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Australian medical insurer to cover holiday n -

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ELEANOR HALL: Doctors have expressed alarm at a plan by insurers to cover overseas medical procedures.

NIB has confirmed that it will begin offering offshore surgical packages to its Australian customers next year that'll cover procedures including cosmetic surgery and major dental work.

The medical insurer says it will guarantee the safety and quality of these services, but Australian practitioners are challenging this claim, saying Australian doctors and dentists must meet higher standards of care and qualifications and that these are not matched overseas.

Katie Hamann reports.

KATIE HAMANN: The global medical tourism industry is now worth a whopping $100 billion a year. And while figures are hard to come by its estimated that tens of thousands of Australians every year are combining nose jobs and knee replacements with tropical holidays. Destinations include Thailand, India, Vietnam, Malaysia and the Philippines.

Cassandra Italia is the director of Global Health Travel, which helps facilitate these journeys.

CASSANDRA ITALIA: In terms of plastic surgery and dental treatment, they're travelling for cost. They can save from between 40 up to 70 per cent. They are also travelling for privacy reasons. You can say that you're going on a holiday with friends and a lot of people want to be anonymous, so they travel overseas to have treatment without informing their friends and family. And that's the case with infertility treatment as well.

Hip and knee replacements, people are travelling purely for waiting time, to jump the queue. We have people that have come to us who have been waiting for 12 to 18 months and it's affecting their quality of life, they don't want to wait anymore, they're happy to pay out of pocket.

KATIE HAMANN: To meet the growing demand for so called medical tourism the insurer NIB has announced plans to offer offshore surgical packages, beginning next year. It's presently in negotiations with service providers in Thailand and Indonesia and intends to offer a number of services, mostly cosmetic.

The company also plans to guarantee the safety and quality of the procedures available.

Dr John Quinn, the executive director of Surgical Affairs at the Royal Australasian College of Surgeons, says this is a dubious claim.

JOHN QUINN: Certainly people can go and have cosmetic surgery or joint surgery in other places, but they need to understand that they don't have any guarantee at all of the training of the operators. They really don't know anything very much about the quality of the hospitals, what their backup facilities are, what their intensive care facilities are should they need them, what their rates of infection and sterility are. And all of those things are published widely in Australian hospitals.

But the bigger concern is also, particularly if they're having prosthesis like joint replacements, they don't have any idea about the quality of the joint replacements, where they're made, what the quality control is. And all of those things are very strictly regulated in Australia.

KATIE HAMANN: And Dr Quinn says, when things go wrong, Australian taxpayers are often forced to foot the bill.

JOHN QUINN: Certainly they have no recourse to the people of wherever they went to. But the other bigger problem is who fix up the complications and the cost of managing those complications in Australia, and it's usually the public health system and it's landed on the doorsteps of surgeons who had nothing to do with the problems in the beginning, don't quite know what's been done, how it's been done and what difficulties there are. And the complications are usually terribly costly. And that cost is borne by the public hospital system in Australia.

KATIE HAMANN: Dr Carmelo Bonanno, has seen firsthand the consequences of a botched job. He's the vice-president of the Australian Dental Association and a practicing dentist.

CARMELO BONANNO: A patient who I had seen at a previous practice and had a fairly healthy mouth - it was heavily filled, but otherwise it was okay - and one day he just presented to my surgery and I hadn't seen him for some years. He said, look, I've just got a little bit of a problem, this bridge I've had has come out. I was just shocked when I looked in his mouth.

He had a mouthful of crowns, they were all very poorly done, and I couldn't work out which was the front of the bridge and which was the back. So I didn't know whether its reinsertion would be with the correct orientation. And that's how bad it was.

KATIE HAMANN: But Cassandra Italia from Global Health Travel rejects the idea that Australian doctors are better qualified and our hospitals safer.

CASSANDRA ITALIA: Global Health Travel as a company only work with JCI accredited hospitals, which is an American hospital international accreditation system. Our international hospitals, to obtain, they have to go through a stringent process in order to get this accreditation. But it basically says that a hospital is accredited to the same standard of a Western hospital.

ELEANOR HALL: That's Cassandra Italia, the Director of Global Health Travel ending that report by Katie Hamann.