Compulsory licensing for US medical tourism agencies?


The American health industry has based opposition to outbound medical tourism on the inability to sue for any potential medical malpractice. “ When we make a mistake it is easier to sue your surgeon/hospital/doctor in the USA than anywhere else in the world” is a poor defensive position when a key reason that US care is so expensive is the huge premiums that hospitals and doctors pay for medical malpractice insurance, as they get sued a lot. When you buy a car is your top concern the possibility that your family could sue the maker if a wheel comes off and kills you?  So the logic of stopping patients from going overseas on the basis that ‘ we are so bad at home that we get sued a lot ‘ is not good.

Of course there may be clinics and hospitals that are incompetent and make mistakes. But the backstreet, under funded, under trained, professional can be a problem in all professions anywhere in the world, not just in the medical sphere. If you get your car fixed by a man with a shed and a hammer, you are unlikely to get the same result as if a garage with all the latest computer technology and equipment fixed it .The same principle applies to medical tourism.

As a patient can choose to sue in the country they were treated or in their home country, sueing overseas is rarely allowed. The patient could sue in the US, but it is waste of time unless the hospital has US assets. Overseas governments will dismiss demands that overseas countries make laws on medical negligence, out of hand.

Imagine undergoing surgery overseas. The doctors and hospital seem reputable. Now, imagine suffering post-surgical complications after returning home. You cannot easily return overseas. So you secure treatment locally, racking up unexpected, out-of-pocket costs. Afterwards, you consider suing. But who’s liable? Is it the surgeon or the hospital? Do you sue domestically or abroad? Did you deal direct with the hospital or were you guided by a US based medical tourism agency? These are the typical questions being considered by Nathan Cortez, an assistant professor of law at Southern Methodist University, who is examining what legal recourse U.S. patients have when problems arise; “ There’s legal uncertainty about everything, as well as a regulatory void. There’s a flood of ethical, policy, legal and moral issues.” But he hasn’t found any court rulings involving disgruntled medical tourists,” The lack of test cases illustrates the legal uncertainty,” Cortez says.

Cortez suggests the Department of Health and Human Services as a viable entity that could coordinate US regulatory controls over medical tourism. He proposes policymakers build on existing consumer protection laws and expand licensing systems. While the US government could not control overseas hospitals, it could demand that agencies based in the US need a licence, just as travel and estate agents do. As the agency is the most likely to be sued, professional indemnity insurance, as it is for many professions, would need to be a requirement of licensing. As Obama moves from state to national licensing systems, a compulsory US licensing system for medical tourism agencies becomes practical. Cortez is in the vanguard of those who feel that the days of unlicensed medical tourism agencies are numbered.




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