American travel writer and editor Olivia Balsinger got veneers in Colombia for a fraction of the price she would have paid in the US.
On June 5, American blogger Alyne Tamir posted a video about how she saved money on healthcare by having medical procedures abroad.
Every year, millions of Americans leave the country in order to save money on exorbitant medications and surgeries — a phenomenon called ” medical tourism.”
Many Americans have saved thousands of dollars by getting dental work, undergoing surgeries, picking up prescription medication, and even giving birth in other countries.
According to American healthcare providers, there are a myriad of factors that are responsible for driving up the cost of healthcare in the US.
Most Americans who travel for medical procedures claim that, despite the low cost of health services in other countries, the quality is comparable — or even superior — to that of the US.
The American healthcare system is known for being notoriously expensive. It doesn’t help that, according to data collected in 2017 by the Gallup-Healthways Well-Being Index, 11.3% of Americans are not able to afford health insurance.
Even those who do have health insurance often find themselves struggling to pay sky-high medical fees. For example, a Reddit user went viral in 2013 when he posted a photo of the hospital bill he received when he was treated for appendicitis. The total charges came to over $55,000, and even with health insurance, he had to pay over $11,000 out of pocket.
This story is nothing new. Compared to the rest of the world, people in the US pay much higher prices for medical services such as hospitalization, doctors’ visits, and prescription medication.
In June, American blogger Alyne Tamir posted a video about how she saves money on healthcare by having medical procedures abroad. Alyne Tamir flew to Egypt and paid $120 for her root canal. An American blogger born in Santa Monica, California, who has been traveling full-time for over two years, Tamir has been documenting her experiences abroad through a blog.
On June 5, she posted a video about how “a simple toothache” opened her eyes to a “whole new world.” In the video, Tamir explained it would have cost $1,500 to fix her tooth in the US. Instead, she had her root canal done in Egypt. “A nice hotel in Egypt costs around $70 a night,” she told INSIDER. “And the actual root canal was only $120. This was at a fancy dentist too; you can definitely get it for way cheaper somewhere else in Egypt.”
Tamir said that the Egyptian dentist did an “amazing job” fixing her tooth. She told us that when she got her teeth checked again in Australia, the dentist there commented that the Egyptian dentist had done a particularly fine job.
Every year, hundreds of thousands of Americans travel abroad in order to receive medical procedures at a much lower cost — a phenomenon called “medical tourism.”
According to a 2015 report by the US International Trade Commission (USITC), between 150,000 and 320,000 Americans travel abroad every year to receive healthcare.
Given the high cost of healthcare in the US, Americans cite savings as the most common reason to travel abroad for health treatment. For Americans without health insurance, the difference in cost can be staggering. The USITC study claimed that, while uninsured Americans can expect to pay $30,000 for a knee replacement in the US, they could get the same surgery for $12,000 in India.
And even for Americans who are insured, most health insurance policies do not cover everything. According to America’s Health Insurance Plans (AHIP), most medical insurance plans do not cover dental work, cosmetic surgeries, and many prescription medications. Even giving birth in an American hospital can be prohibitively expensive. As a result, many Americans would need to pay hundreds or thousands of dollars out of pocket to receive these medical services.
Some Americans accidentally discover that medical services abroad are much more affordable when they sustain an injury or illness on vacation.
American citizen Melissa Karlin was attending university in the UK when she dislocated her knee cap. Thanks to the NHS, she received medical care entirely for free.
Patrice Raplee, a Seattle-based travel photojournalist and editor, was on vacation in Florence a few years ago when she said she bit down hard on a nut embedded in her roll. She said it split her tooth right down the center and caused her to bleed profusely from her mouth.
Raplee said she went to a hospital in Florence to get an emergency medical procedure. She told INSIDER that the doctors spent a few hours administering painkiller and repairing the tooth. At the end of the procedure, she said she asked if her health insurance would be able to cover the cost of everything.
“I remember thinking, ‘Oh my god, how much is this going to cost me?'” Raplee said.
However, the emergency medical procedure, which Raplee estimated would have cost at least $1,000 in the US, ended up costing her 15 euros — the equivalent of $17.43. And the anti-inflammatory medication that she picked up later at the pharmacy cost her three euros, or $3.49. In total, Raplee spent around $20.92 for the entire medical treatment she received.
Melissa Wright claimed she had a similar experience after being mugged and hospitalized in Spain. After spending eight hours in the emergency room and getting treated by six different specialists, she said she received a bill for 108 euros, or $125. According to Wright, when she previously visited the emergency room in the US for a kidney infection, she was charged over $4,000 after she spent two hours in the hospital and had a five-minute consultation with a doctor.
Many Americans take advantage of the lower costs of healthcare abroad to save money on cosmetic surgeries and dental work that are not covered by their health insurance in the US.
Balsinger traveled to Colombia to get veneers.
Since dental work and cosmetic surgery is not usually covered by most health insurance plans in the US, many Americans find that they are able to save thousands of dollars by traveling abroad for these costly procedures.
According to Physicians for a National Health Program, an estimated 108 million Americans have no dental insurance simply because most insurance companies do not offer dental coverage for adults. And dental work is not cheap in the US. According to Authority Dental, basic dental exams can cost between $50 and $200, X-rays can cost anywhere from $25 to $250, and cleanings can go from $75 up to $200.
As a result, many Americans simply do not visit the dentist at all. According to a Gallup poll conducted in 2014, about one-third of Americans did not visit a dentist even once in the past year.
But dental work can be much less expensive abroad. Nina Ragusa, the author of travel blog Where in the World is Nina? who has been traveling full-time since 2011, told INSIDER that she received a dental exam, X-ray, and cleaning from a dentist in Bangkok for $50. When she traveled to Mexico, she did the same thing for $25, and also got a night guard — which typically costs around $300 to $500 in the US — for $25 while she was there.
Cosmetic surgery, which isn’t covered by most American health insurance, can also be very costly. In the US, for example, the average cost of LASIK eye surgery is $2,088 per eye. Ragusa, however, told INSIDER that she received LASIK in South Korea and paid a total of $1,400 — including all of the check-ups before and after the surgery, the surgery itself on both eyes, the medicine, and all future care for life.
Travel writer and editor Olivia Balsinger told us she had a similar experience when she got veneers in Colombia for a fraction of the cost she would have paid in the US. For eight veneers and three crowns — a procedure that would have cost around $15,000 in the US — she paid $4,000.
“The best part was that after the procedure, I wasn’t going to wallow in pain in my New York City apartment,” Balsinger said. “Instead, I was on the beaches of Cartagena.”
Some Americans, especially those with chronic illnesses, need to travel abroad in order to access medical treatment that they simply would not be able to afford in the US.
Sarah May Grunwald is an American citizen living with severe Crohn’s disease, a chronic illness that necessitates frequent hospitalization, surgeries, and medication. However, she said she had trouble receiving adequate healthcare in the US. She told INSIDER that her medical bills from the US have landed her deep in debt. And her monthly medication, which costs about $500 a month, is simply “impossible to afford.”
Now that she is living in Italy, Grunwald said she is finding it easier to maintain her health. She said that she pays about five euros, roughly $5.79, every month for her medication. And the medical procedures that used to cost her thousands of dollars in the US, she said, now cost “so little” that she cannot even recall the exact cost. She estimated that she pays “under 20 euros” for every hospital visit.
Even colonoscopies at private hospitals abroad are cheaper, according to Grunwald. She said that they cost her 400 euros, the equivalent of $463, in Italy; at her old doctor in the US, Grunwald claims the exact same procedure would cost around $3,200.
American freelance writer Rease Kirchner told INSIDER that she went on vacation in Colombia and purchased the medication she needed to treat her chronic dry eye, for a fraction of the cost of the medication in the US.
Although she had health insurance coverage, the prescription for Restasis eye drops would have cost her $500 per month in the US. Since she needed at least a year’s worth of Restasis, it would have cost her $3,000 in total. After doing some research online, she said she found that the same medication was available in Colombia for $50. Kirchner said she flew to Colombia, spent 10 days exploring four different cities, purchased a year’s supply of Restatis, and still spent less than $3,000.
And some Americans have even opted to give birth abroad to save money.
The Guardian reported in January that the US is the most expensive nation in the world to give birth. A 2013 study from Childbirth Connection found that American hospitals charge an average of $32,093 for an uncomplicated vaginal birth and newborn care, and $51,125 for a standard Cesarean section and newborn care. And while health insurance does typically cover most of these costs, American families are still left to pay thousands of dollars out of their own pockets.
It’s no wonder, then, that some Americans choose to give birth in other countries.
Amanda Ponzio Mouttaki, an American blogger and expat living in Morocco, told INSIDER that she had her baby three weeks ago through Caesarean section. Mouttaki said that even though she did not have health insurance, she had to pay $1,100 for the delivery, doctor, a private room in the hospital for two nights, and medication. In total, including the cost of all the prenatal appointments, blood tests, and ultrasounds, she said she spent around $2,000.
Mouttaki said that her sister gave birth in the US, also via Ceasarean, and had a $100,000 hospital bill.
The cost of giving birth also appears to be lower in some parts of China. Charlotte Zhang, an American citizen living in China, said that she had no insurance coverage when she gave birth to two babies in a public hospital in Renqiu, a small city in China’s Hebei province. Each time, she said, cost her less than $200.
According to American healthcare providers, there are a myriad of reasons why healthcare in the US is so expensive compared to other countries.
America’s Health Insurance Plans (AHIP), a national organization that advocates for the health insurance community, described in a recent brief that health insurance premiums are likely to rise in 2019. A major factor that drives up the cost of health insurance, according to AHIP, is the price of prescription drugs — a whopping 95% of specialty drugs cost more than $10,000 per patient per year.
Amanda Guarniere, a nurse practitioner who graduated from the Yale School of Nursing, told INSIDER that another reason why the cost of healthcare is so high in the US is because there is very little competition in the healthcare market in the US.
“If you are eligible for an employer-sponsored plan, you are likely going to choose that plan over one in the marketplace,” Guarniere said. “There’s not much of a choice, if any, in terms of what your plan offers.”
Guarniere said that American physicians tend to have a higher salary expectation compared to those in other countries. She acknowledged that this is “partly cultural.” However, she said that part of it also stems from the fact that American healthcare providers are expected to “pay an obscene amount of money” to receive their education. A higher salary, she said, is often necessary in order to pay off student loans.
However, according to Dr. Mary Jane Minkin, an OB-GYN at Yale New Haven Hospital, most physicians don’t earn high enough salaries to explain the incredibly high cost of healthcare. “Physicians aren’t making a lot of money these days,” she told INSIDER. “Who the heck knows where all the money is going?”
Minkin said that another factor that is driving up the cost of healthcare in the US is malpractice insurance. She said that, unlike other countries where medical malpractice cases are judged by panels of experts, in the US these cases are often reviewed by juries comprised of laypeople who don’t necessarily have a medical background.
As a result, American doctors face a real financial risk from patients’ lawsuits. And even if they do end up winning the case, doctors still need to spend money on hiring lawyers to defend themselves in court.
According to Minkin, this fear of getting sued leads doctors to adopt other cost-driving practices. Unwilling to take the chance that something goes wrong and the patient decides to sue them, doctors will often perform unnecessary Caesarean sections and order many expensive tests for their patients, she said.
“All of these things translate into higher cost of care,” Minkin said. “You have to embed these costs into health insurance, and this forces patients to pay higher premiums.”
The main problem, according to some healthcare providers, is that healthcare is a profit-oriented system in the US. Some believe that the way to improve healthcare in the US is by transitioning to a single-payer system. According to Physicians for a National Health Program, single-payer national health insurance would be funded by public taxpayer money and would provide full medical coverage for all residents of the US.
“It’s not a panacea,” Minkin told us. “But it would get around a lot of the issues with health insurance that people deal with.”
Although healthcare providers told INSIDER that they understand why patients would be tempted to pursue medical tourism, many said that there are risks associated with it.
“I understand why people do it from a financial standpoint,” Dr. Hillary Brenner, a podiatrist in New York, told INSIDER. “But what if something goes awry?
Brenner raised several concerns. “How clean are these instruments?” she said. “Here, they run tests about sterilization. And how are doctors in those countries trained, as opposed to our training here? I’d be petrified.”
Minkin also questioned the safety of the blood supply at hospitals abroad. “Many surgical procedures need a transfusion,” she said. “The blood supply they are using might be good, but the thing is, we don’t know for sure.”
According to Brenner, the risk seems to exceed the benefit.
“You go there to save a buck,” Brenner said. “But if an instrument is wrong, or not sterilized properly, then that might end up costing you more money in the long run. It’s better to get it taken care of properly the first time around.”
Guarniere told us that medical tourism could be a wise option, especially for patients seeking elective-type medical care such as joint replacements and cosmetic surgeries. “That being said, I would want to make sure that the facilities had appropriate patient care and safety standards,” she said.
Most of the Americans INSIDER spoke to, who have traveled abroad for medical reasons, said the quality of healthcare in other countries was excellent — though some reported having a less favorable experience.
American photographer and journalist Eileen W. Cho got a vitamin drip, medicine, X-ray, and check-up for the equivalent of $40 in South Korea.
Raplee said she was initially “rather fearful” when she walked into the hospital in Florence, and she was worried that she would receive substandard care. But she said she was pleasantly surprised to find that the hospital had modern facilities and the doctor had been trained in the US.
Despite charging her 15 euros for the emergency operation, she said the Italian doctor fixed her broken tooth so well that “the repair lasted for years.” According to Raplee, her doctor in the US called it “brilliant” and said he couldn’t believe it cost so little.
For Grunwald, one of the major differences between American and Italian healthcare in her experience was not only the drastic difference in affordability, but also the level of care.
“In America, doctors are much more inclined to not listen to women in pain,” she said. She said that before she was diagnosed with Crohn’s disease, her doctor suggested that she was depressed and hysterical — even though she claimed to be experiencing bloody bowel movements.
“In Italy, I have never been patronized as a woman,” Grunwald told us. “They take my illness seriously and treat me with respect.”
People have reported good experiences in other countries as well. Mouttaki said that her experience giving birth in Morocco was “top notch,” despite costing a fraction of what she would have paid in the US. “I would say that the quality of care I received in Morocco was equal to or surpassed what I got in the US for my previous children,” she said.
American freelance journalist Kira Zalan said that her experience seeing an endocrinologist and an orthopedist in Bangkok was also positive. “The customer service, efficiency, and cost were beyond anything I’d experienced in the US,” she said. And she said she paid around $65 to $80 per visit.
Zhang, however, said she had a less favorable experience giving birth in a Chinese hospital. She described the experience as “very cold and sterile,” and she had difficulty communicating with the doctors. Her Chinese-speaking husband, who was not allowed inside the room, had to resort to “yelling his translations” at the door.
Despite these challenges, Zhang decided to give birth to her second child in China. For her, the low cost outweighed the inconveniences and discomfort.
Many of these Americans said that they intend on traveling abroad to receive affordable and high-quality medical care in the future.
Gigi Griffis, an American writer who has been traveling full-time for the past six years, told INSIDER that she has used healthcare services all over Europe and does not intend on returning to the US anytime soon.
Griffis cited expensive healthcare costs as one of the main reasons why she does not plan on living in the US. “I would never ever choose to have a procedure done in the US,” Griffis said. “Paying five or more times as much for the same or worse care? No thanks.”
Even Americans who do have health insurance said they find that it’s less expensive to access medical care abroad. Wright said that she refuses to use her health insurance in the US. “I can barely afford the co-pays and it only covers 70% of the cost of most visits,” she said. She intends to move to Germany, where she said the healthcare is just as good and much less expensive.
Grunwald has no intention of returning to the US either. “Americans will say it is more expensive here because of malpractice insurance, but that’s not true,” she said. “It’s because in most parts of the world, healthcare is a basic human right.”