After the attacks of Sept. 11, 2001, an increasing number of patients from the Middle East began traveling to Asia for care. “They used to go to America or Europe, but visas became problematic, so they started going to Thailand, Singapore, and India,” Mr. Schroeder said.
Medical Outsourcing
According to Mr. Schroeder, “health care costs are capsizing American businesses. They're starting to look at international health care as a form of outsourcing.”
He noted that Bumrungrad recently signed a landmark deal with Blue Cross of South Carolina for a program called Companion Global Healthcare, which would provide an alternative for people wishing to seek overseas health care.
“It is essentially a pilot project. There's no commercial insurance product attached to it yet,” Mr. Schroeder said. The program provides subscribers with access to a specialized travel agency in Virginia that makes all arrangements for medical travel to Bumrungrad, and coordinates after-care through a network of South Carolina physicians.
But it is only a matter of time before U.S. insurers start actively driving patients overseas, predicted Jeffrey Lefko, a Chicago-based health care consultant who is working with Parkway Group Healthcare, a Singapore-based hospital system, to develop its U.S. referral base.
“A number of U.S. companies have started to work with self-insured plans to make procedures in Singapore a viable option. You're going to see much more of the insurance industry get interested in this,” Mr. Lefko said in an interview.
Further growth of medical travel, especially if pushed from the home front by U.S. insurers, could have a major impact on American health care systems, but Dr. Jason Chin Huat Yap, medical director of the Singapore Tourism Board, said he believes a lot of the unease surrounding these trends is unwarranted.
“Singapore's share of the global health care economy is about $12.6 billion. The U.S. share is about $2,000 billion. Even if you quadrupled our capacity and you threw in India, too, we're not even able to come close to providing health care for all Americans. It's still a very small fraction,” he said at the World Health Care Congress.
He added that a little bit of healthy competition from abroad, “could have a potentially positive structural impact on how the U.S. delivers health care services.”
Mr. Lefko said he believes the emergence of world-class health care systems across the Pacific will likely give U.S. hospitals and clinics a much-needed kick in the bedpan.
“Already 500,000 Americans each year are leaving the U.S. for health care reasons, and this is going to grow. U.S. hospitals and doctors will complain, but the reality is, U.S. hospitals have had plenty of time to straighten out their acts. They've had plenty of opportunities to create better, more economical health care services. Medical tourism's going to level the playing field. I've been in the hospital business for 35 years, and I've seen all sorts of facilities and operations,” Mr. Lefko said. “I wouldn't hesitate to go to any of the hospitals in Singapore.”
A Medical Travel Hot Spot: Singapore
When it comes to medical travel, Singapore presents a classic case of supply and demand, Dr. Yap said at the World Health Care Congress.
Singapore's tertiary-care hospitals have excess capacity that they're trying to fill. “We have a very small population, and on our own we are not able to maintain the state-of-the-art services. So our approach is to fill the service volume with international patients. That way we can acquire the technology, keep the subspecialists, and provide the highest quality services. We're led by the Ministry of Health in this. It is not just an economic enterprise, it is about providing quality health care for everyone,” said Dr. Yap, medical director of the Singapore Tourism Board.
Singapore's hospitals are considered the best in Asia, and the sixth best in the world. “We have one-third of all the JCI accredited facilities, and JCI standards are equivalent or even more stringent than JCAHO's,” Dr. Yap said. “We have lower ICU/CCU infection rates than many centers in the U.S. cities. Health care in Singapore is on par with most U.S. hospitals or better.”
Kamaljeet Singh Gill, general manager of the National Health Care Group, representing several tertiary-care centers in Singapore, explained that his country has a national single-payer health care system, with tiered pricing based on need. “If you have money you pay, if you do not have money you don't pay.” All hospitals in the country are government owned, and they're equivalent to the Mayo Clinic, “but much less expensive.”