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Medical Tourism 101 - A Complete Guide

Why does it seem like Starbucks has a store on every corner where you live? Because the company knows most of us won't go even one block out of our way to get a cup o' cappuccino. Why then, are tens of thousands of people choosing to travel half-way around the world for surgical procedures? It's called "medical tourism," and you might find yourself considering it soon as well.

What is medical tourism?

Rapidly becoming a multi-billion dollar industry, medical tourism is the catch-all phrase describing travel to other countries primarily for medical or dental care. Along with elective plastic surgery procedures like face-lifts and implants, medical tourists also travel for highly specialized operations like heart surgery, cancer treatment and hip replacement. Some medical tours include pre-operation sightseeing, luxury accommodations and extensive post-op care.

Why would I consider it?

Your reasons for choosing to travel for medical care depend on where you live. In the US, medical costs are skyrocketing, and many elective procedures aren't covered by insurance. Procedures abroad may be a fourth or even a tenth of what they might be at home.

In countries with nationalized health such as Canada or Great Britain, the waiting times for treatment may simply be too long, and the cost to see a physician in private practice too high. You may also become a medical tourist if you'd like to combine an exotic vacation with a tummy tuck or, on a more serious note, if you're seeking alternative treatments for cancer or other diseases.

How much money can I save?

The short answer is, potentially lots. For example, a heart valve replacement that would normally cost $200,000 in the US would be $10,000 in India - including round-trip airfare, and a quick vacation package. Looking for a face-lift? This will raise your eyebrows instantly: the price tag is $15,000 in the US, but only $2,600 in Bolivia (And lest you think the Bolivians are amateurs at this, more than 70% of middle and upper-class women in Bolivian have had at least one cosmetic procedure).

According to a CBS News: 60 Minutes report, one patient who received coronary artery bypass surgery in Thailand said the operation cost him $12,000, as opposed to the $100,000 he estimated the operation would have cost him at home in the US.

How do I choose a country for my procedure?

It depends on what type of procedure you're seeking. Some destinations specialize in medical procedures while others are best known for cosmetic surgery. If the procedure you're seeking is elective and non-critical, you may be most interested in a country with beautiful antiquities or beaches.

Countries actively promoting medical tourism for medical procedures include India, Singapore, Thailand, Cuba, Hong Kong, Hungary, Israel, Jordan, Lithuania, Malaysia, and the Philippines.

For plastic surgery, the hotspots are Argentina, Bolivia, Costa Rica, Mexico and Turkey. South Africa specializes not just in medical tourism, but "medical safaris" - lions, elephants AND a nose job. However, the country with the most expertise in plastic surgery may be Brazil, as more plastic and cosmetic surgery procedures are performed in this country annually than in the whole of the European Union.

India, Thailand and Singapore have been most aggressive in building their medical tourism business to date:

INDIA

The sub-continent is so committed to generating revenue from medical tourists, the country's National Health Policy actually declares that treatment of foreign patients is legally an "export" and deemed "eligible for all fiscal incentives extended to export earnings." It's estimated that medical tourism to India is growing by 30% a year.

India boasts 5 hospitals accredited by US-based Joint Commission International, and a global reputation for superior hip resurfacing and heart surgery. It may be somewhat anecdotal, one Indian hospital, Escorts Heart Institute and Research Centers located in Delhi and Faridabad, claims to perform nearly 15,000 heart operations every year with a post-surgery mortality rate of only 0.8 percent - less than half of most major hospitals in the United States. Most medical treatment costs start at about a tenth of the price of comparable treatment in the US. However, for US travelers, extremely long travel times can be a deterrent.

SINGAPORE

As Asia's leading medical hub, Singapore has a reputation for excellent quality, safety and trustworthiness, along with advanced research and technology. In 2006, Singapore hosted the first international Medical Travel Conference with participants from 21 countries coming together to discuss the issues and challenges facing the medical travel industry. Nine hospitals in this small country are accredited by JCI.

THAILAND

With its beautiful terrain, intoxicating culture and stunning beaches, Thailand has been a popular destination for American medical tourists. English is widely spoken, and a high number of physicians are trained in the West. Bangkok's Bumrundgrad hospital alone has more than 200 surgeons who are board-certified in the United States. Hospitals in the country offer services specifically for the international med-tourist. For example, the International Medical Centre in Bangkok offers services in 26 languages, recognizes cultural and religious dietary restrictions and has a special wing for Japanese patients. Although Bumrungrad International Hospital in Bangkok claims JCI accreditation, it's not currently listed on the JCI website.

What's the downside?

If you do travel abroad for medical care, you may have to pay cash for it. Government and basic medical insurance, and sometimes extended medical insurance, often does not pay for the medical procedure. Of course if it's an elective procedure (as most cosmetic procedures are), you're on your own anyway.

Should complications arise, you may not be covered by insurance, or be able to seek adequate compensation through malpractice lawsuits. Most of the countries offering medical tourism have weak malpractice laws, so you'll have little recourse to local courts or medical boards if something goes wrong. Of course, that's part of the reason why the costs abroad are so low - physicians don't have to pay exorbitant malpractice insurance premiums.

Little follow-up care may be provided, and travel or vacation activities soon after surgery can increase the risk of complications. For example, your post-op scars may darken or become more noticeable if you get a sunburn on the beach after your surgery. Long flights home can be uncomfortable at best, and downright dangerous for thrombosis or breathing-related problems. Treating side-effects and any post-operative care will become your responsibility once you get home.

Are there other health risks?

Exotic destinations are also home to exotic infectious diseases for which Westerners often have no immunity - particularly in a weakened, post-op state. Gastrointestinal diseases can slow the recovery process and more serious diseases such as malaria, influenza, or TB, can be life-threatening. Having said that, because these diseases are more common in other countries, doctors are more likely to recognize the symptoms early and get you appropriate treatment.

How do I check out a hospital's credentials?

Although it may seem daunting to research surgical treatment thousands of miles away, it's absolutely necessary for your peace of mind and quality assurance.

The Joint Commission is a US-based non-profit organization formed in 1951 with a mission to maintain and elevate the standards of healthcare delivery through evaluation and accreditation of healthcare organizations. These standards define the performance expectations, structures, or processes that must be in place and cover nearly every aspect of care from admissions and data collection, to daily patent assessments. Since 1999, JCI has also been accrediting hospitals internationally and to date has awarded 81 accreditations. JCI lists accredited hospitals by country.

How do I plan a trip?

So far the Roaming Gnome doesn't offer suggestions for medical tourism, but there are plenty of websites that can assist you with your plans. Google "medical tourism" and you'll find about 15 million entries. Some companies are foreign-based, with offices and representatives in the US or Canada, while others are US or Canadian companies working with representatives abroad. Not all companies organize travel to all destinations - you'll need to do a bit of research to find the best fit.

In any case, once you find a company to help you plan your trip, the process could go something like this:

1. Fill out an application with your details and medical needs.

2. Talk with a US-based case manager to select the hospital, doctor(s) and get a cost estimate.

3. Pay a deposit - avoid companies that want to charge you 100% upfront.

4. Have a phone conference with your chosen doctor and on-site case manager.

5. Fly to your destination for your procedure, where you'll be met by your on-site case manager.

6. Meet with your physician for a pre-op consultation.

7. Have your surgery and recover sufficiently for your post-op vacation or return journey (for some procedures, it may be more practical to have the "tourist" part of your trip first.

How does insurance figure in?

For the most part in the US, health insurance companies will not cover non-elective procedures overseas - and certainly not elective. In other words, you would be responsible for 100% of your own medical costs.

In the future however, employers may offer overseas medical treatment as an option to their covered employees, according to Dr. Arnold Milstein, of Mercer Human Resource Consulting, who has been retained by five Fortune 500 companies to determine whether outsourcing healthcare can be a viable option.

It's also possible to obtain medical insurance while traveling, but it will only cover you in the event of an emergency occurring on that trip. Whether or not you would be covered during an emergency that occurs as a consequence of other medical treatment you were receiving is another question. I would suspect the answer is no.

So should I do it?

If you're seeking a relatively common elective cosmetic procedure, certainly shopping abroad should figure into your decision process. If you have no or limited medical coverage, and need some serious treatment, traveling abroad may be the only option you can afford. In any case, make certain you've spoken in depth with your home physician, fully understand the medical risk, and thoroughly research the physician and facility you intend to visit.

Michele Hickford, a freelance writer who also wrote about plastic surgery and medical tourism. She also enjoyed reading about beautification in her free time.

Please visit http://www.body-philosophy.net for more information.

posted by streamyx-router6149 @ 11:19 PM 1 comments

Detailed Definition of T3 Bandwidth, Also Referred To As a DS3

DS-3 which stands for Digital Signal Level 3, equates to 28 T-1 lines or 44.736 million bits per second (roughly 43-45 Mbps upstream/downstream speeds). DS-3s have enough bandwidth to allow very large database transferring over busy wide area networks and the capability of handling 672 simultaneous voice conversations. DS-3s typically run long haul over fiber optics and coax in the last mile, however there are many exceptions to this. Also, because fiber is only available in limited parts of the US (vs. copper), expensive build-outs are sometimes required for full DS-3 access.

In North America, DS-3 translates into T-3, which is the equivalent of 28 T-1 channels, each operating at a total signaling rate of 1.544 Mbps. The 28 T-1s are multiplexed through an M13 ('Multiplex 1-to-3' multiplexer), and 188 additional signaling and control bits are added to each T-3 frame. As each frame is transmitted 8,000 times a second, the total T-3 signaling rate is 44.736 Mbps. In a channelized application, T-3 supports 672 channels, each of 64 Kbps. In the European hierarchy, a DS-3 is in the form of a E-3, which runs at a total signaling rate of 34.368 Mbps, supports 480 channels, and is the equivalent of 16 E-1s.

If you're moving a DS-3 (or any other DS signal) across continents, the standards of the target country rule. Channels get muxed and demuxed, with signaling conventions translated as well. For example: On the US side T-1s are in multiples of 24 x 64 Kbps circuits (total 1.5 Mbps) and in the UK, it's 30 x 64 Kbps (total 2 Mbps). If you were to interconnect to the US at a DS-3 level, you would not receive 28 T-1s with 6 spare channels- You would get multiples of 30 E/T-1s. As they arrived in the UK, they would be muxed and demuxed, along with translated signaling conventions.

Who uses DS-3s? Companies who host high traffic web sites, support web hosting, and need high capacity bandwidth on an as-needed basis. Also universities/colleges, government offices, and high volume call centers. A full DS3 can accommodate many simultaneous users depending on the requirements of the business. Generally a DS3 line is installed as a major networking channel for large corporations or universities with high volume network traffic. This is an always-on, high-speed connection that provides a dedicated, stable and reliable link to the Internet, and can support up to 500 or more computer users.

If a full 45 Mbps DS-3 isn't quite necessary, then 'tiered' and 'burstable' speeds are also an option. Tiered is more suitable for clients who expect their bandwidth requirements to increase steadily and/or continually in the near future. Clients with other access such as T1 lines can rapidly and easily switch their bandwidth to a single Fractional-DS3. Burstable is a dedicated point-to-point circuit from a customer's premises to the telecommunication carrier's network operation center (NOC). This service is priced in billing tiers of 3mbps increments from 3mbps to 45mbps. As a burstable DS3 user, you always have the full bandwidth available over an unshared, non-fractional 45mbps digital leased line.

Although anyone can purchase a burstable DS-3, this type of connection can be expensive, sometimes costing as much as a full 45 Mbps connection (and usually only available for Internet connectivity, not as Private Line or Point To Point- for which a full DS3 will be required). Burstable lines can often be found at their lowest price within a collocation facility. At a collocation facility (or simply referred to as a "colo") many users share a large OC-3 or OC-12 pipe. As a customer, you will not have to pay for the fixed cost of such a large pipe, but will have the benefit of being able to burst up to very high bandwidths if necessary. If you need the reliability of a large pipe fur bursty traffic but don't have the capital, consider a colo. If you have a steady volume and are consistent, you may consider keeping services 'in house' and going with a T-3/DS-3 connection. Whether you're considering a collocation facility or a T3 to the door, make sure you use a telecommunications broker to help guide you through the many providers and plans available. To view sample DS3 pricing now, please visit the author's free quote generator @ BandwidthSeek.Net

Shaun Sullivan
Telecommunications Broker/Consultant
1(877)520-1924 office
1(512)434-9469 cell
1(775)796-8525 fax
info@bandwidthseek.net
http://www.bandwidthseek.net

posted by streamyx-router6149 @ 9:47 PM 0 comments

Detailed Definition of T3 Bandwidth, Also Referred To As a DS3

DS-3 which stands for Digital Signal Level 3, equates to 28 T-1 lines or 44.736 million bits per second (roughly 43-45 Mbps upstream/downstream speeds). DS-3s have enough bandwidth to allow very large database transferring over busy wide area networks and the capability of handling 672 simultaneous voice conversations. DS-3s typically run long haul over fiber optics and coax in the last mile, however there are many exceptions to this. Also, because fiber is only available in limited parts of the US (vs. copper), expensive build-outs are sometimes required for full DS-3 access.

In North America, DS-3 translates into T-3, which is the equivalent of 28 T-1 channels, each operating at a total signaling rate of 1.544 Mbps. The 28 T-1s are multiplexed through an M13 ('Multiplex 1-to-3' multiplexer), and 188 additional signaling and control bits are added to each T-3 frame. As each frame is transmitted 8,000 times a second, the total T-3 signaling rate is 44.736 Mbps. In a channelized application, T-3 supports 672 channels, each of 64 Kbps. In the European hierarchy, a DS-3 is in the form of a E-3, which runs at a total signaling rate of 34.368 Mbps, supports 480 channels, and is the equivalent of 16 E-1s.

If you're moving a DS-3 (or any other DS signal) across continents, the standards of the target country rule. Channels get muxed and demuxed, with signaling conventions translated as well. For example: On the US side T-1s are in multiples of 24 x 64 Kbps circuits (total 1.5 Mbps) and in the UK, it's 30 x 64 Kbps (total 2 Mbps). If you were to interconnect to the US at a DS-3 level, you would not receive 28 T-1s with 6 spare channels- You would get multiples of 30 E/T-1s. As they arrived in the UK, they would be muxed and demuxed, along with translated signaling conventions.

Who uses DS-3s? Companies who host high traffic web sites, support web hosting, and need high capacity bandwidth on an as-needed basis. Also universities/colleges, government offices, and high volume call centers. A full DS3 can accommodate many simultaneous users depending on the requirements of the business. Generally a DS3 line is installed as a major networking channel for large corporations or universities with high volume network traffic. This is an always-on, high-speed connection that provides a dedicated, stable and reliable link to the Internet, and can support up to 500 or more computer users.

If a full 45 Mbps DS-3 isn't quite necessary, then 'tiered' and 'burstable' speeds are also an option. Tiered is more suitable for clients who expect their bandwidth requirements to increase steadily and/or continually in the near future. Clients with other access such as T1 lines can rapidly and easily switch their bandwidth to a single Fractional-DS3. Burstable is a dedicated point-to-point circuit from a customer's premises to the telecommunication carrier's network operation center (NOC). This service is priced in billing tiers of 3mbps increments from 3mbps to 45mbps. As a burstable DS3 user, you always have the full bandwidth available over an unshared, non-fractional 45mbps digital leased line.

Although anyone can purchase a burstable DS-3, this type of connection can be expensive, sometimes costing as much as a full 45 Mbps connection (and usually only available for Internet connectivity, not as Private Line or Point To Point- for which a full DS3 will be required). Burstable lines can often be found at their lowest price within a collocation facility. At a collocation facility (or simply referred to as a "colo") many users share a large OC-3 or OC-12 pipe. As a customer, you will not have to pay for the fixed cost of such a large pipe, but will have the benefit of being able to burst up to very high bandwidths if necessary. If you need the reliability of a large pipe fur bursty traffic but don't have the capital, consider a colo. If you have a steady volume and are consistent, you may consider keeping services 'in house' and going with a T-3/DS-3 connection. Whether you're considering a collocation facility or a T3 to the door, make sure you use a telecommunications broker to help guide you through the many providers and plans available. To view sample DS3 pricing now, please visit the author's free quote generator @ BandwidthSeek.Net

Shaun Sullivan
Telecommunications Broker/Consultant
1(877)520-1924 office
1(512)434-9469 cell
1(775)796-8525 fax
info@bandwidthseek.net
http://www.bandwidthseek.net

posted by streamyx-router6149 @ 2:28 AM 0 comments