Mr. Lefko said that healthy competition from abroad “could have a potentially positive structural impact on how the U.S. delivers health care services.” He believes the emergence of world-class health care across the Pacific will likely give U.S. hospitals and clinics a much-needed kick in the bedpan.
“Already 500,000 Americans each year are leaving the U.S. for health care reasons, and this is going to grow. U.S. hospitals and doctors will complain, but the reality is, U.S. hospitals have had plenty of time to straighten out their acts. They've had plenty of opportunities to create better, more economical health care services.
Medical tourism's going to level the playing field. I've been in the hospital business for 35 years, and I've seen all sorts of facilities and operations. I wouldn't hesitate to go to any of the hospitals in Singapore,” Mr. Lefko said.
A Medical Travel Hot Spot: Singapore
When it comes to medical travel, Singapore presents a classic case of supply and demand, Dr. Yap said at the World Health Care Congress.
Singapore's tertiary-care hospitals have excess capacity that they're trying to fill. “We have a very small population, and on our own we are not able to maintain the state-of-the-art services. So our approach is to fill the service volume with international patients. That way we can acquire the technology, keep the subspecialists, and provide the highest quality services. We're led by the Ministry of Health in this. It is not just an economic enterprise, it is about providing quality health care for everyone,” said Dr. Yap, medical director of the Singapore Tourism Board.
Singapore's hospitals are considered the best in Asia, and the sixth best in the world. “We have one-third of all the JCI accredited facilities, and JCI standards are equivalent or even more stringent than JCAHO's,” said Dr. Yap. “We have lower ICU/CCU infection rates than many centers in the U.S. cities. Health care in Singapore is on par with most U.S. hospitals or better.”
Kamaljeet Singh Gill, General Manager of the National Health Care Group, representing several tertiary-care centers in Singapore, explained that his country has a national single-payer health care system, with tiered pricing based on need. “If you have money, you pay; if you do not have money, you don't pay.” All hospitals in the country are government owned, and they're equivalent to the Mayo Clinic, “but much less expensive.”
Each hospital in Singapore serves about 1 million people annually, 1% of whom are international patients. He said Americans are still in the minority, representing only about 20% of all international business. But the number is growing. “Even without major marketing effort, we're seeing an increase in U.S. and U.K. patients.”
He stressed that his group is not competing with India or Thailand, and is not promoting “medical tourism,” but rather comprehensive affordable state-of-the-art medical services. In addition to treatment and procedures, hospitals in Singapore offer international visitors a wide range of holistic health services, fresh healthy Asian-style food, art and music therapies, and well-designed healing environments of a sort rarely found in U.S. facilities.
Dr. Yap added that this approach represents a strong shift away from the stereotype of medical tourism, which used to mean elective or commodity surgery at facilities with uncertain quality records, questionable marketing methods, and an absence of care continuity.
“Medical travel involves patients going abroad for needed medical care, with minimal leisure components. This is essential health care that, for whatever reason, the individual cannot access at home.” He stressed that medical teams in Singapore endeavor to be part of the normal care continuum and to develop good interconnectivity with the patient's doctors at home. “We prefer that physicians in the patient's home country refer the patient to us. We're not trying to pull patients away from their home doctors.”
Joyce Lim, assistant manager of the International Business Development Unit of Singapore's National Health Care Group, said, “We request referral letters from the patients' doctors at home. Our doctors recommend certain treatments. We let the patients know what is involved. We advise on cost, length of stay, medications, follow-up all beforehand, before [the patient flies to Singapore]. Surgeries are planned very carefully, so there's no waste of time. After treatment, we provide a full medical report that includes all procedures done, all prescriptions, and post-op follow-up recommendations that patients can take back to their physicians. It includes full, 24/7 contact information.”