When David Woodman announced he was going to Puerto Vallarta, Mexico, for major dental work, his son Josef thought his dad had lost his mind. He had visions of untrained dentists burrowing into his father’s mouth, clutching fistfuls of rusty needles.

So the younger Woodman tagged along, to make sure his father would not fall victim to foreign quackery. “Instead of what I feared, he got a board-trained dentist in a great clinic, with state-of-the-art instruments and panoramic X-rays,” says Woodman, who was so impressed he ended up researching and writing the new book Patients Beyond Borders on the phenomenon of medical tourism. “And he saved $11,000 on a mouthful of teeth. I came away with a different perspective.”

Woodman’s father is not alone in looking abroad for a medical overhaul. After all, if the American healthcare system is not completely broken, it is certainly dysfunctional: 47m people have no health coverage, and 130m have no dental insurance. As baby boomers age into more medical problems with spotty coverage, and would prefer not to deplete their retirement savings, they are looking at all available options.

Enter countries such as India, Thailand, Mexico, Costa Rica, Malaysia and Singapore that cater to the maladies of well-heeled foreigners. In fact about 150,000 Americans a year leave the US to have medical work done and the industry is growing by about 15-20 per cent annually. The quality of care in top hospitals is said to beat most American hospitals, while providing savings of 30-80 per cent. In fact, in 10-15 years, “the best offshore hospitals will routinely be included in networks offered to insured Americans”, predicts Arnold Milstein, chief physician for the consulting firm Mercer Health & Benefits.

Not that medical tourism is a worry-free venture. From the training of foreign doctors and the conditions of far-flung facilities, to the legal limbo should something go awry, to the wisdom of getting on long-haul flights after major surgery, there are troubling questions to consider. But when patients are facing a major operation – a hip replacement, say, that could cost anywhere from $55,000-$85,000 stateside – it seems that more Americans are proving able to get beyond their doubts.

“Many people just can’t afford the procedures here in the US and the value overseas is so much greater,” says Patrick Marsek, managing director of Chicago-based group MedRetreat, which is facilitating 650 overseas surgeries for clients this year. While historically most Americans have gone abroad for dental or cosmetic work, he says, it is now extending to other areas – hip and knee replacements, heart surgery and hysterectomies.

Indeed, there is now a cottage industry growing up around medical tourism, led by companies such as MedRetreat and Planet Hospital. Not just in the US, but in countries with creaky national health systems such as the UK, where lengthy waiting lists for non-emergency surgery have spurred many to look abroad. “Now you can buy a travel package where they’ll literally handle everything for you,” says David Hancock, author of the newly published guide The Complete Medical Tourist. “They pick you up at your front door, take you to the airport, fly you in and accompany you to all clinical visits and operations. Then you’re off to a five-star hotel to recuperate for two weeks, before flying you back and getting a private car back home. And it all comes in at half of what it would be at a private hospital in the UK.”

As Josef Woodman discovered, the steep discounts are not because of ramshackle venues and dodgy doctors. Bumrungrad Hospital in Bangkok, for instance – which caters to an estimated 400,000 foreigners a year – is known for its marble floors and luxury amenities that make it look more like a resort hotel than a healthcare facility. “When I returned from my tour of 20 hospitals overseas, I showed my son the slides, and he kept asking if they were photos of my hotel,” Woodman says. “In fact they were all pictures of the wards. Often they’re not just as nice as American hospitals – they’re three times as nice.”

So why isn’t everyone jetting off for a few dental crowns or a tummy tuck? For one, heading abroad will put you in a hazy legal zone should anything go wrong. Where a botched surgery might lead to a multi-million-dollar settlement in the US, malpractice awards abroad tend to be capped at a much smaller amount – never mind the potential nightmare of navigating through a foreign legal system.

To avoid ham-handed foreign surgeons, remember that all venues are not created equal. If a hospital has only done 50 relevant surgeries and cannot produce success rates or dossiers on their top surgeons – who have ideally been board-certified in the US or Europe, before returning to their home countries – steer clear.

To do medical tourism right, there are a few key steps to take. Whether you are on your own or working with a healthcare planner such as MedRetreat, look for hospitals accredited by the nonprofit Joint Commission International, and those affiliated with top American institutions.

As your search narrows, do your due diligence and find out how many surgeries your target hospital has performed, and what the documented success rates are. To wit: Wockhardt Hospital in India, which caters to foreigners, has a success rate of 98.4 per cent after 15,000 cardiovascular surgeries, which compares favourably with any US hospital and means “you won’t be coming back with a scalpel in your belly”, Woodman says.

While India and Thailand tend to get the lion’s share of attention for medical tourism, Woodman suggests Singapore could actually be your best value. It is ranked sixth in the world for healthcare by the World Health Organisation, has 11 JCI-accredited hospitals, and houses a facility allied with the legendary American institution Johns Hopkins. Singapore might cost you about 20 per cent more than what you would find in India or Thailand, but it is still roughly half the cost of procedures in the US.

For Don Williams, a Denver technician for Apple Computer, Malaysia seemed a savvy bet. Hampered for years by an old knee injury that was only getting worse, Williams, 61, started looking abroad for solutions after being prodded by his wife Joy.

With the help of MedRetreat, they settled on treatment earlier this year at Adventist Hospital, a church-affiliated institution on the island of Penang.

Williams had health coverage, but his deductible was so high that for the same price that he would pay for a knee replacement in the US, he could have the same work done – and enjoy a month-long vacation with his wife at a five-star Malaysian resort, the Eastern and Oriental.

“It was a very luxurious place to recuperate,” says Williams, who recently was able to go on his first walk in a long time, and looks forward to biking and hiking again. “We loved it.”

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