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At the Forefront of Medical Tourism Law

by Lydia Lum , June 25, 2009

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Imagine undergoing surgery overseas to save yourself money. The doctors and hospital seem reputable. Your primary U.S. physician endorsed your choice. So did your insurance carrier, which covers eligible expenses as if they were accrued domestically. Now, imagine suffering post-surgical complications after returning home. You can’t easily return overseas. So you secure treatment locally, racking up unexpected, out-of-pocket costs. Afterward, you consider suing.

But who’s liable? The surgeon, or your primary care doctor? How about your insurance company? Do you sue domestically or abroad?

Those are some typical questions being considered by Nathan Cortez, an assistant professor of law at Southern Methodist University, where he teaches courses in administrative law, health law, Federal Drug Administration law and the legislative process.

His research focuses on medical tourism, the fast-growing but seemingly unregulated industry of health care professionals offering consumers more-affordable care abroad. Among other things, Cortez is examining what legal recourse U.S. patients have when problems arise.

“There’s legal uncertainty about everything, as well as a regulatory void,” he says. “There’s a flood of ethical, policy, legal and moral issues.”

High-quality medical procedures overseas run the gamut, from dental implants to hip joint re-surfacing; prostate removal to organ transplant. Some operations are as much as 90 percent cheaper in foreign countries, Cortez says, adding that the most popular destinations include India, Chile and Thailand.

In 2005 alone, one particular Bangkok, Thailand, hospital saw more than 55,000 Americans. In a 2008 issue of the Indiana Law Journal, Cortez suggests the Department of Health and Human Services as a viable entity that could coordinate U.S. regulatory controls over medical tourism. He proposes policymakers build on existing consumer protection laws and expand licensing systems.

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