Two sides of medical tourism

Medical travelling, health tourism, cross-border care – when there´s a hype the labels tend to grow in numbers. Every week I get invitations to medical tourism fairs and exhibitions, activities perhaps more frequent and economically important than the travelling and treatments as such. Not least Europe east of the EU seems to catch up, with numerous conferences and exhibitions in Russia, Belorussia and Ukraine.

Would you trust the doctor in Minsk?

Today probably not too many people would think of going to Kiev or Minsk to have a hip replacement but things might change. Belarus even claims to have a "medical tourism city". In Russia the target group seems rather to be wealthy residents interested to go abroad to avoid the many downsides of Russian healthcare. As there are no EU-Russia mobility regulations, going West will be expensive to Russians but the steady flow of medical tourists already flying from Moscow to London, Zurich or the US suggests that they can afford it.

Two lanes

As the inter-EU exchange of cross-border patients becomes more organised, with the cross-border directive implemented into national law, you can expect two major routes of patients to emerge: one for publicly funded treatments, according to the directive, and one for out of pocket paid services. The private one is alredy rich of cosmetic and life-style surgery but probably as well complicated, resource-demanding and sometimes accute specialist procedures not available in the country of the patient. The public alley will deal with treatments suffering from long waiting lists, lack of quality or unavailibility at home.

Which will be the broad way?

You shouldn´t be too sure that the public road will prove broader than the private one as many governments want to restrict travelling for care.

In the private lane there is a tradition of simplifying access, picking up the visitor at the airport and providing a smooth procedure, where the public process has a lot to learn. For both public and private there is a lack of information of alternatives and of outcomes transparency that might put patients at risk and anyhow will keep back the growth of cross-border care.

Johan Hjertqvist

Next EHCI to stress prevention

The work on the 7th edition of the Euro Health Consumer Index is gathering speed, with the Expert Panel meeting on April 22 in Berlin. Much of the discussion revolved around an increased emphasis on preventive medicine. “Prevention” might therefore become a separate sub-discipline in the 2013 EHCI, with three Prevention indicators being moved over and completed with 4 – 6 new indicators. The new Index will be published in November.

Oct 1: EU patient mobility to follow Powerhouse criteria

As decided by the European parliament in 2011, by October 2013 every citizen of the EU will have the opportunity to go abroad to have a medical treatment. The patient will have the right to bring her "voucher" in the form of the same public funding that otherwise would be available for a treatment in her own member state.

As the national governments now prepare for the implementation of the Brussels ruling, it is clear (as HCP has written about since 2009) that patients will be able to access far better information than today. Governments will be obliged to provide foreign visitors with information about their legal rights, what to do in case ol maltreatment and so forth but also about treatment options, access, quality of care, patient safety et cetera. There will be distinct information about treatment prices and additional costs. All this will make it much easier to dare going cross-border to access treatmenst that are more accessible (shorter waiting), have higher quality (less risks, better outcomes) or really exist (while the relevant therapy might be lacking in the home country of the patient) - three key critera for having the right to exploit the cross-border care directive.

A few EU member states will allow citizens to make their own judgement why to travel to another country while the large majority of member states will be using a set of conditons to allow for treatment abroad, with the three reasons I just mentioned being central.

As I have suggested before you can expect some governments to be at the front, welcoming mobility and transparency, while many others will lag behind, doing a minimum of informations and co-ordinations work.

From the view of patients and health consumers, the tearing down of cross-border barriers are welcome. Fort the first time there will be a realistic chance for not only wealthy people and insiders to look for superior care in other countries. That key performance and price data gradually will be brought together is fully in line with the Powerhouse advocacy and action since ten years. We are pleased to find that one indicator used for long by the Euro Health Consumer Index, i.e. whether there is an easily available national list of legitimate doctors, will materialise as a component of the pan-EU information system, contributing to credibility and patient safety.

There will be reasons to come back with further check-ups on the implementation of patient mobility information, as October 1 approaches.

Johan Hjertqvist
HCP Founder & President

EHCI News April 2013