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Medical Tourism (?)

This topic comes up from time to time. I might have been the one that brought it up the last time. Its just that every time I have some medical issue while I am traveling I am stunned at the difference in cost and service.

I will spare you the details, but in the last 2 years I have had one procedure that would have been $5,000+ in the US (insurance would not cover) and another that the out of pocket here vs with insurance in the US cost about the same (maybe a little less here). Yesterday I had two diagnostic tests and nearly an hour with a specialist that, with insurance, would have cost about the same as what I paid out of pocket. Biggest difference has been the quality of service. Tests done by the doctor not a PA or nurse or tech. No waiting, polite, helpful, kind, and outstanding facilities. Most of the other patients are Hungarian, Swiss or Austrian for some reason. And this is about the poorest country in the EU. And dont even get me started on dental costs. And none of this is through the public healthcare, this is all private providers.

Now I did pay more for a prescription today. What the insurance in the US would have paid 100% of, I had to pay about $2.75 for (one less glass of wine tonight).

Then there is a little more complicated procedure that I have been putting off for years. The cost difference is significant. Even with US insurance.

Posted by
8594 posts

It's a couple of years old but this book "The Healing of America" by T. R. Reid, is a great overview of the US health care system and comparing it to other countries around the world. I wouldn't hesitate to go anywhere in Europe for medical care.

Posted by
11449 posts

We had similar experiences when we lived in Rome. Husband’s cardiologist appointment with the doctor was for an hour, complete with EKG and Echocardiogram done by the doc, €250. Here, although covered by insurance, is thousands, he gets 15-30 minutes with a doc, procedures are done by a tech, results delivered electronically. Feels remote.

An MRI in Rome in 2015 was €420. Same one MRI here in January was north of $2500. Again, covered by insurance, but what the???

Prescribed Pharmaceuticals cost so little we didn’t even submit to insurance .

Posted by
18544 posts

Stan, including Albania, Kosovo, Bosnia, Belarus, Ukraine, Macedonia. russia, Moldova.

Laurel, that's what I had yesterday 45.000 forints (less than $150)

Posted by
8594 posts

Ok, except for Russia & Belarus. I've been in two of the other countries you mention, and had contact with the medical system as part of my job. Almost every doctor I met had spent all or part of their time training in the West.

Posted by
7657 posts

With planning, yeah, you can find great savings. You really need to have some type elective type procedure, one that you can choose the time. Maybe you also rationalize that the cost of getting there, and then staying before the procedure, then recovery and follow up is a "sunk" cost or just "on vacation", not necessarily related to the medical cost. I suppose I could have looked into it for hernia surgery a few years ago, but like many, where do you start?

I would not have concerns about quality of care, and if for some reason I needed urgent or emergency care, I would have no worries. We do often get over-the-counter meds while in Europe, much cheaper.

Some from the US might have some culture shock, I know family and friends that go to the Doctor insisting they need this medicine or that one (that they saw on TV), and largely the Doctors just write the script, I got the sense that in Europe that doesn't happen, that the Doctors are more reserved, and less swayed by a patient. The number and experiences of Americans insisting on Paxlovid while in Europe sort of brought that out.

Posted by
10298 posts

Costs:
The OTC price depends on the country. Europe is too varied as are the economies. OTC in France are expensive; I stock up in Spain or Portugal, and of course Costco. On the other hand, my prescriptions are 10% the after-insurance cost in the US. A asthma inhaler in the US is up to $48 but it's 5 Euros in France. Squeeze the customers.

Yes, they are tighter with the prescriptions. Leaving the US, my US MD wanted to put me on two medications due to my age and borderline numbers. Two French MDs ran their own blood tests (10% the cost) and said I was fine and didn't need anything more. That's when I realized about for-profit medicine, drug companies pushing their meds and doctors' fear of lawsuits.

No, nobody has heard o Paxloid, except when I see questions here. It is available because my cousin got it when she got off the plane from the US and tested positive a day later. Although I've been living in both the US and France for decades, I was surprised by some French attitudes but now I understand.

A French doctor shocked and insulted me when she said that the Americans are afraid of everything. I then thought about the medicines they didn't put me on. I thought about the Paxlovid and how some people are still avoiding others, and I realize that it's not fear, but Americans have an idea that they can control their destiny if they eat blueberries and kale, walk a 10,000 steps, take vitamins, take Paxlovid. So it's not fear, but it's feeling a sense of taking action to exert control during a very chaotic period. It's very different in Europe, even among people I know with damaged immune systems. They want to interact and enjoy.

Back to medical tourism. Dental work is expensive where I live, but the flight to Budapest and hotel would be even more.

Posted by
18544 posts

Bets, I don't like tge term I used. Medical Tourism.

You actually hit on one of my complaints and that is the sentence that begins "In Europe".

I think what makes it work for me here is that the country is poor and the national healthcare service reflects that; so there are a lot of private facilities where doctors and staff can earn 20% more than nothing.

There is one "exam" that my insurance will only pay for every 5 years. I have a family history of cancer so I would rather not wait 5 years. Cash price in the US is $5000 to $6000. Last one here was $350. The difference easily paid for the vacation LOL.

I guess we see how my heart procedure goes? What can possibly go wrong?

Posted by
10298 posts

Nothing will go wrong. Those are such skilled doctors. And you'll have good Hungarian wine to drink. You can start refiling those arteries again with a good goulash.

Posted by
1546 posts

OOP cost of one insulin vial:
US$200+ in the US (need Rx)
C$30 in Canada (Costco--no need for Rx)

Posted by
2267 posts

I had a benign cyst in my mouth and the ENT my GP referred me to wanted me to pre-pay the $450+ remaining on my deductible before my appointment!

My dentist friend in Madrid had told me he could connect me with an oral surgeon to take care of it there, and I had it snipped out two weeks ago for €150.

Saw the dentist in his clinic on the same trip—exam, cleaning, and one filling for €65.

Posted by
10298 posts

Good for you, Scudder. You are tempting me to head to the border.

Posted by
359 posts

After dealing with my mother's accident and subsequent surgery in Ypres, the saying in my family is, "If you feel an accident or major illness coming on, get on the plane to Belgium." Not joking.

Posted by
1546 posts

Healthcare costs in the US are indeed out of control.

I had an evaluation for a gum graft by a local periodontist. He asked for US$270 just to look at my gum without doing anything but giving a quote.

Then, I was in Budapest and saw a specialist who examined me for free. I finally did not have the procedure with him because he was going on vacation. James E gave me a referral for a dentist, who in turn recommended this periodontist to me. Thank you again, James.

Posted by
1994 posts

If you have a standard operation then foreign doctors are fine. I do think for rare diseases and conditions that the US is better in terms of medical.

I have German friends who have had terrible luck with German healthcare. Again common ailments and conditions are treated but doctors there have missed a cancer diagnosis.

So I can agree with part of your statement but having chronic illnesses or rare illnesses are not treated as well.IMO.

And yes, many European doctors train in US.

Posted by
10298 posts

So Heather, if I remember correctly you work in healthcare, but are you are basing your opinion on one German friend's missed diagnosis? Which German system was she in? Public? Private? There's more than one. Do you know how many missed diagnosis there are in the US? Do you think that rural and inner city Americans get the same level of testing and diagnosis as a person with excellent insurance at the best Chicago teaching hospital? What about all the women who are told it's emotion, not disease because they are young?

Some Europeans come to the US for post doc training but do you really think they pay those medical school fees? They train in Europe.

Friends, family, and I have experience with healthcare in France and Austria, including high-risk childbirth, neonatal, triple negative breast cancer, aneurism, sudden blindness, chronic illness...
We also know that for-profit medicine leads bill padding with over testing and treatment.

You need more exposure to the reality of excellent treatments and survival rates. Let's just say that you feel more comfortable where you are and that this is your unsubstantiated opinion and prejudice.

Posted by
158 posts

I live in Jordan and take an expensive medication. In Jordan, getting it from the best (and probably most expensive) hospital in the country, a 3 month supply (6 syringes) costs about $2500. (It's fully covered by my insurance, luckily). When I visited family in the US last summer and had to fill a script, a one month supply (2 syringes) was $7800.

Posted by
18544 posts

The varied experineces are interesting and prove that "In Europe ....." is a concept that does not exist. And there are good and bad in each.

The National system here isnt particullarly pleasant. There are long waits for many, many things. I am considering a procedure here and the wait time is 6 to 12 months. I could get it done in the States on a two week notice.

But I really dont want this breaking down into a US vs Europe health care argument. The intent was has anyone got experience traveling for services, do many do it, was it worth the effort, personal experiences, etc.....

(Bets, great discussion to have, just not the right place. But if you and I could find the right place I would enjoy it)

Posted by
995 posts

One thing to keep in mind is that in Europe we have many different systems for delivering healthcare, although all of them ultimately ensure that all residents do standard healthcare regardless of their ability to afford it. In Switzerland we do not have a public healthcare system, the federal office for healthcare employs about 500 people who mainly involved in regulatory activities. So if you do find yourself having to obtain healthcare services in Switzerland they will be privately delivered.

Posted by
18544 posts

Good point. I know my dentist in Budapest has a number of Swiss patients for some reason. I have residency, but I am still not entitled to the government system without payment. But I can choose to pay the government system and get in the waiting line or go private for about 50% more. Private is still about the same cost as the US with US insurance, and a lot less with my private policy in Hungary. Austria apparently has no private providers. There is no "European" Healthcare system.

Posted by
724 posts

I have had excellent experiences with medical tourism (or whatever you want to call it).

It all started in 2015 when my traveling companion started exhibiting some weird behavior in Istanbul. (Actually it started a few weeks prior in the US, but it got worse when we were in Istanbul.) We went to the emergency room where they did a lot of diagnostics, including MRI's and heaven only knows what else. Then, we had follow up consultations with a neurologist, who I will swear had to have been educated in the US. He spoke completely unaccented American English. Our other friend, an MD who was with us at the emergency center, remarked that the facility and procedures were on a par with what one would see in the US. It turned out that my friend had dementia, and his condition has only gotten worse since then. Anyhow, the bill at the end of all the diagnostics and consultations came to $1300. I don't know exactly what it would have cost in the US, but it would have certainly been a lot more than that. I would always joke later that if I got sick I was going to hop on a plane and head to Turkey.

Fast forward to 2021, when my dentist told me that I needed a truly massive amount of dental work to the tune of $75K that wouldn't be covered by insurance. That joke about hopping on a plane to Turkey suddenly ceased to be a joke. It turns out that dental tourism is a huge thing in Turkey, and I wound up going to Turkey to get my dental work done. Even with a higher end clinic, the bill came to $16K. I did wind up making three trips to Turkey instead of the two originally planned, and there were some expenses with that. At the end of it all, though, the dental work was absolutely first rate, and I have no regrets whatsoever. (And, as a bonus, I also got to explore some cool places between clinic visits.)