Nip-and-tuck travel crimped as US tightens belts
July 30, 2009
Before the financial crisis, Americans who travelled overseas for surgery typically opted for cosmetic and dental procedures. But belt tightening, it seems, has made a dent even in those industries aimed at making people look prettier, perkier, poutier and, of course, younger.
Since the financial meltdown, the tendency among international medical tourists has been to travel abroad for orthopaedic procedures such as hip and knee replacements, heart procedures, ophthalmology and bariatric surgery.
Trailing behind these procedures are cosmetic and dental surgery, according to figures presented yesterday to a South African health tourism congress aimed at pulling more health tourists to our sunny climes. Other reasons to travel abroad for surgical procedures include treatment for cancer, in vitro fertilisation treatment, transplants and alternative treatments.
The findings contradict some reports that more people are turning to procedures such as breast augmentation to make themselves feel better in tough times.
But the fall is to be expected, given that the US middle class bulked up the plastic surgery patient list for years. A 2005 study of the American Society of Plastic Surgeons found that only 10 percent of people who recently had or considered cosmetic procedures earned more than $90 000 (about R700 000) a year. The majority had a household income between $30 000 and $60 000.
So, facing financial constraints, the US middle class would likely cut back discretionary spending on non-essentials such as nose jobs, tummy tucks and liposuction.
Because we live in a globalised economy, replete with international medical tourism that has given rise to the "safari-after-surgery" concept in Africa, it means that plastic surgeons around the world are feeling the pinch.
Unskilled despair
The despair that is the daily reality of the 1.5 million people who have given up looking for work is chilling.
The jobs data released by Statistics SA this week show that of the 267 000 jobs lost in the second quarter, the majority were in private households. This brings the number of jobs lost since the beginning of the year to almost 500 000.
The second-quarter data points to domestic workers losing their jobs, perhaps because middle class households have cut spending where they can.
Men and women have either lost hope because repeated searches for work have come up with nothing or they don't have the money to pay for the trip into town and back to spend the day knocking on doors.
Regardless of the reasons, discouraged job seekers and the many recently unemployed domestic workers already have limited options in terms of the work they can do because of their inadequate skills.
In a research note on the employment data, Econometrix says the link between skills and unemployment has once again been confirmed.
The unemployment rate only rose for one race group, that is black Africans. Among whites and coloureds the rate remained unchanged at 4.6 percent and 19.5 percent, respectively, and for Indians unemployment decreased quite sharply from 12.7 percent in the first quarter to 11.3 percent in the second quarter. In contrast, for black Africans unemployment rose to 27.9 percent from 27.7 percent.
It is a well known fact from other statistical sources that the proportionate level of skills and education among black Africans is far lower than other race groups, where for example Indians have the highest levels of skills and education, Econometrix says.
In recessionary times most employers are inclined to retain a smaller pool of skilled staff to keep operations going.
All this points once again to the urgency that is required to upgrade South Africa's education system across the board so that people have the means with which to rise out of poverty.
Medical ills
THE ANC has listed on its website key features of the proposed national health insurance (NHI) scheme, which it says will ensure that every citizen has access to the same level of quality health care irrespective of their employment status or income.
The ruling party speaks of social solidarity, which means that those people who can afford treatment will subsidise those who can't. It also highlights that money will not be required upfront by a doctor or a hospital before treating a patient.
The one point that should please everyone who belongs to a medical aid scheme is that the premiums will be lower than what people are currently contributing. These suggestions should be applauded.
There are at least 49 million people for whom the government will have to provide health care and everyone will be entitled to these benefits. This is the same government that is not managing to equip hospitals with basic equipment, medicines, beds, linen and enough nurses and doctors for the 41.2 million people who currently rely on the state for health care services.
Generally, South African health care institutions don't have all the required resources, be they public or private.
People will share their experiences of waiting for hours for beds in private hospitals, staff who ignore patients when they ring bells for attention and doctors who don't think they are accountable to their patients. Likewise. people who use state facilities can tell of their frustration at waiting for hours in long queues, unhygienic buildings and rude personnel.
So there is a problem all round and the private health care institutions don't necessarily provide the "hotel experience" former health minister Manto Tshabalala-Msimang once referred to.
Would it not be wise for the government to fix these ills, improve its efficiencies, and get to the bottom of what is the cause of the ridiculous costs in the private sector before overhauling the entire system?
Edited by Peter DeIonno. With contributions from Ingi Salgado, Samantha Enslin-Payne and Slindile Khanyile
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