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Opportunities as Health Care Industry Faces Disruption

The new health care reform law in the U.S. provides a catalyst for disruption of the health care industry in the U.S. with ripple effects expected to be felt in the world of medical tourism. As this blog focuses on medical tourism with emphasis on Thailand as a medical tourism destination, I’m going to discuss a coupe of opportunities that seem to be presenting themselves as a result of this disruption.

The first opportunity is a direct impact on the medical tourism industry itself, which is to say that as the effects of U.S. health care reform begin to be felt there will be an impact on the number of medical tourists seeking health care overseas. The question is will the numbers increase or decrease. On the one hand the requirement that Americans purchase health insurance might lead them to make every effort to use those purchased benefits rather than seeking care at a medical tourism destination in another country. But there is a significant moral hazard that has been created in the new law due to the fact that the cost of health insurance is substantially higher than the penalty for not purchasing. So many people will opt for the lower cost penalty and then seek care at overseas hospitals provided that there is still a cost and convenience advantage. The penalty, up to $695, will narrow the cost advantage but it doesn’t appear that it will close the gap completely. With major procedures at popular medical tourist destinations costing one-third to one-tenth of what they do in the U.S., it still appears that there is cost savings when all is taken into account, including premiums, deductibles, air fare, hotel, and the new penalty. So the cost gap may narrow but not close completely. Furthermore, there is a distinct possibility that premiums will increase so that the penalty looks even more attractive and the cost advantage of medical tourism increases. There is also the possibility that wait times may increase, something that is famous in Canada and the UK, and quality of care may decrease as millions more enter the system. It is too early to tell but there could be a very large increase in medical tourists as fallout from U.S. health care reform. Thailand has one of the most advanced medical tourism industries and could benefit from this, provided that political stability can return to the country.

With disruption of the overall health care industry underway, it would seem that the time is ripe for disruption of certain silos within the industry. The patient records debate has been going on for some time and there are emerging competing solutions for breaking down the silos and getting patient records into a portable and electronic format. Two such solutions are Google Health and Microsoft HealthVault. There are also numerous other closed source solutions and vendors are circling, trying to make sales of hugely expensive software packages for this space. Many people fear a sort of SAP for the health care industry – huge, expensive, difficult to use software packages that require expensive consultants to set up and maintain. Isn’t this space perfect for open source solutions based on some of the standards being hammered out now? Bringing this discussion into the context of Thailand as a medical tourism destination, the country could become a leader in electronic patient records. The private hospitals that the medical tourists visit are already leaders in health care IT. If they adopt the standards in their infrastructure and open it up to import/export to other standards compliant medical centers around the world they could have yet another strong selling point by making it easy for foreign patients to grant access to their medical history so they could get a thorough prescreening before they ever leave home.

So I see two opportunities that could use immediate action to capitalize upon, 1) leveraging off of the fallout from U.S. health care reform and 2) rolling out standards compliant patient health care data interchange.

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