Medical tourism…. at what price? (Part two)

If, for many patients, price is a key determinant of choice of medical tourism destination or provider, how do prospective patients make a realistic comparison and what do they need to factor in.

In Part One of this article, I looked at the wide disparity of domestic prices that are used to make prices in medical tourism destinations appear attractive.

Taking the example of a UK patient seeking a hip replacement abroad, we see that the patient is faced with a problem.

When looking at possible destinations, the patient is being told that the price for a hip replacement price in the UK ranges from £7,950 according to one medical tourism provider’s web site to £34,000 at another web site. Are any of these prices anywhere near the mark? How attractive are the medical tourism prices on offer, if the patient is being given this kind of misleading comparison.

The Private Healthcare UK Self-Pay Market Study 2013 which examined over 7,800 published prices for private treatment in the UK provides us with the true basis for comparison. Prices for private hip replacement in the UK range from £14,980 (in a Norfolk hospital) to £7,610 (in an Essex hospital). As you can see, there is an opportunity for domestic medical tourism in the UK. Indeed this happens… UK patients (both NHS and private) can shop around and have the choice of providers across the UK. UK hospitals are in competition with providers of low cost surgery in other countries..

Will NHS shortcomings drive demand for medical tourism?

A patient in Norfolk needing a hip replacement has the option to stay at home and pay £14,980 to fix their problem. Or… he or she could travel 100 miles to the Essex hospital and get it done for £7,610. Or…. the patient could explore the medical tourism option. But it’s not as simple as many medical tourism providers believe.

It’s about comparing the real cost of treatment at home against the real cost of treatment abroad and it is this that provides some insight into why planeloads of unhappy UK NHS patients aren’t heading overseas for their hip replacements.

Let’s take our patient in Norfolk who needs a hip replacement. We’ll call her Thelma. Thelma is 70 (the typical age for a hip replacement patient in the UK). She is retired but has a decent amount of savings. Thelma has been looked after by the UK’s NHS system for many years. She lives in Gorleston in Norfolk. Her nearest NHS hospitals are the James Paget University Hospital and the Norfolk and Norwich University Hospital. But the NHS has a problem…. Healthcare budgets are being cut and there is increasing demand for free NHS services. Although there is a government requirement for NHS hospitals to treat all waiting list patients within 18 weeks, her local hospitals are not performing. (See: Waiting times concerns at two Norfolk hospitals). At the James Paget University Hospital in Gorleston only 67% of orthopaedic patients are being treated within the 18 weeks and at the Norfolk and Norwich University Hospital just 82%.

So…. what are Thelma’s options? And how attractive is the medical tourism option to Thelma?

Stay at home? Get it free? Go abroad?

Here are the options that Thelma might consider:

  1. Stay with the free NHS and wait for her hip operation at her local hospital. No cost, just a longer wait.
  2. Stay with the free NHS and opt to go to a different NHS hospital where the waiting time is shorter. Under the NHS, patients have a choice of hospital… any NHS hospital. No cost, a shorter wait but Thelma may need to travel to an NHS hospital further afield. She becomes domestic medical tourist, funded by the NHS.
  3. Decide to exploit her rights under EU law, go to a hospital within the EU for her operation. Thelma pays for the operation and the NHS refunds her the amount of money that her local hospital would have paid for the operation. (probably around £6,000). She becomes a medical tourist, funded by the NHS under the European Directive on Cross Border Healthcare. (See: A UK patient’s guide to the European Directive). No cost for the operation, but she will have to fund the cost of travel and accommodation for herself and her companion.
  4. Go private in the UK. Decide to pay to have a private hip operation straightaway. She stays in Norfolk and gets it done for £14,980.
  5. Go private in the UK. Decide to pay to have a private hip operation straightaway. She travels 100 miles to Essex in Norfolk and gets it done for £7,610.
  6. Become a medical tourist. Thelma starts looking at the options for going abroad for treatment. She discovers that she can fly to Prague in the Czech Republic and have the operation for £5,400.

So… how attractive is the medical tourism option for Thelma?

Let’s look at the cost in more detail.

  • The £5,400 covers all hospital costs and a one week stay at the clinic.
  • She will need to stay for a week’s rehabilitation. The clinic in Prague charges £850 for this, inclusive of all therapy, accommodation and meals.
  • She wants to take her husband along. He will be there throughout the two week stay. So he will need accommodation. Let’s say we allow 18 nights in total. A 3 star hotel in Prague works out at around £1,000.
  • They will need flights. Luckily, the couple can fly Easyjet from London Stansted to Prague for around £200 return for the two of them.
  • They will need some specialist travel insurance because their regular travel insurance will not cover them for medical travel. Let’s allow £250 for this.

So how much does medical tourism cost in the real world?

In Thelma’s case, if we add up the real cost of going to Prague for hip replacement:

  • £5,400 plus £850 plus £1,000 plus £200 plus £250.

So, in total, £7,700.

…which is about the same price that Thelma will pay, if she opts to go the private hospital 100 miles away in her own country.

If you were a 70 year old woman with a hip problem…… which option would you go for?

Find out what private surgery really costs in the UK

You can purchase a copy of the Private Healthcare UK Self-Pay Market Study 2013 for £450 from Private Healthcare UK. We talked to senior industry figures about their view of the market sector, carried out an online survey of participants in the private healthcare sector, including hospital managers, clinicians and senior decision makers, and analysed over 7,800 prices for the most common procedures.

Download a report overview to view the contents and an example pricing analysis.

Previous comments on this article

When make considerations for your health there is a fine line between cost, time and service. We all want the best service but we can’t all pay for it. If the procedure is able to wait a while, it’s not urgent, it may be able to wait for the free service. After factoring in all expenses each person has to decide the best option for them–to stay local or go abroad.

Joyce Hampton (23/02/2014 05:53:36)

I agree. But the reality is that the majority of medical travellers (certainly out from the UK) fly low cost airlines and indeed this is one of the factors that is pushed by the agencies and providers.
If the UK medical tourist were to upgrade to business class, this would negate the cost advantage for many.

Keith Pollard (07/02/2014 16:49:39)

Keith, you had me going all up until you suggested EasyJet to Prague.

My fear with the low cost airlines is that their seat configurations are often narrow. Unless Thelma and husband are of normal to small stature, they may be uncomfortable in a seat that is narrow in width, and would be more comfortable in a business class seat, and safer. Pressure on a wound and healing could be compromised and the patient uncomfortable during the flight.

Easyjet flies Narrow Body A319s and A320s, with a seat pitch of 29.0 inches and a seat width of 18.0 inches, with no upgrade seats.

Standard Seats on British Airways which flies the same aircraft, but uses different seats are 17.0 inches, but Standard Club seats (Rows 1-3) are 19 inches, with a seat pitch of 34 inches.

Czech Airlines has a standard business class seat that is 19.2 inches on the A320.

When calculating medical tourism composite packages, one has to take into account patient safety, comfort, and mitigate any pressure on the wound that could contribute to complications. If that means a little more spent on transportation and creature comforts in the name of safety, wound care and mitigation of blood clots, then so be it.

Maria Todd, MHA PhD
Mercury Advisory

Maria Todd MHA PhD (03/02/2014 22:08:12)

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Keith Pollard
As Editor in Chief of International Medical Travel Journal (IMTJ) and a Healthcare Consultant for LaingBuisson, Keith Pollard is one of Europe’s leading experts on private healthcare, medical tourism and cross border healthcare, providing consultancy and research services, and attending and contributing to major conferences across the world on the subject. He has been involved in private healthcare, medical travel and cross border healthcare since the 1990s. His career has embraced the management of private hospitals in the UK, research and feasibility studies for healthcare ventures, the marketing and business development aspects of healthcare and medical travel and publishing, research and consultancy on cross border healthcare.