Tropical settings, warm beaches, four-star cuisine and a kidney transplant.
That's the unusual combination of elements that often make up medical tourism trips, or the crossing of borders to obtain health care. Such travel as become popular because of some countries' rising medical costs, long waiting lists to undergo procedures and slowness to approve new treatments, said Rudy Rupak, CEO and founder of Calabasas-based medical tourism agency Planet Hospital.
The seeds of the company were planted after a 2002 trip to Bangkok by Rupak and his fiancée Valerie Capeloto, who had became ill while overseas.
"She was in a great deal of agony," said Rupak. "I pushed her to go to the local hospital and it was phenomenal."
Capeloto, who suffers from lupus, was apprehensive at first and wanted to get back to the States before seeking help. Out of concern for her health, Rupak persuaded her to seek attention in Bangkok.
For her three-day hospitalization she had her own private room, chef and was catered to constantly, Rupak said. The total cost of the visit was $411, which was less than Capeloto's $500 insurance deductible.
"It was very organized and very quiet," said Capeloto. "I was in the hospital for three days and it was a good experience."
Impressed with the quality of care, she began spreading the gospel of her overseas experience. She started accompanying friends and acquaintances to different locations throughout the world for treatment.
In 2005, Rupak and Capeloto launched Planet Hospital and its website. As the business grew, concierges, or "location managers," were hired to greet the arriving patients at their international ports-of-entry, just as Capeloto had been doing.
"People think America has the best health care in the world. I don't dispute that America does . . . if you can afford it," said Rupak. "For those of us who can't, we could still get the best care abroad."
The destination depends on the procedure required. Those seeking gender reassignment and plastic surgeries may be referred to Thailand, Costa Rica or Panama. The need for a kidney transplant, meanwhile, could likely require a trip to the Philippines.
Many factors go into choosing the right location, including cost, a patient's comfort level and determing who is the best physician for the job, Rupak said.
"Some of the patients have apprehensions about it," he said. "But then they arrive, and they see the doctor, the hospital, they see the concierge who takes care of them from the moment they land to the moment they leave. We have had patients say they will never have surgery in America again."
According to Rupak, the company is now seeking locations with a less exotic feel. They hope that travel to countries such as Australia will seem more inviting for people who need treatement.
"You tell somebody you're going to Australia . . . it changes the dynamic," said Rupak. "It might not be as cheap, but the tradeoff is it's not India and it's still a lot cheaper than America."
A cardiac surgery might cost about $60,000 in the United States, $12,000 in India and in Australia, $35,000 with travel for two included.
"If you can afford Australia by all means, go there, if India is too scary for you," said Rupak. "But if you can't afford Australia and you're nervous about going to India, let us help you get over it."
Rupak pointed out, however, that Planet Hospital's goal is not to locate the cheapest surgery from the lowest bidder, but rather to find the most affordable and qualified physician available.
Because the U.S. Food and Drug Adminstration's approval process can be so slow, other countries can often offer a wider range of medical options.
"In other countries they are performing procedures that we won't do for another three years," said Geoff Moss, Planet Hospital's president of public relations and branding.
And some of those procedures were invented in the United States, Rupak said.
"We are the admission desk to some of the best doctors around the world," said Rupak. "We have a third party that does background checks on all the doctors on our list . . . We also have a board of advisers of 12 doctors from different specialties . . . who conduct phone interviews and do peer reviews and, in some cases, we have had our reviewers scrub into the surgeries to oversee a procedure."
Recently the company has started a surrogate mothers program in India and is looking to find more viable locations for legitimate stem cell treatments.
"There is so much snake oil in the whole stem cell world that we are trying to take the high road and identify who the real legitimate players are and create a pathway to them," said Rupak.