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Economics & Investments

Medical Tourism ~ Progress and Prospects

Economics & Investments

Medical Tourism has emerged as a substantial segment of today’s health care market, whose impetus is not surprisingly caught in the wake of rising health care costs.  As the rise in health care costs continues to shift responsibility for payment to patients, less expensive alternatives are being sought.  

The health care market has transitioned over the years from a patient-centered system to a consumer-centered system, more closely approximating basic economic and marketing principles than in previous years.  Cost differentials are major factors of American health consumers when choosing a medical tourism destination, as noted by the following:

Who is a Medical Tourist?

The medical tourist is potentially anyone.  Markets for medical tourism include patients and their families; participants in academic medical conferences and conventions; business-to-business meetings between product and service vendors, and any mix of the above.  Jacksonville Florida for example is touting itself as “America’s HealthCenter” with a view toward increasing demand and recognition of its growing diversity in patient care services, medical businesses and tourist resources.  

The attraction of the Florida coast beach scene serves to bolster the Jacksonville marketing efforts.  The Jacksonville intiative involves 11 partners of various related medical subdisciplines, including the Mayo Clinic, CyberKnife Canter Center at Memorial Hospital, Baptist Health, St Luke’s Hospital and several other cutting edge service providers.  The Jacksonville model is reflected in other world locations, each offering its own touristic enticement as well as medical treatment.

Hence, the medical tourist can include patients, providers, healthcare administrators, payors, regulators, NGO’s, business people and interested parties.

Why Medical Tourism?

Medical tourism originated for the purpose of solving health care problems.  Additional measures of urgency are noted when these problems concern the health and livelihood of a loved one.  Aesculapius (L.) of ancient times reportedly attracted scores of patients from the old world over.  The Pythian Odes of Pindar maintained Aesculapius had been taught the use of drugs, incantation, love potions, surgery and the ability to bring the dead back to life – from a vial of blood from the Gorgons, given to him by Athena, but only if used properly.  There were few other practitioners with similar skills, resulting in the first recorded mass movement of medical tourism.

Recall the BBC’s Dr. Who, traveling time and space to solve health problems throughout universes.  In the real world, one can travel to exotic settings and plan a vacation around a medical tourism expedition, a bright idea in the light of traveling to solve a health problem.  

For the price of a selected surgical procedures in the US, one may travel to the hosting country, stay in a waterside resort complete with all the amenities and appurtenances of your favorite vacation spot, undergo your procedure and then spend an additional week vacationing and relaxing in luxurious splendor.  One might even have money left over upon their return home when comparing the price of your touristic experience with what the procedure would have cost in the US.

And your eHealthRecords [see ehealthrecords.ORG] flash drive “Data Stick” travelled with you all the way, with your entire medical record including digitalized real-time and standard imaging studies in tow that you may need to present to your treating physician in the host country.  

The Himalayas are reportedly still growing.  The Himalayan system, which includes outlying subranges stretches across six countries: Bhutan, China, India, Nepal, Pakistan and Afghanistan.  What better tourist attraction can you imagine after having your surgery completed in the booming system of India, than to visit the Himalayas?

Three main factors driving the popularity of medical tourism today would include:

  • Access to high quality care at lower than prevailing prices
  • Short waiting periods with no waiting lists
  • Availability of innovative treatments that may not be available near home

Globalization is yet another important factor.  It affects just about every aspect of our lives these days, health care being no exception.  Worldwide collaboration by providers, the medical-pharmaceutical and device manufacturing and treatment leviathan are shaping the healthcare marketplace further into a global economy.

In view of the McTeague principle having driven US markets and dominated the US healthcare system for years and years, the results stand before us.  Ever-rising costs of medication, treatment, regulatory fees, insurance, education, interest and fees on loans and infrastructure, are resulting in the US healthcare system becoming the most expensive on earth.  

Through medical tourism, by traveling, individuals can receive the same or better treatment from qualified and frequently American Board Certified individuals who have returned home worldwide after having been trained directly by marquee university, marquee professors, and charging 30-90% less than the cost in the US.

And in some cases their training facilities have followed them to their overseas homes, notably Johns Hopkins, Duke and others.  Status-quo US proponents of McTeague economics have published articles on medical tourism and retail clinics, making claims of their emergence as “disruptive health care innovations,” referring to alternatives to their proven washout status-quo models, whose effects have yet to be fully recognized.  

Medical tourism is thus one of several innovations challenging the status quo of the traditional US healthcare system as patients seek more conscientious care at lower costs.

Impact of Medical Tourism

In 2007, more than 750,000 Americans left the country seeking less expensive medical treatments.  According to the Deloitte Center for Health Solutions Research, that number is expected to grow to 6 million by 2010, having the potential to decrease US health care expenditures by many billions of dollars.  Other findings from the Deloitte Center include:

  • Outbound US medical tourism represents $2.1 billion spent by Americans overseas for care, mostly for elective procedures, amounting to approximately $16 billion in lost US healthcare revenue
  • Surgical procedures in India, Thailand, Singapore and elsewhere can cost as little as 10% of the cost for a comparable procedure in the US
  • Inbound medical tourism represents $5 billion or less in US revenue

Many players in the medical tourism arena have augmented standard medical services with local traditional methods of healing.  For example, India has added “Wellness Tourism” to their marketing pitch by including spa, yoga and Ayurveda.  “Ayurveda” roughly translates into “wisdom for living” or “knowledge of a long life,” based on an ancient system and philosophy of Indian healthcare.  

Medical tourism is described as “booming” in India and reportedly generated over $600 million in revenue in 2007.  The Indian market is a component of the Asian Medical Tourism market, a segment of medical tourism which includes India, Thailand, Singapore, Malaysia and the Phillipines.

The Bharat Book Review has published a comprehensive report entitled Asian Medical Tourism Analysis (2008-2012), which lends insight into the growing Asian markets, evaluating several detailed primary components as well as pertinent incidental components of medical tourism in Asia.  While the data are extracted from Asian countries, the contents and data organization can be useful in strategic planning and projecting in any country.  

The volume includes analyses and commentary on medical tourism distribution networks, preferred destinations, accreditations, market analysis, segmentation and risk, roadblocks, and numerous tabular data relating to costs of specific procedures in specific countries, statistical tabulations of details of medical tourism per country and revenue generation, also broken down by country, procedure etc.

Medical Tourism:  Visions of the Future

The future augurs well for the continued growth and expansion of medical tourism.  It will become increasingly more attractive in the US and abroad.  The US population includes an estimated 43 million medically uninsured and 120 million dental uninsured – numbers that are both likely to grow.  Notwithstanding, citizens of countries with thoroughgoing differences in reimbursement structure [Britain, Canada, etc.]; and countries with long waiting lists for major surgery will also be eager to exercise overseas options.

The future of health care will see increased investment in medical staff and patients crossing borders—resulting in greater access to care and economic incentives.  The imminent surge in global medical tourism will be a catalyst for bureaucracies, insurers and provider organizations to rethink and restructure the current relative role of premiums, provider reimbusement and services.  It will stimulate competition between US providers and insurers, and counterpart international providers and insurers, fostering an inadvertent leveling of the domestic playing field.

Several trends support the reality that the market for medical tourism will continue to expand in years ahead.  While longevity continues to increase, baby-boomers will represent an increasingly significant market.  By 2015, the health of many baby-boomers will necessitate treatment; and with more than 220 million boomers in the US, Canada, Europe, Australia and New Zealand, a significant market for inexpensive, high-quality medical care follows in its wake.

The imminent dominion of medical tourism, in monetary terms, is estimated to bring to India for example, as much as $2.2 billion per year by 2012.  Distinctive to India as a medical tourism destination, it’s technological sophistication is cutting edge and Indian pharmaceuticals meet the requirements of the US Food and Drug Administration.  Argentina, Costa Rica, Cuba, Jamaica, South Africa, Jordan, Malaysia, Hungary, Latvia and Estonia are in various stages of breaking  into the medical tourism market as well, and more countries join the list every year.  

Dubai–a destination already known as a luxury vacation paradise–is scheduled to open the Dubai Healthcare City by 2010. Situated on the Red Sea, this clinic will be the largest international medical center between Europe and Southeast Asia.  Slated to include a new branch of the Harvard Medical School, it may become the most prestigious foreign clinic on the horizon.

Medical Tourism has experienced exponential growth in the recent past.  In the early days of medical tourism, patients simply traveled to where the procedure or treatment was to be performed, underwent the treatment and returned home shortly thereafter.  Those days are long gone in many venues.  Now, work and play can truly be united.

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