WellPoint and Health Insurance and Medical Tourism

Hoosier doctors fret about medical tourism

January 19, 2009
If globalization comes to health care, could it push doctors and hospitals to the brink of a bailout?

That's the fear of Indiana doctors, who saw such a scenario become a whole lot more plausible late last year after Indianapolis-based WellPoint Inc. announced a pilot "medical tourism" project in Wisconsin that would pay for a company's workers to receive care in India.

If WellPoint's program catches on with employers, warned Indianapolis Dr. Greg Larkin, it could cause many U.S. health care providers to fail or to sharply raise their prices. That's because WellPoint's program targets the profitable elective procedures—like hip and knee replacements—that hospitals use to cover the cost of unprofitable care, such as emergency surgery for patients who can't pay.

Some minor government response is already happening in the Indiana General Assembly. Rep. Craig Fry, D-Mishawaka, chairman of the House of Representatives Insurance Committee, filed House Bill 1084 this month that would forbid health insurers from encouraging workers to seek care overseas. It has the support of the Indiana State Medical Association, a large doctors' group.

WellPoint officials, however, see the potential for savings from medical tourism.

"More and more employer clients have been asking about access to foreign providers as a means of reducing their claim expenditures," said Dr. Sam Nussbaum, chief medical officer for WellPoint, in a Nov. 12 statement. "Medical tourism is a promising option for improving access to affordable, quality health care."
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