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Dubious Middlemen And Greedy Doctors: Inside Germany's Medical Touri

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  • Dubious Middlemen And Greedy Doctors: Inside Germany's Medical Touri

    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
    http://www.spiegel.de/international/germany/german-health-care-system-cashes-in-on-foreign-patients-a-933517.html




    From: A. Papazian
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