Keep Metro Detroit a health tourism destination

Posted by hpayne on April 4, 2013

“People might be surprised to know that we have the best health care in the world,” said Wayne County Executive Robert Ficano after a State of the County address touting Metro Detroit health systems as an attraction for so-called health tourism.

“We just need to do a better job of marketing.”

Actually, the world already knows that the U.S. has the world’s best health care. It is Ficano’s political peers in Washington who have panned U.S. health care as second rate and in need of an extreme makeover.

Today, Detroit is a destination for foreigners — some 50,000 Canadians cross the border for treatment every year — desperately seeking specialists for everything from cancer to joint replacement.

But as the U.S. moves toward Obamacare, modeled on universal care systems abroad, fewer U.S. doctors will be less able to serve foreign customers, much less American customers.

“I fear (for Detroiters’ health care) access because more and more people in the medical field are going to revolt against a system that tries to control them,” Detroit native and world-renowned neurosurgeon Ben Carson tells me.

Ficano is correct — the U.S. is No. 1 for health care. So why does the Organization for Economic Cooperation and Development rank the U.S. just 28th in life expectancy?

Because the U.S. is the murder capital of the developed world. Strip out fatal injuries from OECD tables and the U.S. vaults to the top. Wealth equals health. It also equals unparalleled access. For example, the U.S. has the highest breast cancer survival rate according to the Centers for Disease Control, 9 percent higher than Canada. From prostate cancer (184 percent higher) to colon cancer mortality among men (10 percent higher), Canadians suffer worse cancer survival rates than their neighbors.

Why? Because universal care does not mean universal access to treatment. In nationally-regulated systems from Canada to Germany, government regulation and health reimbursement creates doctor shortages and reduced treatment. This means “waits of six months or more for elective surgeries were reported to occur ‘very often’ or ‘often’ by 26-57 percent of executives” in non-U.S. systems, according to Harvard professor Robert Blendon. “Only 1 percent of U.S. hospitals reported this.”

That’s why medical tourists come to the U.S. But Obamacare is already pinching the U.S. advantage.

To deal with the federal act’s coming blizzard of paperwork, the U.S. is experiencing a wave of hospital megamergers — including the consolidation of Detroit Beaumont and Henry Ford hospital systems, a marriage that will mean less doctors and less innovation.

For years, health care innovation had been occurring away from hospitals in more nimble, less bureaucratic outpatient clinics.

“Today, most patients needing long-term dialysis no longer get it in hospitals but go to less costly, more convenient outpatient clinics,” reports Scott Gottlieb, a physician with the American Enterprise Institute.

“Complex issues like cancer are handled in specialized centers with expertise to better manage these problems, at lower cost.”

In Massachusetts where Obamacare’s cousin, Romneycare, has been in place since 2006, patient wait times have increased amid growing physician shortages, even as health care costs have soared to the highest in the nation.

The U.S. health system doesn’t need a overhaul, say experts like Carson, it just needs tweaking to empower individuals with tax incentives like corporations receive. “Let’s talk about what makes sense, what historically has made sense,” Carson said.

Instead, the U.S has embarked on a government-run system already proven wanting in the rest of the world. How do we know? Because the rest of the world has been coming here for years.

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