Surgeries Worth the Journey

Thank you for exposing the inequities in the rates patients pay for surgeries at American as opposed to foreign hospitals in "Under the Knife in Bangalore" [May 12].

In 2003 when I needed major back surgery, I found that my non-group health insurer had not contracted with my local hospital, where my surgery would be performed. I would be charged the "rack rates" your article exposed. My insurance, on the other hand, would only pay reasonable and customary charges for this spinal procedure, probably far short of the "rack rate." So, even people with insurance can be charged this rack rate, yet their insurance would cover far less. I decided to get a second opinion at a neurosurgery hospital in Montreal, only a one-hour drive away. This Canadian hospital quoted me a very reasonable rate based on a flat fee per day of confinement. I paid only a separate fee to the neurosurgeon. My insurer agreed to pay all charges from the Canadian hospital and the surgeon's fee. I was able to schedule my surgery much sooner in Canada and probably saved my insurer around $30,000. I had a full recovery and enjoy white-water kayaking, back-country skiing, and even rock climbing.

Ray Heimbecker
Montgomery, Vt.

As a patient who had plastic surgery after weight loss, I couldn't be more pleased with my final outcome as a result of the outstanding efforts of my doctor and the staff of a clinic in Tijuana, Mexico. I checked my doctor's credentials, read testimonials of previous patients, and learned everything I could of him, the procedures he performs, and his education, experience, and accreditation through the American Society for Aesthetic Plastic Surgery. I had several phone calls and corresponded with him and his staff, so I knew exactly what to expect. To reiterate what the story said, do your homework and research, and you'll increase chances of a successful result.

Verajane S. Hurlbut
Winter Haven, Fla.

I found it interesting that medicare reimbursement in the United States for several procedures listed in your "Cross an Ocean, Save Big" table, comparing the costs to other countries', fell in the middle, between Singapore and Taiwan. These countries do not have the regulatory hurdles or costs associated with malpractice that U.S. physicians have. Yet Medicare reimbursement is similar. As physician shortages loom in this country and more physicians refuse to participate in Medicare, the population that had better get used to flying to Taiwan for hip replacement isn't the uninsured but our seniors.

Dan M. Podeschi, M.D.
Roanoke, Va.