Can the worlds economy be used to lower the cost of popular medical procedures? Check out this idea for a new cost lowering model.
Many people in the USA are holding their breath as they find their medical benefits shrinking, their premiums growing and their share of the bill rising. There has been much written about the concept of medical tourism in well know newspapers such as the NY Times (see a recent article here)
The problem is that for procedures such as bypass, or joint replacement or even for plastic surgery, the costs, especially in the large cities have gone out of control, yet, flying to a hospital in Buffalo, NY for instance, can save someone tens of thousands of dollars for the same procedure. Going oversea to countries such as Belgium where the costs are controlled somewhat by the government, the savings may be even greater.
Of course, many people want their doctor to do the procedure, even though their doctor, their hospital and their other services (using NJ for example) often have costs that have no bearing on the true cost of providing the service, with facility fees that are out of control even with the so called insurance company negotiated rates. In Stephen Brills article on healthcare costs a few months ago, he had demonstrated that Medicare seemed to be the only insurer capable of negotiating rates that were near reasonable with hospitals. (If you missed his story, read it here).
Most people are unaware of who actually is doing the work while they are under anesthesia, so in reality, medical tourism may indeed be quite helpful in lowering healthcare costs, but how do we convince people in mass to do it? Perhaps, it would be a more comfortable decision if there was an incentive for someone to be willing to have the procedure done elsewhere, either monetary or other. With all the bullying insurance carriers do to healthcare providers, which does not always end in a good way, and sometimes ends up costing more, having people visit a less expensive but safe and effective facility should be an insurance related business model.
Imagine, you require a hip replacement. The hospital with the NY doctors charges fees with everything including the doctor of 59,000, yet, you could fly to Buffalo, and have the entire procedure with excellent quality rehabilitation for under $20k including the flight in a comfortable airplane. Medical tourism is a great niche that has not been tapped.
Imagine, your insurance company says to you that you can have it done in NY or NJ, and will have to pay up to $10,000 or more in miscellaneous fees, yet, if you do the other option, which includes a comfortable one hour or five hour flight, all transfers, with surgical follow-up from your doctor at home, and the insurance company will wave the deductible and cover everything at 100%.
Imagine this being done or offered to all patients, with excellent care and followup while allowing you to get full coverage. Imagine the insurance carrier handling all the details included in the deal and then imagine saving 30-40 thousand dollars just for doing things a little differently.
While this may sound too good to be true, the fact is more and more people with limited insurance coverage are exploring these options and the reality is that, the end result may be lower healthcare costs as the large overpriced institutions will need to lower the amounts they charge to get back the business that is now going abroad or to buffalo.
Will Obamacare plans do this? It is hard to say however, if you are in an insurance exchange and the insurance company actuaries are trying to meet certain price points to be extra competitive, it could happen.
What do you think? Pipedream, or a great business model? This may be a great niche for a willing entrepreneur to look into to set up these relationships and their air and profit from the idea of medical tourism.