Beauty from Afar

I have always attributed the phrase in the headline to Mark Twain, among my favorite authors … but I see by Wikipedia that it is of mixed or uncertain parentage. No matter. Please consider the link as a footnote to this post … my sixth footnote of the day. Earlier, I added what had been the five end notes to Chapter 1 of Beauty from Afar to the online pages where they belong, turning them into footnotes.

I see that I felt rightfully obligated to be fastidious about attributing statistics and numbers to their original source; and careful and fair readers should note that I chose sources that are known for doing good research and that I couch  prose that surrounds any  statistics rather carefully. There is almost nothing worse in journalism or argument than using bad statistics, or using good statistics badly, and it is done all the time.

To the extent that I am not guilty, I credit a professor of mine, Edward Tufte, whom I knew originally in the 1970s when he taught undergraduates at Yale. He has gone on to much bigger things.

Here, again, is the link to the last bit of Chapter 1:

Chapter 1 Page 9 | Medical Tourism: A Moving Target

We’ll begin Chapter 2 … oh, well. Before Monday, certainly.

When I was writing Beauty from Afar, my publisher really, really, really wanted me to say how many people traveled abroad for medical care, surgery, cosmetic surgery and dentistry.

I probably should have accommodated my publisher’s wishes, and thrown a number out there and backed it up as best as I could. That is pretty much what McKinsey and other researchers have done since. What I chose to do has invited a lot less ridicule and a lot less controversy. I could have stood up to the former and the latter probably would have been good for book sales.

What I did, instead, is mostly in the segment/page I put online today:

Chapter 1 Page 7 | 100,000 Fellow Travelers — or More

I came up with a very reasonable estimate on the number of U.S. residents who were having cosmetic surgery abroad in 2004-2005.  I didn’t have any basis, I thought, for guesstimating how many Americans were going abroad for anything other than cosmetic surgery or dentistry. Four or five years later, I think I am still on the non-ridiculous side of the argument.

But that doesn’t keep journalists from asking the question. How many people go abroad for medical care? And the answer is — who do you want to count? I have no trouble saying “a million” — if you want to count dentistry, and cosmetic surgery, and every person who drives to Mexico for any kind of medical care at all. Throw in some millions of Americans living abroad who already get medical care overseas … you want to count them, as well? I can make the number quite large.

But the number of people who get on an airplane and fly overseas for life-saving or extending surgery, non-cosmetic surgery, is a relatively small number, no matter what you’ve read elsewhere. It is perhaps in the tens of thousands annually. It’s not trivial. But it’s not huge, either.

Most medical travel is regional. Americans are not lined up to go to the Far East for new hips or heart valves. Numbers that suggest otherwise should be looked at very carefully.