Prices are going up.

Inflation is surging.

And this is affecting everything.

Food, gas, paying rent and health care.

And unfortunately, not everyone can put health care on the essentials list for a doctor.

That's a tough pill to swallow.

Alok, as a nurse, I'm feeling this, too, and I don't even know where to start.

But listen to this.

As of 2020, approximately one in ten U.S. adults under the age of 65 are medically uninsured.

And as of a recent survey since the pandemic, nearly one in five U.S. adults stated that if they needed quality medical care, they would not be able to pay for it.

And this disproportionately affects black and Latino communities.

Now, if you don't qualify for public health care like Medicare or Medicaid, and private or employer programs aren't available to you, you might be looking for ways to cut those medical expenses.

Enter the budding market of medical tourism alone.

Are we talking about mixing a vacation with some well-needed medical care?

Because if so, sign me up.

It's kind of Sheena but it has the potential to be so much more than that.

With health care costs rising.

People are looking for ways to save some cash.

And the international community is taking notice My friend Professor Neil Lunt from the University of York in the U.K. can explain it better.

Medical tourism is when patients make a decision to travel out of their own jurisdiction to another country for treatment.

So they might get on a plane, they might cross the border, catch a ferry or or drive medical treatments that diverse.

They may be cosmetic.

They may be elective surgery, fertility treatment, transplantation.

Back up.

Hold on.

We're not going to act like we don't see this big elephant in the room.

Why our health care costs in the U.S. so expensive to begin with.

Our team over at Two Cents are here to fill us in.

Thanks you all.

So why does health care costs so much more in the U.S. than other wealthy nations?

Some like to blame doctors and nurses for making too much money.

Some blame patients for demanding too many tests and procedures.

But recent studies suggest that the real culprit is an imbalance of market power.

Hospital systems have been consolidating rapidly in the last few decades, even buying up independent physicians offices until there are only one or two options in many regions.

This gives them tremendous power to set the prices however they want.

And there are virtually no government regulations to keep them in check.

As a customer, your relationship with hospitals is unlike any other industry.

When you buy a car, you can take your time to research your options.

You can go to different dealerships to find the best bargain.

But if you go to the E.R.

for a medical emergency, you're in no position to do comparison shopping.

You're not going to drive across town to another hospital who can maybe give you a better deal In fact, we usually don't even see the price because we're not the ones paying for it.

Our insurance is hopefully.

Ideally, your insurance company would negotiate on your behalf to lower the price.

But private insurance companies are generally too small and divided to have enough leverage to negotiate effectively.

The only ones big enough are the government run plans like Medicare and Medicaid.

And their patients do pay much less for health care, except for prescription drugs, thanks to intense lobbying by the pharmaceutical industry.

Medicare is prohibited from haggling over drug prices.

But most Americans are on private or employer based health care plans, and they're just no match for the outsized market power of giant hospital chains.

Until the federal government steps in or you're old enough to be on Medicare.

You'll just have to keep paying whatever prices they set.

Medical tourism can be seen as a way for vulnerable patients to reclaim some consumer power.

Though it's only feasible with some non-emergency procedures The savings can be significant.

It's true.

The savings can be significant.

But before you go cashing in your piggy bank, you have to weigh the risks for sure.

On one hand, it's estimated you could save up to 90% depending on the medical procedure and the country you're going to.

And this is an estimate from patients beyond borders.

In international organizations specializing in medical tourism.

But on the other hand, the CDC cautions people from doing this for a mountain of reasons, including the risk of getting an infectious disease like hepatitis or HIV.

A post procedural complication like deep vein thrombosis or a blood clot you may even be given counterfeit medications.

The team doing the procedure may not have the right training or certifications.

There's a lot of things to look out for.

However, if you ask a company that provides information about the medical tourism business sector, they will tell you that business is booming.

Now, you already know in actuality, the exact number of people that participate in medical tourism is hard to pin down.

The key Take-Home message is there's no central data source, so trying to put an overall global figure on medical tourists is really difficult.

So a number of years ago, I wrote a paper with colleagues called Three Myths of Medical Tourism.

That was our way of trying to say, Well, actually there's definitely something going on here, but the numbers don't stack up.

Hold up.

So if there isn't an independent, multinational central data source tracking medical tourism, then what's that?

What all these news stories I see about patients traveling to Far-Flung countries and successfully receiving cheaper health care?

Well, during Neal's research, he discovered that the media was intensely focused on individual cases and not necessarily the size of patient flow, meaning how many people were traveling for the sole purpose of medical tourism.

I mean, it makes sense.

Stories about medical tourism make for some great content and but when Neil started to take a closer look at the numbers, a different story emerged.

We know that there are tens of millions of people who are underinsured in the United States.

That doesn't necessarily mean that those same sorts of people are likely to travel overseas for medical treatment.

And it might be that, for example, they are second or even third generation migrants who are traveling back to a country that they've got a really strong connection to.

And perhaps they combine treatment with visiting family, perhaps through annual catch ups.

Or in other words, when you hear stories about medical tourism, maybe, just maybe the numbers are a tad bit inflated to build hype around an emerging industry.

However, the book on medical tourism is not closed.

Like with any business, supply and demand matters.

Health care costs are going up.

People still need medical care and are traveling for all sorts of procedures, including cosmetic procedures and more.

So the question is, if I'm a medical tourist, where should I go?

Well, that depends on what type of procedure you're seeking and how far you're willing to travel.

While countries like Malaysia and Thailand represent some of the largest markets for medical tourism, given proximity cost and regional or cultural connections, you are more likely to find American medical tourists jetting off to Mexico, Panama or Costa Rica.

For example, in Mexico, you'll see a wide variety of medical procedures offered.

There's dental procedures like root canal, teeth whitening, dental implants, wisdom, tooth extraction, orthopedic procedures like a near hip replacement.

You can get fertility treatment, cancer treatment, even an organ transplant such as the kidney or cornea.

And before you throw on a high, I'm a medical tourist T-shirt and jump on a plane we've got to run through a quick health checklist.

The CDC recommends that you check in with a primary care doctor and tribal health specialist at least one month before flying out.

You're going to want to make sure you chat about your overall health.

Get information on any destinations specific vaccines.

You may even get prescribed medications ahead of time to make sure you have quality meds that are not counterfeit.

Your doctor may also talk with you about certain posts, procedural complications and what to avoid, such as not flying for ten days after any chest or abdominal surgery because of pressure changes.

During the pre-travel checkup.

There are some things that your doctor should know.

You should let your doctor know if you are pregnant or if you have any known allergies, and especially if you have any other health concerns.

Discuss the timetable of your trip, where you are staying, and any other planned activities.

If you plan on going swimming or doing anything physical after your procedure, please let your doctor know.

Don't leave anything out so they can give you the proper guidance.

Don't forget to travel health kit.

Take a look at the episode description for a list of items the CDC recommends that you take with you on your journey.

Also, be aware that if you travel abroad, your health insurance may not cover you.

You might be paying out of pocket which still might be cheaper than getting it done here with health insurance, hence the entire concept of medical tourism.

But that's another episode you may want to consider getting medical evacuation insurance though, because that will literally evacuate you in the event of emergency.

Like, for example, if something happens in a remote location, it'll get you to the nearest hospital for treatment.

Next, make sure you ask lots of questions about the facility, where the procedure will occur.

There are no amount of questions that are too much when it comes to your body, your health and being in a foreign place.

We put some examples in the description and make sure you are being super observant.

Take a look around.

Make sure the office is clean and the staff is using proper precautions like washing their hands, using clean instruments and wearing gloves.

If you do not see any of these things, get out of Dodge and leave fast.

Yeah, for real.

If you're getting a medical procedure done and the staff are not wearing gloves or washing their hands, you're out.

You're going through that exit door.

And let's talk about communication you have to make sure that you can communicate with the medical team if you're going somewhere where you don't speak the local language.

You may need to hire an interpreter, ask the hospital for a translator, or if you have local friends or family in the area, bring them with you.

Now when you return home, believe it or not, your care is not over.

You're still at risk for complications.

So plan a visit to your doctor to discuss follow up care and after surgery treatment.

If you haven't seen our recent poll, check it out on our community tab.

We asked, would you travel outside of the U.S. to access medical services that are too expensive at home?

And you guys overwhelmingly said yes.

But do you still feel that way after watching this episode?

Let us know in the comments below.

Sheena, I know someone out there watching is like, you know what?

I am going to be a medical tourist just make sure that you do your research.

Please check out our bio for some research suggestions and watch our collab episode with Two Cents.

That's it for us.

As always.

Thanks for watching.

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