From a spare bedroom in his Calabasas home, Rudy Rupak keeps track of kidney transplants in the Philippines and tummy tucks in Costa Rica, sex changes in Thailand and eyelid surgery in Panama.
Rupak isn't a doctor but a new breed of travel agent. As the president and co-founder of PlanetHospital, he helps Americans get medical treatments that they might be unable to afford at home, and throws in a little tourism on the side. His is a for-profit business, but Rupak sees himself as an advocate of affordable healthcare that is humanely delivered.
"In the U.S., a lot of patients say when they see a doctor, they're ushered in and out of there. Managed care forces that," Rupak says. "In a foreign country, the doctor will see them at all hours of the day. Some of our patients have even had dinner with their doctor."
Rupak witnessed foreign healthcare in 2002 while vacationing in Thailand with his fiancee, Valerie Capeloto, who has lupus. She fell ill and was afraid to go to a hospital in Bangkok. He convinced her to give it a try.
"Within minutes, I was in my own room, and they sent down an Australian-trained doctor," recalls Capeloto. "Soon, I had a private nurse -- and a chef who came in and discussed meal plans."
The total cost of a two-night hospital stay: $411.
Capeloto, who had been working as a teaching assistant, soon found herself escorting medical clients overseas, traveling with three or four patients at a time. Rupak took over the company in June 2005, while Capeloto is starting a foundation to bring PlanetHospital to people who can't afford any medical treatment at all.
Rupak, who was born in London to natives of India, brought a good resume to PlanetHospital: He attended medical school in South Africa, sold title insurance in India for a while and produced two movies in Montreal, where he owned a medical debts call center.
At PlanetHospital he has 30 employees in 13 countries. Rupak, 37, and Capeloto, 45, have visited all the hospitals and hotels where they send patients.
"We look for the little things," he says. "For instance, low beds, which are common in Asia, aren't good for a patient with hip surgery."
Orange resident Rick Thues, 54, turned to PlanetHospital when he decided to have surgery to resurface his hip joint.
He logged on to PlanetHospital's website and ticked a box guaranteeing someone would call him within 30 minutes. Half an hour later, Rupak was on the phone.
Thues' HMO would have covered a more-traditional full hip replacement but would not pay for the newer resurfacing procedure. He said it would have cost him $20,000 with a different health plan.
PlanetHospital arranged for Thues to have the operation in New Delhi. He paid $12,000 for a month's stay for him and his wife in a private hospital room and then a four-star hotel, three meals a day and some sightseeing, including a visit to the Taj Mahal.
"My HMO and the medical system in the U.S. really let me down," Thues says. "PlanetHospital gave me a way to do the right thing by exporting my medical needs to a very competent foreign doctor."
Rupak is especially proud of what he calls the "medicine of tomorrow" -- procedures not yet approved in the U.S. or not covered by most insurance plans.
Last year, he introduced the Best of Both Worlds service, in which American board-certified surgeons travel with patients to perform procedures overseas. Rupak says it saves patients 20% to 40% of the U.S. costs.
Now he's planning Diaspora Healthcare for immigrants from El Salvador; clients will pay monthly premiums of about $100 that will give them basic care in the U.S. and far greater coverage in El Salvador.
There are about 50 medical tourism companies operating in the U.S. today, and the fast growth of the industry has raised some red flags. But the success rates of most internationally accredited hospitals are similar to those in the U.S., says Josef Woodman, author of Patients Beyond Borders, a guide to medical tourism.
Diana Ernst, a healthcare policy fellow at the Pacific Research Institute, a San Francisco nonprofit, says people need to be aware that if something goes wrong in a hospital in Sao Paulo, Brazil, or San Jose, Costa Rica, they won't have much recourse. They can't sue the international providers and can't get their money back.
For many Americans, "there's an element of distrust," she says. "But if foreign hospitals can convince Americans that they offer quality healthcare at lower prices, that will change."
Rupak is focused on convincing as many people as he can.
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Who: Rudy Rupak
Occupation: President and founder of PlanetHospital
Education: High school diploma (but he's taught an MBA-level course)
Personal: Lives in Calabasas with Valerie Capeloto, his fiancee and business partner; has a 15-year-old daughter from a previous relationship
Languages spoken: English, French, Hindi, Bengal
Favorite foreign land: Canada, with Dubai a close second
Number of countries visited: 89