Thailand has long been a popular, albeit risky, destination for young Aussies to slip in cosmetic surgery while soaking up the sun at cheap luxury resorts. But now one of Australia's biggest health insurers is offering to cover people for their operations abroad and the Australian Medical Association wants to shut the scheme down.
Mother and daughter Sue Syson and Tiffany Mackinnon are two Australians heading to Thailand on a cosmetic surgery holiday.
Tiffany says she's wanted to get surgery since she was in her teens.
“I have been thinking about getting breast implants since I was around 13," says Tiffany. "For me to go and have something put in my body is a big thing... I’m very nervous about having an operation.”
Sue has been on a medical tourism trip before and says she's looking forward to getting her dental work finished.
"I’m really excited because I know that I’m going to have it all completed this time," says Sue. "And I’m going to have a really good holiday so it's going to be great."
Virgina Riddle-Cross is the Managing Director of SOMNIO Medical Holidays - one of Australia’s most popular medical tourism agencies. She often runs tours like the one that Tiffany and Sue are going on.
She says tourism agencies like hers help take the stress out of medical tourism.
"We actually arrange the flights, their accommodation... the support in Australia, the support in Thailand or wherever they're going abroad," says Ms Riddle-Cross. "[We] make sure that they’re well looked after."
Medical tourism is big business. Globally it’s a multi-billion dollar industry and each year at least 15,000 Australians are going under the knife offshore.
Aussies have been travelling to Thailand for cheap medical treatment for over a decade. What’s just changed is that patients can now get a 12-month guarantee on offshore dental and cosmetic surgery under a controversial new product from NIB - one of Australia’s largest health insurers.
Mark Fitzgibbon is the Chief Executive Officer of NIB and says there is a market for giving medical tourists some security.
"This is a worldwide phenomenon," says Mr Fitzgibbon. "People are travelling across borders for medical treatment."
"What we’re trying to do is make it all the more trustworthy and safer."
But leading Australian cosmetic surgeon Dr Nick Moncrieff sees the darker side of medical tourism. He disagrees with NIB supporting Australians going offshore for surgery.
Dr Moncrieff has fixed hundreds of botched nose jobs, tummy tucks and breast augmentations that have gone bad in Thailand.
"You can have a brand spanking new hospital with marble floors but it doesn’t mean the processes are going to be as stringent and strictly controlled as they are in Australia," says Dr Moncrieff.
The Australian Medical Association is concerned the new NIB package makes off shore surgery seem safer despite the high risk of complication. They warn that Medicare may end up footing the bill for failed procedures.
Dr Steve Hambleton is the president of the Australian Medical Association and says problems associated with medical tourism could cost the taxpayer.
"Many of these surgeries have a much longer complication time, a much longer follow up time than just a year so that cost will be ultimately born by the Australian health system in some way," says Dr Hambleton
NIB says the concerns about medical tourism are understandable but that their insurance package will just give some tourists added security.
"It’s a typical reaction. This is brand new it sounds threatening," says Mr Fitzgibbon. "Whether NIB options exist or not it's not going to stop Australians travelling overseas."
"We’re doing the front-end quality assurance... and they know if there is a problem and inevitably there will be problem from time to time - they have NIB standing behind them."
"Either you're on this train or you're under it as I see it."
Tiffany says she did have concerns about coming home with a botched procedure but she was comfortable with the risk.
"My concerns about having breast surgery was seeing a lot of the horror stories and you know the breasts not being right really," says Tiffany. "But I think for me [the] good outweighs the bad."
In a move to rid anxiety from patients like Tiffany, NIB will vet doctors in Thailand and the hospitals they work in. If patients do suffer any complications they can have it dealt with in Australia at no extra cost for up to one year.
In addition to overseas packages NIB will also offer cosmetic surgery options in Australia and has signed up 21 plastic surgeons locally.
And when you look at the costs of the surgeries it's easy to see why people are heading overseas.
In Australia breast implants will set you back $8,000-12,000. In Thailand it's under $4,000.
A facelift here will cost you around $10,000 - in Thailand that halves to around $5000.
Tummy tucks in Australia are $7,000-8,000 - Off shore it's around $5,000.
Dental implants range from $3,500-$7,500 in Australia compared to a starting price of around $2,000 in Thailand.
The new NIB fund will inevitably increase the competition for Australian surgeons but Dr Moncrieff says Australian insurers are just thinking of their bottom line.
“I don’t think that this process should be facilitated by an Australian insurance provider who are doing this to make money to increase their profit not because they’ve got the patients best interest at heart,” says Dr Moncrieff.
Dr Hambleton says people should think twice before heading overseas and put their trust in the medical system here in Australia.
"There will be adverse outcomes that need to be dealt with when people come home," says Dr Hambleton. "People can conceivably get very, very ill... and if you get to intensive care we’re talking tens of thousands of dollars potentially.”
"People should look at the quality of the product in this country - we've got properly trained surgeons, hospital accreditation that you can rely on... we have a great system in this country and people should be very confident that you can get great treatment right here."