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CONTENTS

Medical Spotlight: Varicose Vein Removal

Across the Border Treatment for ALS

Early Retirement and Medical Travel

Kay Brooks Lauds Medical Care, Treatment - and Caring - in Israel

Change Begins at Home: Government Health Care Programs May Consider Medical Travel to Save Money, Enhance Quality

Tips for Medical Travelers

Hot Spot Destinations
Israel
Singapore
Tunisia

Travel Tips

Latest News in Medical Travel

The information in Medical Travel Today and Your Medical Travel is believed to be accurate, but in some instances, may represent opinion or judgment.  The newsletter's providers do not guarantee the accuracy or completeness of any of the information and shall not be liable for any loss or damage caused - directly or indirectly - by or from the information.  All information should be considered a supplement to - and not a substitute for - the care provided by a licensed healthcare provider or other appropriate expert.  The appearance of advertising in this newsletter should in no way be interpreted as a product or service endorsement by the newsletter's providers.

Hot Spot Destinations

Israel

Complicated procedures including surgeries on the hip, eye, brain, and nervous system are available

Top quality medical facilities

Comfortable climate

Dead Sea and other healing and historical sites are located in Israel

Visit Israel Medical Tour for more information regarding medical tourism in Israel.

Singapore

Approximately 410,000 people visited in 2006 for medical care alone

Known for its beautiful sites and booming economy

Consists of superb medical centers and specialty hospitals

Home to many medical firsts

Costs are 60-80% less than the U.S.

To learn more about medical travel to Singapore, visit Parkway Health.

TunisiaTunisia

Tunisia is geographically convenient to Europe

Offers modern and specialized private medical clinics

This north African country possesses golden beaches, museums, golf and beautiful weather

Prices are 50% of those in Europe and the United States for the same procedure.

For more information about medical travel in Tunisia, please click here.

Travel Tips



What would a vacation be like if you left the camera at home? Or ran out of an important prescription when miles away from home? People are often flustered and have the feeling they've left something important behind when preparing to travel.
Read more...

Headlines in Medical Tourism
Medical Tourism: Why your HMO may send you to India for surgery

Daily Finance- February 19   Would you fly to Turkey for a heart bypass operation? What if you could be assured that the facilities and staff were equal to or better than what you would find at home? What if, by doing so, you could put $15,000 in your pocket?

Parents seek fertility treatments across the border Calgary Herald - February 16 Inside the sleek offices of Seattle Reproductive Medicine in Washington state, Dr. Paul Lin and other physicians often see Canadian couples eager to buy what isn't for sale in their own country: pregnancy with a donor egg.

Medical Tourism Closer to Home
Human Resource Executive Online - February 10 Medical tourism has become a viable option for uninsured or under-insured individuals in need of medical procedures. 

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Dear Medical Traveler,

Welcome to Your Medical Travel: your resource for tips and information on the newest topics in medical tourism.

Questions? Comments? Contact Alyson Kuritz at editor@yourmedicaltravel.com

Visit our Web site Your Medical Travel for more information.

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Medical Spotlight: Varicose Vein Removal

Varicose veins are a prevalent and painful condition. Varicose veins are caused when the valve of a deeper large vein in the leg begins to leak blood back into smaller veins near the surface of the leg, often due to a faulty valve. The smaller veins become stretched and painful swelling can occurs. This swelling can be debilitating as standing and walking increases the pressure in the veins in the legs.

When prescribed exercises or compression stockings fail to bring relief, two types of treatment are typically prescribed: surgery or laser removal.

Surgery options include stripping the vein, ambulatory phlebectomy, or endoscopic vein surgery. In most cases laser vein removal is considered cosmetic and is not covered by insurance.

COST FOR VARICOSE VEIN SURGERY

U.S. Inpatient Price U.S. Outpatient Price Average of 3 Lowest Foreign Prices Including Travel Cost
$7,993 $2,685 $1,576

Source: Mattoo A. and Rathindran R.
"Does Health Insurance Trade Impede Trade in Healthcare Services"
World Bank Policy Research Working Paper 3667,  July 2005

Stripping is usually done under general anesthesia with the goal of removing the leaking. The vein is tied off using a small wire inserted into the vein through an incision at the groin. The wire is inserted through the length of the vein. The vein is then stripped out through a second incision. This option may require an overnight stay and a full recovery can take up to two weeks. 

Ambulatory phlebectomy removes varicose veins on the surface of the legs. Performed under local anesthesia, it involves making tiny incisions through which the varicose veins are removed. Because veins are very collapsible, even large veins may be removed through the tiny incisions used in this technique. No stitches are required. The patient is able to walk following the procedure.

Endoscopic vein surgery usually is used only in severe cases when varicose veins are causing skin ulcers. Performed under general anesthesia, endoscopic vein surgery, involves creating a small incision near the vein. The doctor then inserts a tiny camera at the end of a thin tube to move through the vein. A surgical device at the end of the camera is used to close the vein. A full recovery may take a month or more.

The least invasive option for addressing varicose veins is laser vein removal. Performed under local anesthesia the surgeon, guided by ultrasound, uses a needle to insert a wire through an incision in the main problematic vein. The wire then guides the placement of a catheter and small laser through the entire vein. The surgeon activates the laser and pulls it back out of the vein. The laser collapses the vein walls, which effectively stops the blood from leaking back into the smaller leg veins. After an observation period of up to six hours patients can usually walk out of the doctor's office.

Across the Border Treatment for ALS

Thanks to the Greater New York Chapter of the ALS Foundation, Your Medical Travel had the opportunity to interview Bev, a woman who traveled to Mexico in hopes of getting positive treatment for her husband, who had been diagnosed with ALS.

About ALS
Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease that attacks nerve cells in the brain and spinal cord resulting in muscle weakness and atrophy. Because of the degenerative nature of ALS, there can be significant costs for medical care, equipment, and home health care as the disease progresses. Approximately 5,600 people in the United States are diagnosed with ALS each year. It is estimated that as many as 30,000 Americans may have the disease at any given time. ALS can strike anyone as it occurs throughout the world with no racial, ethnic, or socioeconomic boundaries.

YMT: How is ALS diagnosed?
B: Everybody is different.  For some victims, it starts with slurred speech.  This happened in my husband's case.  Toward the end of the day his speech would become extremely slurred, and I thought that he had been drinking.  Time went on and he would complain that his neck would hurt him and his walking was just not right.   The last straw happened one morning when he brought back pancakes from McDonald's.  By the time he was able to spread the butter on his meal, his pancakes were cold.  We went to the cardiologist thinking that it could be stroke-related.  He went through further testing -- had needles stuck in his face and hands.  The following week I got a call, confirming that it was ALS. 

YMT: What treatment is available?
B: There is medication available to slow the process, but not make it go away. We went to Beth Israel for treatment, but the whole process is extremely overwhelming.  In fact, I had to go to the appointments with a tape recorder because I didn't want to miss one thing that the doctor was saying.  We were automatically placed on Medicare, which helped with the financial burden tremendously.   Medicare also helped him get a home health aide.  After some time there, friends persuaded us to travel to Mexico for three weeks.  There is a treatment center there called American Biologics, which offers all organic food and drips. 

YMT: Where in Mexico did you travel?
B: We went to Tijuana, Mexico.

YMT: What was your experience like in Mexico?  How were the accommodations/medical personnel?
B: We flew to San Diego and were picked up by the center and taken over the border.  We stayed in a nice hospital room, and we were given three meals a day.  The people were very nice and supportive.  They provided my husband's medication and offered all organic food.  It was a fun time.  We met other people, and I was happy to spend quality time with him.  He had a great experience.

YMT:  What was the follow-up care like?
B: We had periodic conference calls with them to give updates and see what they would recommend. This lasted for about two months. 

YMT: Do you have any suggestions to offer others?
B: Get acquainted with a Hoyer lift as early as possible. This will be used constantly to help lift for activities like going to the bathroom.  I would also recommend getting involved with the ALS Association.  They were my rock and advised me on every step of the way.  It is a lonely disease, so it is also important to receive support from family and friends.  Home health aides were an enormous help with lifting, but there is no replacement for family.

About the ALS Association of Greater New York
As one of the ALS Association's leading chapters, the Greater New York Chapter covers Long Island, New York City, Westchester, and Rockland Counties and Northern and Central New Jersey. It plays a major role in promoting the mission to lead the fight to cure and treat ALS. The ALS Association is the only national, not-for-profit voluntary health organization dedicated solely to the fight against ALS. ALSA is a member of the National Health Council.

Early Retirement and Medical Travel


If you would like to share your medical tourism experience with our readers, please contact the Editor at editor@yourmedicaltravel.com.

Medical Vacations: The Retiree Health Care Solution?
By Billy and Akaisha Kaderli

Excerpted with permission from The Adventurer's Guide to Early Retirement, 3rd Edition, RetireEarlyLifestyle.com

The debate over U.S. health care reform rages on. But you don't have to wait for someone else to dictate your future. You have many options -- if you're willing to take a vacation. If recovering from a medical procedure while lying on a palm-swept beach, relaxing by the hotel pool, or shopping for terrific bargains sounds good, then medical vacations may be the right solution for you.

From hip replacement to heart surgery, more people are discovering the advantages of traveling abroad for their medical needs.

A big growth industry
In just the past few years, medical vacations have gone from a tiny niche market to an impressive growth story with substantial market-share gains. From Mexico to India, Costa Rica to Thailand, hospitals are taking advantage of this global trend. And U.S. companies are taking note as well. Aetna (NYSE: AET) and Blue Cross Blue Shield of South Carolina are among the health care companies tailoring their corporate health insurance plans to give employees the opportunity to head to India or elsewhere for surgeries such as knee replacements and the more modern, less invasive approach to hip replacement, hip resurfacing.

In the Western Hemisphere, Costa Rica is currently the "in" destination for travelers, especially for dental and cosmetic surgery needs. You can schedule online and receive a custom-made package, appointment, and prices in your e-mail response.

For years, people in the American Southwest have capitalized on the high-quality dental work available south of the border for a fraction of U.S. prices. Now more people are traveling to Guadalajara in Mexico for body augmentation and other surgeries, too. Many of the doctors there are U.S.-trained, and the equipment is top of the line. (We know, because we've used it.)

In Asia, one of the world's most acclaimed hospitals is located in Bangkok, Thailand. Bumrungrad looks more like a five-star hotel than a medical facility -- until you get to the third floor. World leaders from around the globe fly here for medical procedures. Bumrungrad's Web site is user-friendly, as is its professional, English-speaking staff. The hospital has more than 200 surgeons who are board-certified in the United States. We have quipped many times that the cheapest health care plan is an air ticket to Bangkok.

Also close by is the Bangkok Heart Hospital. Both of these facilities are located in the center of the city, with easy access to shopping and attractions. If necessary, they will arrange your hotel stay along with the medical procedure you're having performed, all without waiting times or disqualifications. Your entire extensive physical will be done in one morning, with your blood results and consultation that afternoon. In and out in a single day. How's that for service?

Is it safe?
Many people interested in medical tourism are concerned about the quality and safety of going abroad for technical and complex medical care -- and how to get post-operative care once they return home. All of the hospitals mentioned here use the latest equipment and are either internationally accredited facilities or have U.S.-trained physicians on staff. Some U.S. health plans also provide an in-state network of physicians who will treat a patient who's gone abroad for medical care. The one thing that sets these hospitals apart from many of their U.S. counterparts is their attention to customer service -- they are professional and courteous in a way you rarely see anymore at home.

According to 2005 statistics from the University of Delaware, Escorts Heart Institute in Delhi and Faridabad, India, performs nearly 15,000 heart operations every year, and the death rate among patients during surgery is only 0.8 percent -- less than half that of most major hospitals in the United States. India also has top-notch centers for hip and knee replacement, cosmetic surgery, dentistry, bone marrow transplants, and cancer therapy. Virtually all of these clinics are equipped with the latest electronic and medical diagnostic equipment.

Sounds good, but what's the cost?
Even though you get high-quality care at these hospitals, prices are quite a bit lower than what you'll find in the United States. Several sources report big cost savings in recent years for many procedures. For example, coronary angiography in Bangkok costs less than $900. A metal-free dental bridge that runs $5,500 in the United States costs about $500 in India, and a knee replacement in Thailand with six days of physical therapy costs about a fifth of what it would in the United States. Cosmetic surgery savings are even greater. A full facelift that might cost $20,000 in the United States runs about $1,250 in South Africa.

The attraction is straightforward. The costs for everything from facelifts, dental implants, or hormone therapy to reverse the signs of aging can be one-half or less for comparable procedures in the United States. Have your surgery, then recover and recuperate in a beautiful mountain setting or at a resort hotel.

Most procedures can be found online, letting you know what's included in the cost. The figure quoted to you will cover everything, including follow-up visits. There are no hidden charges, and the price includes the room, doctor, and staff.

If you'd like to retire soon, but you're held back by health care issues, or if you've got the health care blues and need a holiday break, why not do some research online and take a vacation?
And when it's time to recover, don't forget your suntan lotion.

Kay Brooks Lauds Medical Care, Treatment - and Caring - in Israel

Kay Brooks, an American who now lives in Aqaba, Jordan, wrenched her knee while climbing a high rock step a few months ago.  She didn't know what was wrong or what to do, and was unsuccessful in getting an appropriate diagnosis or treatment in the locality of southern Jordan.

Thanks to a referral from two American women who had traveled to Israel for knee replacement in January, Kay connected with IMS Israel, the leading medical travel resource for accessing quality medical care in Israel.

"Ira Nissel, president of IMS, is wonderful and personally interested in each and every patient," says Kay.  "He seemed to always have time for every question or need.  He was like a guardian angel in this whole process."

Kay says that Ira made all her arrangements including official letters to facilitate crossing the southern border between Jordan and Israel and for use at the airport in Eilat, Israel; flight recommendations; transportation from Ben Gurion Airport in Tel Aviv; comfortable and convenient lodging in the Tel Aviv area; an MRI appointment for the injured knee; and two consultations with the highly recommended orthopedic surgeon, Dr. Yehuda Amit at Sheba Medical Center.  Ira also arranged for all local transportation. 

Later, per Dr. Amit's diagnosis and prescribed treatment for a separate problem with chronic foot pain, Ira made the two appointments needed to help with that condition (custom-made foot orthotics).  He made sure she got to the appointments and subsequently, wherever else she needed to go.

"I made only my flight reservations and he did everything else," she says.  "From the time I arrived in Tel Aviv until I left, I never felt alone or without help. I was never apprehensive because I knew that Ira would take care of all the details.  This was a huge relief, and made the whole process possible.  He and his wife even visited me my first night in Tel Aviv to make sure I was okay and that everything I might need was taken care of."

She reports that Ira was able to make the appointments for her with Dr. Amit in a surprisingly short time, and also the MRI appointment. 

"From the time of my request for assistance to the time of my receiving the very highest quality medical attention was only a few days, nothing like weeks or months.  I was amazed," said Brooks.

It turned out Kay did not require knee surgery at this time, and is very relieved to know what her condition is (primarily one of cartilage degeneration).  She understands what she can and cannot do as well as what to expect in the future - possibly a periodic series of therapeutic injections into the knee which Dr. Amit would be available to administer on a return visit.

 According to Nissel, IMS clients always get the red carpet treatment. 

"The beauty of IMS is that we are involved in helping patients access high quality medical treatment and medical solutions - in addition to all the other ancillary services," adds Nissel. "This is a great value add for every patient."

Change Begins at Home: Government Health Care Programs May Consider Medical Travel to Save Money, Enhance Quality

DENVER, Co. - January 22, 2009 -  Medical travel provides a unique opportunity for the U.S.  Medicare and Medicaid programs to lower health care costs, especially during an economic downturn, suggests BridgeHealth International, Inc., the premier provider of medical travel services aimed at guiding health plans, insurance carriers, employers, third party administrators, individuals accessing benefits via voluntary benefits plans, health and affinity card programs or Consumer Directed Health Care Plans (CDHP), and individual consumers seeking medical travel options.  

"Medicare recipients living abroad already access care at international hospitals and those living in the United States also deserve these opportunities, with the same access to high quality, cost effective care," says Victor Lazzaro, Jr., CEO of BridgeHealth.  "This viable opportunity should extend to Medicaid beneficiaries within the U.S. because the pressures to reduce costs are great, especially in this current economic crisis, and quality shouldn't be sacrificed."

BridgeHealth International already facilitates similar programs with the U. K.'s National Health Service (NHS) for its members to travel within the European Union for care.  Since its launch 60 years ago, the NHS has grown to become the world's largest publicly funded health service. It is also one of the most efficient and comprehensive models, with the philosophy that good health care should be universal, regardless of wealth. The NHS is free at the point of use for more than 60 million U.K. residents. It covers everything from prenatal screening and routine treatments for coughs and colds to open heart surgery, accident and emergency treatment, and end-of-life care.

"BridgeHealth International coordinates travel within the European Union for people covered by the National Health Service," Lazzaro concludes.  "If similarly replicated within the United States, medical travel programs for Medicaid and Medicare recipients will significantly enhance quality, accessibility and cost savings. Change begins at home."

About BridgeHealth International, Inc.
BridgeHealth International, Inc. (BridgeHealth) is the premier service provider in the burgeoning medical travel industry, founded with a vision "to create a trusted bridge to the world of international healthcare." BridgeHealth serves health plans, insurance carriers, employers, third party administrators, individuals accessing benefits via voluntary benefits plans, health and affinity card programs or Consumer Directed Health Care Plans (CDHP), and individual consumers seeking medical travel options.  Visit www.bridgehealthinternational.com.

Tips for Medical Travelers

Traveling can be a very exciting time, but don't let your enthusiasm keep you from remembering important documents and information.  Here are some vital things to consider when traveling, courtesy of Travel Doctor.

  1. Make copies of all important documents. Some items you should copy include tickets, driver's license, passport, visas, medical documents, and prescriptions.  You should leave the copies with a family member or friend who can send you the back-up copies if needed.  It is also a good idea to leave your itinerary with a trusted friend to ensure that someone knows where you are supposed to be at all times.  
  2. Familiarize yourself with the local laws and customs.  Different countries have different customs when it comes to tipping, eating, and greetings.  It is important to remember that you are a visitor in their country and that you should respect their standards.  In addition to customs, the laws can vary tremendously from country to country.  To avoid hassle and trouble, research the local laws of your destination before traveling. 
  3. Never leave luggage unattended.  This may seem like common sense, but it only takes a second to turn what would have been a relaxing retreat into a search for all new clothes, shoes, accessories, and other necessities. 
  4. Do not use your home address on your luggage tags.  There is no need to advertise your home address.  It is safer to place a business card in the luggage tag.  You might also want to place one inside the bag for extra identification. 
  5. Try to blend in.  Do not wear flashy jewelry or conspicuous clothing; this will send a flag to locals.  Taking out large wads of cash to make a purchase can make you a target for theft.  Plan for the day ahead of you: how much money you will need, how many credit cards to bring (if any), and what to wear. 
  6. Take note of where your local embassy is located.  If anything does go wrong, you will want to know how to contact those from your own country.   The embassy is your connection to your home country and can help if you lose your passport or run into any trouble. 

For more tips, please visit Travel Doctor.

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Copyright © 2009 Your Medical Travel is published by CPR Communications.
Information in this newsletter should not be considered as medical advice.