Michael Moore's documentary Sicko sheds light on the quality of care patients are receiving overseas in Europe, and even in Cuba, where part of the health-care system is free.
Here in the United States, many uninsured people are dealing with the frustrations that arise when mounting costs of medical procedures keep them from the treatment they need.
When Roberta Berger of St. Petersburg traveled to Malaysia to get hip replacement surgery last November, she became part of a growing industry that is pushing an unorthodox solution to this problem: medical tourism.
Medical tourism refers to the business of traveling, often to a third-world country, to take advantage of the lower costs of medical procedures.
Berger got her surgery in Malaysia for about one-tenth of what it would have cost here in the United States, and now she wants to help others do the same.
In 2000, she had surgery on her right hip at the Florida Orthopedic Institute. About a year later, she left her job and became an independent stock broker.
She later realized that she needed to have her left hip replaced as well, but had no insurance to cover it. "No insurance, no money, the market was crashing and we're straight commission," Berger said of her new situation.
She began looking into how much it would cost to pay for the surgery out of pocket. "By the time I got an idea, it was going to be at least $100,000," Berger said, adding that there was no way she could afford it.
By doing some online research, and consulting with a medical tourism company, she was able to travel overseas and receive the same surgery for a little more than $8,000.
Berger was happy with the results of her surgery, but unimpressed by the service she received from the medical tourism company that arranged it. She decided to start a business that would make the process easier for the patient.
"When things weren't going right, because I've been in hospital administration, I said, 'No, I don't want anybody else to go through this,' " she said.
Her new company, Medical Tourist MD, is in its infancy at this point. Berger has done extensive research and traveled throughout Asia with two doctors to get a better grasp of the way the hospitals work, but has only arranged surgery for one person.
That may be because medical tourism is still a fairly uncharted territory, which leaves many questions unanswered.
Medical tourists are on their own when it comes to choosing a company to book their trip, and deciding on a country, hospital and doctor can be daunting.
There is also no medical standard for the companies that arrange the trips but that may change as health-care providers start to follow the lead of pioneers like Berger.
United Group Programs, a health insurance administration company based out of Boca Raton, has begun providing insurance packages to employers that cover treatment overseas.
Also in the works is the formation of the first Medical Tourism Association, said Jonathan Edelheit, the group's vice president of sales.
The association will certify and credential medical tourism companies which are multiplying by the day, Edelheit said.
"There are probably hundreds of companies around the country that are providing it and there will probably be tens of thousands within the next 12 months," Edelheit said.
There is also the question of accrediting the hospitals.
Thomas Johnsrud worked for four years as the director of Operation for Accreditation at the Joint Council, the organization that accredits about 4,000 hospitals in the U.S. and has begun accrediting hospitals internationally.
"Some of these hospitals exceed some of the operations here in the U.S.," said Johnsrud, who is currently working as a consultant for a private hospital provider in Asia.
He said the low price of care in many of the Asian countries comes from the lower cost of labor, but that many of the doctors and surgeons have been trained in the U.S.
Berger said that the benefits far outweigh the risks in having a procedure overseas, including the experience of being immersed in another culture.
She also hopes providing medically trained escorts to and from the host country and local contacts for the tourist will help set her company apart.
"I haven't seen one person out there with my background that wants to do it the way I want to do it," she said.
Nick Johnson can be reached at firstname.lastname@example.org or 893-8361.
For information, visit www.medicaltouristmd.com.