Health Care in United States, Aging Population and Global Healthcare

Medical Health System is a huge part of the economy as U.S. National Health Expenditure (NHE) is 3.2 trillion annually (2015 data). Even though the United States is spending a higher proportion (17.8% - 2015 data) of its Gross Domestic Product (GDP) on healthcare than other developed countries, it is still unaffordable, or even inaccessible to many. Worldwide U.S. health system is ranked 37th in terms of overall efficiency.

Factors contributing to the inefficiency:

  • Drugs - The price is set by the pharmaceutical company and cannot be negotiated down.
  • Administrative Cost - The billing system is too complicated, co-pay, co-insurance, and deductibles. It is not a single-payer system as in Canada, Denmark, Sweden, and Norway.
  • Referred Specialist - PCPs are not taking care of patient needs and refer them to more expensive specialists. Specialists are compensated at an average of 45% more than the primary care physicians with expected increase income of 16% compared to 10% for the primary care physicians.
  • Newer Treatments - Newer treatment options are not necessarily better than older ones, but it cost more.
  • Defensive Medicine - Doctors & hospitals are afraid to be taken to court (medical malpractice lawsuits). They order more tests to leave a paper trail.

The U.S. healthcare system is great in treating most difficult cases and American doctors, nurses and medicines are incredible, but the expenditure is astronomical.

Foreign-Born Physicians and U.S. Healthcare

The U.S. population is aging and retiring; baby boomers are becoming heavy users of health care. By 2030, 71 million Americans (about 20% of the U.S. population) will be 65 and older. This issue, coupled with a shortage of health workers, are straining this sector. There are not enough native-born physicians and healthcare workers to meet the growing need. The shortage of professionals will be even more pronounced as one-third of physicians also retiring in the coming years.

Currently, more than 25% of physicians are born (born & trained) outside of the U.S. According to 2010 data, about one-fifth of nursing, home health, and psychiatric aides, as well as one-sixth of dentists, pharmacists, and clinical lab technician, are foreign-born. This system is heavily depending on proper immigration policies.

Doctors who are born and/or trained outside of United States often end up practicing in rural or low-income areas where there is a shortage of physicians. The foreign-born specialists bridge the cultural, language, and trust gaps in the system and communicate with patients for a better outcome.

It is estimated that the United States will face a shortage of approximately 46,000 to 90,000 physicians by 2025. This means that foreign-born professionals will have to help fill the gap and they play a crucial role in the health labor force.

Medical Tourism and U.S. Healthcare

The medical tourism industry, where people travel abroad to receive medical treatment, is growing fast. Medical tourism offers reliable and quality medical care (physicians, drugs, devices, etc) abroad at a lower cost (and no wait time). There are estimated 11 to 14 million medical travelers annually – and this number grows by 15-25% a year.

To resolve the shortage of healthcare professionals in the U.S. and Canada, crossing the border to get medical services is a viable option. Medical tourists from the U.S., Canada, Australia, … travel to Thailand, Costa Rica, Mexico, India, Malaysia, Philippines ... to get treatment. They travel to get services not covered by insurance, like infertility and plastics, or partially covered, like dental and bariatrics.

For example, a heart bypass that costs an average of $90,000 in the U.S., costs about $30,000 in Costa Rica. The average cost of a hip replacement is $33,000 in the U.S., compared to $12,000 in Thailand. The average cost of RNY Gastric Bypass is over $25,000 in the U.S., as the cost in Tijuana, Mexico is $6,500 (including accommodation cost). Taking into account the cost of travel, the total cost for medical tourists can be as little as one-half to one-fifth of the going rate in the United States.

The National Health Expenditure is expected to grow to 20% of GDP by 2025 and the health care spending spiral with age. As life expectancy lengthens and baby boom cohort ages, it is likely that the burden of high cost of healthcare is shifted from government to consumers. Here is an opportunity for aging population to combine a short vacation with medical care.

One of the most global healthcare popular procedures for overweight adults is bariatric and metabolic surgery in Mexico. Weight loss surgery is becoming more and more popular as it renews obese individuals and prolongs their lives. Tijuana, Mexico is becoming the mecca for gastric surgeries. You can find top certified surgeons and accredited facilities to get an equal or a better treatment at an affordable price.

More Reading

Doctors Who Trained Abroad Are Better at Their Jobs
Doctors from Abroad: A Cure for the Physician Shortage in America

Medical Tourism a Cure for US Healtcare Shortage