May 25, 2011

Today we went to three different hospitals to examine the differences between private and public hospitals, as well as further understand the medical tourism industry. First, we went to a private hospital Clinica Biblica, where they provide medical tourism, which apparently is an industry exclusive to private institutions. The amount of technology they have, as well as the single-room accomodations for patients, was very overwhelming in general. The hospital was very quiet and the staff very friendly, but how could it not be with such ideal organization? The nurse providing the tour discussed that prices of procedures at this particular institution are ¼ the prices of those in the United States, which is why medical tourism is so popular. The hospital provides an entire package for medical tourists, including tours and transportation. Medical tourists will typically stay in Costa Rica for 10 to 12 days for their procedures and recoveries. 10 to 12 percent of the 17 percent medical tourist rate that comes from the United States. This hospital overall was very small and an incredible facility, where soon they will be building a sustainable parking deck including charging for electric cars. It was a very impressive facility but it is very apparent that the hospital is stricly funded via private monies.

The National Hospital, a public institution, was completely different from Clinica Biblica. No wonder medical tourists do not attend public institutions (besides the fact that most cannot); the hospital overall was not very sanitary, rooms were six people to a single room and were not isolated from the exterior of the hospital, and the hospital was very crowded in general. This hospital specifically focused on gerentology, so imagine the amount of people in the three general public hospitals in San Jose. There are other hospitals as well that have other specialties, such as pediatric care. The lack of funding for this hospital has forced them to not have a 24 hour emergency center. Essentially this hospital was doing the best it could with the resources it had, even physicians who earn 2,000 USD per month as chiefs, whereas physicians at private institutions earn 10,000 USD per month. I was impressed with the amiable personality of the chief depite how obviously underfunded and lacking this facility is.

Finally we went to CIMA, one of the largest hospitals I have ever seen and a premier location for medical tourists. The hospital was incredible, having JCI accreditation and extensive technologies, as wel as rooms with suites for single patients and their families. This facility is provided information via independent agencies who set up the tourists packages, and will be prepared for them when they arrive. This hospital does focus on the locals of San Jose, or so they say, even providing travel for physicians to go to more rural areas, but clearly the emphasis of this institution is business. It was surprising to find out that the hospital only has 58 rooms with its' magnanimous size. 30% of CIMA's patients are medical tourists. According to our guide, the challenges for CIMA are that it is metric-driven so it is difficult to justify new technologies, the local cultures, as well as working with individual physicians rather than teams of physicians, which is typical to medical practices globally. Even services such as those given by medical physicians apparently is business-oriented as well: where teams of physicians work together for a mutual salary, individual physicians can price-gouge their own treatment plans and operations as they wish...at least from my personal economic perspective. The facility overall was comparable to those in the United States and sustainable practices were seemingly limited with the hospital focused on business revenues.

Coming from an economic perspective with an academic history invested in researching medical tourism, particularly the push and pull factors guiding Americans abroad, it was fascinating to actually put a face and physical atmosphere to all of the facts and figures. The research seems to be true: medical tourism, though I was not able to get into personal files or delve deeper into the facilities themselves, fuel local economies and save money for those who are seeking medical care, particularly if they are the most expensive cardiovascular or plastic surgery operations. I was amazed to see the differences and hospitals that provided medical tourism and those who did not; it almost took a physical form of differentiating between "developed" and "developing" from technologies and services provided, to the facilities themselves. I was very pleased with the day overall and enjoyed the ability to personally substantiate that which I had been researching for months now.