TL and Medical Tourism
 

TL in the setting vary from planet to planet, f.e., Lunion (SM 2124) is at TL 10, neighboring Derchon (SM 2024) is at TL 7.

That means that people on Derchon can suffer from crippling or life-threatening illnesses or injuries that on Lunion simply do not exist or a rather minor nuisance.

Interstellar travel is fast and cheap, so "medical tourism" will be a reason why people from Derchon will visit Lunion. Probably, there will be hotels, clinics or doctors on Lunion who have specialized in treating patients like this.

This upon up some possibilities.

To the government of Derchon, it could be tempting to save money on expensive hospitals. Simply put the sick in low berth and store them, until you have enough to fill empty space on the next free trader.
The problem - in the next frontier war, when interstellar travel is cut short, you will have a lot of sick people who cannot leave the planet.

To an employer on Derchon, it could be an option to pay the trip of a needed specialist to Lunion so that he is back in three weeks instead of to debit his health care months or years.

To the doctors on Lunion, it would give them a steady stream of patients.

To free traders and space lanes, it would mean a steady stream of passengers.

So, what else would come out of this?

Re: TL and Medical Tourism
 

The funny thing is, in the real world, medical tourism often works the other way around.

People from lower tech countries do come to the US for treatment but usually are sponsored by some charity because of the cost of treatment. The average person from a Nairobi can’t afford to travel to the US, stay here and pay for treatment. Only the wealthy or sponsored can do it.

...and keep in mind the several discussions here about how money from a TL-7 planet isn’t worth as much as money from a TL-10 planet.

However US citizens far more often travel to other countries for treatment because it’s cheaper. If you don’t need absolute cutting edge tech to fix your problem, going to a lower tech and thus cheaper area for treatment becomes an option. Also, it may provide options for treatment that aren’t available due to regulation or ethical issues.

I expect that medical tourism in Traveller would involve more people traveling to lower tech planets to receive less expensive treatment that can be effectively provided at that tech level... especially plastic surgery.

Re: TL and Medical Tourism
 

Another possibility that might evolve would be a variation of the Doctors without Borders concept. Instead however, they purchase a jump ship, hire a crew, but furnish the ship with state of the art medical equipment and supplies and even possibly, the means to manufacture low requirements medical supplies.

If you wan to get "crazy about it" so to speak, take a hard look at the Modular Cutter series of designs. Imagine being able to have what amounts to a mini-MASH module that can be transported to various worlds at need, and when no longer necessary, be picked up and transported to another world with a minimal of fuss.

Hmmm. Might need to try my hand at designing a mobile hospital unit and post it on my thread on ships...

Just out of curiosity, what would be the minimal staff you'd want to see for a mobile hospital unit? Since each "module" will contain its own energy production, have its own surgical theaters, have its own secure medical supply area (as cargo bay areas as well as secure sleeping quarters in the form of staterooms - what would you want to see overall?

I could even envision the ability to have specialized mobile vehicular recovery vehicles in the same vein as the role helicopters have today. Having the ability to create trans-atmospheric vehicles might even permit people on the wrong side of the world, being able to access medical care quickly via a fast pinnace with a 4G acceleration. When minutes count, the pinnace arrives quickly.

Possibly the only real limitation to this kind of medical service might be the need for specialists.

So - devise your "wish list" of absolutely MUST haves, a list of those "would be nice to have" and some sort of operational budget required. I could almost see something like this being funded by the subsector Nobles for those worlds whose population rating is insufficient to be able to fund those fancy hospitals.

Something to think about.

Re: TL and Medical Tourism
 

Just a quickie for you, this was created via GURPS MODULAR VEHICLES (freely available for download if you want it). Unlike the original Medical Module from GURPS TRAVELLER MODULAR CUTTER book, this one has an operating theater in it (good for two patients) plus a Military Sickbay. Because this unit is supposed to be capable of operating separately from ships power, I gave it its own engineering section so as to provide the energy core power system required. The bunk room permits up to 16 people to sleep in it, but usually handles four. This could be used as a place for people to stay if necessary, for registered nurses or medical technicians. This fits into a 30 dton hull that would be standard for a modular cutter to employ. While 3 dtons may not seem like a lot of room for stores, one could easily remove the air raft area entirely, and gain more storage space.

Note that this module could be transported on any vessel and simply used on worlds where it is needed. An entire medical facility could be created such that some modules have labs in them instead of medic bays or operating theaters or what have you. Note too, that this facility has a DR of 100 against small arms fire and the like. ;)


Crew: 3 Total. 2 Medical, 1 Flight Crew.

Hull: 30-ton VGSL, non Lifting Body, Medium Frame, Standard Materials, Crystaliron (Expensive) Armored Hull (DR 100), Standard Compartmentalization.

Engineering: Sm Engineering/10, Small Utility/10.

Accommodations: 2 Stateroom/10, Bunk Room/10, Operating Theater/10 (2 Patients), Military Sickbay/10 (4 Patients), 2 Low Berth/ 9 (8 Cryoberths).

Stores: 2 Vehicle Bay/ 7 (Air Raft[.051960], 0.5 dtons for small craft available). 3 Hold

Statistics: DMass 52.15 stons, EMass 52.15 stons, LMass 52.15 stons, Base Cost MCr1.96, Load Cost MCr0.05, Total Cost MCr2.01, HP 6,000, Damage Threshold 600, Size Mod +7, HT 12, 6.7 Man-Hours/day Maintenance.

Re: TL and Medical Tourism
 

I think you know that's not the main reason Americans go out of country for medical procedures. The reason is purely due to our jacked up prices and lack of national healthcare. So while certainly possible for one or more Traveller planets to suffer similarly, it's not really an issue of TL alone.

Re: TL and Medical Tourism
 

I pretty much said straight out it’s because it’s cheaper, but thanks for playing.

...and thanks for adding pointless current politics to a thread about a society hundreds or thousands of years in the future... which notably doesn’t have national healthcare either.

I don’t think all the starlets headed to Mexico for boob jobs are covered by Mexico’s national healthcare system... and you’ll note that the country most people DO come to when they need the best care, is the one without the national health care system.

...and if you’d like to know what national healthcare is really like, go qualify to be treated by the VA and then die in the parking lot waiting for an appointment while they repeatedly cancel them so their attendance records look good. Have a heart attack in a hospital bed there while nurses laugh about the fact that none of them know how to use a crash cart.

...and watch those employees responsible for the deaths of patients keep their jobs because they are federal employees and immune from firing.

I qualify for the VA and would rather pay out of pocket than soil the soles of my shoes by setting foot in the place.

...but the POINT is, in Traveller, if a given lower tech planet can do a procedure at their tech level it will be cheaper than the same procedure on a high tech planet for a number of reasons. The only reason to have most procedures done on a high tech planet is if you’re already there and the procedure is so trivial that it’s not worth the trip, or if the procedure can only be done at the higher tech level.

I have actually wondered about starships with sickbay facilities setting up medical practice in the extraterritorial starport areaespecially in under developed planets.

Re: TL and Medical Tourism
 

GURPS Traveller Starports has a sidebar "The Starport as Hospital" about how the starport may have the only good medical facility on the planet, and that the Imperium de facto subsidizes this as part of frontier development.

Of course, for Class 1 or 2 starports there won't be a hospital unless it was explicitly added for the reason above.

Adventure seed or random encounter: A ship lands on Class 1 or worse starport planet and people desperate from medical help come to the ship hoping they can help.

ObSF: Four Day Planet by H. Beam Piper, where the overbuilt starport is the only hospital on a planet with 40,000 people or so.

Another reason for medical tourism is to get treatments, services, or implants which are illegal or highly restricted on your home planet. Because of ethical or religious reasons, or social restrictions, etc.

Re: TL and Medical Tourism
 

Does the phenomenon of people traveling from a developed to a less developed country in search of cheaper health care occur in countries other than the United States? More to the point, how do the time, difficulty, and expense of crossing the Rio Grande compare to those of crossing interstellar space? If, on a given planet, red tape and and excessive concern for safety (neither of which necessarily correlate with development or tech level) interfere with practice there, could one simply set up a clinic in orbit rather than hauling people between the stars? This last has the advantage that one now has a space station full of unethical doctors- the adventure possibilities practically write themselves.

Still, that's rather a different sort of adventure than the OP was thinking of. Sticking with his idea, possible complications for the adventure include the obvious medical tropes. "The voyage will take longer than planned unless one can pull off this bit of difficult piloting, can the patient on life support be kept alive?" is a classic. Contagious diseases are always fun, whether trying to keep them from spreading in the tightly enclosed quarters of a spaceship (or, in games that run more to Star Trek, trying to muster enough rubber science to cure one that has already spread throughout the ship before everyone dies of it), or trying to smuggle someone suffering from one through quarantine to reach treatment.

Re: TL and Medical Tourism
 

Some friends of mine went to romania and turkey for dental work. Germans go to poland for cosmetic operations. But of course it doesn´t take a week or several weeks to get there and equally long to get back. If they would miss that much work (=pay) to get there it would probably not be worth it. And there is no TL difference involved - they get the same treatment they would get here, only cheaper. If the offer would be "cheaper and be treated as in 1920" I don´t believe anybody would go.

Re: TL and Medical Tourism
 

My next door neighbor happens to be in the business of arranging travel for medical tourism. It's entirely about cost. In the US, hospital costs are mostly defined by how much the insurer will pay without raising a fuss, with the cost of unreimbursed emergency room care built into the overhead the hospital uses to justify prices to insurance companies that raise a fuss about the cost.

By contrast, if someone goes through medical tourism, they fly to Cancun (if they go through my neighbor's business), get their medical procedure done in a hospital (or medical tourism wing of a hospital) equipped to top-of-the-line quality and luxurious comforts, get first class doctors, good (and abundant) nursing care, and recovery in a popular vacation destination. Prices are aimed at making a profit for everyone while still beating the price of domestic hospitals by a lot, even after travel costs.

If you have medical care that can be scheduled, and the time under care doesn't take too much time away from work, it's a big win for the patient. So it's not the place to be treated for a heart attack or cancer (unless you can take off a lot of time for the repeat care in the latter), but it's great for a hip replacement or facelift.

Meanwhile, people in Cancun who depend on the national health care get the sort of care one might expect in a country on the border between developed and third world. It's probably much better than the care a poor person in the US gets, but far short of what wealthy or well-insured people in the US get, or what one can get in the medical tourism hospital.

- - -

In the case of Traveller, medical tourism would be expensive. Even low passage is an expensive trip; Cr1000 is about US$4000, and then the patient has to be away from the homeworld for longer than is optimal for someone with a job. A better model is the mobile hospital -- or even the permanent off-world technology hospital. Most lower technology people can't afford advanced care at the advanced hospital (except for the free vaccination programs they'd offer out of self-interest), but if the world has enough population that the upper class is reasonably numerous, the rich could justify such a facility -- just as a wealthy Mexican could go to the medical tourism hospital for premium care if they weren't satisfied with the regular hospital.

Re: TL and Medical Tourism
 

This. One of the most gameable and sad realities about tourism is the massive inequalities that it creates and engenders, as well as the cultural hegemony it can then exert. The people who live in a tourist destination often make far less money than is needed to pay the prices aimed at the wealthy tourists, and (worse, perhaps) the only way they can come close is by working for the resorts or whatever that attract the tourists. Things only get worse when there's a 3-TL (frex) difference between the two groups, and the tourism is medical. You could run an entire campaign (either single-system or circuit hospital ship) telling these kinds of stories, including everything from natives begging tourists to pay for their children's or elder's healthcare to theft and sabotage by the lower classes to out-and-out class warfare. And where do the various nobles involved stand on these issues?

***

As a transwoman (genderqueer, but transwoman works as well as anything else does), this also brings to mind the phenomenon of transfolk going to Thailand (most famously) to get their gender-affirming surgery. Obviously, it's because of cost and it's same TL, but it's also because of inherent prejudice in our culture, society, economy, and insurance system. Play around with all of those, maybe mix and match them. Any spaceship with a doctor might find itself asking what it should do when a local celebrity, politician, or religious figure of a world without the technology to perform gender-affirming surgery beyond a sharp knife shows up at the spaceport, asking them to do the surgery. Does their answer change if the planet's culture is very accepting of trans identities?

***

I also think of the brain GAIN Cuba has experienced for some time. It's because they built one of the best medical education systems in the world ~ and, like true communists, offered to allow at least a good chunk of the tuition to be paid in labor. Sure, embargoes meant that you had outdated, inadequate, or just very little equipment while you did the two years guest labor to pay off your schooling, but it meant you were top of your field globally. Imagine that happening on one of the lower-TL planets in your subsector. They can't provide the whizbang tools, but they've managed to scrape together enough money for databases and virtual holographic teachers and direct skill download from the higher-TL planets that their medical education system is the best in the subsector, but you have to work for them for 4 years to pay for that schooling. Northern Exposure in the Third Imperium, anybody? A character who took the training and ran from the labor? Wars developing as the planetary noble, desperate to keep his edge faces losing one of the suppliers of educational materials?

Re: TL and Medical Tourism
 

We chose to have specialist treatment done privately in Germany rather than the UK for a number of reasons.

The UK National Health System (NHS) though excellent value for routine medical care(IMHO) isn't really suited to unusual medical conditions, due to resource constraints (they can't afford to have a specialist in obscure medical conditions on stand-by just in case). As a result specialist treatment is available state-paid but there are often long waiting lists. Alternatively you can pay to have it done privately within a much reduced time-frame. Once you have decided to go private you may as well shop around.

Germany had a world renowned specialist and whilst there were some specialists in the UK, they didn't have the same international reputation. The best in the world has to live somewhere, why wouldn't you travel to the best in the world (or galaxy) if you could afford it.

As someone else pointed out, it is not just the treatment, there is also recovery to consider. In our case the total cost of the treatment plus a few days locally in a hotel so that daily monitoring could occur was less in Germany than London. Favourable exchange rates and the fact that you can find European hotels that are less expensive than London hotels meant we could spend a long weekend in Hamburg for the price of 2 nights in London and could therefore have a few days decompressing. For me as a Brit, a few days in Hamburg is more fun than a few days in London anyway. There was the psychological benefit of thinking of the trip as a "holiday" to Hamburg plus some treatment compared to thinking of it as going to London for treatment.

Our one experience of a German hospital was that it seemed to be better equipped, maintained and run than the UK hospitals we have been to in the past. It should be remembered however that this was a private hospital and we have only been in NHS hospitals (and you only tend to dwell on the bad things about hospitals). A positive medical experience (in terms of feelings rather than any treatment) can generate psychological (placebo) recovery benefits.

Re: TL and Medical Tourism
 

I've heard plenty of reference to people going a lot further than Germany to get work done - apparently there's plenty of places in South Asia that can do good quality work at low prices.