Global Medical Tourism

As you know, medical procedure prices are extremely high in the United States. As an alternative to high U.S. prices, we have medical and dental provider locations in India. Until the last few years, people looked at countries outside the U.S. and its hospitals as inferior imitations of those in developed countries. Western expatriates as well as wealthier Third World “natives”, having very little trust in local hospitals or doctors, would fly to the United States for something as simple as an executive check-up.

In the past 30 years, the costs of health care have soared in developed countries, especially in the United States. Due to rapidly escalating health care costs, Americans, Europeans, Canadians and Australians in ever increasing numbers began to search for alternatives that could reduce their personal out of pocket medical expenses. In the last few years, millions of people from developed nations have chosen to become Medical Tourists.

Need a coronary bypass surgery that costs more than $150,000 in the U.S.? Simply pack your bags. Take a vacation, and pay $6,500. Need an elective Caesarean section? That’s about $1,000 including a four day hospital stay in a private room. How about a breast augmentation with smooth saline implants? Breast implants will cost you $2,000. If you are willing to travel, the list of more affordable medical procedures is seemingly endless: cardiac surgery, orthopedic surgery, weight loss procedures, cancer treatments, cosmetic surgery, general surgery, medications, infertility treatments, dental, glasses, stress reduction programs, neurosurgery, laparoscopic procedures, sex reassignment surgery, experimental treatments and so much more.

International rates are very low compared to what is paid in the United States, Europe or Australia. In some cases, the savings from dental work alone can give people extra money for a luxury vacation. For example, a family can take an expensive, four-star, luxury vacation in a Mexican Oceanside Villa and pay for the trip with the savings they receive on getting their glasses, medications and dental work from local providers. Medical Tourism can certainly be a win-win proposition. While taking care of health needs at deep discounts, shopping excursions, river tours, sight-seeing, nature excursions, intellectual pursuits, religious pilgrimages, cruises, ancient site tours, safaris, hunting or fishing trips and trips to nearby beaches can all be arranged around a medical appointment schedule. Medical Tourism is a simple concept: people can combine medical treatments with vacations, and use the savings on the medical care to pay for the vacation.

As with everything, there is one major drawback. Although most Americans have gone to a physician in the U.S. with international training, the majority of Americans remain very skeptical about traveling to other countries for their medical care. Logic mandates that there are international hospitals and health care professionals that can match those in the United States. Thus, the key is weeding through thousands of potential sources for international medical care and finding the right clinical provider, location and overall travel package.

At Medical Discounts International (MDI), we help consumers find international sources of U.S. equivalent medical care at affordable prices. MDI evaluates health care providers on five criteria: (1) the locations current geo-political issues, safety, security and weather; (2) the cost of services performed including the cost of transportation, food and lodging; (3) the convenience for the patient; (4) the quality standards as set and evaluated by an objective third party, and finally, (5) the local tourist and vacation attractions.

Medical Tourism is not for everyone, but it is a viable option for people who can not afford the high costs of health care in the United States.

Medical And Dental Treatment And Coverage In Oaxaca, Mexico

When I first gave up the practice of law in Toronto in favor of early retirement in Oaxaca, I assumed that the years I would add to my life by leading a much more stress-free existence in Mexico, would be lost by the inferior health care system to which I would be exposed, subjected and restricted. This, then, is my assessment of the extent to which my presuppositions have been accurate, together with information and advice for both vacationers to and would-be ex-patriot residents of Oaxaca.

Aside from the small, private hospitals, often referred to as clĂ­nicas, there are four publicly funded and insurance – based hospitals in the city, as well as a hospital just outside of the city offering specialized treatment for a number of serious ailments. There is the Red Cross facility available to all, often used for emergency treatment only. The civic hospital provides free services or treatment at a modest cost based on a sliding scale respecting means. ISSSTE is a federally funded facility restricted to government employees who are members of a union. Finally, there is IMSS, a federal insurance program available to ex-pat residents and Mexican citizens alike, with an extensive network of clinic doctors and a large hospital. It’s funding is provided in large part by business owners. Aside from these hospitals, there are several, small, easily accessed clinics scattered throughout suburban and rural neighborhoods.

For the vacationer, and the ex-pat with a VISA permitting residency in the country, the most common means by which to obtain emergency treatment is through Red Cross, IMSS (which accepts patients without coverage on a pay-per-service basis) or a private hospital. However, the last of these three is the only one in which you can be reasonably reassured of being attended in a timely fashion by extremely competent and efficient personnel.

WHAT TO DO AS A VACATIONER

If you do not have out-of-country healthcare coverage, by all means go out and buy it before leaving for your trip. However, it’s advisable to first inquire of your credit card company, to ascertain if in fact you already have at least some coverage simply by virtue of, for example, having a gold or platinum card. You can then make a more informed decision concerned whether or not to purchase coverage, and if so at what level. On the other hand, a broken leg, gastrointestinal problem or other non-life threatening ailment can be attended by a private doctor or clinic without breaking the bank. Of course for an outlay of more than $100, it’s nice to be reimbursed.

If you intend to make a claim to your private carrier, credit card company or government funded health care plan, ensure that you not only keep all receipts, but request a written diagnosis and treatment plan, and that the prescriptions you are given indicate for what purpose each medicine is being prescribed (i.e. antibiotic, analgesic, etc.). Many doctors provide all required information simply as a matter of course. Accepted practice, at least except for when narcotic medications are being prescribed, is for the pharmacy to return prescription forms to you. Often medical plans require translations of each document that is presented to them as a prerequisite for processing and reimbursement. When in doubt, submit all documentation with your claim, making sure to determine if originals are required, and keep copies. Frequently, as is the case with Ontario, it’s a two step process. Treatment receipts and diagnosis is submitted to the provincial plan. Once you’re notified of the portion not covered, prescription receipts together with a request for reimbursement for the amount not covered by the province, is submitted to one’s private plan. In theory, between the two plans, 100% reimbursement is achieved.

You can ask the manager of your hotel or bed and breakfast to do you a favor by translating each of your supporting documents, to save you the trouble upon your return home. Make a note of the then prevailing rate of exchange, and submit a calculation to your plan with your documentation, to more easily facilitate payment. When a member of a clerical staff is processing your claim, he’ll be less inclined to put yours aside for another day or week if it already contains all the necessary and relevant data, organized in a readable format.

Concerning where to go in the event of illness or emergency, your accommodations host should be able to make recommendations for English speaking physicians with private practices, and for private clinics. Regarding competency of the former, while there is a medical school in Oaxaca, many doctors travel out-of-state for their post-graduate training such as to universities in Mexico City or the US, and regularly attend conferences and upgrading courses. Some travel abroad within the context of their specialization training. Indeed the Oaxacan populace appears to take notice of and prefer those physicians who are able to display foreign diplomas.

Our personal experience with emergency treatment over the past 10 years has been nothing but positive for ourselves, our family and our guests, at hospitals Carmen and Molina, both downtown … in terms of competence, speed with which one is attended, and the presence of English speaking ER doctors. On the other hand, we cannot recommend the emergency departments at the civic hospital or IMSS because of delays in receiving treatment, and at minimum in the case of IMSS unavailability of competent medical personnel 24 hours a day to attend to even a commonplace emergency (i.e. suturing). Having said this, many excellent surgeons with private practices perform surgery at the non-private hospitals where there tends to be the more state-of-the-art and sophisticated equipment.

The normal range in price for a consultation with a family doctor, specialist or dentist, is $20 – $50 (all figures are stated in US dollars and are approximate for 2008 unless stated otherwise).

PURELY ELECTIVE AND COSMETIC PROCEDURES

Over the past several years Oaxaca has become a popular destination for Americans and Canadians seeking both plastic surgery and extensive dental work. Word has spread of the competence and quality of work of both nip-and-tuck and dental surgeons, and of course of their extremely reasonable charges relative to those paid to hometown practitioners. Many foreigners, as well as Mexicans from Mexico City and other regions of the country come to Oaxaca for face lifts, breast reductions and augmentations, liposuction and other appearance enhancing procedures. A friend who attended for plastic surgery in Oaxaca by a well-known plastic surgeon a couple of years ago, recently commented that she had read an article in a Canadian magazine indicating the cost for the same procedure which she had performed for $500, was $3500 – $5000 at home. In effect she had a free trip to Oaxaca, and returned home with extra money in her pocket.

Our personal experience with dental treatment has been extremely positive. Cost tends to be about a third to a half of American and Canadian prices, for example for crowns and bridges, implants, root canals, gum and bone work, etc. While the use of nitrous oxide (laughing gas) has not yet arrived in most Mexican cities, a dentist with a gentle touch can more than make up for that lack of temporary high while in the chair.

RESOLVING THE EX-PAT CONUNDRUM

Get whatever coverage is made available to you both in your homeland and in Mexico, subject of course to affordability.

To my thinking, with IMSS coverage costing under $400 annually for a couple, why not go for it regardless of what other coverage you already have. Then supplement IMSS with international coverage for catastrophic injuries unless you have other similar insurance from another source. Our Oaxacan friends tend to disagree, but theirs is a different mindset where insurance in general has historically not been stressed or valued, be it home, car or health.

Some American acquaintances swear by IMSS since it provides regular care including preventive procedures, all dispensed by government employed physicians including specialists, together with lab tests, medication and hospitalization. There are restrictions the first year of enrolment, and there are caveats. The level of cleanliness in the clinic environment tends to be below the standard to which most of us have become accustomed growing up in the US and Canada. Many physicians have not received the quality of medical education of their private counterparts. The medications provided through the clinic pharmacy are often not the best available in the marketplace for treatment of a particular ailment, because of cost. Often the wait to see your designated doctor or for your lab tests can be long, requiring a half day commitment for each step in the process: visiting a general physician, going for one set of tests, then for another, and finally seeing a specialist.

So why bother with IMSS at all, with all these downsides? It’s a failsafe, another form of assurance that you’ll be cared for in the event of a lengthy and serious illness. As suggested earlier, often it’s the largest hospitals such as IMSS which have the best equipment, and surgeons with private practices who perform some of the surgeries. And there is no additional cost for hospitalization once you have full IMSS coverage. While attending a private clinic is more akin to your experiences before moving to Mexico, if you must remain in hospital for a lengthy period of time, the cost of doing so in a clinic could be prohibitive…just like back home.

Visiting private physicians, and even biting the bullet and getting your tests done at privately owned laboratories, reasonably assures you of a familiar quality of care. Coupled with IMSS coverage, you can now be confident that you’re covered in almost all respects. In the event of a protracted hospital stay you can afford to be there for as long as necessary. The best locally available equipment will be used in your diagnosis and treatment, and you have a reasonable likelihood that attending surgeons are those who split their time between private practice and clinic work, and performing procedures in one or more large hospitals.

We maintain IMSS coverage, but rarely use it, preferring to tap our Oaxacan social networks for referrals to specialists to the extent they are required. And in any event, after having been resident in Oaxaca for a few years, those of us who are in our fifties or older have already been introduced to a broad range of specialists. As strange as it still is to be a Canadian and subscribe to the pay-as-you-play philosophy of medical care, it serves our purposes, with the IMSS safety net just in case.

Under certain circumstances you may not want to rely on even the best Oaxaca has to offer. Indeed the stream of Oaxacans traveling to Mexico City flows briskly and wide. The middle and upper classes with contacts in the nation’s capital, there quickly seek out the best in terms of physicians and state-of-the-art equipment, for diagnosis and for treatment of life-threatening diseases.

Even doctors working in Oaxaca at the IMSS and ISSSTE hospitals can make arrangements for patients to receive treatment not available here, to be attended in Mexico City or other larger centers. However, the process can be slow. We know of one case, that of a two-month-old baby with heart problems, who was finally sent to Puebla for surgery at ISSSTE, only to die before the procedure could be performed.

The solution, unless you have quality foreign coverage perhaps as part of your retirement pension plan, is to buy insurance which will pay for treatment in Mexico City, or better yet throughout the world as long as you can make your way to one of the participating top-of-the-line hospitals. In my case, I have a low annual premium, with high deductible which is waived in the event of accident. Again, it’s a failsafe mechanism in the event of, for example, a serious car accident, or cancer, stroke, heart attack, or other catastrophic ailment which would otherwise not be affordable. Oaxaca has less than the best of diagnostic equipment and treatment facilities. My plan provides for a $10,000 deductible, $2,000 annual premium, with member private hospitals in Oaxaca, Mexico City and elsewhere in the republic, and of course abroad including the US, with the Mayo Clinic in Rochester being a participant.

In summary, my medical coverage and plan for treatment is the following. We have our regular family physician, who, along with our Oaxacan friends, refers us to specialists in which we have the utmost confidence, and to whom we pay per visit. The same holds true for dental treatment. We have IMSS coverage which we reluctantly (because we don’t use it) renew on an annual basis, but believe it’s worth the price in the event we need extended hospitalization, or to have surgical procedures performed not available in private clinics. And I have my catastrophic coverage which hopefully I’ll never need to access.

Medical care and coverage can be inexpensive, and just as easily it can be costly. It’s a matter of the individual or family having a philosophy, or set of priorities, before electing to move to Oaxaca. You have to determine how you want to lead your life in terms of balancing having less disposable income as a result of medical and insurance costs, with having greater peace of mind in knowing that whatever is thrown your way will be looked after as best possible given your new life in a foreign land. If you cannot achieve a level of comfort in the resolution of these issues and decisions, then perhaps the move is not for you.

Dental Tips – All About Meth Mouth

Speed, chalk, ice, crystal, glass. No matter what you call the addictive stimulant, Methamphetamine use is skyrocketing and so is the number of cases of meth mouth across the nation. Dulled and rotting smiles plagued by oral health issues such as tooth loss, gum disease and tooth decay are all considered symptoms of heavy methamphetamine use, and that is nothing to smile about.

The National Institute on Drug Abuse estimates that over 10 million Americans have tried methamphetamine and more than 1.4 million are habitual users of the substance. The last results of the National Survey on Drug Use and Health indicated that 850,000 Americans age 12 and older had abused methamphetamine at least once in the year prior to being questioned (2008). The number is so large as the white, odorless, bitter tasting power drug is versatile and can be consumed in a number of ways, including snorting, shooting and smoking the drug.

No matter how the drug is ingested, those statistics are alarming. Methamphetamine is toxic to the nervous system and can cause numerous health problems. Meth users usually get hooked on the drug as they may feel alert, awake and ready to conquer the world, but behind the scenes users are at a greater risk for:

  • Developing health issues related to the rapid heart rate, irregular heartbeat, raised blood pressure and increased body temperature caused by ingesting the substance.
  • Mood swings
  • Violent Behavior
  • Anxiety
  • Confusion
  • Sleep disorders including insomnia
  • HIV/AIDS
  • Hepatitis
  • Dental Problems

Dental problems in methamphetamine users are also known as “meth mouth” and typical characteristics of the condition include blackened, stained, rotting and crumbling teeth. The drug itself is not the cause of the dental issues, but users on a high from the substance will be at a greater risk for:

  • Bruxism: Bruxism is also known as teeth clenching and grinding and the act can cause enamel damage. When high, meth users have no concept of how often they are clenching and grinding and that can lead to worn down and cracked tooth enamel.
  • Lack of Oral Hygiene: Brushing and flossing daily are essential components associated with good oral health. However, a healthy smile will be the last concern of a habitual meth user. Neglect is one such issue that can lead to tooth decay.
  • Dry Mouth: Saliva production is essential to oral health as the natural process can rinse the mouth of bacteria and spare food particles. However, meth may cause a person to nod off for days, sleep with their mouths open and slow down the natural production of the fluid. That lack of moisture can increase tooth decay concentrated (but not exclusive) to the gum line.

New research indicates that dentists may be the first line of defense in diagnosis the condition of meth mouth and may be able to find closeted drug users among their patients. With this knowledge, it would be up to the oral health care practitioner to help their patient get both the medical and dental treatment they need to help curb their addictions. In response to this thinking, The National Institutes of Health’s National Institute on Drug Abuse recently granted the UCLA School of Dentistry a whopping $1.86 million to study the oral and dental consequences of methamphetamine use.

Individual Health And Dental Insurance Deals

Looking for a good deal on individual health and dental insurance? Finding the right health insurance is quite difficult today. Even more difficult is finding the right insurance package deal, but it is not impossible. There are thousands of health insurance providers who are competing to stay on top and the only way they can do this is when people like you and me buy their services. Different companies offer different types of plans. While some offer only general health insurance, there are others which offer package deals including individual health and dental insurance.

Different plans also have different costs, deductibles and premiums and these details are something that you have to be really careful about when purchasing an individual health and dental insurance package. Here are some of the important things that you may have to consider in order to get the best package deal at an affordable price.

1. How much is the monthly premium – when companies offer package deal such as health and dental, they charge slightly higher premium. This is much better than buying separate health and dental plans, but is the amount of premium something that you will be able to afford? Combining two or more services per plan is a good idea, but may not be affordable for many. Before choosing your package deal, make sure that you can afford monthly premium.

2. How much extra you have to pay when you make a claim – there are some plans which require you to pay something extra when you visit your doctor. This amount is usually a fixed amount and has to be paid out of pocket. The amount you pay depends on whether the health care provider belongs to the network of the insurance company and on the type of treatment you have received. When shopping around for a health and dental policy, make sure that the costs are mentioned clearly in the plan.

3. How much are the deductibles – before your coverage starts, you may be required to pay a certain amount of money out of your pocket. This amount usually determines the amount of monthly premiums you will pay. If you pay a higher deductible, you will be required to pay a lower monthly premium. When comparing insurance plans, make sure that you know how much your deductible will be.

4. How much extra you have to pay from your pocket – sometimes, apart from the deductibles, you have to pay a percentage of your medical costs. This is usually less than 30 percent, but you must find out what exactly is stated in your policy.

5. Which doctors can you receive treatment from – there are certain plans which have their own list of doctors and dentists that you can visit. However, there are some plans where you are free to choose your own health care provider. When you choose your own, you will be required to pay a higher premium and when you utilize the services of those professionals who belong to the insurance company’s network, you pay less premium. Compare to see which plan offers the most benefits and is also budget-friendly.

How to Tell If You Might Need TMJ Dental Treatment

Temporomandibular Joint Dysfunction (TMJ) is a painful condition in which your jaw joints are no longer in the optimal position. This causes pain and dysfunction when it comes to moving your jaw, and can also lead to damage in the jaw joint and your teeth. Many people actually suffer from this painful condition, however, there are a various TMJ dental treatments that can help. If you are wondering if you might have TMJ, consider the symptoms listed below and see whether or not any apply to you. If they do, it would be good to see your dentist for further evaluation.

A few of the common symptoms those suffering from TMJ dental issues might notice include a clicking or popping noise when opening and closing the jaw, difficulty in opening and closing the mouth, teeth grinding either during the night or the day, and pain in the jaw. A dentist might also point out that you have extra wear on your teeth, and you might have pain in your teeth that the dentist can’t come up with a reason for. Your jaw might have shifted so that your bite is different, meaning that your teeth come together in a different way than they used to.

Besides the primary symptoms that are associated with TMJ dental problems, there are some secondary symptoms that many people also suffer from. These are usually caused by the symptoms mentioned above. For example, the tension in your jaw and the teeth grinding might cause you to have unexplained headaches or migraines, or make your facial muscles sore. Sometimes symptoms are also noticed in the ears, since this area is near the temporomandibular joint. These symptoms might include ringing, pain, or a stuffy feeling in the ears. Those with more advanced cases might also start to get pain in their neck and shoulders because you might be creating tension in them to try to alleviate the lesson the work required by other muscles due to the TMJ.

Although sometimes TMJ dental symptoms do go away on their own, if you have a persistent problem that starts to get worse it is time to see about getting a proper diagnosis and treatment. Some of the symptoms associated with TMJ are also associated with other, possibly more serious, medical conditions, so it is a good idea to get checked out so that you can determine the cause and proper treatment for your condition.