記事紹介：Medical Tourism Is On The Rise — And It's Pretty Depressing, Honestly

今回は、米国のハフポストに掲載された下記の記事を紹介したいと思う。

Medical Tourism Is On The Rise — And It's Pretty Depressing, Honestly

This Type Of Tourism Is On The Rise — And It's Pretty Depressing, Honestly

タイトル通り、医療ツーリズムに関する記事だが、それが流行る一方で裏にある問題点を指摘している記事だ。

その中に歯科治療に関するエピソードが紹介されている。
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One of the main reasons for medical tourism, unsurprisingly, is cost. When Anna McKitrick, a 30-year-old who hosts vegan food tours around the world, woke up one morning in July 2020 with excruciating pain in her mouth, she knew she had to do something — and fast. “I woke up and thought someone shot me in the face,” McKitrick told HuffPost. “I’d never been in that much pain in my life.”

She ended up having the tooth extracted in the United States but needed an implant urgently. “When you extract a tooth, it’s a bit of a time crunch,” she said. “You have to put something in the empty space or it will mess up your teeth for life.”

She was working as a server in Los Angeles at the time, and even with dental insurance, she was quoted $40,000 to cover the work she needed done.
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緊急でインプラントの治療が必要になった彼女は、歯科の保険に入っていたにも関わらず40,000 USD (600万円)の見積もりを出されたとのこと。そのため、歯科治療を始め高額な治療では他国に医療を求めていく、すなわちコスト理由による医療ツーリズムが大きな需要となる。この患者さんの場合はコスタリカを訪れている。その費用はアメリカでの4分の1、およそ10,000ドルだったとのこと。

続いて医療ツーリズムの状況について。
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According to Patients Beyond Borders, a medical tourism guide, Mexico is the most-visited destination for medical travel, followed by Costa Rica, Thailand, Turkey and Colombia. Among the most popular procedures Patients Beyond Borders has reported on are general and complex dental work (65%), cosmetic and plastic surgery or non-invasive cosmetic treatments (15%), bariatric or weight loss treatments (5%), and fertility treatments (5%).

Mexico is such a popular destination for medical tourism that it even has dedicated border entrances specifically for medical tourists, with Vequist recalling how he once breezed through a security line with a doctor — a process that can usually take hours.
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医療ツーリズムの資料によれば、目的として人気なのはトップがメキシコ、ついでコスタリカ、タイ、トルコ、コロンビアとなっている。そして治療領域では歯科・美容・減量・不妊などが入ってくる。
そして驚くべきことに、メキシコには医療ツーリズム客専用の入国口が設けられているらしい。国として活性化させたいことがよくわかる。

続いて、リスクの面についても述べらている。
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There are some major risks to consider when it comes to medical tourism.
However, not everyone in the medical industry is on board with patients traveling for treatment.

Dr. Kelly Killeen, a Los Angeles-based plastic surgeon, has recently emerged as a voice on TikTok, warning her followers about some of the potential downsides of medical tourism, specifically as it pertains to cosmetic and elective surgeries.

“I try to start these conversations the same way every time, which is to say that there are wonderful doctors all over the world,” she told HuffPost. “The key to finding a wonderful doctor is being able to check credentials, check facilities, and knowing the local rules for how doctors practice. The problem with going out of the country is that we’re not familiar with their systems. Unless you are from the country, with an intimate knowledge of how the system works, it’s a risk.”

“The good surgeons in those countries are not significantly cheaper than the United States,” she continued. “It’s very important to understand that if you’re going somewhere that’s charging a tenth of what you paid in Los Angeles, it’s very unlikely that you’re going to a top-notch surgeon and facility.”

Although Killeen acknowledged that the American medical system has made care difficult and cost-prohibitive, she said that in the case of some of these cosmetic surgical procedures, the risk does not outweigh the reward or the savings.

“On a weekly basis, I get two to three people in my DMs asking for help during a post-op period where they can’t get ahold of the surgeon they saw,” she said. “It breaks my heart to say that legally I cannot provide them with medical care. They end up in the emergency room, and that’s not where they should be ― they should be in their surgeon’s office.”

Proximity to your doctor is something to be mindful of as a potential drawback for medical tourism. McKitrick, who ended up having to fly back to Costa Rica for a follow-up procedure, said she was not “financially or emotionally prepared” to go back.

“If I were to do it again, I’d probably go to a place I was more familiar with, or a place where I know people, as it was a bit tough emotionally being post-op in a completely foreign country,” she said.

Another consideration to keep in mind when seeking treatment abroad is the difference in legal systems. As Vequist said, the U.S. is extremely litigious, making the process of pursuing damages in the event that something goes wrong more straightforward.

“You can sue for anything,” he said. “The doctor, the hospital, the dentist needs to be fearful. Internationally, there is very little ability to pursue damages.”
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ざっくり言えば、コストだけを見て医療ツーリズムに行く場合、医師の質が低い可能性が高いことがリスクとして述べられている。さらに主治医と連絡が取れなくなったり、再手術が必要な際に距離が遠かったり、訴訟することが国際間になると難しかったり、というリスクがある。

この辺りは医療ツーリズム全般に言えることであり、患者側のリテラシーとしても高めていかなければいけないところだ。とはいえ、米国の医療が高額すぎるため、他国に活路を見いたす傾向は今後も続くと思われる。