Medical tourism has its risks and rewards

How's this for an ideal winter getaway: fly someplace warm, save some money, relax on the beach … and undergo surgery.

More and more Minnesotans are getting their tummy tucks, colonoscopies and other medical procedures done in other countries at bargain prices, enjoying the travel while they're at it. Many say their care was not only cheaper overseas, but more pleasant or thorough in other ways than the care they would have received back home. But while thousands of medical tourism patients a year report positive experiences, there also are plenty of horror stories, warned a University of Minnesota expert.

"I would encourage people to exercise caution, do everything possible to gather information, and make thoughtful choices," said Leigh Turner, associate professor at the U's Center for Bioethics and co-editor of "Risks and Challenges in Medical Tourism: Understanding the Global Market for Health Services" (2012).

Retired Edina businessman Bob Nathanson, 63, gets his annual physical exams and dentistry done in Bangkok, Thailand. "In the U.S., I keep insurance costs down by using a plan with a big deductible, and the physical isn't covered," he said. "[Bangkok's] Bumrungrad Hospital is as beautiful and modern as anything in the U.S., and the doctors you see have all had training in the U.S. or Australia." The basic Thai physical costs just $100 and is extensive — blood, urine and stool tests, chest x-ray, eye exam — Nathanson said. Two hours later, the doctor presents the results in his office. A CD and a written report arrive the next day.

Though Nita Singh's annual physicals are covered by insurance, the 50-year-old Minnetonka woman paid $5,000 out of pocket locally for an "executive physical" because she wanted tests the basic procedure didn't provide. When it was time for another extensive physical, she had it done in Thailand for $500.

Before the trip, she visited the hospital website and selected specialists based on their résumés. Each was Harvard educated, she said. The Thai doctors discovered she had gallstones, which doctors at home had missed.

According to Dr. David Kalin, chairman of the International Board of Medicine and Surgery in Florida, "The people who choose another country for their medical care fall into three categories: people without insurance coverage or whose procedure would not be covered by insurance and who want to have the work done at a fraction of the cost; [natives of other countries who are] more comfortable returning to their home country for medical care; and people who are adventurous and have the resources to seek out the world's top providers wherever they may be."

Elisha Lasalle, 46, of Plymouth, believes that getting treatment in Mexico saved her life after doctors here said they could do nothing more to save her failing kidneys. She had no health insurance. Tired of being hooked to a dialysis machine for eight hours a day, Lasalle went online and found an MD in Puerto Vallarta who also practices the alternative therapies naturopathy and iridology. She quit her job, sold everything she owned and moved to Puerto Vallarta. Her Mexican doctor advised a complete change of diet and mind-set, along with exercise and "energy work." "I spent a lot of time just walking in the ocean, which felt very spiritual and energizing," she said. Three years later, feeling she had regained her health, Lasalle returned to Minnesota. Today, she said, "I'm not connected to any machines. I work two part-time jobs to support myself. I don't have a main physician here because my trust level isn't there. I'm trying to save money to return to Mexico."

Turner advises anyone considering having a medical procedure outside the country to do thorough homework. If something goes wrong in a foreign country, "it can often be a real challenge for patients in terms of legal recourse," he said. "People trying to seek restitution may find that's not an option." Victims of a botched surgery may face hundreds of thousands of dollars of postoperative care back home. Support from U.S. consulates and embassies abroad is unpredictable.

Despite the risks, Turner said the popularity of medical tourism points to problems in the U.S. health care system. "If you're underinsured or lack insurance, this is the most expensive medical care in the world. For-profit hospitals and fee-for-service providers do well in this environment — but patients view it as a punitive health-care arena."

Turner advises checking the U.S. State Department website (www.state.gov/travel) and the Centers for Disease Control and Prevention (www.cdc.gov/travel). The CDC publishes "CDC Health Information for International Travel" (commonly called the "Yellow Book") every two years, with warnings about health care in particular countries. The International Board of Medicine and Surgery certifies doctors, hospitals and medical tourism consultants around the world (www.ibms.us).

Anne Nicolai is a Minnesota writer and book editor living in San Miguel de Allende, Guanajuato, Mexico. Find her at editorsma.com and karaokeani.com