John Freeman paid $18,000 for a heart procedure in Turkey that he says would have cost him $120,000 in the United States.
John Freeman paid $18,000 for a heart procedure in Turkey that he says would have cost him $120,000 in the United States.

With the passage of America's Health Care Reform bill, more Americans will have access to affordable health insurance. But they have yet to see lower costs for medical treatment. Because of that continuing expense, many Americans choose to go abroad for one-time medical surgeries or procedures.

Grim choice

John Freeman took that gamble a few years ago. The 62-year-old retired computer analyst dropped his health care insurance because the high monthly premiums and a huge deductible were eating up his retirement savings. He hoped he would not need major medical care until he turned 65 and qualified for the government's Medicare insurance program.

But last year, Freeman had a heart attack. He was told surgery in his hometown of Reno, Nevada, would cost close to $120,000. Freeman felt he faced two grim choices: use up all of his savings or die.

"I thought that the American medical system was going to take away my life savings and essentially ruin any prospects I had for a pleasant retirement after the operation," he says.

Freeman chose Anadolu Medical Center in Turkey, in
Freeman chose Anadolu Medical Center in Turkey, in part, because its website stated an affiliation with Johns Hopkins University in the United States.

Exploring his options

So Freeman did what hundreds of thousands of Americans do each year. He went abroad for the surgery.

After some research, he decided to have his operation performed at the Anadolu Medical Center outside of Istanbul, Turkey. The price was just 15 percent of what it would have cost in Reno: $18,000, all-inclusive, except for airfare.

Both the American Medical Association and the American College of Surgeons have acknowledged that medical tourism is a growing industry because of lower medical costs overseas. They have issued statements encouraging patients to seek out the treatment that best suits their needs. However, both organizations also warn patients to make sure they choose certified doctors and surgeons at health care institutions that have met high standards of accreditation.

John Freeman took that advice seriously when he researched Anadolu Medical Center.

"When I first looked at the website, there's a logo that says 'Affiliated with Johns Hopkins University' and I think that really helped my comfort zone because I knew there was an affiliation with a well-known American hospital," he says. "I knew my doctor was in meetings with American doctors about things like heart surgery techniques."

Medical tourism

Americans first began going abroad for cosmetic surgery such as facelifts, breast implants and reductions, and tummy tucks in the 1980s and 90s. Today, common medical procedures sought overseas include cardiac surgery, knee and hip replacements, liver transplants and dental work.

Wouter Hoeberechts, CEO of WorldMedAssist, helps a
Wouter Hoeberechts, CEO of WorldMedAssist, helps ailing Americans find accredited and affordable medical treatment in six countries.

"We have a problem delivering affordable quality health care in this country," says Wouter Hoeberechts, CEO of WorldMedAssist, the medical tourism provider that helped John Freeman find his surgeon in Turkey.

He founded WMA three years ago to offer ailing Americans accredited and affordable medical treatment in six countries.

Hoeberechts, originally from the Netherlands, says all the hospitals affiliated with his company meet high U.S. standards and many of their board-certified doctors and surgeons trained in America.

"What we try to do is - for each hospital that we work with - become the number one or number two provider of U.S. patients, so that we really can build a very good relationship with those hospitals and make sure that patient benefits from that," says Hoeberechts.

Freeman did a little sightseeing while in Turkey f
Freeman did a little sightseeing while in Turkey for a medical procedure.

Surgery abroad

John Freeman can attest to that. He says he received professional surgery and excellent care from attentive doctors and nurses.  

"If one can say that about such an essentially unpleasant thing, I actually really enjoyed the whole experience and the price was very good," he says. "I got it done and can still have a retirement."

Hoeberechts says WorldMedAssist has successfully sent several hundred patients abroad for medical treatment at a discount. WMA is one of a growing number of companies providing this service.

But medical tourism is not for everyone. Prospective patients must be fit for travel, the cost must make economic sense, the length of stay should be relatively short and follow-up care must be predictable and fairly brief.

Aftercare challenges

Aftercare is the challenge John Freeman faces. Now that he's back home, his doctor wants him to take some expensive post-operation tests. But, still without insurance and feeling okay, Freeman says he doesn't want to spend the money.

That attitude concerns neurosurgeon and Harvard educator, Dr. Teo Forcht Dagi. He oversaw the writing of the statement on medical tourism for the American College of Surgeons. Dagi stresses that overseas medical treatment is not for routine or on-going health problems. He notes aftercare is of concern to both the ACS and the American Medical Association because follow-up is rare.

"So what you get may be cost, but what you give up may be the on-going relationship, the communication, the follow-up care, and things, traditionally, American patients have held very dear," says Dagi.

Seeing growth potential in medical tourism, many major American health care insurance providers have started pilot programs that offer overseas coverage. If a subscriber can get quality care for less overseas, the companies calculate they will have to pay out less money in reimbursement.

Medical industry observers expect to see an increase in medical travelers, as continuing costly health care at home drives more Americans to seek medical services overseas.