Human Exceptionalism

Medical Tourism Cannot Be the Answer

I have reported here at SHS that due to the “NHS meltdown,” tens of thousands of UK patients travel abroad to receive care they should be able to receive close to home. Now, the concept is apparently spreading in the USA, at least if the AMAMedical News is to be believed. From the story:

The American Medical Association House of Delegates recently took an interest in medical tourism as well. At its Annual Meeting in June, it approved a set of guidelines designed to help ensure that globe-trotting patients have all the information they need to decide for themselves when to go overseas, and that they are protected when they go. The guidelines, outlined in a report by the AMA Council on Medical Service, also consider the role of physicians back home involved in their traveling patients’ follow-up care.

Right now, it is too early to conclude whether the risks of medical tourism outweigh the advantages. Meanwhile, long-standing AMA policy on pluralism in health care supports the ability of patients to choose their treatments and physicians.

The operative word is “choose.” The guidelines state that medical care outside the United States must be voluntary, and that any financial incentives should not inappropriately limit the diagnostic and therapeutic alternatives, or restrict treatment or referral options. In the end, the decision to travel for care is those patients’–not anybody else’s.

There’s the “C-word” again, the excuse for every pullback from upholding robust ethical norms.

Rather than shrug its collective shoulders about the threat of medical tourism, it seems to me that the AMA should instead strive to promote policies where patients wouldn’t feel so pressed that they would consider traveling 5000 miles, to be treated by doctors they have never met, in a circumstance where they are far from family and friends. But, alas, this is the kind of bland “leadership” we too often get from our instituions these days:

The cost of care and the issue of the uninsured need to be addressed at home so patients don’t feel like they have to look elsewhere for affordable, quality medicine. But while patients are seeking care elsewhere, they need to be fully informed about the risks of opting for medical tourism. Traveling overseas may be their choice. What they certainly don’t need is anybody else forcing the decision on them.

But that is what will happen if the current trends continue and the medical establishment doesn’t take a stronger stand.

Yes, people should have choices, but the AMA’s bland “safeguards” approach could grease the skids for HMOs or publicly funded programs outsourcing expensive surgeries and other forms of care to India or other nations. Whatever happened to leadership?

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