The Ethnic Employee


In developed and developing countries minorities and ethnicities are growing at a rapid pace, and soon in many developed countries the minorities and ethnicities will stop being the minority and become the majority. From Asians, Latin Americans, Southeast Asians, Pacific Islanders, People from the Middle East and Gulf Coast Countries, and other regions, these ethnicities and cultures, their people, descendants, and heirs live everywhere in the world. Despite their large numbers and diversified spread throughout the world, surprisingly no one is tapping into this extremely diverse ethnic marketplace.

The story is the same no matter what country, in every country in the world there are specific nationalities, ethnicities and people of certain religions. This is an untapped market that many countries and hospitals are not tapping into and have not even thought of. A few months ago, I had a conference call with key executives of one of the largest associations for US health insurance companies and health insurance agents who had been researching medical tourism for several months.

I mentioned that years ago, before I was President of the Medical Tourism Association, I was running a large national healthcare administrator, when we first allowed American patients to travel overseas for healthcare. We administered healthcare benefits for employees of US companies from diverse ethnicities and countries. I recall the first patient that went overseas. They raised the question of whether they could return to their home country of Bogota, Colombia for medical care.

They lived in Miami and wanted to have the procedure in Colombia and recover with their family who resided there. The cost for the surgical procedure would have cost over $20,000 in the US. In the end it cost the US employer only $2,000 including airfare for the surgery to be performed in Colombia.

More than 1/3rd of the US population, about 34%, claim that they are a “minority” of a certain racial or ethnic heritage. In 2000 it was about 23%, so in just the past 8 years minorities have grown in the US by over 11% and will continue to grow. By 2050, the minority population in the US is projected to be 235.7 million out of a total U.S. population of 439 million. This means more than 50% (appx 54%) of people living in the United States will be of ethnic origin.

The nation is projected to reach the 400 million population milestone in 2039. Meanwhile, the Hispanic population is projected to nearly triple, from 46.7 million to 132.8 million during the 2008-2050 period. Hispanics’ share of the nation’s total population is projected to double, from 15 percent to 30 percent.

Thus, nearly one in three U.S. residents would be Hispanic. The Asian population is projected to climb from 15.5 million to 40.6 million. The Asian share of the United State’s population is expected to rise from 5.1 percent to 9.2 percent.

  • In 2050, the nation’s population of children is expected to be 62% minority, up from 44% today. Thirty-nine percent are projected to be Hispanic (up from 22 percent in 2008), and 38 % are projected to be Whites, which will be a decrease from being a majority at 56% in 2008 to a minority of 38% in 2050.
  • The working-age population is projected to become more than 50% minority in 2039 and be 55% minority in 2050 (up from 34% in 2008).

The minorities and ethnic groups in America will actually be in the majority and no longer be a minority. Asians and Hispanics are the two fastest growing minorities.

There are approximately 45.5 million Hispanics and about 15.2 million Asians in the US. From July 2006 to July 2007 the Hispanic population in the US grew by 3.3 percent and the Asian population grew by 2.9%. The white population during this period grew by only .3%.

In the US Census in 2000 whites accounted for 77.1% of the population, while today they account for less than 66% of the population! In New Mexico, California and Texas more than 50 % of the population are ethnic and whites are in the minority. The latest US Census Bureau report from several years ago states 66.9% of Hispanics are Mexican, 14.3% from Central and South America, 8.6% Puerto Rican, 3.7% Cuban, and 6.5% from other Hispanic countries.

54.1% of Hispanics and 56.8% of American Asians living in the US said they would consider the option of going overseas for medical care. I am sure that statistic would remain consistent with other ethnic groups such as Asians, people from the Middle East, and European Americans.

According the US Census Bureau 2006 report, the largest proportion of immigrants go to California, New York, Texas, Florida and New Jersey. Almost 50% of the foreign born population occurring in the US is from Latin America, and more than 25% is from Asia. The median age of minority/ethnic populations in the US is 36.6 years old.


Minorities owned approximately 18 percent of the 23 million U.S. firms in 2002, according to a survey conducted by the U.S. Small Business Administration. The minority populations also have buying power, according to the U.S. Small Business Administration. Hispanics and Latinos constituted the largest minority business community, owning 6.6 percent of all U.S. firms, 3.7 percent of employer firms and 7.4 percent of non-employer firms.

*Every 10 years the US census bureau issues new statistics and reports, so 2010 will release new statistics.

Let’s look at some statistics of the number of ethnic/minority Americans.  Please note that these numbers are considerably larger today in 2009, as these statistics are from 2000.


The first implementation of medical tourism in the United States

When I was the first person to implement Medical Tourism in the US over 4 years ago I broke a lot stigmas and biases that people had about American patients traveling overseas.  Many people were skeptical and thought Americans simply would not travel internationally for healthcare.  Many people ignored the fact that ethnic or minority Americans have a history of traveling back home for healthcare because it is less expensive and they are familiar with the quality of care.

Why are ethnic and minority Americans more willing to travel?    For example why did  51.4% of Hispanic Americans and 56.8% of Asian American surveyed say they would consider going overseas?

* Ethnic Americans travel more than the average American and a majority have already traveled to their “home” country

* There are no cultural biases or cultural issues to overcome

* No educational obstacles to overcome about the safety, cleanliness of the foreign country

*  There is already a belief in the high quality of care in the “home” country

* Patient can recover with family or relatives in the “home” country

* Patient can spend time with extended family or visit the country on tourism

Ethnicities and US Health Insurance plans

So, why doesn’t every US health insurance company implement medical tourism?  Under most current US healthcare insurance plans, there is no coverage for overseas treatments, therefore if an ethnic American would like to go overseas for medical care it is not covered.  This also means that US employers and insurance companies are forced to pay up to 90% more for the cost of major surgeries, even though these potential “patients” would be happy to travel overseas for only 10% of the cost of surgery in the US.  

For those of you in the industry or who attended our annual conference in San Francisco, you will see that times are changing.  Many US health insurance companies have woken up and realize how the demographics of people are changing in the US and how medical tourism can be a real consumer driven vehicle to lower costs for healthcare.  

This is why several major health insurance carriers like Aetna, Wellpoint, Blue Cross Blue Shield, and several other insurance companies and other BCBS organizations have implemented medical tourism.   This also is the reason why many large US health insurance companies now have proposals they are requesting from hospitals and medical tourism facilitators in the industry to propose medical tourism to them.  

I have talked to many US employers, some of whom have over 100,000 employees, all who are moving forward with implementing medical tourism.  Some have implemented it as of 2009, some in 2010.   None of them are broadcasting it to the world though.  

The savings of up to 90% is simply too much not to ignore, and the fact that the majority of ethnic Americans would be willing to travel overseas for medical care means that most likely in 2009 and 2010 will be “banner” years as more US employers and health insurance companies adopt medical tourism.

Other Developing Countries

While I address a focus on the United States, it is the same story for many countries Many developing countries, such as Canada, United Kingdom, France and other countries in Europe are facing the same situation, where the minorities are growing and may one day outpace.   In these countries the potential ethnic patient represent the same large opportunities as in the United States.  

The first target for medical tourism and the easiest target is simply the ethnic patient.   There are less hurdles to overcome and they are more likely to travel internationally for healthcare.   Having said that, in the United States many non-ethnic Americans (white) are now aware of the high quality of care available overseas and the excellent outcomes, and they are starting to travel in very large numbers.

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