medical tourism

Old Mar 5th 2018, 10:47 pm
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Default medical tourism

During the past two or three years, an Indian doctor (Ravi Shetty; you can Wikipedia him) has set up a very well-appointed hospital here in Cayman as part of a long-term business-plan to attract "medical tourists" from the USA. There's only been a trickle so far, and to help cover overheads he has been taking local patients as well. While my wife was in there earlier this year, I spoke with her room-mate's husband (US citizens and residents both of them), and he told me that he had researched medical-tourism facilities in Panama, Mexico and one other Latin American country whose name I've forgotten, and that this Cayman hospital offered the best deal.

Now Cayman is a high-cost Island, and I find it hard to believe his findings. I wonder if any BE member has done any similar research, and can either confirm or refute his report. My wife and I have long had a vague intention to go and live somewhere else in this general region, if our health deteriorates and we run out of insurance. Cuba and Jamaica are prime candidates, and Mexico. If I can clear the decks about whether Cayman is as competitive as elsewhere, I'd be very glad - and very grateful for useful advice. Thank you.
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Old Mar 6th 2018, 1:27 pm
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Default Re: medical tourism

I sort of doubt it. Medical tourism is usualy about

get em in for popular safer procedures
Put em in 5* hotels to recover
Collect loadsa money

This model does not match the requirements of older age... Here we have a public underfunded and private well funded hospital. Theres a local medical school with some senior lecturers who do things like plastics. In the same way, boob jobs and similar are available here at the same cost as private work in pkaces like france and belgium, which is < half the uk private cost.

Harver - a caribbean small operation competes with thai and european huge hospitals with fantastic support services and advantages of scale and tax regime, not sure how good a business prospect it is really, and for an ageing local - whats the cost of a stay? Here its approx 1000-1500 us a day for an ordinary issue, need high deoendancy ? You’d better hope not.

Another factor - new airliners fly at higher cabin pressures, 5k ft rather than 8k. This is the same as a medevac flight, so now, if you can board a flight to london or the us, you can be there relatively easily and dependant on their systems of course,
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Old Mar 6th 2018, 1:35 pm
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We have a lot of cuban medics here on loan. They are excellent people, but their training excludes some of the high tech stuff in europe. Unlike the states theres no insurance or money obsessed culture in medicine [if in doubt do more tests, charge more] but they do a good job generally. If you visit cuba you by law have to pay local health insurance but its about a dollar a day all in, excellent.

Personally if ill i would prefer to fly to europe credit card in hand. The treatment is superior and a lot cheaper. Belgium is really good, and open to lots of private work. France is more difficukt to access, Germany is a no no, the UK is expensive unless you have legitimate NHS access.
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Old Mar 6th 2018, 1:42 pm
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Default Re: medical tourism

Another feature - if you count as a ‘3rd world country’ there are numerous breaks for medicines and things like knee joints available. Medicines here are relatively affordable, some are even free [eg HIV treatments are funded by richer countries.]

A knee replacement is about 300 pounds for the joint and 100 pounds for the op, because the joints are highly discounted and the local public hospital costs minimal, a surgeon flies over from i think trinidad or venezuela once a month to operate for a day, great value.

Theres a lot of this, a grenadian max fax surgeon operating in the states runs a dental clinic with 2 local dentists, and is here 1 in 3 months to do the more complex stuff.
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Old Apr 28th 2018, 1:55 am
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Default Re: medical tourism

Gordon, why don't you just come back to Australia and use the Medicare system?

Cuba seems like a crazy pick for so many reasons. Foreigners still can't buy property there, so you're completely dependent on using a local contact to grift the system and "do the right thing" by you for many years (and for the government to be continuously willing to look the other way). Even if the honest broker is honest, what happens if he dies and the property gets passed on to the relatives? Will all of them be as honest? Including if some relative of some cashed-up exile in Miami wants the property and makes a higher offer?

Plus - do you really want to spend your twilight years in a repressive police state plagued with shortages? Regardless of how good most of the doctors may be - what happens when your medication needs to be refrigerated but there's a black out and no fuel for the generator? Or when the next big hurricane comes and they don't have the capacity to clean up quickly? Etc etc etc.

If you remain in the Caribbean I think you are much better off in Mexico or somewhere in South America like Ecuador, or some other country there. I continually urge people to give Peru a look.
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Old Apr 28th 2018, 3:02 am
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Default Re: medical tourism

Carcajou: the first thing I have to say to all your questions is that I somehow missed a few crucial words in my OP. I didn't mean that we would live in Cuba or Jamaica (God forbid!), but rather that we might turn to them for medical care. Our "living wills" - what the doctors call DNS notices, DNS standing for "Do Not Resuscitate", and what we ourselves call PTP, for "Pull The Plug" - specify treatment in those two countries only, if Cayman itself can't fix us.

I apologise for misleading you about choosing Cuba or Jamaica as bolt-holes. We wouldn't choose them. Jamaica is crime-ridden pretty much all over, especially for foreign retirees; and Cuba is - as you say - a police-state, and it's never nice when crime and extortion are a government monopoly; that's impossible for private citizens to deal with. Incidentally, buying property anywhere would not be on our list of things to do, because of our age. It never makes sense for 78-year-olds to buy new residences. What's the point? And by the same token, what's the point of worrying over-much about declining desperate life-saving measures, at that age?

As for the hurricane risk: that doesn't really bother us, either. We survived for three weeks without power and piped water here in Cayman after the big 2004 storm (no generator, and with severely rationed rainwater), so we could survive again if we had to. And if things got really desperate, there might be nowhere to run anyway. Look how poorly the US's quasi-state of Puerto Rico has fared since its hurricane. Look at how New Orleans and Houston fared.

We're spoiled for choice in this part of the world, aren't we? There are a dozen countries we could comfortably live in. At the moment, we can afford to stay where we are, and to fly the grandchildren over from Norway twice a year. Australia... well, we no longer have any affinity for Oz; we both left in 1963, and our last visits were in 1995. We are Permanent Expats now, and feel most comfortable among other expats, of whatever origin.
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Old Apr 28th 2018, 4:53 am
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Default Re: medical tourism

Originally Posted by Gordon Barlow View Post
Carcajou: the first thing I have to say to all your questions is that I somehow missed a few crucial words in my OP. I didn't mean that we would live in Cuba or Jamaica (God forbid!), but rather that we might turn to them for medical care. Our "living wills" - what the doctors call DNS notices, DNS standing for "Do Not Resuscitate", and what we ourselves call PTP, for "Pull The Plug" - specify treatment in those two countries only, if Cayman itself can't fix us.

I apologise for misleading you about choosing Cuba or Jamaica as bolt-holes. We wouldn't choose them. Jamaica is crime-ridden pretty much all over, especially for foreign retirees; and Cuba is - as you say - a police-state, and it's never nice when crime and extortion are a government monopoly; that's impossible for private citizens to deal with. Incidentally, buying property anywhere would not be on our list of things to do, because of our age. It never makes sense for 78-year-olds to buy new residences. What's the point? And by the same token, what's the point of worrying over-much about declining desperate life-saving measures, at that age?

As for the hurricane risk: that doesn't really bother us, either. We survived for three weeks without power and piped water here in Cayman after the big 2004 storm (no generator, and with severely rationed rainwater), so we could survive again if we had to. And if things got really desperate, there might be nowhere to run anyway. Look how poorly the US's quasi-state of Puerto Rico has fared since its hurricane. Look at how New Orleans and Houston fared.

We're spoiled for choice in this part of the world, aren't we? There are a dozen countries we could comfortably live in. At the moment, we can afford to stay where we are, and to fly the grandchildren over from Norway twice a year. Australia... well, we no longer have any affinity for Oz; we both left in 1963, and our last visits were in 1995. We are Permanent Expats now, and feel most comfortable among other expats, of whatever origin.
Gordon, this all makes complete sense now. I did find it very, very odd to hear (especially) Cuba and Jamaica mentioned as relocation sites, but on global Internet forums you can get allsorts so I didn't question it too much. Mentioned as medical destinations is of course, very different, and quite sensible.

As you know from some of the other threads I am in Country WA now, but spent the majority of my growing-up years in Miami, and many of my childhood friends were from Caribbean nations (a lot from Cuba, Haiti, and Jamaica, but also other islands), whose families ended up in Miami for one reason or another. We'll be back for a visit, not this year but not long after, and will visit a few islands then - as you said, spoiled for choice in the region, and my wife and I are having a hard time deciding. We think we have a few in mind though.

I do understand why you won't come back to Australia. Sometimes life takes you away from a place so long that you just drift away from it. I don't rule out ever moving back to North America (also some childhood and rellies in Quebec), but don't think it will ever happen for the same reason. If you've been gone for 50 years it would be harder to re-adjust in Australia than it would be to go somewhere else in the Caribbean. Seems you have had a very successful time in the Caymans and have a lot of experience in the region - so I would bet your existing medical and insurance arrangements suit you just fine, and probably aren't worth changing unless this new deal shows obvious and substantial improvement over what your current plans are.

Good luck.
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Old Apr 28th 2018, 5:56 am
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Default Re: medical tourism

Originally Posted by carcajou View Post
As you know from some of the other threads I am in Country WA now, but spent the majority of my growing-up years in Miami, and many of my childhood friends were from Caribbean nations (a lot from Cuba, Haiti, and Jamaica, but also other islands), whose families ended up in Miami for one reason or another. We'll be back for a visit, not this year but not long after, and will visit a few islands then - as you said, spoiled for choice in the region, and my wife and I are having a hard time deciding. We think we have a few in mind though.

I do understand why you won't come back to Australia. Sometimes life takes you away from a place so long that you just drift away from it. I don't rule out ever moving back to North America (also some childhood and rellies in Quebec), but don't think it will ever happen for the same reason. If you've been gone for 50 years it would be harder to re-adjust in Australia than it would be to go somewhere else in the Caribbean. Seems you have had a very successful time in the Caymans and have a lot of experience in the region - so I would bet your existing medical and insurance arrangements suit you just fine, and probably aren't worth changing unless this new deal shows obvious and substantial improvement over what your current plans are.
Good to read your friendly post, Carcajou. The only thing I miss from Oz is watching Rugby League - although as I type this it's half-time in Melbourne at the Warriors game on Sky Sports! Almost perfect footie from the Storm, so far. Living in Miami and WA you probably don't know or like the NRL, so I won't bore you any more about it! Sigh.

Grand Cayman's not a pretty Island, but it's a relaxed life. I'm not one of the Island's resident billionaires - or even millionaires - but I earn a few bucks as a consultant, to relieve the stress on the family savings! The cheapest medical insurance costs us US$8600, which covers in-hospital treatment only; out-of-a-bed problems we have to pay ourselves. Full medical, dental and eye treatment would cost something like US$25K, so we take a chance on those things. Some friends of mine have received excellent treatment in Havana; foreigners get priority over citizens there. Kingston too has pretty good medical care. Unfortunately, Cayman's insurance doesn't extend to outside the Islands. And anyway this little island (population 60,000) has pretty high standards since the Indian doctor opened his hospital. It hasn't been wildly successful in the field of medical tourism, but we locals love it. My wife was in there for two collapsed lungs (at different times last year and this) at a total cost of US$25K or so, with a deductible of US$1200. I mention those figures for any prospective medical-tourist reading this.

Oh, and one more thing's worth mentioning... Medical marijuana is legal here now - not the smoking stuff itself (though that's readily available on some of the back streets!) but the cannabis oil, on prescription. I've read that it's technically legal in Australia too, but very hard to find a doctor who's licensed to prescribe it. That's a great pity.
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Old Apr 29th 2018, 2:58 am
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Default Re: medical tourism

It's funny how sport from the home country stays a part of the life of the expat even if every other part of the culture has dissipated. You're right, I don't watch NRL - I've tried to adopt the Fremantle Dockers as my AFL team but still after several years haven't been to a game, despite lots of people offering me free tickets. I largely gave up spectator sport since moving to Australia . . . but still try to make time for the Miami Dolphins and Miami Heat. I'm probably the only one within 1,000 km who watches the NFL, much like you're probably the only one in the Caymans who watches NRL. A lot of teenagers around here do know the NBA which surprised me when I first got here. I think it helps that several Australians have gone to that league and found success.

Enjoy the rest of your weekend Gordon. I will look forwards to seeing your commentary in other threads.
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Old Apr 29th 2018, 9:48 am
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From britain to the caribbean - well of course we share cricket... The england side playing the west indies in Grenada was a pretty glorious week for everyone, but fundamentally cricket is a game of much discussion, beer or similar, with very occasional intense viewing of actual sport. Watching the old MCC hat wearers negotiating local beach bars while hundreds of more liberal supporters like the moustache cricket club and the barmy army took over entire stretches of little rum shops opposite the stadium.

Its definitely watched everywhere, even village crickets good, often they are hard played grudge matches with no quarter given or requested.

The yoof of Grenada have somewhat dropped cricket now, in favour of basketball, so thats the other tv in beach bars. Theres also a strong following for athletics and some football [thats soccer to some.]
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Old Feb 22nd 2019, 11:50 am
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Default Re: medical tourism

Due to limited medical resources in our country last year i went to united kingdom for my cousin neck surgery and after his surgery he's perfectly fine now and to the docotors.
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Old Feb 22nd 2019, 1:57 pm
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Default Re: medical tourism

Originally Posted by uk_grenada View Post
We have a lot of cuban medics here on loan. They are excellent people, but their training excludes some of the high tech stuff in europe. Unlike the states theres no insurance or money obsessed culture in medicine [if in doubt do more tests, charge more] but they do a good job generally. If you visit cuba you by law have to pay local health insurance but its about a dollar a day all in, excellent.

Personally if ill i would prefer to fly to europe credit card in hand. The treatment is superior and a lot cheaper. Belgium is really good, and open to lots of private work. France is more difficukt to access, Germany is a no no, the UK is expensive unless you have legitimate NHS access.
I wonder why Germany is a "no no" for you. Just curious. Private treatment is easy to get, affordable (outpatient) and they have excellent doctors. You just need to research a bit.
I live in Thailand where lots of ppl travel to for low cost medical treatment. If I have a health issue I try to hold out until the next Europe trip where I use German or Austrian private healthcare. On many occasions I paid the same or less for the treatment in Germany or Austria than in Bangkok and I don't get fleeced for diagnostics which have nothing to do with my problem. The unnecessary knee op would have cost more in Bkk than in Austria. But physiotherapy cured the knee. Thailand has some good doctors but they are hard to get to at government hospitals.
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Old Feb 23rd 2019, 1:39 pm
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Default Re: medical tourism

Germany is a nono because it is expensive compared with belgium, and france/belgium are easily accessible by car/train from the uk.

Effectively, it a[pears that like the uk, germanys state healthcare system fleeces anyone who has to pay. Consider the worst scenario - following an op you get an infection and end up in ICU for a week. In the uk thats 28 thousand pounds. In Germany 34 thousand, in Belgium 12 thousand, but many surgeons will underwrite their work, if you have such an issue the hospital picks up the tab as you chose to pay them for the op in the first place. There is a similar arrangement sometimes with the nhs in the uk, but the up front cost is higher. NB i used to run clinical engineering in a number of nhs hospitals, the ‘game’ is well understood.
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Old Feb 23rd 2019, 1:42 pm
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A good indicator of costs - plastic surgery like boob jobs - google patrick dedoncker in belgium for his price list and compare with where you live.
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Old Feb 26th 2019, 7:37 am
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Default Re: medical tourism

Originally Posted by uk_grenada View Post
Germany is a nono because it is expensive compared with belgium, and france/belgium are easily accessible by car/train from the uk.

Effectively, it a[pears that like the uk, germanys state healthcare system fleeces anyone who has to pay. Consider the worst scenario - following an op you get an infection and end up in ICU for a week. In the uk thats 28 thousand pounds. In Germany 34 thousand, in Belgium 12 thousand, but many surgeons will underwrite their work, if you have such an issue the hospital picks up the tab as you chose to pay them for the op in the first place. There is a similar arrangement sometimes with the nhs in the uk, but the up front cost is higher. NB i used to run clinical engineering in a number of nhs hospitals, the ‘game’ is well understood.
There is no need to go to a government subsidised hospital in Germany. Pick a private one.
Fees and charges are not the same in gov. hospitals countrywide. They vary depending on who runs them and on location. Doctors' fees for private treatment are regulated. Doctor sends the bill, not the hospital.
I have no price comparison between Belgium, Germany and Austria for treatment either in or outpatient. Dr Dedonckeren's pricelist doesn't help as I'm not considering a boob job. Price for a hip replacement in Belgium would be interesting.
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