Beauty from Afar

It was really in 2004 and 2005 when the U.S. media “discovered” Medical Tourism … about the same time I did. (Maybe just a little after I did. 😉 ) And it was discovered because the media noticed that people were going overseas for serious, life-saving procedures, not just cosmetic surgery and dentistry.

Chapter 3 Page 5 | The Media Imprimatur

Medical tourism and travel has been episodically in the news in the U.S. ever since and remains a story in parallel with the dominant narrative about healthcare reform in the U.S. that arose in 2008 — 2009.  I’ve often been asked if real healthcare reform in the United States would be the end of medical tourism, and the answer is no. Medical tourism and international medical care will remain less costly alternatives and U.S. patients and insurers will continue to explore and integrate the travel-for-care options that are available.

We’ve hit the end of Chapter 3. Chapter 4 will look at what surgeries and procedures that patients choose to have done overseas — specifically, it is mostly a list of cosmetic procedures and average prices and savings in 2004 — 2005. As I go through it, I’ll try to put forth any updates of which I am aware. Chapters 4 and 5 (which is a tutorial on doing Internet research) are, to me, the driest parts of the book but I’ve encountered readers who thanked me for them. So … off we go. Tomorrow, probably.

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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Introduction Page 4 | Seeking Beauty from Afar: How I Got My Smile Back

It’s so … Foreign …

The mainstream media in the United States didn?t really know what to do with the story. It was so … foreign … and always seemed tainted with desperation and a little craziness. No one seemed to know how many people were getting on airplanes and traveling abroad for inexpensive plastic surgery. Doctors in the United States, when asked, uniformly warned against the practice.

If you paid attention only to newspaper, magazine, and television reports emanating from the United States in 2004 regarding traveling outside the country for cosmetic or plastic surgery, you would reasonably conclude, in fact, that anyone who did so successfully was simply lucky. First-person stories such as my own were few and far between. The bulk of the reporting fell into two broad categories:

1. Horror stories. If someone went overseas for plastic or cosmetic surgery and came back dissatisfied, disfigured, or, very occasionally, in a box, it was news. As a journalist, I fully empathize with why this was so. Such cautionary tales of … “This could happen to you!” … are a staple of journalism everywhere.
2. Novelty stories. I would call them success stories, but they were rarely offered as such. As opposed to the this-could-happen-to-you tales, these were stories that portrayed traveling abroad for surgery as though the patient (and the reporter) had stumbled upon something exotic, something cutting edge, not quite ready for prime time. Again, as a journalist, I empathized. As my editor at Northeast said, “It’s new to our readers.”

I was reminded of the last phenomenon on which I’d done significant research and reporting, the rise of the Internet in the mid-1990s. Reading and watching the mainstream media at that time, one could be forgiven for thinking that the new medium was notable only for spreading pornography (horror) and creating instant millionaires (novelty.) Eventually — and it took several years — the media found context, understood what was happening, and started explaining it better.

The same sort of comprehension regarding medical tourism started to evolve in 2004. As I continued the routine of research, reading dozens of e-mails a day, plowing through message-board postings, checking for the latest news, home and abroad, I watched the story change. It would not have happened so fast without the Internet. In fact, it wouldn’t have happened at all without the Internet. But change it did, rapidly.

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