Oct 26

Chapter 3 Page 5 | The Media Imprimatur

The media in the United States did not really discover medical tourism until 2004-05, and it was found in the Far East rather than in central and South America. It was Bumrungrad Hospital in Thailand and the Apollo Hospital Group in India and Penang Adventist Hospital in Malaysia that made 60 Minutes and the front pages of the Wall Street Journal and The New York Times, not the plucky surgeons and dentists of Costa Rica, Mexico, and Brazil — even though far more U.S. citizens were heading South for inexpensive medical and dental care and surgery than were heading to the Far East. There are a few good reasons for that, which I offer not as an apology for the media but as explanation:

1. The story wasn’t about cosmetic surgery, which, despite its popularity and the professionalism of its practitioners, doesn’t get the same treatment in the news as does “real” medicine. Cosmetic surgery news is fluffier, more frivolous, than open-heart surgery news. The international hospitals of the Far East, wisely, didn’t play up cosmetic surgery — though they do a lot of it. They played up cardiothoracic surgery, and their state-of-the-art technology and facilities, and thus were taken more seriously. For the first time, much was made of the fact that there is an estimated 42 million people in the United States who lack adequate medical insurance who could go out of the country to get treatment they could not otherwise afford.

2. The story was delivered in part as a business story with big dollar signs, the kind that gets attention from the media. India put a $2 billion sticker on medical tourism. As previously noted, Bumrungrad sees more than 350,000 patients a year.

3. The story was generated by big multipurpose hospitals, and supported by the tourism and economic development officials of their respective countries. This is the way countries in the Far East go after markets, and there is nothing in Central or South America to compare as yet.

As we move through the first decade of the 21st century, medical tourism is still both newly discovered and in transition. The tip of the iceberg remains elective medical care, mostly cosmetic surgery and dentistry; beneath the surface is the larger consumer health-care market of North America and Europe.

And the media is paying attention. In February 2006 a West Virginia state legislator introduced the first bill in the country providing for the outsourcing of medical care to foreign countries. In Chicago, Blue Cross/Blue Shield investigated and then approved payment for an insured child’s heart surgery in India. And when President Bush visited India for the first time in March 2006, the two countries released a statement pledging American support for Indian efforts to support medical tourism, saying there is “enormous potential for collaboration” in health tourism.

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Sep 25

… and I am quite sure I am the only one who noticed.

Here is what should have been yesterday’s update:

60 Minutes and Medical Tourism Part 2

And yesterday’s update, of course, should have come today:

Vignettes … Didi, Fabio … Part 3

I fixed the internal navigation of the site. And if I haven’t mentioned it before — I will be wildly grateful to anyone who points out any technical or factual errors I might make in the course of publishing the text of Beauty from Afar.

The 60 Minutes show in 2005 that featured Bumrungrad International hospital in Thailand did much to legitimize medical tourism in the United States.  It spurred more serious journalistic coverage of the subject and, thereafter, people who went abroad for medical care were treated with a little more respect.

It also got the attention of my publisher, which asked me if I could write Beauty from Afar faster than I had agreed. By contract, I owed them the book in January 2006. After some hemming and hawing and looking at the calendar, I said I could turn it in by October 2005.

It was April 2005 at this point. I was saying, “Sure, I can write this in six months.” And I did.


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Sep 25

Chapter 1 Page 2

Fast forward to April 2005, a year later. My phone rings in Connecticut, a little too early. “Did you see 60 Minutes last night?” the voice asks. I hadn’t, actually; instead, I had been sitting in a gymnasium in West Haven listening to my son play clarinet with his high school concert band. But I had known what 60 Minutes was doing. Weeks before, Ruben Toral, who is responsible for public relations at Bumrungrad Hospital in Thailand, had told me that CBS had been filming there.

Later, I watch a tape of the show and am frankly astonished that it portrays medical care in Thailand and India as being of the highest quality, and at a fraction of the cost of the same care in the United States. The lid is off, I think. It is not a new story to me, of course; but that 60 Minutes had done it raised the credibility level. If there was something awful about medical tourism, anything especially dangerous about going overseas for health care, surely they would have found it?

Millions of people saw the show. Hundreds of thousands of people — at least the ones who have already been overseas for health care — felt vindicated, a little less crazy. The next morning, I read, on a prominent mailing list on the Internet, this comment:

“This could turn out to be one of the most important stories 60 Minutes has ever produced. First, because it addresses one of the most critical issues in America: rising health-care cost (combined with the uninsured), and second, because the show’s audience are the prime consumers of these services: the aging baby-boomers. While I can see that it might take a few years for flying to Asia for major surgery to catch on, I predict that insurance companies will eventually find a way to use these options to force U.S. health-care providers to lower their prices. (Of course, then the battles in Congress will start …)”

Whatever sense I had of being privy to a secret vanished.

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