Medical tourism is booming

Written by admin on September 26, 2008 – 2:46 pm -

Don’t be shocked if some more affluent friends return from faraway trips looking extremely well rested. Look more carefully. There may be telltale scars. Medical tourism is booming.

Medical tourism is on the rise. Some noted destinations are India, Brazil, Argentina, Panama, and Malaysia. According to statistics by McKinsey & Company and the Confederation of India, it is forecast there will be an explosion of people heading overseas to save money to have certain procedures done.

In 2004, an estimated $40 billion was spent in the medical tourism industry. It’s forecast that by 2012, revenues will top $100 billion. Brazil is known as an international Mecca for cosmetic and plastic surgeries. Ivo Pitanguy, the world-renowned plastic surgeon who opened a clinic outside of Rio de Janeiro more than 40 years ago, catapulted the country into the limelight. He trained doctors from all over the world and if you were a disciple of the master, it was tantamount to the plastic surgery Good Housekeeping Seal of Approval.

Currently, Brazil is the second largest market for plastic surgery in the world after the U.S. That’s attributed to the high quality of service and its comparatively low cost.

Brazil is also becoming a medical tourism destination for other types of procedures. It has the most hospitals of any country outside the U.S. that are fully accredited by the Joint Commission (JCAHO), the largest U.S. hospital accreditation organization, according to MedRetreat, a website dedicated to medical tourism.

The flight time is approximately 8 to 12 hours from most US cities. That’s an additional reason that the country is predicted to become one of the world’s most dominant economies, according to Jim O’Neill of Goldman Sachs.

Panama is another country that’s hopped on the medical tourism bandwagon. The costs, on average, are 40 to 70 percent lower than costs for similar procedures in the U.S., according to a report on medical tourism published by the National Center for Policy Analysis (NCPA) last November. Hospitals catering to foreigners are clean and English is the lingua franca among the personnel. Many of its doctors have been trained in the US and the country views medical tourism as a way of bolstering the economy.

Costa Rica, like Panama, has become a popular destination among North American patients for inexpensive, high-quality medical care. Costs of procedures are generally cost less than half of the same procedures in the U.S.; the price of a dental veneer, for instance, is approximately $350 in Panama, whereas the same procedure is $1,250 in New York or Chicago. With those types of savings, you can afford to take a vacation.

Malaysia’s medical tourism industry has experienced staggering growth over recent years. According to the Association of Private Hospitals, the number of foreigners seeking healthcare services in Malaysia has grown from 75,210 patients in 2001 to 296,687 patients in 2006.

The large volume of patients in 2006 generated approximately $59 million of revenue. It’s projected that the number of foreigners seeking medical treatment in Malaysia will continue to grow at a rate of 30 percent a year until 2010.

There’s wide array of available medical procedures—including dental, cosmetic and cardiac surgeries—at significantly lower costs than in the U.S. In Malaysia, cardiac bypass surgery costs approximately $6,000 to $7,000.

India has become a well-known medical tourist destination for cardiac and orthopedic procedures. In the past, American patients have traveled to India for procedures such as Birmingham hip resurfacing, which wasn’t unavailable in the U.S. since it hadn’t been approved by the FDA until recently.

Medical tourists also journey to India for procedures that cost a small king’s ransom in the U.S.; for example, Apollo Hospital in New Delhi charges $4,000 for cardiac surgery while the same procedure would cost about $30,000 in an American hospital.

But not all US doctors are sanguine over people traveling abroad for medical care. If something goes wrong, they’re in far-away countries. And many people don’t allow enough time for extensive follow-up visits.

But unless medical care (and not just cosmetic surgery which is a luxury), are covered by insurance, there’s bound to be a surge of people traveling overseas for various surgeries. It may mean life or death.

(Listen to me discuss this issue on WTOP.)


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As economy tanks, is business travel about to go down the tubes?

Written by admin on September 23, 2008 – 2:47 pm -

How are business travelers coping with sky-high fares and air travel hassles? They aren’t.

Many are opting for alternatives rather than face-to-face meetings.

Michael Roth, owner and consultant at Horizons Aloft, says he travels during the beginning of a project and for sales meetings. During the non-critical phases, he uses conference calls and video-conferencing. Roth believes this is more efficient in increasing productivity and reducing costs.

Isobel Warren, a writer and professional speaker, admits she’s definitely feeling the pinch. “As an independent business person, I count every penny and these days and I’m counting them twice,” she says. “Because of rising costs and diminished service, I am traveling less and conducting more research by phone or via the Internet.”

Warren feels there’s no substitute for face-to-face encounters. As a result, she feels that decreased travel may diminish her effectiveness.

Other executives rely on conferencing services such as Go to Meeting as much as possible.

Still, many feel the lack of personal contact will have a negative impact on business. People like to shake hands before doling out contracts.

Marc Casto, owner of Casto Travel, says that as a member of the travel community, he can vouch that many companies are significantly reducing non-essential travel. With the faltering economy and higher travel costs, plus reduced frequency of flights, this comes as no surprise.

Casto says many of his clients are looking for ways to trim 25 percent or more off of their business travel costs since it’s a means of boosting profit. “When you take into consideration that airfares are expected to increase by another 10 to 15 percent by the end of the year — on top of at least that much of an increase year over year — the only way to achieve that type of cost savings is through a significant reduction in the number of flights booked.”

One barometer is the announcements within the hotel industry. Over the last few years there has been a surge of new rooms added into the US market with the expectation that the travel boom of the last two years would continue. Now, a number of the properties are revising their forecasts and are looking increasingly downwards.

How are you compensating and what accommodations are you or is your company making? Clearly in this economic environment, people are going to need to be increasingly creative.

Karen Fawcett is president of Bonjour Paris


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Here’s a tip on one of the last great travel mysteries

Written by admin on September 18, 2008 – 2:49 pm -

When the time comes to settling up their bills, even savvy travelers develop amnesia about tipping.

Should you tip taxi drivers, leave a monetary “thank you” for hotel maids or shell out something extra for the room service waiter when a surcharge has already been added to the tab?

How much does a doorman deserve if he hails a cab that happens to be waiting smack in front of the door?

Is a tip merited if passengers are climbing out of the car in time for you to climb in?

Do you cross his palm each and every time the doorman stands at attention holding an umbrella to protect you from deluges of rain?

What about the battalion of concierges who accomplish impossible feats? These men and women definitely are some of the best-connected in any city’s top hotels. They’re famous for snagging impossible-to-get reservations at restaurants, tickets for sold-out plays and other cultural events.

For special clients and tokens of appreciation, a definite underground exists. Clients know better than to ask specifics. Instead, they’re appreciative of miracles in the same way a child is when a magician mysteriously pulls a rabbit out of a black satin top hat.

Do you tip him or her as you check into the hotel — or when you’re leaving?

That depends on whether or not you’re a regular. If you are, dollars to doughnuts the concierge will have already reserved a better room than newcomers might receive. Yes, some quarters (not to mention bathrooms) are definitely better than others. Contrary to the photos on the hotel’s site, assume its marketing department knows better than to showcase the worst room and has no compunction when photographers use wide-angle lenses. What may look like a perfectly satisfactory room can be situated so close to the elevator or the storage room that getting an uninterrupted night’s sleep is a challenge.

It’s as if there’s a pipeline among hotel employees as to who’s a good tipper and who’s not. Those who are (amazingly) merit extra service.

Even though the general manager’s office would be unhappy to hear this, my experience has always been that when I ask the housekeeper for an extra washcloth or two and reward her with a bit of pocket money, I don’t need to ask on subsequent days. Being a maid in a hotel invariably is an entry-level, low paying job and what are peanuts to you, can make a difference in that person’s standard of living.

The debate as to when it’s appropriate to leave a few extra coins or bills is ongoing. Don’t take what some guidebooks advise as gospel and use the advice as rules of thumb. There are so many variables.

There’s no right or wrong; there may be recommendations, but consider them precisely that. Nothing is carved in stone and before you know it, there’ll be a new set of rules. And please don’t think that the dollar and the Euro are at parity. If only that were the case. Tip according to the country where you are.

In Paris, for example, tips are included at restaurants — allegedly. Unless the place is a dive and there’s no service, don’t stiff the waiter if you want to return. It’s amazing what great memories service personnel have.

The same is true in other EU countries. But in Italy, Spain and some other countries, there’s a cover charge for just occupying the table and having a roll plunked in front of you. Don’t expect a rebate if you don’t want bread and tell the waiter to take it back to the kitchen. Once you sit down, the table as well as the cover charge are yours.

In this era of the strong Euro and pitifully weak dollar, EU residents are flocking to the US to shop until they drop and to take advantage of the “good” life. Don’t be surprised if you see a notice on menus in multiple languages announcing that service isn’t included.

Restaurant owners and managers are well aware their staff’s take home pay is predicated on tips. Some places will even add a “suggested” tip, as if tourists and business people forget their math skills when leaving home.

When I was last in China, the taxi driver refused a tip because they’re illegal and each cab is equipped with a tiny microphone. When I later traveled to Hong Kong, I tried exiting the cab without tipping.  It’s a miracle my hand wasn’t slapped.

We may not have been speaking the same language but there are times that a shared language isn’t a necessity. It’s amazing what looks can convey. A glare is worth a thousand words and I reached into my wallet as quickly as I could. The idea of being tarred and feathered lacked appeal.

What are some of your hints when it comes to tipping?  Undoubtedly, there are a thousand variations and permutations.

Karen Fawcett is president of Bonjour Paris.


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More women are hitting the road solo — are you ready?

Written by admin on September 15, 2008 – 2:50 pm -

Many women used to feel guilty if they went on vacations without their husbands or families in tow. Are they entitled to time alone or with female friends?

They might have been forgiven if they were heading to a spa. The first Golden Door was inaugurated in 1958 in Escondido, Calif. Its founder, Deborah Szekely, was a pioneer in the keep yourself in shape, pamper (and lose weight) movement. Discretion was guaranteed as many of rich and famous, actresses and socialites were the center’s primary clients. But they were considered select since money wasn’t an object.

What began as something “exclusive” is no longer. All-female retreats and women-only travel companies have grown by more than 200 percent since 1993.

Some married women may feel guilty about leaving their husbands alone while their spouses are frequently delighted. There’s nothing like watching a man pace in front of a store while his wife shops. Husbands often prefer staying home and supervising the couple’s children which minimizes another concern.

Karen Fawcett is the president of Bonjour Paris.


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Do swinging cruises shock you? Then stay out of clubs échangistes

Written by admin on September 9, 2008 – 2:52 pm -

So Yolo Cruises is launching its virgin cruise for “swingers” on April 26, 2009. The week-long charter aboard a Carnival Cruise ship, will set sail from Tampa and head to the Western Caribbean with stops in the Caymans, Cozumel, Belize, Roatan and Honduras.

Shocked? Don’t be.

In France, there are more than 400 clubs échangistes — and don’t assume that a door marked Club Privé in one of Paris’s tonier neighborhoods is reserved for members who want to discuss philosophy. Natives and tourists mix … without a language barrier.

By comparison, the swinging cruise will be relatively tame. Nudity will be restricted to pools, spa tub areas, and special themed parties. Similarly, Acts of Oneness (or twoness or eightness) must remain in staterooms or designated “playrooms.”

“It’s not simply about sex,” says Marlene Brustle, president of YOLO (You Only Live Once). “Some people want to watch.”

The group hopes to book 2000 passengers for the maiden voyage and anticipates there will be a market (albeit niche) for three to four cruises each year. Prices range from $949 for an inside cabin to $3,499 for a penthouse suite.

Stéphane Julienne, a journalist who has written extensively on swinging in France, says Europeans are the king of swing.

“The European, and probably the world Mecca for swinging, is Cap d’Agde,” he says, referring to a naturalist resort on France’s Mediterranean coast. These clubs are perfectly legal since there’s no prostitution and it’s consensual.

People from every stratum of social and economic life participate and don’t feel the need to hide. “It’s become a leisure activity, like going to the theatre or the cinema,” says Alain Plumey, curator of Paris’s Musée de l’Érotisme.

There are clubs in every big American and European city. People just aren’t as open about them. In France, people accept them as reality and at the end of an evening, always say goodnight and shake hands. You might even run into one another the following day but no one will even acknowledge the evening before.

For many, c’est normale.

Karen Fawcett is president of Bonjour Paris


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No time to visit France for a culinary vacation? Try Las Vegas

Written by admin on September 8, 2008 – 2:54 pm -

Snagging a table in Paris often isn’t a last minute event, especially if you’re shooting for the Michelin stars. People clamor for admission into the doors of some restaurants as if they were the gates to heaven. It doesn’t hurt if you’re staying at a hotel where the concierge has clout. But don’t expect him or her to perform miracles if you decide your heart is set on eating at a specific restaurant that night.

But there’s no need to leave the States — unless you want to. You can always head to Las Vegas and come away with a taste of the City of Light.

The same culture and history is lacking but hey, there’s a time and a place for everything. There’s no mandate you’re required to hop on a transatlantic flight. Plus, you may not have the time.

Some of France’s leading chefs have set up satellite restaurants in the desert where, “What happens here stays here.” Among them are Joel Robuchon, Alain Ducasse, Guy Savoy and Jean-Georges Vongerichten.

People are required to reserve in Vegas as if they were dining in Paris. But don’t expect these restaurants’ meals to be cheap. Even with the weak dollar, a meal in Las Vegas is going to set you back a minimum of $100 per person.

Come to think of it, you might not want to keep your culinary forays in Vegas a secret.

Karen Fawcett is the president of Bonjour Paris


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Welcome to the new world of English

Written by admin on September 4, 2008 – 2:57 pm -

Even though English has been accepted as the international language of business, the French Teachers’ Union doesn’t agree with a proposal presented by the Ministry of Education. Undoubtedly members of the Académie française, founded in 1635 by Cardinal Richelieu to preserve the French language, agree with the union.

The French Minister of Education Xavier Darcos declared that speaking fluent English is essential to being successful. He has proposed that free English lessons be offered during school holidays and be accessible to everyone.

It’s anticipated that President Nicholas Sarkozy will back the plan as he’s publicly stated that English fluency is critical to attract businesses to France.

Xavier Darcos stated, “It’s a handicap to speak poor English. Affluent families send their children abroad to learn English, I’m offering lessons to everyone right here.” Undoubtedly, being able to communicate will create a more competitive playing field.

Times are changing. Just two years ago, former President Jacques Chirac stormed out of an EU summit meeting when a fellow Frenchman started making his presentation in English.

C’est la vie. Why do I feel that in the not too distant future, it’s going to be hard to have a conversation in French with anyone under the age of 40? For that matter, it already is.

Karen Fawcett is president of Bonjour Paris


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For Americans abroad, no dollar news is good news

Written by admin on September 3, 2008 – 2:58 pm -

The dollar is stronger than it’s been for a long time, and some American travelers and expatriates are breathing a sigh of relief, hoping this is only the beginning. Many of them are tired of living on a diet of bread and pasta.

Maybe you don’t think currency markets are exciting, but lots of people monitor the exchange rate. They cheer when the dollar rises — and cry when it falls.

The U.S. dollar has risen to $1.45.16 to the euro, the highest since Feb. 14, 2008.

According to Meg Browne, vice president of foreign-exchange research at Brown Brothers Harriman & Co., the dollar is on an uptrend. “Growth and monetary-policy differentials are beginning to shift in favor of the U.S. dollar,” she said in a recent interview.

Two analysts — Standard Chartered Plc and BNP Paribas SA — have reportedly raised their forecasts for the dollar. London-based Standard predicts the dollar will rise to $1.44 per euro by year-end and $1.36 by the end of the first quarter of 2009, compared with previous forecasts of $1.49 and $1.42.

The decline in oil prices, plus Europe’s weakened economy, is contributing to the dollar’s rise. But neither Americans, nor people in the hospitality industry who depend on US tourists, are resting easy. The dollar has a long way to go until people feel it’s a good travel buy. And that’s not factoring in the increased airfare costs and airlines’ decreased service.

It’s too soon to forecast how soon Americans will return to Europe but the rise in the dollar can’t hurt. Part of it is a matter of psychology.

But the news is something. Let’s hope it continues.

Karen Fawcett is president of Bonjour Paris


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Evacuation problems make a compelling argument for high-speed train

Written by admin on September 1, 2008 – 3:00 pm -

Hurricane Gustav is a wake-up call to Congress. America needs to fund and implement an alternative and effective means of transportation.

Who can forget the images of cars backed up on I-10 as nervous residents flee the approaching storm? And how many air travelers are stranded in New Orleans now that the airport has closed?

In Europe, there’s an additional transportation option: modern trains capable of speeds of up to 180 miles per hour.

People lobby to have lines installed close enough to their homes to up their real estate values and diminish their commuting time, just not so close that they can hear the trains or feel their rumble. And mile for mile, they cause substantially less pollution than planes or cars.

The European Union enacted legislation last year that will require national rail systems to open up to operators from other countries by 2010. And, equally important, they will require train sets that are interoperable, unlike the old Orient Express that had to change engines are border crossings because of different rail gauges. Ultimately, there will be a pan-European high-speed train system.

Imagine what a difference a high-speed train could have made in New Orleans.

Karen Fawcett is president of Bonjour Paris.


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