What began as a trickle a decade ago is becoming a flood as people from countries like the US, the UK and Australia stream into Asia and Eastern Europe in search of youth, beauty, and freedom from chronic pain and disability, writes Lesleigh Green.
As medical, hospital and health care costs spiralled out of control in developed countries, the result was the quiet evolution of a multi-billion dollar international export industry, known as ‘medical tourism’, whose benefits and burgeoning reputation spread in the first instance largely by word of mouth through local patient networks.
More recently, comments have flooded providers’ websites, as glowing patient testimonials pay daily tribute to overseas doctors, clinics and hospitals that have “…made my dreams come true”, “…given me new hope” or perhaps “…freed me from a world of pain at long last”.
“As with everything you purchase or invest in – and especially with services that may affect your overall appearance, health and well-being – you must do the research and carefully evaluate the risks and benefits before you engage a provider and pay your money,” says Melbourne-based Cassandra Italia, whose five-year-old Global Health Travel (GHT) company takes more than 1000 patients overseas for surgery and medical treatment each year.
GHT says it uses only internationally accredited and regularly benchmarked hospitals and clinics, such as the respected Bumrungrad International Hospital complex in Thailand, which treats more than 400,000 visiting patients from 190 different countries every year, and which employs leading specialist doctors and dental surgeons, most of whom have been educated and post-graduate trained in countries like the UK, the USA and Australia.
Different types of specialist surgery and treatment, such as gastric surgery and IVF, are also offered at globally renowned hospitals under internationally regarded specialists in India and Malaysia, while the new field of surgery using the patient’s own stem cells is being investigated in Shanghai.
“You’d be surprised how many medical tourists are tempted to do very silly things they’d never do at home before or after an operation then want to blame someone else if something goes wrong which, fortunately, is a rare occurrence when you consider how many patients are involved overall.”
In the USA in 2006 alone, half a million patients sought affordable medical and surgical treatment and even basic health care in places like Mexico and Hong Kong. Today, that number has doubled.
Many people in the US are not medically insured (you must be employed or a family member of an employed person to get medical insurance) and, until recently, there was no national system similar to Australia’s Medicare to cover basic health needs.
In the UK, patients with some money to spend and no time to waste on a waiting list are escaping the beleaguered and often belittled national health system to seek surgery and health treatments in countries like Turkey and Hungary, famous since the 19th century for their health spas, bath houses and regenerative therapies.
The main motivation for Australian patients taking their body business offshore is the escalating cost of dental treatment, including cosmetic dentistry, plastic surgery and other elective and reconstructive operations and procedures.
This, combined with widening gaps between what Medicare and private insurance funds will pay for particular procedures, hospital stays, prosthetics and medicines, and what the patient has to pay to bridge the gap, has driven the desire to look elsewhere for more affordable alternatives.
The lengthening waiting periods for both necessary elective procedures, caused by an escalating population with too few GPs and specialists to service its needs and a hospital system under pressure, has led to increasing patient frustration especially in cases where pain and disability are the prices paid for delaying surgical intervention.
As has happened with Australia’s once mighty manufacturing industry, where high costs have forced production and jobs offshore, the overpriced, overburdened, under-resourced Australian health system risks losing customers as would-be patients vote with their feet and their wallets to access the services that local specialists, such as plastic surgeons and cosmetic dentists, rely on to support their well-heeled lifestyles.
Australian dentists could find themselves increasing bereft of patients requiring high level, lucrative care. Without free national dental care and with limits on private cover for major dental work, some Australians resist going to the dentist until damage mounts and they are faced with quotes totalling tens of thousands of dollars.
With high tech, best practice, speedy, transformational dental services available for 70 percent less cost in a top notch Thai clinic, the urge to take a week’s holiday, jump on a plane and return refreshed, pain-free and with a nice smile, is already proving irresistible to Australians.
And age is no barrier to a successful outcome as website testimonials clearly show.
A grey-haired man called Damian from Queensland has provided a smiling video testimonial for a major dental ‘full mouth’ reconstruction, including 20 crowns, a number of root canals and four dental plates, just days after surgery in Thailand. It saved him untold thousands of dollars and he was delighted by the whole experience. He even claims “it didn’t hurt”!
A tattooed, grey-bearded Daniel Martindale from north Queensland, was ecstatic following an operation on his spine in Thailand that allowed him to throw away his walking stick and freed him from 20 years of pain. His Australian doctors had told him surgery in an Australian capital city would cost $60-100,000. He paid $11,000.
Patient Yarna Burke claims she was up and about and ready to go shopping with an escort in Bangkok three days after her facelift, free of pain killers and bandaged up “like a demented car accident victim” but “not caring what anyone thought”.
Yarna loved the results when they were revealed and couldn’t wait to introduce her new look to her friends and colleagues. She also had dental assessments while in Thailand and said she would return for dental surgery next year.
And 83 year old Basil from Darwin, who still works part time, spoke from his Bangkok hospital bed following a total hip replacement. A second hip also requires surgery. His condition had prevented him from driving, impaired his walking and was very painful.
Because he had no private medical insurance, Basil could not afford the $80-90,000 Darwin doctors told him it would cost to do both hips privately, although in some Australian cities the cost would be more like $50,000. On the free list, he would have to wait two-years.
Basil decided to do one hip for around $12,000 in Thailand and with the enhanced movement this provided, went off travelling in Asia after recovering from surgery. His other hip will be done free of charge in the public health system in Australia next year.
Medical Holiday Options
Costs below are a guide only and don’t include travel, hotel accommodation, the company’s patient care package or medical travel insurance. They may not include pre-op tests for patients over 40 years, other tests, additional procedures, or take-home medications. These are some of the most popular procedures accessed overseas by patients of Global Health Travel aged 50-plus.
Dentistry (cosmetic and general)
Where: Choice of 2 specialist dental clinics, Thailand
Cost: About 70% cheaper, e.g. a dental crown $300 versus $1000+ in Australia
Other benefits: Latest technology, high standards of practice, quality implants and prosthetics, quick turnaround, results aesthetically pleasing, no hospital stay, no special recovery care required
Time away: 7 days
Where: Bumrungrad International Hospital, Bangkok
Cost: Depends on how many areas of the face/neck lifted. About 50% cheaper than Australia.
Other benefits: Highly qualified aesthetic plastic surgeons, top quality implants (if required), privacy and quality nursing care during recovery, high levels of patient satisfaction with outcomes.
Time away: 14 days
Where: Bumrungrad International Hospital, Bangkok, Thailand
Cost: Day surgery, combined upper and lower eyelids, about $2,000 or about 60% saving on Australian costs
Benefits: A more alert, youthful look
Time Away: 7-10 days
Total Hip Replacement
Where: Bumrungrad International Hospital, Thailand
Cost: $12,000 per hip. Approx 50% saving on Australian prices
Other benefits: No painful waiting period during which the condition could worsen
Time away: 14 -21 days
Knee Surgery (total knee replacement)
Where: Bumrungrad International Hospital, Orthopaedic Centre, Thailand
Cost: Around $AUD13,200 one knee; saving 50-60% of Australian cost
Other benefits: Improves mobility, repairs or reconstructs worn/damaged knees
Time away: 10-15 days
Lasik Eye Surgery
Where: Lasik Eye Clinic,Bangkok, Thailand
Cost: $1000 per eye. In Australia, around $3000 per eye
Other benefits: No hospital stay, no recovery period.
Time away: 7 days including time to enjoy a holiday without your specs!
Cost: $3 per individual hair graft versus $6 per graft in Australia; 50% saving on around 1500 grafts required for a full transplant
Other benefits: Patient’s own hair used, quick turnaround
Time away: A few days – or longer to enjoy the holiday
Comprehensive Health Checks
One two-hour session provides comprehensive testing and analysis of body systems, including current diseases, conditions and future risks, tumour markers, mammograms, organs, blood, skin and bone analyses etc. Not available in Australia. Full medical report provided, including recommendations.
Where: Malaysia, South Korea, Thailand, Singapore
Cost: from $400. Not available in Australia.
Other benefits: ‘One-stop shop’, quick and affordable, unlike endless doctor visits and tests in Australia. Ideal for time-poor business travellers and tourists.
Time away: N/A
The Australian Competitive Edge
Admittedly the cost of cosmetic surgeries in Australia is not cheap, though it is usually lower than that in the United States. Nevertheless, a good number of retirees prefer to have their treatments performed at home for a number of reasons.
First it is becoming a regulated industry. The ASPS (Australian Society of Plastic Surgeons Incorporated) is a well-recognised, independent and non-profit organisation composed of thousands of cosmetic surgeons all across different territories. It maintains very high standards and implements stringent rules for all its members to ensure the quality of health care they provide.
The Australasian College of Cosmetic Surgery also participates in policing rogue doctors. Dr. Colin Moore, for example, emphasises the prohibition of marketing time-limited offers, which can force patients to make rash decisions.
Australia is not afraid to invest on technologies and state-of-the-art equipment. It possesses larger numbers of PET and CT scans than its competitors such as Thailand, Malaysia, and even New Zealand.
Layt Clinic in the Gold Coast recently acquired 3D imaging technology that is specifically useful for those who want chin augmentation. Known as Vectra 3D imaging, the machine allows doctors as well as patients to create a more realistic model that helps the latter set more achievable expectations.
The quality of health care in the country is extremely high. Based on a June 2010 report of the Australian Institute of Health and Welfare, over 50 percent of private hospitals and 80 percent of public health hospitals had been accredited because of their safety standards.
In spite of having one of the best health policies and infrastructure in the world, there is still the risk of botched surgeries in Australia. Dr. Kourosh Tavakoli said that more than 25 percent of his surgeries were corrective measures, and more than 50 percent of such patients were between 30 and 40 years old.
Alarmingly along with the growth of the industry, is the mushrooming of fly-by-night salons and ‘clinics’ that offer dirt-cheap and mostly illegal procedures, including cosmetic fillers, such as Botox.
Why Go Overseas?
The real driving force, though is the cost of cosmetic treatments. In a study conducted by McKinsey and Company in 2008, more than 99 percent of Asia’s clientele were coming from Oceania, which includes both New Zealand and Australia.
A neck lift in Thailand, for example, costs only $1,875 while the mid-face lift is $2,950. For a full facelift, including almost a week stay in the hospital and hotel for post-operative care, you would spend roughly $10,000 overseas — half the price from the same procedure performed in either Sydney or Melbourne.
While Singapore is more expensive than other Southeast Asian countries, it still offers cheaper treatments than Australia. A knee replacement surgery, for instance, costs only $9,000 as opposed to $15,000 here.
It is enticing to think you can save money and get an exotic holiday to boot. The Bumrungrad International Hospital, one of the prestigious health care facilities in Bangkok, provides not just treatments but also accommodation in a luxurious hotel or serviced apartment, more than 100 interpreters, visa extension, and embassy assistance. South African travel agencies will include Safari tours, while Thailand offers a jaunt to Phuket or any of its idyllic beach islands.
Abroad medical professionals are often highly qualified. Indian doctors are trained in either the United States or the United Kingdom. Others have master’s degrees and PhDs as well as register several years’ experience in the field.
While medical tourism is an attractive option to Australians, for many it will not be worth the potential risks travelling to these countries for such high-risk procedures.
Cultural differences such as language barriers and traditions can potentially lead to failed surgeries, and each country carries with it its individual health risk. A Deloitte report in August 2011 revealed the increased risk of acquiring MROs (multi-resistant organisms), which can also complicate the management of the existing ones.
Some of the notorious MROs are NDM-1 (metallo-beta-lactamase-1) of New Delhi and MRSA (methicillin-resistant staphylococcus aureus), derived from Hong Kong, Singapore, and Japan. Countries such as Sri Lanka, Vietnam, and Korea have some of the highest rates of penicillin resistance (though this is also moderately common in Australia).
Tips to Keep in Mind
Whether you are planning for an Australian or overseas cosmetic procedure, the things you have to do remain the same:
Do your research. Research should be as extensive as possible. Who are your doctors? How much are you willing to spend for the treatment? Where are you staying? What kind of procedure are you looking forward to? Some countries fare better in certain surgeries.
Get a price quote. First get a quote here in Australia. The procedure may appear affordable, and there may no longer be a need to travel overseas. You also have to ask for one for at least 3 other countries for better price comparison.
Make a reservation. Should you decide to have your cosmetic treatment abroad, you can either do it all by yourself or work with a travel agency. The latter, of course, is more expensive, but the company will already take care of everything. You can also start looking for health care facilities with all-inclusive packages, including a stay in a good accommodation, tours, and professional fees.
Obtain travel insurance. Most of the travel insurance policies do not cover cosmetic treatments, but they can still potentially save you money nonetheless, especially if you have to extend your stay or have to be evacuated to a much better facility. Australia’s NIB, meanwhile, is currently under review, as it aims to extend specific insurance policies to retirees seeking overseas medical and cosmetic treatment.
Choose a professional. The idea of spending a fraction of a cost both in Australia and abroad sounds enticing, but avoid going down that path for your own safety. If you like Australian cosmetic procedures, begin by looking for doctors who belong to ASPS. You can use their website to search for one that operates near you. Check and verify qualifications as well as credentials. Better yet, ask for recommendations not only from friends but also from your own general practitioner.
Prepare yourself mentally. Cosmetic surgeries alter not only your physical appearance but also your mental state. It is not uncommon to hear stories of men and women who eventually suffered depression after the procedure.
Understand the risks. Every time you go under the knife, there are accompanying risks. Unless these are dangers you are willing to face, defer your decision for any cosmetic surgery.
Determine their post-operative care. Post-operative care is extremely important. The first few hours or days after surgery make you easily prone to infections, among others. You also need support for complete healing and minimal scarring. What kind of support can the health care professional provide you? If you are having your treatment overseas, is your total holiday stay enough to cover good post-operative pain management and care?