DUBIOUS MIDDLEMEN AND GREEDY DOCTORS: INSIDE GERMANY’S MEDICAL TOURISM BUSINESS
Der Spiegel, Germany
Nov 20 2013
By Udo Ludwig, Matthias Schepp and Antje Windmann
German hospitals are earning a billion euros a year with foreign
patients. Sarkis Sargsyan is one, and like so many others, the Russian
cancer patient fell into the clutches of a questionable middleman
and greedy doctors.
The metastases are scattered around his body like pieces of shrapnel.
The German doctors have shown them to him on shaded computer images,
which reveal lighter formations in his liver, lungs and brain.
ANZEIGE
It’s a Friday in July 2013. Sarkis Sargsyan, a 46-year-old Russian
citizen, is lying on a treatment table in the Klinikum rechts der
Isar, a university hospital in Munich. A sign on the door reads
“Linear Accelerator III.” A mask made of hard blue plastic encloses
his hairless skull and face. Two women in white gowns are adjusting
Sargsyan’s head so that the intersecting red laser beams from the
irradiation unit line up precisely with the markings on the mask.
Sargsyan, wearing a black tracksuit, is lying peacefully on the table.
His hands are folded across his stomach, his eyes closed. The women
turn on the machine, which begins to emit a low humming noise. The
radiation is now being targeted at the enemy inside his head.
The story of Sarkis Sargsyan is one of adversity, despair and hope.
It’s also a tale of allegedly false promises, lavish profits and a
brutal lack of scruples. It began in September 2012, when Sargsyan
discovered blood in his stool. He went to a hospital in Moscow, where
a colonoscopy was performed. “You have a tumor in your intestine,
and it doesn’t look good,” the doctor reportedly said, looking serious.
“If you have money,” he added, “you should go to Germany. They’ll
help you there.”
The doctor’s words reassured Sargsyan because they sounded like an
insurance policy. His family owns a small hotel and restaurant in
Moscow, and he was convinced he could afford the treatment.
‘Treatment in Germany’
He researched German clinics and doctors online with the help of his
wife, Nelly, 38, and his brother Derenik, 49.
If you type the words “treatment in Germany” into a search engine on
the Russian-language Internet, you get some 3 million hits, including
the websites of those who have identified a potential market in
people like Sargsyan. An army of “patient facilitators” appears on the
screen, offering services to patients that include overcoming language
barriers, procuring visas, scheduling flights and, most importantly,
setting up appointments at top hospitals and clinics. “You have to
be careful with them,” the doctor in Moscow had warned Sargsyan.
An acquaintance suggested to Sargsyan that he try IMZ GmbH, a
Munich-based agency. IMZ stands for Innovation Medizin Zentrum
(Innovation Medicine Center), which sounds impressive enough. When
Sargsyan’s brother Derenik called IMZ, he described the suspected
cancer diagnosis to a doctor named Arsen B., who had attended medical
school in Armenia, where the Sargsyans were born. “Come to Munich,”
the doctor allegedly said. “Then your brother’s illness will soon be
nothing but a memory.”
A few days later, Sarkis, Nelly and Derenik boarded a flight to
Munich. But they had no idea how long the trip would last — and that
they were about to begin the worst period of their life.
A Global Market Worth Billions
Even medicine has now succumbed to globalization. Like the Sargsyans,
hundreds of thousands of people receive treatment in a foreign country
every year. This medical tourism earns German hospitals and doctors
roughly ~@1 billion ($1.35 billion) in annual revenues. In 2011,
82,854 foreign patients were treated in Germany on an inpatient
basis and about 123,000 on an outpatient basis. Russians make up
the largest group of non-European Union patients in Germany, with
about 6,000 receiving inpatient treatment each year. Their share of
the total foreign patient population has increased six-fold since
2003. “And the interest keeps growing and growing,” says Vladimir
Pyatin, Russia’s deputy consul general in Bonn, the western city that
was once Germany’s capital.
Receiving medical treatment in Germany has always been seen as a
privilege in Russia. Famed novelist Fyodor Dostoyevsky went to the
spa in Baden-Baden, writer Nikolai Gogol searched for a cure for his
melancholy in the Baltic seaside resort of Travemunde, former President
Boris Yeltsin, who had had five bypass surgeries, had regular checkups
at the German Heart Institute in Berlin, and former first lady Raisa
Gorbachev was treated for leukemia at the Munster University Hospital.
The reasons for the current boom are simple: The state health care
system in Russia has been bled dry. The number of hospitals has
declined by almost half since 2000. Many underpaid doctors have
left the country. There is a shortage of equipment, and hygiene in
hospitals is disastrous. Only 35 percent of Russians are satisfied
with medical care in their country.
In comparison, Germany looks like a paradise, with well-trained
doctors working with state-of-the-art technology in spotless hospital
wards. German hospitals also cater to Russian patients, who, as
self-payers, present a lucrative source of income.
This seemingly presents a win-win situation. And that’s what it
would be if weren’t for several factors: the brokers who shamelessly
exploit their customers, padding their invoices, urging them to have
unnecessary tests done and, in the worst case, sending them home
after they have received subpar treatment; the hospitals that turn a
blind eye to all of this merely to make a profit; and the politicians
who are aware of the legal gray area in which medical tourism lies,
yet behave as if they were blind, deaf and dumb.
A Knight in Shining Armor
Sargsyan, his wife and brother landed in Munich on Sept. 16, 2012.
They had already paid ~@3,500 to the IMZ agency as an advance for
the treatment and visas, the Sargsyans say.
According to their account, soon after their arrival, they went to
the IMZ broker’s office at the Sheraton Munchen Arabellapark Hotel.
There, they allege they were greeted by a man in a suit, Arsen B.,
whose business card listed an exotic combination of titles: “Prof. Dr.
med. Dr. h. c. med., neurosurgeon – orthopedics, Director – Senior
Physician.” B. allegedly promised to make the necessary arrangements
for Sargsyan with a network of private clinics and doctors’ offices.
The family felt like they had met their knight in shining armor.
However, IMZ disputes this account, saying that Arsen B. was abroad
on this date and that it does not have an office at this location.
Sargsyan is sitting in a furnished, two-room apartment in northern
Munich as he describes his first few days in Germany. He has just
returned from radiation treatment, and the blue mask is lying in
his lap.
He was a karate fighter and strong as lightning, says his wife, Nelly,
a petite, friendly woman. The couple has been married for 21 years.
Nelly’s description of her husband is a far cry from the person sitting
on the sofa. He has dark bags under his eyes, and he looks depressed
and exhausted. It’s hard to imagine that this man has ever laughed.
Sargsyan talks about how the first appointment took him to the
Arabella Clinic, where another colonoscopy was performed. The
diagnosis described “a coarse tumor that is not passable.” A tissue
sample revealed that the tumor was malignant. Doctors also found
metastases in Sargsyan’s liver and lungs. An interpreter with the
agency translated for the patient. “The news was bad,” says Sargsyan,
“but I trusted the doctors.” He also trusted Arsen B., who seemed to
have a plan for everything.
To prevent intestinal obstruction, Sargsyan was given a colostomy.
Local doctors performed the first cycle of chemotherapy, followed
by radiation therapy. The brother handled financial matters, paying
~@10,000 to the IMZ office for the initial treatment. Because he paid
with a credit card, he was also charged a 5 percent surcharge. “Thank
you for your confidence,” the customer receipts read.
According to the initial estimate, the ~@10,000 was supposed to cover
the chemo and radiation therapy. But soon the brother was asked to
pay another ~@20,000 because the doctors had supposedly forgotten to
include the medications in their first bill. No payment, no treatment,
Arsen B. reportedly told the brother. That is how Derenik Sargsyan
tells the story. However, Arsen B. claims that the additional payment
became due because the treatment turned out to be much more complex
and costly than originally predicted.
“From the very beginning, patients are told that, generally speaking,
the actual doctors’ costs are higher than the preliminary cost
estimate,” Arsen B. says.
During a break in treatment at the beginning of the year, the family
returned home to Moscow. After two weeks, Sargsyan suddenly collapsed
at home. He was making strange sounds and garbling his words.
“Gasoline, I need gasoline,” he said, pointing to a water glass.
Doctors in Moscow suspected that there were metastases in his head.
His brother Derenik called the IMZ agency in Germany and was told to
“come back immediately.”
The agency has had a Facebook page since December 2011. The name IMZ
is a clever choice because, when it’s entered into a search engine,
one of the first hits is the home page of the Isar Medizin Zentrum, a
well-known private clinic in Munich. The logos of the two organizations
— three curved, parallel arches — are also strikingly similar. But
the agency and the clinic are completely unrelated, and a lawsuit is
in the works. The clinic feels that its trademark has been “massively
infringed upon.”
On the Russian website, the agency advertised until recently its
services with flowery slogans, such as: “Life goes on, and we make
sure that illnesses don’t prevent you from enjoying it to its fullest”
and “You will still be able to enjoy the world in all of its colors.”
Read the rest at
From: A. Papazian
http://www.spiegel.de/international/germany/german-health-care-system-cashes-in-on-foreign-patients-a-933517.html