Oct 23

Chapter 3 Page 4 | Origins of  the term “Medical Tourism” (cont.)

Dr. Fournier claims he was the seventh cosmetic surgeon in the world to put up a Web site and I have no reason to doubt him; whether he was 7th or 17th, or 70th doesn’t matter much. U.S. cosmetic surgeons were quick to seize on the new medium of Internet marketing to spread information and awareness, but several of the Costa Ricans were right there with them, as were surgeons in other countries. Once reliant for marketing solely on word of mouth, occasional visits to the United States, and flight magazines, cosmetic surgeons around the world found they had a platform from which they could reach customers directly and at a minimal cost. As the demand for cosmetic surgery in the world’s No. 1 market, the United States, shifted into overdrive in the late 1990s, more surgeons abroad targeted the United States. Though their market share was tiny,  their growth rate likely was faster than that in the United States, and it remains so today. Business for foreign surgeons in 2005 was threefold, or fivefold (depending on who you ask) what it was in 1995, when things were already going well.

Around 1998, the phrase “medical tourism” finally began creeping into news accounts. The Washington Times noted in March of 1998 that medical tourism was one of the few bright spots in the economy of Castro’s Cuba. In April, officials in Miami, Florida were touting “the concept of medical tourism” in an Associated Press article. They were not talking about patients going abroad or even coming from abroad; the Miami Health Care Alliance simply thought maybe vacationers who were coming to Florida might like to visit a few doctors, seeing as how they were in town anyway. If you look in a big database of periodicals and magazines published prior to 2001, most of the references to medical tourism come from overseas. The New Straits Times of Malaysia ran a number of stories about the potential of medical tourism for that country, for India and for the rest of the Pacific Rim nations. The Jerusalem Post in 1999 referred to medical tourism as “a huge business.” But if it was a huge business, it was a remarkably unreported one in the United States in the late 1990s. For me, the earliest reference to medical tourism that bestowed proper global context to the term belonged to Prof. Sander Gilman, author of Making the Body Beautiful: A Cultural History of Aesthetic Surgery, published in January 2001.  He wrote:

The globalization of aesthetic surgery has spawned numerous centers that link surgery and tourism. North Americans have long gone to Mexico, the Dominican Republic, and Brazil; now the United Kingdom has started to offer “aesthetic surgery” tours for Americans as well. People in the United Kingdom flock to Marbella in Spain for discrete face-lifts, but Poland and Russia are now competing for this market. For medical tourists in the Middle East,  Israel has become the country of choice for many procedures, even for citizens of countries that do not have political ties to Israel;  Germans visit South Africa for breast reductions and penis enlargements as well as to see the Kruger National park;  South Korea and Singapore are important for the Asian market; and Beirut, Lebanon, is the place to go for quick, no-questions asked transgender surgery. Medical tourism has become big business, and aesthetic surgery, because of its elective nature, is a large part of the action. For every procedure recorded in one country, similar procedures are being undertaken on that country’s citizens elsewhere … Aesthetic surgery has become a worldwide phenomenon in the past few decades. (3)

(3) Sander L. Gilman, Making the Body Beautiful: A Cultural History of Aesthetic Surgery. (Princeton University Press, Jan 15, 2001), 8.

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Sep 26

In Chapter 1 of Beauty from Afar, I suggested that medical tourism was already a big business in 2005 and that it might be acting as a safety valve for the U.S. health-care system. I was right on both counts.

Chapter 1 Page 4 | Patients Going Abroad: A Burgeoning Industry

Medical tourism was and is a big business and that fact has been a source of great frustration to entrepreneurs who believed then, and even today, that therefore it can be tamed, routinized and turned into a corporate profit engine.  The biggest problem with that has been that the part of medical tourism that looks like it would be very profitable — putting Americans on airplanes and sending them overseas for surgery — is not a very big part of the medical tourism business at all. It is a very small part of the picture, relatively speaking, and will remain so unless and until American businesses and government embrace medical tourism.

Most of medical tourism from the United States is still for elective procedures, dentistry and cosmetic surgery; and the Great Recession has affected that business substantially. Yes, people are more interested than ever in saving money. However, through the medical tourism boom of 1998-2007 or so — a lot of Americans were paying for their cosmetic surgery and dentistry with credit cards or by taking second mortgages out on their homes. That is not happening quite so much any more, for obvious reasons.

Yet medical tourism is working well as a safety valve for many people the world over who cannot get or afford the care they need or want locally. It has been consumer driven. It is in the hands of patients.

Big research companies talk about medical tourism being worth many billions of dollars, with many more to come. They are right, though their methodology is often deeply flawed and even laughable. But those medical tourism dollars are spread out all over the world and are very difficult to count.

The next segment will talk about spiraling medical costs in the U.S. There’s a topic that certainly hasn’t gone stale in a few years. I’ll be interested in whatever it was that I had to say. 😉

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