"No one should have to choose between medicine and other necessities. No one should have to use the emergency room every time a child gets sick. And no one should have to live in constant fear that a medical problem will become a financial crisis"
- Brad Henry
A couple of days I received an e mail from my local dentist. "Hey we miss you!", it extolled, "Time for another check up". I'll bet they miss me.
Like most normal human beings I hate going to the dentist. When they approach my sensitive gums with a sharp pick gleefully making small talk, it is a miserable ordeal. I do not want to hear about their wife and kids. I just want it over. But, as awful as the experience is, that is not the worst of it.
It used to be you went to the dentist for a cleaning or a cavity and it was a mundane affair. You checked in, had the work done, checked out and went home eating cookies as an act of revenge for the violation you just experienced. Not anymore.
Today it is all about the "up charge". You are hit as soon as you go into the waiting room with TV screens telling you about all the 'specials' the office offers.
"I just want a cleaning", you tell the receptionist. You are taken to the exam room and the hygienist presents with you with a menu of choices for you to approve before she gets started.
"You can have a cleaning," she tells you, "but for a little more money we will tell you if you have cancer". Or something like,"Oh you want both sides of your teeth cleaned. Well, that is extra."
It is a scam, disguised as good intentions. If you are not well informed it is easy to spend a ridiculous amount of money for a simple "cleaning". So, my dentist, after presenting me with a series of up charge offers that were all declined, gloomily sent me to the front desk to pay for my simple cleaning and, with a coupon, I got out of there after paying $180.
So here we are traveling in a foreign country and I receive this e mail. I started to wonder if I had a better option. After some research I found a local dentist that had staff that spoke english and offered cleaning services. So yesterday I spent the afternoon at the dentist.
Below is what I saw when I arrived.
A little background before I go further on my adventure.
Medical tourism is a real thing and full of land mines. One site writes - "Medical tourism is promoted extensively on tourism websites. According to Bloomberg News, Mexico is the #2 destination for medical tourism worldwide, attracting nearly one million tourists annually for health care.”
Many benefits can be found in such expeditions. The cost of medical care in the USA is obscene and a national disgrace. We do NOT have the best medical care in the world by far.
Check out this review -
We are 36th on this list. Saudi Arabia is rated higher! Other lists show us higher but I can find none that even put us close to being in the top 10.
You can go to Spain, who is in the top 10, pay cash for a hip replacement, then go on a two week holiday. After that you break your hip again and have a second procedure and still pay less for the cost of one hip replacement in Indianapolis.
Keep that in mind next time you drive past one of those shiny ads in the city telling you how great their hospital is and how they do things with your welfare in mind. As the nation lurches toward another election and gets worked up over "Medicare for all" we remain the only country in the Western world where you can go bankrupt for getting sick. We need to grow up and recognize our medical system is broken.
So medical tourism is a real choice for many -
Top Specialties for Medical Tourists (from Patients Without Borders):
• Cosmetic surgery • Dentistry (general, restorative, cosmetic) • Cardiovascular (angioplasty, CABG, transplants) • Orthopedics (joint and spine; sports medicine) • Cancer (often high-acuity or last resort) • Reproductive (fertility, women’s health) • Weight loss (LAP-BAND, gastric bypass) • Scans, tests, health screenings and second opinions.
Top Countries for Medical Tourism
CNBC lists the top countries for medical tourism and the most popular procedures (http://www.cnbc.com/id/101487998)
• Mexico, (Dental work; cosmetic surgery) • India, (Fertility treatments; orthopedic and cardiac care; oncology) • Thailand, (Cosmetic surgery) • Brazil, (Cosmetic surgery)
However, their is real danger in such excursions. Scams and spurious medical advice is common in the USA. A average episode of Dr Oz is testimony to this fact.
Dr Paul Offit writes an excellent book on this subject -
Scams in other countries are another thing all together. We ran into a couple while traveling in India who had brought their autistic child to the country for "Blood treatments" to cure the disorder. Due to the internet, anyone can make a website that is full of hope and promise only to offer sham therapy. You have to be careful.
Furthermore, there are other concerns. Things can go wrong and you do not have adequate follow up. There are infection risks due to inadequately prepared equipment. Communication barriers can be a real danger. And, you have no legal remedies should you feel you need them.
You have to be careful and do your homework. But does that mean you should not consider this option if , after research, you feel it is a reasonable way to get more affordable care? The answer is no. It may be a great choice.
I am not an average consumer. I practiced medicine for over 25 years so due to my education I felt comfortable in taking calculated risks. I am not an expert in all things (Colleen just said 'Amen') but I do have some discernment in these matters.
So when I was dropped off by uber at the above clinic I was ready to turn around if I felt uncomfortable. When I went in, I was greeted by a friendly staff who spoke english. The waiting room was small, clean, and refreshingly free of TV screens offering other services. I filled out the same paperwork as I do here. I was then led to the exam room.
The first thing I noted was the rinse and spit bowel. I had not seen one of those in awhile. They used to be common in the USA. Most dentists have replaced them with a sophisticated and expensive suction system. I admit I felt nostalgic seeing the bowel. The rest of the room was filled with shining , clean equipment. Small, but efficient.
There was no hygienist. I was introduced to the dentist who would do the cleaning. I am sure USA dentists would consider that beneath them because it doesn't pay much and they have a hygienist staff for that treatment.
He proceeded to the cleaning in an efficient manner. His instruments were sterile. He spoke the only english he knew, "Open", "Close". He then would gesture to the bowel and I happily rinsed and spit.
When he was done, he called his english speaking assistant back in and made sure I understood his assessment of my oral heath. There was no up charge pitch. It was simple, professional, and efficient.
And it cost $30 dollars
We, as Americans, need to have a real discussion about heath care. We are being robbed.
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