Medical tourism has been promoted as an inexpensive and even enjoyable way to see the world while getting high-quality cosmetic and elective surgeries for pennies on the dollar, compared with U.S. healthcare costs.
Despite that rosy outlook, however, most Americans are just not interested in leaving the country for their healthcare needs.
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The underlying conditions needed to support medical tourism are largely being met, experts say. The quality and depth of foreign medical facilities has continued to improve. Costs are still a bargain for many procedures, and medical tourism travel brokers have become better at putting together the packages needed for a successful experience.
Forecasts for attractive growth rates for medical tourism ran head on into the recession, notes Paul H. Keckley, executive director of the Deloitte Center for Health Solutions, a unit of the consulting firm that closely follows medical tourism trends. If that wasn't enough, the expected support of employers and health insurers has failed to materialize.
"We had estimated that employers would drive the medical tourism market," Keckley says. "We thought they would approach the medical insurance companies and tell them that they needed to add [medical tourism] benefits."
"But the major employers are not clamoring for medical tourism right now," he continues. Healthcare inflation has been under 4 percent each of the past two years, he says, so employers are under less pressure to trim healthcare expenses. And while such savings are still a major priority, "medical tourism doesn't show up as a top-tier issue."
It's also not a top-tier issue for consumers. Deloitte conducts an annual survey of U.S. and global healthcare trends. Among consumers from a dozen countries, Americans are the least likely to go outside their home country for healthcare.
Only 3 percent of Americans would definitely consider traveling outside the United States for either necessary or elective care, Deloitte reported in its 2011 survey. And only 1 percent had actually done so in the past year.
Uninsured consumers are more likely to practice medical tourism, Deloitte reported. And the willingness to travel varies directly by age. More than 30 percent of younger consumers say they would at least consider travel outside the United States for healthcare. The percentages decline for progressively older age groups, and are only 21 percent for baby boomers and 17 percent for seniors.
While the total market for medical tourism may be flat, that's not true for all markets and providers, says Geoff Moss, a vice president at Planet Hospital. Based in Los Angeles, it specializes in medical tourism and has developed its own network of recommended physicians and hospitals. Moss estimates that company business has been growing at a 30 percent annual clip for several years.
Three reasons emerge for medical tourism, and have helped support Planet Hospital's expansions. First, procedures remain far cheaper in many overseas markets than the United States. Second, some needed treatments are more accessible and can be scheduled sooner than at busy U.S. facilities. Third, certain specialized treatments may not even be available in the United States, due to differing healthcare regulations and even cultural acceptance of some healthcare practices.
"We still do the standard medical tourism procedures," Moss says. "We still do the hearts, and the knee replacements, and the spines and the hips." But the company has found a real niche in more sophisticated treatments that are either not available in the United States, in short supply, or extremely expensive.
"We offer procedures that aren't available in the United States," Moss says. The company, for example, works with several Chinese hospitals that provide stem cell therapies. It also works with medical facilities in Japan and South Korea for very expensive cancer therapies, including proton beam therapy.
"The U.S. has only eight to 10 beam therapy treatment centers," he explains. And the cost can easily hit $250,000 for a 12-week treatment regimen. Costs in Japan and South Korea are only a fourth that amount, and the treatment is more readily available.
Likewise, Planet Hospital has developed and expanded a surrogate birth program in India. "We may create the embryos here and then take them to India, where they are deposited in the surrogate," Moss says. "Or in some cases, our clients want an Indian egg donor." The legality of the procedure hinges on the baby needing to be genetically linked to one of the parents, Moss explains.
More than half of Planet Hospital's surrogacy work is with gay and lesbian couples, he says. And with same-sex marriages being recognized by more and more states, the demand by same-sex couples of surrogate birthing services has been expanding.
Accreditation bodies have been expanding their reviews of foreign hospitals to include more facilities and to provide accreditation of specific procedures and disciplines. The Joint Commission International is the major U.S.-based provider of foreign hospital certifications. It has a list of certified facilities and countries on its website.
A smaller list of recommended international healthcare providers has been drawn up by Patients Beyond Borders, a provider of medical tourism information.