YOU GOTTA HAVE HEART

At the crossroads of health care and bargain travel, Willy discovers medical tourism and pays pennies on the dollar

EVERYONE IS TALKING about the astronomical cost of health care. But major operations don’t have to be financially unattainable in your life.

Just how affordable can health care be? To discover the answer, you might have to be like the nearly 1 million Americans who go overseas every year for radically discounted surgical procedures. They’re part of an ongoing trend at the crossroads of health care and travel called “medical tourism.”

According to Deloitte Center for Health Solutions, 875,000 Americans went abroad for procedures ranging from dentistry to elective hip replacement to bypass surgery in 2010. And that number was estimated to have increased to as much as 1.6 million in 2012.

Out of all those many Americans who opted for medical tourism, I want to tell you about just one of them. His name is Willy Bearden.

Willy is a sixty-two-year-old documentary filmmaker living in Memphis, Tennessee, whose arteries were clogged from decades of enjoying Southern cooking. “I’ve always had a soft spot for barbeque, tamales, cakes, and pies, and anything fried,” he says.

Since 1988, he’s owned and operated the William Bearden Company and makes a living doing corporate video for such clients as FedEx and Fred’s Super Dollar Stores. He’s also made documentary films like Horn Island Journal, The Story of Cotton, and Visualizing the Blues, among others.

Willy’s documentaries air on local and regional PBS stations and he’s become a Ken Burns of the Deep South, telling the stories of both Memphis and the Mississippi Delta in a personal and revealing way.

It was on Horn Island back in 2008 that Willy first felt something might be wrong with his heart. He was unusually winded after hauling camping gear across the barrier island off the Mississippi Gulf coast but didn’t make too much of it at the time.

This was right around when Willy made the reluctant decision to go without health insurance for himself, his wife, his twenty-year-old son, and his nineteen-year-old daughter. The cost of his health insurance was going up from $1,200 a month to $1,800. Sure, he could swing it because he was making more than $100,000 at the time, but he decided he didn’t want to pay the increase.

Willy knew full well that he was taking a gamble if he ran into a catastrophic accident or illness. Over the next three years, he would continue to notice a strange tightness in his chest at times. But he learned to adjust to his health problems.

“I [remember I] was producing a corporate show in Long Beach, California. The walk from the hotel to the Long Beach Convention Center was about two blocks. Luckily it was downhill on the way there,” Willy recalls.

“But the walk back was pretty miserable for me. I would have to stop every hundred feet or so, sometimes disguising my stop by taking a photo with my camera. I didn’t feel that I could share with my coworkers just how much I was hurting. I knew they might freak out and call an ambulance, and I would be in a bad situation. My fear was that I would have to have emergency surgery, which would cost upwards of $200,000, and I would have to go bankrupt. It was all a very confusing and bizarre situation.”

Eventually a friend convinced him to go see a cardiologist. Based on his persistent symptoms, the doctor believed Willy had clogged arteries and recommended a heart catheterization to confirm the blockage.

The price quote for a cash payer? More than $30,000 for the test that would give a definitive diagnosis; then another $60,000 to $80,000 for the arterial stents he’d likely need; and more—much more—if the situation was bad enough to warrant heart bypass surgery.

“The price I was quoted here was a nebulous ‘$150,000 to $300,000’ figure [for the bypass]. That stopped me in my tracks and got me on the path of searching out alternatives,” Willy says.

Within fourteen days, he used the research skills critical to documentary filmmaking to learn everything he could about medical tourism. He homed in on India mainly because of his wanderlust for a place he’d never been before.

Willy targeted a Fortis Hospital location in the bustling Indian city of Bangalore and read the bios of all their doctors online. He e-mailed a Dr. Vivek Jawali and got a response within a day.

He asked for a picture of the hospital rooms where patients stay—and they weren’t what he imagined. “I was relieved to see a modern hospital room with a desktop computer, TV, and modern amenities. . . . It was simply the nicest hospital room I had ever seen,” Willy says.

He probed for further info, such as the hospital’s rate of staph infection and patient testimonials. Everything he read put his mind at ease. “I think we’re all wired to think there’s some gimmick, some catch, but there was none here. Admittedly, I took a huge risk, but I could see no other option.”

On January 10, 2011, Willy started his trip to India. It was a Monday. When he arrived in Bangalore, hospital staffers were there to pick him up and help him settle into his hospital room. Everybody spoke English.

Willy told me he felt like these people genuinely cared about him—a feeling he had not necessarily gotten from the U.S. medical establishment. That’s something money can’t buy.

“The nurses and staff were so friendly and interested in me. I have always been a good judge of character, and have always prided myself in seeing beyond what is said. My dealings with the Indian people, whether the janitors or the X-ray technicians, were positive and very human. I felt the compassion and care from these former strangers at a very deep, very personal level.”

The next day he had a heart catheterization and learned all four coronary arteries were blocked 70 to 90 percent. He was going to need bypass surgery.

At that point, reality set in. Here was Willy, a stranger in a strange land, 9,028 miles from home, needing to have his sternum sawn open and his heart dissected.

That was when he met Dr. Vivek Jawali in person for the first time. It was Friday.

“I had deluded myself, somewhat, by believing that mine would be an easy fix, and I was staring at the reality of having my chest cracked open and my heart completely replumbed. It was scary,” Willy remembers. “After a while, I sat and talked with Dr. Jawali, who drew on a piece of paper exactly what he was going to do to my heart. I was so moved by his manner, his compassion, and his intelligence, that I was completely OK with going ahead with the surgery. That, and the fact that I probably would have been dead in six months if I hadn’t had the surgery.”

After their talk, the five-hour bypass surgery was scheduled for the following Monday. It went off without a hitch. Willy’s post-op care consisted of attentive nurses and regular visits from Dr. Jawali.

“[Following the surgery,] Dr. Jawali looked at me and said, ‘You are just as important in this as I am. You have a huge role to play in your recovery, but I can tell from your face and your demeanor that you’ll come through this just fine. In fact, you will be so surprised at how quickly you’ll bounce back and be healthy again.’”

Two days later, Willy was up and ambling around the hallways.

“I had the surgery on a Monday, and by Friday I had been up walking around the hospital floor so much that I was feeling great. I decided to put my T-shirt and blue jeans on. The nurses were very concerned about this and wanted me to put my pajamas back on, but Dr. Jawali told them to let me do what I felt like doing. I think the act of putting my clothes on was a very important psychological step for me. I felt as if I had gone through this incredible journey and I was on the other side of it—alive.”

Within a few days, Willy was able to check out of the hospital and into a four-star Bangalore hotel called the Woodrose for $100 a day, which included three vegetarian meals daily in the restaurant.

He had continuing checkups with Dr. Jawali, but the balance of the conversation switched to the doctor’s curiosity about Willy’s film work. That’s when he knew he was fully on the mend.

After eighteen days in India, Willy got on a plane and made the long flight back to Memphis. Stateside, he gets free follow-up care from a friend who’s a nurse practitioner, and his long-term post-op recovery is overseen virtually by Dr. Jawali. (Willy is now Facebook friends with Dr. Jawali!)

The total cost for the extensive medical care Willy received in India? $9,000. That is not a typo. That’s nine thousand dollars. He paid for it on his debit card! His airfare, meanwhile, was $1,500 and his hotel stay cost him $500.

Willy has since become something of an ambassador for medical tourism. He’s done interviews with local Memphis papers and appeared at the third annual India Summit at Atlanta’s Emory University to share a patient’s perspective on medical tourism.

Now he plans to pay it forward. Another friend of his is going to Bangalore for heart valve replacement surgery, so he’ll pick up the tab for that friend’s post-hospital hotel stay.

At the time I wrote this, Willy still did not have insurance. But he was planning to get it and to record his journey to reinstating his coverage in a documentary made with the help of a local doctor. Meanwhile, he’s changed the way he eats to prevent future heart problems. “I have been sticking to a diet low in sodium and high in fiber and whole foods for the past two years. I eat chicken and fish frequently but rarely eat red meat. I feel really good.”

If you’re thinking about medical tourism, here are some important things to keep in mind:

Check with your insurer first.

• Like all medicine, the path to medical tourism basically has two routes: You can either buy services at the going market rate and pay cash out-of-pocket, or you can run a procedure through your insurer if they allow it. Of course, not all insurers are onboard with medical tourism. But it’s always worth calling your insurer during the planning stage and asking about your options.

Carefully vet all facilities and doctors.

• The Joint Commission International (JCI) is the top dog when it comes to inspecting medical sites around the world. At JointCommissionInternational.org, you can see if a facility you’re considering has passed inspection and meets standards. Some 220 overseas medical sites are accredited by JCI. If the one you’re considering isn’t, I’d advise you to look at another one that is. You also want to be sure the doctors you’re considering are trained or board certified in the United States or another First World country.
• Meanwhile, the American Medical Association also has its own succinct recommendations for patients and insurers interested in medical tourism. Do a Google or Bing search for “AMA medical tourism guidelines” to see them.

Make a plan for communicating with relatives back home.

• Willy used the desktop computer in his Bangalore hospital room to e-mail friends and family while he was on the mend. But smartphones also make it very easy to stay in touch thanks to free video chat options like Skype, Google Chat (for Android), and FaceTime (for Apple iOS).
• One word of warning, though: Never use your regular cell phone overseas. You’ll generally have to buy an unlocked world phone and a SIM card for your country of destination to avoid getting hammered on the data rates from your U.S.-based wireless provider.

Know the downsides.

• While it has a lot of pluses, medical tourism is not for everybody. Knowing what to expect can help you make a decision about whether it’s right for your life. Some of the criticisms of medical tourism include: fewer regulations in the industry; bringing malpractice litigation can be difficult; a lack of adequate follow-up care; and the culture shock and jet lag can sometimes be too much for patients.