Nothing new under the sun: Healthcare edition

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Any medical tourists on board?

Looking through my news alerts today I saw a couple items that support the old adage, “there’s nothing new under the sun.”

Exhibit 1: Biosimilars

Two academics have been arguing for a few months that biosimilars aren’t like generics after all and that the US should regulate the prices of biotech drugs once they go off patent. They’ve been banging their heads against the wall and are getting tired of it. “Time to throw in the towel on biosimilars,” they write in the Wall Street Journal.

I don’t disagree. In fact, I’ve been saying the same thing since 2006. (See A better idea than biogenerics.) No one listened so I gave up talking about it around 2011 (US biogenerics policy makes me sad).

Maybe I shouldn’t be so cynical –I think I’ll write to the authors and see if I can lend them a hand!

Exhibit 2: Medical Tourism

In 2007 I got pretty excited about medical tourism (aka medical travel) as a way to reduce costs without cutting quality –at a time when we were throwing our hands up about costs and coverage in the US. I went so far as to travel to Singapore and South Korea to research the topic and set up a TripAdvisor-style website to facilitate the phenomenon. Here’s the transcript of my interview with the author of the first serious book on the topic.

It’s a great topic to write about, and there are some excellent anecdotes, but it didn’t catch on in a big way a decade ago and I’m skeptical it will do so now.  Before the Affordable Care Act many middle class people were uninsured, so going abroad for orthopedic or heart surgery could mean the difference between losing one’s house/retirement savings or not. It was still a novel idea. But with the ACA there were many fewer people for whom it made great sense.

Most of what I saw was people going abroad for cosmetic treatments or dentistry. The other category was immigrants going back to their home country for treatment. (My sister-in-law went back to Canada for LASIK, for example.) Then as now, the US is the biggest destination country for medical “tourists.”

I really haven’t followed the field lately, but I’m seeing the same kinds of stories now (A prescription for a passport? Health plans covering medical tourism) that I saw then. This one says the industry is $439 billion growing at 15-25% per year. I haven’t reviewed the research but I promise you the market definition must be pretty broad!

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By healthcare business consultant David E. Williams, president of Health Business Group.

 

 

August 23, 2019

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