WEST PALM BEACH -- Visit the Taj Mahal, get a hip replacement. Fly over a volcano, have heart bypass surgery. Have that nip/tuck you’ve been wanting, recuperate at a beach resort. 

 

In an era when 47 million Americans – 3.6 million in Florida – have no health insurance, the chance to save thousands on both necessary and elective surgeries is luring patients to exotic locales.

 

Medical Tourism, a new monthly magazine published in West Palm Beach,  explores this phenomenon and points out precautions prospective patients should take when traveling out of the country for health care.

 

The take-home message is: Do extensive research before you go.

 

“Some of these people have never left their state, never traveled with a passport in hand, and [they’re going] to a third-world country where they may be traveling in a rickshaw,” said Renee-Marie Stephano, editor of the new magazine.

 

Also general counsel for the Medical Tourism Association, an international organization based in Palm Beach County, Stephano said she wants the magazine to be an educational guide to overseas medicine.

 

An estimated 500,000 Americans traveled abroad in 2006 for some type of health care, but Jonathan Edelheit, president of the MTA, said that is expected to rise into the millions as early as next year.

 

Edelheit said he has been in talks with American corporations and insurers in the U.S. who are gearing up to offer medical tourism as part of their benefits packages.

 

“I know of several large employers that I just can’t name -- insurers and large employers – who will be starting in 2009,” he said. “They’re coming to us for advice and guidance on how to implement this in a U.S. health plan.”

 

The savings can be substantial. “The [medical devices] used in a knee replacement cost almost $9,000 in the U.S., and in India, they cost about $2,000,” Edelheit said.

 

The first issue of the magazine, which debuted in December, included articles comparing surgical costs in the U.S. and Costa Rica, just a 2 ½-hour plane ride from South Florida. The issue included features on eco-tourism activities available there.

 

Heart bypass surgery in Costa Rica costs $24,000, including travel, compared with $130,000 in the U.S. Hip replacements go for $12,000 compared with $43,000 in the U.S., a facelift for $5,000 or less compared with $7,000 to $13,000 in the U.S., and a root canal, $125 to $250, compared with $360 to $900 in the U.S. The numbers are from an August 2007 survey by the association.

 

At least one major insurer already has been covering health costs outside the U.S. for several years. Health Net, Inc., one of the nation’s largest managed health care companies, offers a plan in southern California that allows members to get their care in Mexico.

 

“It’s not medical tourism in the sense of combining vacation with a medical stay,” said Brad Kieffer, a Health Net spokesperson, “but it is access to medical care in another country.”

 

Health Net partners with Sistemas Medicos Nacionales, which has a network of hospitals and doctors, and is the first non-U.S. health plan accredited by the state of California, Kieffer said. As such, it must abide by all the same rules and regulations as the company’s HMO plans north of the border.

 

“It costs less for us to pay for this care, and the savings is passed on to our members,” Kieffer said. Their premiums can be one-third as much [as a California plan,]” he said.

 

Uninsured people who choose to travel for health care to save money can find a number of overseas hospitals affiliated with prestigious American hospitals, such as Harvard Medical School, Cleveland Clinic Foundation, and Johns Hopkins School of Medicine. All have representatives on the MTA’s advisory board.

 

Harris Benny, CEO of Johns Hopkins Medical International, said the university was not thinking about medical tourism when it set out to do international medicine more than a decade ago. Now it has a presence in places such as Beirut, Abu Dhabi, Singapore, and Panama.

 

“No, what we had in mind was to bring the best health care to the local community there,” Benny said. “We want to enhance and improve standards of global medicine and medical education. It’s a very comprehensive mission.”

 

While Johns Hopkins does not seek to get people to travel to its affiliated hospitals abroad, some of them promote such care. Punta Pacifica, a new facility in Panama City, touts its Johns Hopkins affiliation on its Web site.

 

“We are the only hospital in Central America in affiliation with Johns Hopkins Medicine International. At Hospital Punta Pacifica, you will be treated by outstanding health care professionals. Many of the doctors and surgeons here are American-trained and almost all are English-speaking,” it says.

 

In addition to hospitals with high-profile affiliations, about 140 overseas facilities are accredited by the Joint Commission International, an extension of the Joint Commission, a non-profit group that accredits hospitals and other health facilities in the U.S.

 

Christine McGuire, 36, of North Palm Beach, went to Cima Hospital in Costa Rica for full-body liposuction in July 2007 after checking prices and the hospital’s reputation. She learned it was an affiliate of a Texas hospital, and she was able to check out both the doctor and hospital online.

 

The hospital’s Web site says it opened in 2000, is affiliated with Baylor University Medical Center, and has “world class medical treatment, designed and organized for Americans.”

 

McGuire said the price and the fact that it was affiliated with Baylor sold her. She could have surgery and 12 days recuperating at a nearby retreat with nursing care, daily massage and meals, for less than $8,000 -- almost the same price as the surgery alone in the U.S.

 

“I had spent five years trying to lose the weight,” she said, “so I got it done.” Her trip was arranged by a medical travel company, Premier MedEscape in Palm Beach Gardens, a member of the MTA.

 

Joe Gasparoni said when he and his wife Lourdes started the company about a year ago, most of the patients were looking for lower-cost cosmetic surgery. That quickly expanded to cardiac surgery, bariatric surgery or orthopedic procedures such as knee and hip replacements.

 

“Usually the people are either uninsured or underinsured,” he said. But some employers and insurers are also beginning to look abroad for lower-cost alternatives, he said.

 

Gasparoni said he has sent patients primarily to Latin America, to physicians who were trained in the U.S. or have affiliations with U.S. hospitals. Prospective patients find his company through the Internet, the MTA and word of mouth, he said.

 

Stephano said she hopes the magazine, which is available on the Internet at  http://www.medicaltravelauthority.com, will also become a resource for potential medical travelers. The second issue is on India, where medical tourism has become a $2 billion business, growing at a rate of 25 percent a year, Stephano said. The third issue will explore the U.S. health-care crisis and off-shore stem cell treatments, still only available in limited clinical trials in the U.S.

 

The glossy full-color magazine, printed in Fort Lauderdale, is supported by advertising from medical travel companies and overseas hospitals. It is given away free, mostly at medical tourism conferences, Stephano said, but has a growing list of subscribers, including U.S. health care companies and third-party insurance administrators.

 

Stephano has no journalism or publishing experience but writes some of the articles and finds experts here and abroad to write the rest. She has traveled to nine countries so far for research, returning recently from Monterrey, Mexico, and has trips to Guatemala and Malaysia in the works. She spent 10 days in India touring the major hospitals there that promote medical travel for foreign patients.

 

 “I go to hospitals, look at how appealing it would be to an American patient, review their specialties, the nurse-to-patient ratios, find out if they speak English,” she said. “I meet with hospital management and administration, find out what type of patients they’re seeking to attract.”

 

A goal for sometime this year, Stephano said, is to have the Web version translated into Spanish, Chinese and Arabic “to make it a truly international magazine.”

Nancy McVicar can be reached at nmcvicar@aol.com.