Could Medical Tourism Aid Health-Care Delivery? Medical Tourism-Wherein Patients Seek More Affordable or Specialized Treatment outside Their Home Countries-Represents a Major Challenge for Health-Care Delivery in Developed Countries Such as the United States. It Also Offers an Opportunity to Integrate and Improve Medical Delivery Globally

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Health care has long been one of the most local of all industries, but in today's world, people, information, ideas, and technologies are increasingly crossing national borders. The move to "go global" is such a strong force that hardly any human activity is exempt from its impact.

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Medical tourism, an outgrowth of the globalization of services, has emerged as an innovative, border-crossing industry, and many developing countries are poised to take advantage of this opportunity. But this opportunity also represents a challenge to health-care-delivery systems in developed countries such as the United States.

U.S. health-care costs, already an estimated $2 trillion a year, are predicted to double in the coming decade. By 2020, health-care spending is projected to consume 21% of U.S. GDP, compared with 16% of GDP in other developed countries.

Today, more than 40 governments are involved in supporting medical tourism, and the number is growing each year. The medical community in developed countries has started to recognize medical tourism as a real phenomenon with significant impacts on both practitioners and patients. Yet "medical tourism" is not a phrase that has come up openly in the U.S. debate on health-care reform.

Just after the 2011 Patient Protection and Affordable Care Act (PPACA) was passed, President Obama signed into law the Health Care and Education Reconciliation Act, which made a number of significant changes to the PPACA. According to Chris Brandt and Michael Cohen of Deloitte Consulting, these reforms represent one of the most significant disruptive events for U.S. health-care providers in the last century. Key challenges that providers will face due to this reform include:

* Estimating the potential impact of increased coverage and associated revenues on profit margins.

* Reviewing the operational capacity to ascertain whether or not the providers can respond to the pent-up demand from the newly insured.

* Handling the approximately 32 million people added to the list of those seeking primary medical care, typically provided by an internist or family-care physician.

A nationwide shortage of doctors--projected by the American Academy of Family Physicians to reach 40,000 primary-care physicians by 2020--may eventually mean long hours in the waiting rooms at busy clinics, less quality time available with doctors in examining rooms, and emergency rooms packed with patients who couldn't find physicians elsewhere.

For past 30 years, the United States has relied heavily on foreign-born and foreign-educated doctors to help meet the demand for healthcare services. About a quarter of all physicians now practicing in the United States came from other countries. In 2007, more than 38% of U.S. family-medicine residents were international medical graduates, according to the American Academy of Family Physicians.

If medical tourism continues to grow at its current rate, recruiting foreign-born physicians and nursing staff to the United States will become more challenging. In 2006, the Association of American Medical Colleges recommended that medical schools increase their student enrollment 30% by 2015 in order to address the nation's growing shortage of physicians. …