Global health reform

Medical tourism is no longer just the province of the uninsured and desperate. As health care costs soar in the United States, it is also the insured and their insurers who are scouring the globe for quality at a bargain. This is further evidence that one of our main tenets is true: reforming our delivery system to increase the value of our health care dollar is just as important as covering all Americans.

Medical tourism, or as some prefer to call it "Global Health Care," could become a $150 billion market, according to Wouter Hoeberechts, CEO of WorldMed Assist, a company that assists Americans in accessing overseas care. He was among the experts who took part in a panel on the topic at the recent Association of Health Care Journalists conference just outside Washington.

Going overseas for health care makes sense, he argued, if the care is not urgent, if it doesn't require a lengthy foreign stay or prolonged follow-up care, and if it's relatively expensive, say $15,000 or more. Hoeberechts sees patient demand for orthopedic and spinal surgery, weight loss surgery, cosmetic and dental procedures, some cardiology and even transplants. Heart bypass surgery, for instance, can cost $149,000 in the U.S. (although insurers usually negotiate steep discounts) compared to $10,000 in India including airfare and lodging.

We all hear the conventional wisdom about how the aging Baby Boomers are going to bankrupt the country. Well, Sweden has Baby Boomers too, but their spending on health is lower than ours per capita and stable. How do they do it?

The answers range from free preventive care to widespread adoption of electronic medical records (95 percent of doctors and hospitals use EMRs).

Maggie Mahar at Health Beat blogged about the World Health Care Congress Europe in Berlin and she had a chance to talk to a top economist, Mona Heurgren, on Sweden's National Board of Health and Welfare. Sweden has the oldest population in the European Union but its health costs haven't been rising. "Over the last 15 years or so, the share of our citizens who are older has been growing, yet health care spending has stayed level at about 9 percent of GDP," Heurgren told her.