Ruben Toral sits down with Curtis Schroeder, CEO Bumrungrad International, a Bangkok Thailand hospital that has been around for 28 years and was one of the early movers in medical tourism.

Bumrungrad treats about 450,000 medical tourists per year from 190 countries and is in the process of expanding. It currently has 73 clinics in 7 countries.

Bumrungrad International was the first Joint Commission International Accredited Hospital in the world. The JCI accreditation created a beachhead in Asia for medical quality. The fact that a Thai hospital was the first to receive the JCI accreditation came as a surprise to many within the global health care and hospital communities.

The JCI accreditation helped establish a sense of credibility for foreigners to travel to Asia, and Thailand specifically, for medical care. Foreign tourists, Insurers, Embassy employees, and Self-employed employers rely on third party validation rather than a flashy brochure or web site to make decisions. So the JCI has played an important role in the growth of medical tourism.

This interview was filmed at the Consumer Health World Conference in Washington DC. Click here to watch all interviews from the Conference. Click here to purchase conference multimedia.

Dan Snyder, Group Executive Vice President and Group Chief Operating Officer of Parkway Health, the leading hospital group in Asia, spoke at the Health Care Globalization Summit.

In this Medical Tourism session, titled The Globalization of Healthcare-How International Networks Can Ease the US Burden, the panelists explore the perception of medical tourism in the US and the future of medical tourism in the context of a national and global health care crisis.

Medical Tourism is like a Toyota Corolla – a new approach to health care, an innovative product with mass market appeal, valued for high quality affordable pricing, and delivered through a global seamless network. That is the promise of medical tourism, a quality service that everyone can access globally at an affordable price.

But what is the reality? The 1975 Toyota Corolla was perceived as a low end automobile when it entered the US market. But this was the spearhead for Toyota into the US market and the beginning of a dramatic change in the US automotive industry. Today, in overseas healthcare, there is a foreign product trying to penetrate the US market, riding on the back of a crisis. Today the crisis is a health care crisis. In 1975 the crisis was the oil shock of the early 1970s. Medical Tourism, like the early Corolla, appeals to a fringe segment of the US population and is perceived as cheap, rather than good, with a limited sales and service network. This is version 1.0 of medical tourism – interesting but fragmented, signaling change but not adopted by the mass market.

Is medical tourism version 1.0 of a new health care model? Where is medical tourism going & what are the forces driving it?

Experts provide insight into the mega-trends behind medical tourism & how this consumer-driven initiative is creating a new, global platform for the delivery of lower cost healthcare

Moderator
Ruben Toral, CEO, MedNet Asia

Ceani Guevara, Engagement Manager, McKinsey & Company
Paul Mango, Director, McKinsey & Company

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The Campaign to End Aids (C2EA) was created to ignite a political conversation about ending the AIDS epidemic. In response to the lack of attention on HIV/AIDS issues during the 2004 Presidential election, a group of concerned HIV/AIDS leaders formed C2EA. Their idea was to use traditional grass roots organizing by people impacted by the HIV to get the issue of ending AIDS on political and media radars. C2EA is re-igniting the kind of activism that proved effective fighting AIDS in the late 1980′s. Larry Bryant, National Field Organizer, and Charles King, Housing Works President, join Reporting AIDS to discuss the Campaign to End AIDS.

Medical tourism has become a booming global industry. As health care costs fly high in the United States, some patients are taking their medical business across borders and into the hospitals of Mexico, Thailand, Singapore, India, and other countries where the cost of surgery and other procedures is lower. Many of the hospitals in these countries have partnered with local resorts and five star hotels to offer patients luxurious accommodations for recuperation. Patients can combine a knee replacement or cardiac surgery with a tropical vacation, and they only have to spend a fraction of what they would pay in the U.S.

Until recently, most medical tourists sought overseas healthcare independently, opting to pay out of pocket. But now insurance companies are interested in getting in on the game. BlueCross BlueShield of South Carolina has struck a deal with Thailand’s Bumrungrad Hospital, allowing patients needing surgeries not covered in the U.S. to go under the scalpel in Bangkok. United Group Programs, in Boca Raton, Florida which assists self-insured employers with administration, has begun advocating surgeries in a Thai hospital. Other insurance companies and employers may soon follow suit, and overseas hospitals are working hard to lure them. Bumrungrad has its own marketing chief, Ruben Toral, who travels to America to meet with insurers and employers interested in reducing costs of employee insurance plans.

While medical tourism has opened a whole new set of markets, it has also created a slew of issues. Countries differ widely in their clinical standards and accreditation requirements. Many of these overseas hospitals are internationally accredited, but a large number are not. Doctors and patients in Western countries tend to be wary of foreign healthcare systems, particularly those in developing nations like India, with some doctors reluctant even to send patient records abroad. The culture of medicine differs vastly from one country to the next. Thailand’s policy on stem cell research is much looser than that of the U.S., for example. Medical outsourcing also has legal implications. In the U.S., patients can win large claims for medical malpractice, but the legal systems of many countries don’t allow for this.

Despite these problems, the trend appears to be spiking upwards. Josef Woodman, author of Patients Without Borders, a book on medical outsourcing, estimates over 150,000 North Americans and Europeans are traveling to foreign countries for medical treatments each year. Asia’s medical tourism industry is expected to be worth $4 billion by 2012, according to UK consulting firm Abacus International.

This video is from Consumer Health World, May 2007. Register now for the December conference in Washington DC. Visit the online store to purchase the conference multimedia from the May 2007 conference shortly.

In this UK Building Better Businesses in Healthcare panel

How to reach the female consumer? She is more assertive, she intends to make her own choices, and she actively seeks out information prior to any consultation with a healthcare practitioner, and when she goes into the GPs office, she wants an active and equal dialogue with the practitioner. Compare that to 20 years ago. So how do we engage her? Consumers are exposed to 1,500 commercial messages per day. The aim for any healthcare practitioner is to engage with the female consumer in her own world, on her own terms, talking to her about her interests. It is a blend of art and science. Art is in the message, science is how you reach her (what media channel?).

20 years ago the target female consumer was over 50 and affluent. Increasingly, you need to find out more about her – is she single, married, divorced, with children, urban or rural. Start to build a profile of your target consumer at her micro level. What will attract her attention and arouse a response. What is the response you want? Awareness of a condition? Or for her to pick up the phone?

How does she consume media? Does she pick up the newspaper, read a magizine, watch TV, go to the movies, use the internet, run into out of home media such as billboards, hand-dryers?? What is your budget? Can you afford a national poster campaign? Or a regional TV ad? Is PR your best route? Do you want broad awareness? Today’s media landscape is undergoing rapid change.

Patients are willing to pay more if they think they are getting value. Consumers are becoming medical entrepreneurs. Consumers are feeling more empowered – finding information, making decisions and acting based on perceptions of cost and benefit.

Access and referral are the conventional drivers of the clinical pathway. What are the new drivers? That question is answered in this panel.

The Building Better Businesses in Healthcare Conference was organized by Harley Street Direct.

Seven new cases of the H5N1 — or Avian Flu — virus occurred over the past two weeks killing five, Mike Leavitt, Secretary of the Department of Health and Human Services, revealed Thursday.

Just because the Avian Flu no longer generates the media buzz it once did does not make the danger of an outbreak any less real, he added.

“We continue to take this threat seriously,” said Leavitt during a press conference at the Center for Disease Control in Atlanta where he was joined by Dr. Julie Gerberding, Director of the CDC, to announce new mitigation guidelines to fight potential pandemic outbreaks.

“Pandemic Influenza is not necessarily imminent but it is inevitable,” Gerberding warned and said that because of this, planning needed to continue across public and private sectors, as well as within families and communities.

As such, the CDC released community guidelines that do not involve medicines and vaccines. These so-called non-pharmaceutical interventions include recommendations on school closures, liberal work leave policies, the reduction of public gatherings and the voluntary quarantining of households where outbreaks occur.

Included with these guidelines is a new Pandemic severity index that borrows from those meteorologists use with hurricanes. For example, a Category 1 pandemic would be a nuisance while a Category 5 would be on the scale of the 1918 flu that killed millions worldwide.

Also included is the release of a new government Web site — www.PandemicFlu.gov — managed by the Department of Health and Human Services.

The nation’s goal is to slow down a pandemic’s spread, she added and, essentially, to buy time.

“We all know that if a pandemic virus occurs the first thing we would do is try to extinguish it but that might not be feasible,” Gerberding conceded, despite various government agencies working together to create what they describe as “early, targeted, layered measures.”

“We’re not likely to have an effective vaccine in the first six months of a pandemic,” she added, reflecting general consensus that US and world supplies of anti-viral medications such as Tamiflu are in short supply.

“This is going to be really hard work,” said Dr. Martin Cetron, Director for the Division of Global Migration and Quarantine at the CDC, about creating tools and strategies to maximize the number of lives saved during a pandemic.

“One thing that would be much harder would be to come up with a solution on the fly in the midst of a pandemic. That would be really hard and almost insufferable.”

The podcast above is a recording of the Center for Disease Control Press Conference on Pandemic Flu Preparedness.

Unite For Sight® is a 501(c)(3) non-profit organization that empowers communities worldwide to improve eye health and eliminate preventable blindness. At Unite for Sight’s Third Annual International Health Conference at Yale University in April 2006, Unite For Sight partner ophthalmologists Dr. James Clarke (Accra, Ghana), Dr. T. Senthil (Chennai, India), and Dr. Seth Wanye (Tamale, Ghana) discussed eye care needs and Unite For Sight programs in their countries.

Unite For Sight works with eye clinics worldwide that previously attempted to provide free cataract surgeries and other eye care services in their community, but were precluded from doing so by lack of staffing and funding. Unite For Sight’s model engages students and lay persons (both local and visiting) as support staff to eye doctors in the field, thus enabling community-based screening programs led by eye clinics without the need for extensive paid staff. The volunteers and eye clinic’s doctors jointly provide daily screening outreach programs in rural communities, and transport patients to the base eye clinic for treatment and surgery. Unite For Sight funds the eye care for the patients, who receive the same quality of surgical care in the same facilities as those who can afford to pay.

Professor Karol Sikora, from Cancer Partners UK, recently spoke at the Building Better Businesses in Healthcare Conference in London. His presentation was titled: Modern Healthcare – Technological Dream or Economic Nightmare? Professor Sikora talks about the past, present and future of technology and its role in the UK health care system.

The conference was organized by Harley Street Direct.

Karol Sikora

Karol is Professor of Cancer Medicine and honorary Consultant Oncologist at Imperial College School of Medicine, Hammersmith Hospital, London where he was Clinical Director of Cancer Services for 12 years. He is Scientific Director of Medical Solutions PLC, Britain’s leading cancer diagnostic company and Special Adviser to HCA International in the creation of the London Cancer Group – the largest UK cancer network outside the NHS in HCA’s six major London private hospitals.

This includes the construction of a major new international cancer centre for care, teaching and research in London at the Harley St. Clinic with joint ventures with 5 major NHS Cancer Centres. He has recently been appointed Dean of Britain’s first independent Medical School at the Universities of Brunel and Buckingham.

He studied medical science and biochemistry at Cambridge, where he obtained a double first. After clinical training he became a house physician at The Middlesex Hospital and registrar in oncology at St Bartholomew’s Hospital.

He then became a research student at the MRC Laboratory for Molecular Biology in Cambridge working with Nobel Prize winner, Dr. Sydney Brenner. He obtained his PhD and then spent a year as a clinical fellow at Stanford University, California before returning to direct the Ludwig Institute in Cambridge. He has been Clinical Director for Cancer Services at Hammersmith for 12 years and established a major cancer research laboratory there funded by the Imperial Cancer Research Fund.

He became Deputy Director (Clinical Research) of the ICRF. From 1997 to 1999 he was Chief of the WHO Cancer Programme based in Lyon and from 1999 to 2002, Vice President, Global Clinical Research (Oncology) at Pharmacia Corporation.

Karol has published over 300 papers and written or edited 19 books including Treatment of Cancer – the standard British postgraduate textbook now going to its fifth edition. He is on the editorial board of several journals and is the founding editor of Gene Therapy and Cancer Strategy. He is a former member of the UK Health Department’s Expert Advisory Group on Cancer (the Calman-Hine Committee), the Committee on Safety of Medicines and remains an adviser to the WHO Cancer Programme.

Tam McDonald, CEO of Harley Street, provides the outsiders perspective on the US health care system. In the UK, which is a single-payor system, solutions to health care are determined centrally, by the government. While the UK spends half what we spend as a function of gross domestic product, the outcomes are higher. But there are stresses within the UK system as well. They have to make hard choices about where to spend tax dollars. Throwing more money at healthcare is not sustainable.

The UK will most likely see a devolution of responsibility from the National Health Service to the consumer. The idea that everyone can get everything all the time is vanishing fast.