The Washington Diplomat / August 2003
By Larry Luxner
The U.S. government's post-9/11 efforts to make it harder for non-Americans to enter the country has had an unintended consequence: a sharp drop in foreigners — particularly wealthy Arabs — seeking medical treatment in the United States.
At Texas Medical Center, only 15,352 international patients were treated in 2001, down from over 19,000 the year before; 2002 figures aren't yet available. Such patients are coveted by major medical institutions because they're generally not covered by health insurance and tend to pay in cash, up front.
Wendeline Jongenburger, director of international programs at the University of Texas M.D. Anderson Cancer Center, said the number of Saudi patients alone fell by 65% after the Sept. 11 terrorist attacks, and has yet to recover.
Following the attacks, many patients ranging from Mexicans to Moroccans couldn't get visas and simply cancelled their scheduled operations and checkups. Now, says Ruthy Khawaja, director of international services at Methodist Hospital, fewer foreigners are cancelling for that reason, but it could be that they simply aren't bothering to apply.
"With all the difficulties in getting a visa, Middle Easterners are not coming here," Khawaja said. "When there isn't difficulty in getting visas for patients, there are delays in getting visas for companions. And if you've just been diagnosed with cancer, every moment is an eternity."
Also, she said, "airport procedures have become tedious and sometimes really frightening to patients, so that's been a deterrent. When I visited the Mideast last year, there were all kinds of horror stories, urban legends about the things that can happen to you in the airport here. Even those who have visas are reluctant to come, if it's not an acute situation."
That translates into untold millions of dollars in lost revenues for Texas Medical Center, the world's largest medical complex. It's also caused headaches for physicans coming to TMC to do fellowships and residences — often forcing them to miss classes at the center's various teaching hospitals.
To remedy the situation, TMC is lobbying hard for the creation of a medical visa that will give priority to foreigners seeking medical treatment.
"We are working right now with the Department of Homeland Security and the State Department just to make certain the notion will be acceptable," said Kathy Stream, senior vice-president of TMC. "The creation of an additional visa type requires the approval of Congress. We're not trying to bypass any security measures; we are just trying to get prioritized screening for our international patients."
Last October, TMC invited the heads of the nation's largest medical centers to Houston to discuss the medical visa issue and then lobby their senators and representatives. The effort is being coordinated by TMC's International Affairs Advisory Council.
Doug Abel, TMC's government affairs manager, said "we've sent a proposal to Washington, and it's being looked at. We've also had discussions with members of the Texas legislature."
The creation of a special medical visa wouldn't come a moment too soon for Memorial Hermann Hospital, which served 300 foreign patients last year, down from 450 a year prior to 9/11.
"It currently takes six to eight weeks [to get a visa], and there are severe cases that cannot wait," said Karem Botani, the hospital's manager of international affairs. "For example, I have a patient from Saudi Arabia who was supposed to arrive yesterday, because he needs a liver transplant. Unfortunately, he wasn't able to obtain a visa."
Before 9/11, it took between 24 hours and three days for most prospective patients from the Middle East to obtain a U.S. visa. Now, it's five to six weeks — a little better than last year, but still too long, says Nagib Mustafa, international attaché at Texas Children's Hospital.
"Parents still say their first option would be to come to the States," said Mustafa. "But if their child is sick, they won't wait three or four months to get a visa, especially when it takes only a week to get a visa for most European countries."