One of the few things that Republican and Democratic politicians in the United States can agree upon today is that their country can no longer afford Medicare and Medicaid. In 2009, the U.S. government's principal health-care entitlement programs between them spent $876 billion -- an expenditure about the size of the entire economy of Mexico. The Congressional Budget Office projects that those costs will continue growing at 7 percent a year for at least the next decade, considerably outpacing GDP growth. And as the costs of Medicare and Medicaid have ballooned, the programs have become an explosive political issue. On Tuesday, May 24, Democratic candidate Kathy Hochul won a decisive upset in a Republican-leaning New York congressional district in a special election that was widely viewed as a referendum on Republicans' ambitious plan to overhaul Medicare.
It's not just the entitlement programs, either. Total health-care expenditures in the United States in 2009 topped $2.5 trillion --18 percent of GDP. And the efficiency of all that spending appears pretty low. According to World Bank data, Costa Rica and the United States have the same life expectancy (79 years), but Costa Ricans spend only 16 percent what Americans spend per citizen on health services.
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That statistic, however, suggests a possible solution -- or at least a partial one -- to America's health-care woes. Maybe Medicare's services don't need to be cut, overhauled, or saved. Instead, they should be outsourced. The U.S. government could save billions by simply letting its citizens go abroad for their federally funded health care.
Medical tourism has a bad reputation in the United States, synonymous with doctors in Tijuana and St. Barts hawking cut-rate plastic surgery and taking a liberal hand with the prescription pad. But going abroad for treatment is already a big business, and an entirely legitimate one. The Bumrungrad International Hospital in Bangkok, for example, sees tens of thousands of American patients each year, part of an industry that brought 380,000 foreigners to Thailand for treatment in 2005 alone. U.S. patients are attracted not just by the low costs but also by the quality of treatment. The Bumrungrad hospital has international accreditation from the Joint Commission International, the global arm of a leading certifying organization for U.S. hospitals. And Americans have other options besides Thailand. India's Apollo hospital chain has a 99 percent success rate in the 50,000-plus cardiac surgeries it has done, equal to the performance of the best U.S. cardiac surgery centers.
And if the idea of going under a knife wielded by a foreign doctor worries you, you probably shouldn't go to a hospital in the United States, either. According to economists Aaditya Mattoo and Randeep Rathindran, there is a 25 percent chance that the physician you visit in a U.S. hospital was educated abroad -- and the great majority of those foreign-educated doctors now come from developing countries. It's not really a matter of the quality of the doctor who will treat you; it's just a question of where the treatment will happen.
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