A recurring topic at IB over the past couple of years is a phenomenon known as “medical tourism” – basically, patients who seek medical care outside their own country. Medical tourists take advantage of the high-quality care, and the technology for delivering such care, that is increasingly available around the world - including many so-called third world nations – at a fraction of its cost at home. Not a surprise that up to now, medical tourists tend to be wealthier patients and tend to come from wealthier nations.
Some nations – especially Jordan, Bahrain, Qatar – are spending billions to construct first-class medical facilities, and have contracted with high-profile U.S. health care organizations – Harvard and Johns Hopkins Medical schools, for example, and Cleveland Clinic – to help equip and staff the facilities, and ensure the delivery of a “world-class” level of care. Nations such as India, Thailand, South Africa, and others too have built a fair number of truly excellent health care facilities that also cost far less than in the U.S. and perhaps surprisingly, less than in Western Europe as well. And they deliver arguably equivalent care.
Medical tourism among Americans has been steadily growing even though it still represents a tiny fraction of total Ameerican spending on health care.
But now comes news that medical tourism is rapidly growing in the U.K.
This should be a surprise to most Americans. In the first place, most Americans believe care in the U.K. is “free”. No Brit needs to seek care in another country in order to save money. And in the second place, most Americans believe that access to health care, the quality of health care received, and finally the resulting health of the British population are superior to the U.S. And in large part, such superior outcomes are believed to be a natural product of the single-payer U.K. system. Nevertheless, medical tourism is present, and growing rapidly in the U.K. That’s surprising – at least to me it is.
As reported in the London Daily Mail, there seem to be two main reasons. First reason: to escape the waiting list for service. The average waiting time for specialist or hospital care, after one has seen one’s GP, is more than 4 months. In the U.S. we hear a lot of objection that the queues are imaginary. But medical tourists suggest that the queues in the U.K. are not imaginary after all. Second reason – and more recently: to escape superbug infections in NHS hospitals. Both reasons involve, at least as reported in the Daily Mail, the desire to “escape” the NHS.
The head of a British patient advocacy group believes that Medical tourism reflects “shrinking public faith in the Government's handling of the NHS”. The shadow health secretary (the shadow knows) says the growth in medical tourism figures are “a terrible indictment of government policies” that were “undermining the efforts of NHS staff”. In other words, the blame is being aimed directly at the government – not at doctors or hospitals, or other clinical staff for that matter.
And this is a very important distinction. Brits are not afraid of their doctors. But they seem to be losing confidence in their health care system. More people seem to believe their government is mismanaging NHS and this naturally leads to fear of NHS. So the growing phenomenon of medical tourism may well reflect the growing dissatisfaction with government mismanagement of the health care system. Voting with your feet, I guess you could say.
One department of health official stated that “almost half of patients were treated within 18 weeks of seeing a GP.” Almost half, eh? So the median wait is even longer than 18 weeks? The same official added “Most people who had hospital care did not contract infections.” Is it reassuring to be told that "most” people won't be infected by the hospital they are in? Government statements like these make it easy to understand why people are mistrustful.The incidence of medical tourism in the U.K. is still quite small but I think the important questions are: how soon can the government restore public confidence in their ability to manage NHS? And how exactly will they go about it?