Stuck with an insurance plan that won’t cover the procedure and without $100,000 handy to pay out of pocket, the 37-year-old Dyer woman will have a minimally invasive spinal fusion in Bangalore, India.
“I feel really good about the decision,” she said. “It’s a little scary, but that’s OK.”
The fear is quelled by hope that the ever-present pain, pinching and numbness will be gone in hours and that a healthier life will come after physical therapy.
The married mother of two, who also is a breast cancer survivor, is among the growing number of people seeking cheaper medical treatment overseas. She arranged the surgery through New Hampshire-based medical tourism company Healthbase Online Inc.
CEO Saroja Mohanasundaram said the company has handled medical travel for more than five years. The firm started with hospitals in five countries and now works with 21.
“It’s all due to customer demand,” she said.
The company links patients with doctors who offer medical, cosmetic and dental procedures. Facilities and doctors must meet local and international standards, Mohanasundaram said.
The company does cost and doctor comparisons, and the patient chooses one.
Tacke had a conference call with her neurosurgeon, who often travels to the U.S. to give medical talks and even did his clinical fellowship at Wayne State University in Detroit.
“It’s not like I picked a name out of a hat,” Tacke said.
Tacke, who had a discectomy in 2007, is covered by her self-employed husband’s insurance policy. But the discectomy — the surgical removal of herniated disc material that presses on a nerve root or the spinal cord — puts her in a “pre-existing condition” category. She signed a document stating medical treatment to her spine would not be covered.
In 2009, the pain returned, and an MRI showed things had worsened. She tried cortisone shots and physical therapy, to no avail, and has leaned on narcotic painkillers and muscle relaxers since then.
She said going abroad for care is the best option for her. The 2010 major federal health care overhaul does not fully take effect until 2014.
“To be asked to hold on for two more years, it’s not a way to live,” she said.
Americans traveling to India pay about 80 percent less for treatment than they would here, Mohanasundaram said.
“It’s just a different country and time zone,” she said. “Other than that, they will have the same quality and the same experience.”
Tacke said in the U.S. she would have paid up to $100,000, not including physical therapy, for her surgery. In India, it will cost $16,000, including the surgery, meals, airfare, transportation and the post-surgery hotel stay for her and her mother-in-law.
Mohanasundaram said the hospitals have a separate wing for international patients. The rooms have an extra bed for the patient’s companion, as well as Internet access, TV and DVD player.
Some people picture the impoverished parts of India when Tacke mentions her trip, but she is quick to show them websites for the modern hospital and upscale hotel where she will recover.
Dr. Alexander Stemer, president and CEO of Medical Specialists Centers of Indiana, said people who partake in medical tourism have a willing suspension of disbelief.
“They are choosing to ignore the possibility that something can go wrong after their return,” he said.
Stemer said he understands why an uninsured person in constant back pain would seek treatment in another country, but he cautioned there are significant risks.
If something goes wrong, there is no recourse. In America, people can review their medical records and file a lawsuit.
“You forfeit that when you go to India,” Stemer said. “What do you do if you’re not quite right? Who would handle the consequences?”
A hospital can’t be judged based on the pictures on its website, he said. Many foreign countries do not have the same set of standards as the United States. Foreign hospitals aren’t required to report post-operative infections, for example.
“You’re left with a certain amount of uncertainty,” he said.
He suggests uninsured people try to negotiate their medical bills, asking providers for the same discount they would give an insured person, before considering treatment overseas.
Professor Samuel Flint, associate director of the School of Public and Environmental Affairs at Indiana University Northwest, said he has not seen many systematic studies of medical tourism. Anecdotally, it appears safe.
“(The industry) is not filled with wild tales of people having their kidneys taken out and (they) don’t realize it until they’re on a plane,” he said. “You can get some well-trained physicians and very state-of-the-art hospitals.”
Flint said the U.S. is a medical tourism destination as well.
“We go to other countries for low-cost care; people from other countries come here and pay full tilt for good care,” he said.