical tourism companies.
In the European Union (EU), agreements between member nations are in the place that allow cross-border healthcare, although insurers are required to reimburse some medical care costs obtained in other EU countries. Such travelers can be covered by their home insurance in any EU or any country belonging to the European Economic Area, as long as they have their European health insurance card (or adequate paperwork).
Britain’s largest private health insurer, British United Provident Association (BUPA), has contracts with Ruby Hospital in India. In addition, Mumbai-based Wockhardt Hospitals are also on BUPA’s emergency international network of participating hospitals.
Opposition to employer-sponsored medical tourism
A lot of insurance companies and employers are approaching the issue of medical tourism tentatively. They are concerned whether the benefits will outweigh the potential risks. As a result, some insurers have incentives only for employees that are willing to travel within the United States for discounted care (so called domestic medical tourism).
Some labor unions have actively opposed medical tourism benefits. They have expressed fears that employees seeking care abroad can be viewed as a practice of outsourcing. There is also an issue of legal liability and potential job losses in the US health care industry. Concerns could be heard that medical tourism could become mandatory, although supporters dismissed these claims as overblown and misplaced.
Last Updated: Sep 17, 2014