Health care for tourists is turning into a highly lucrative business, in spite of its potential to damage the DR?s image as a safe tourist destination. Annet Cardenas, a reporter for the Diario Libre, discovered that some of the highest-priced services were found at the two clinics run by Hospiten in this country: one in Bavaro and the other in Santo Domingo. Nearly all of the hotels in the Bavaro area have equipped offices for the services of Hospiten personnel, and most patients are moved in Hospiten ambulances to the Hospiten clinic at a cost of US$350. Abdominal pains cost one tourist US$125 and a fractured toe caused another to be brought ?urgently? to Santo Domingo and treated for US$701. The medical case of one young Italian is as sad as his death. A hospital bill of RD$1,323,679.79 included a daily fee for intensive care that ascended to RD$34,680 and consults that varied between RD$9,180 and RD$16,830. Many tour operators are worried about these high costs, as they could cause higher insurance premiums needed to travel to the Dominican Republic. There was a general acceptance of the high quality of the service and the professional care that the patients received, however. In spite of their uneasiness over the situation, none of the tour operators could be identified for fear that Hospiten would take them off of their service list. According to the reporter, the excessively high fees that Hospiten charges have allowed the Spanish company to pay rents and commissions to the hotels that use their services and have successively driven out smaller medical practitioners from the area. Some, such as the Bournigal, Dr Correa and Dr Canela clinics, have simply relocated to other areas, while others, such as Toursmed, SA, have disappeared altogether.