Fred Schuler is the type of guy you’d want to have a pitcher with within two minutes of speaking to him. He’s affable and funny –- he laughs easily and regularly –- and seems like he’d have a lot of great stories, given his peripatetic lifestyle as a professional golf caddy on the PGA and LPGA tour circuit. But ask Schuler to describe the crippling pain that took him off the green and put him into a wheelchair for two months, and you can practically hear the 61-year-old wince.
“Other than excruciating?" Schuler asked gamely. “I was living on Aleve and Tylenol. I couldn’t straighten up, I was hunched over. Toward the end I could walk 100 yards [with a cane] and then I was toast."
After living with the pain for almost four years, Schuler had few options: He was uninsured and out of a job, thanks to his debilitating disc problems. An orthopedic surgeon Schuler met at work offered to treat him for free. But upon examining his X-rays he realized Schuler’s condition was far worse than he’d thought.
“I exercised every avenue I could in terms of getting public assistance to get some medical health here and kept running into dead ends," Schuler said.
That’s when Schuler turned to a solution more post-50 Americans are considering as healthcare costs continue to rise: medical tourism.
Once only something done by the incredibly wealthy, medical tourism is "really turning into something people understand," said Josef Woodman, CEO of Patients Beyond Borders, which produces guidebooks on medical travel. The organization estimates that in 2012, 600,000 people will travel abroad for treatment -- a number anticipated to grow 15 to 20 percent annually as boomers age.
"Our population is continuing to age into financially challenging procedures,” Woodman said. "Every month the insurance companies find a way to take benefits off the table. Each month there is a slightly bigger piece of the population pie that is going to find the cost savings very attractive."
"I would tend to say that 80 percent or more of the people using medical tourism are baby boomers," said Rajesh Rao, CEO of IndUSHealth, a medical travel program provider for patients and employer health care plans. "I would say the bulk of utilization happens with baby boomers just because they’re at an age where they need more intervention."
Most of the people deciding to go abroad for treatments that are unaffordable in the United States are paying out of pocket. But with the cost of a round-trip ticket (or two, if they decide to bring along a companion), treatment and hotel accommodations, is it really that much cheaper?
The answer is a resounding yes, say experts, doctors and patients like Schuler.
A survey conducted by Patients Beyond Borders shows the jaw-dropping differences in cost. In 2011, you could pay $88,000 for a coronary artery bypass graft in the U.S., or $9,500 in India (which saw the highest average savings, at 65 to 90 percent). For a hip replacement in Mexico, it’s $12,500 instead of $33,000 on average in the States.
And for those uninsured adults -– 16.5 percent of Americans between the ages of 45 and 64 in 2010 -- that extra “$20,000-$30,000 ... can be the difference between refinancing your home” and being out thousands, said Woodman.
So given all the cost benefits, why hasn’t medical tourism taken off?
"We’re so used to the adage that you get what you pay for, it takes a little thinking outside of the box," Rao said. "By just going outside, you end up getting a lot better quality and a lot better care for a lower cost. Until you actually see it, it’s hard to believe."
Yet that same adage still may apply on a case-by-case basis, said Dr. Doug Lundy, an orthopedic trauma surgeon at [Resurgens Orthopaedics in Atlanta.
Some patients who travel outside the U.S. for care are treated extremely well, Lundy said. "And sometimes you look at it, hold your breath and think, 'Wow, you paid so much money for this and you got substandard work done.' Sometimes you have to do the work over again."
In a 2009 Gallup poll, the most recent on the matter, 29 percent of Americans said they would consider going abroad for "alternative treatments for a major medical problem." But that number jumped 13 percentage points when those surveyed were asked if they would go abroad if treatment were cheaper and the quality similar to that found in the U.S.
For a number of international hospitals hoping to cash in on this growing market, the latter is increasingly the case. More hospitals than ever are rushing to meet the exacting standards of the Joint Commission International, an organization that has placed its seal of approval on "469 distinct accredited or certified organizations
In 50 countries to date," a spokeswoman reported, certifying hospitals on everything from architectural design to superbug prevention.
The JCI-accredited hospital at which Schuler was treated –- Fortis Hospitals in Bangalore, India, formerly known as Wockhardt Hospitals and is associated with Harvard Medical International -– exceeded his expectations.
"They picked me up at the airport at 4 a.m. their time and took me to the hospital" for X-rays, Schuler said. "My room was incredible, the care was phenomenal. I was there in the hospital for seven days and I was in what I consider to be a four- to five-star health facility."
"When they rolled me into surgery, I remember looking at my doctor and saying, 'If it’s not successful, just let me go,'" Schuler continued. "He said, 'It'll be ok.' By 8 a.m. I was under the knife and by noon they got me up and I was pain-free. I could not believe it."
"The first thing the doctor said after my surgery was, 'My, you’re a lot taller than I thought you were!'" Schuler laughed. "I had nothing negative happen to me, so I would promote it 100 percent."
Whether you decide to stay put and visit your own doctor or go abroad for your next costly treatment, do yourself a favor and research your options. In part two of this series, we’ll go over the advantages and disadvantages of medical travel, and we’ll have tips on what kind of questions to ask when you consider going abroad for treatment.
Check out our slideshow below to see what some of the more popular facilities look like.
Severence Hospital In Seoul, South Korea
An A-Class Living Room at <a href="http://www.yuhs.or.kr/en/hospitals/severance/Sev_Intro/Gnr_info/" target="_hplink">Severance Hospital</a> in South Korea, where the average treatment is 30 to 45 percent less than the cost of similar services in the U.S., according to Patients Beyond Borders.
Anadolu Medical Center In Istanbul, Turkey
An exterior shot of <a href="http://www.anadolumedicalcentre.co.uk/" target="_hplink">Anadolu Medical Center</a> in Turkey, the average treatment is 50 to 65 percent less than the cost of similar services in the U.S., according to Patients Beyond Borders.
ASAN Medical Center In Seoul, South Korea
Visit <a href="http://eng.amc.seoul.kr/lang/AboutAMCController.do?forward=/jsp/en/AMCMain.jsp&sslpage=http%3A//www.google.com/url?sa%3Dt%26rct%3Dj%26q%3D%26esrc%3Ds%26source%3Dweb%26cd%3D1%26ved%3D0CEoQFjAA%26url%3Dhttp%253A%252F%252Feng.amc.seoul.kr%252F%26ei%3DodjHT5iDHYKZ6AH9v_3MDw%26usg%3DAFQjCNEr-0S0ZvopcZYAHM5aSiFL1DXs9Q" target="_hplink">ASAN Medical Center's website</a> for more information.
Bangkok Hospital In Bangkok, Thailand
<a href="http://www.bangkokhospital.com/" target="_hplink">Bangkok Hospital</a> is located in Thailand, where the average treatment is 50 to 70 percent less than the cost of similar services in the U.S., according to Patients Beyond Borders.
Bumrungrad International Hospital In Bangkok, Thailand
<a href="http://www.bumrungrad.com/thailandhospital" target="_hplink">This hospital</a> is one of the top names in medical travel -- it was the first Asian hospital to receive JCI accreditation.
Bumrungrad Cozy Interior
A nurse turns down a bed in Bumrungrad.
CIMA San Jose In Costa Rica
American patients who seek treatment at <a href="http://www.hospitalcima.com/" target="_hplink">CIMA San Jose</a> or other Costa Rican health care facilities can expect savings of 40 to 65 percent.
CIMA San Jose Helipad
A patient gets airlifted in.
Prince Court Medical Center In Kuala Lumpur, Malaysia
Concierge service is one of the perks at <a href="http://www.princecourt.com/" target="_hplink">Prince Court Medical Center</a> in Malaysia. The average treatment is 65 to 80 percent less than the cost of similar services in the U.S., according to Patients Beyond Borders.
SDMC Ara Damansara In Malaysia
<a href="http://www.simedarbyhealthcare.com/company-info/facilities/sdmc-ara-damansara" target="_hplink">Sime Darby Medical Centre Ara Damansara</a> in Selangor Darul ehsan, Malaysia focuses on brain, heart, and spine and joint issues.