HealthAbroad.net: Point of View

The number of people traveling from Western Europe to Poland for cheaper medical care is likely to rise by 20 percent per year.

Visitors from Western Europe can get some medical treatments in Poland, the Czech Republic and Hungary for upto 60 percent of the costs in their own countries. The proliferation of low cost airlines has given an additional impetus to this trend.

An interview with Dr. Jason Yap on how and why Singapore is promoting medical tourism in a big way. Dr. Yap is the Director of Information Services of the Singapore Medicine section of the Singapore Tourism Board.

A few things to point out from the interview:

• in 2006, more than 400,000 patients came to Singapore with a majority from neighboring South East Asian countries and others from the Middle East, North America and Europe.

• Patients are seeking out Singapore for high end, complex and research driven elective surgeries such as pediatric luekemia, bone marrow transplants, cancer treatments in addition to the usual knee and hip replacements.

• Singapore is marginally more expensive than India but also benefits from having better infrastructure. A knee replacement which costs around $40,000 in the US, costs around $9000 in Singapore and around $6,000 in India.

p.s- Very informative blog as well.

500,000 in the last year to be exact, according to the Turkish culture and tourism ministry undersecretary.

The Anatolia region is the prime European location for geothermal potential and is likely to attract investments in medical tourism and real estate.

Geothermal springs and geysers and the cheap yet high quality surgical procedures attract foreign and mainly European patients to Turkey.

Hospitals in the Malaysian state of Penang, which contribute about half of the country’s annual medical tourism revenue have asked the government to increase to number of flights to the state in an effort to further hike medical tourism revenues. Better and more frequent connections have been requested between Penang and Jakarta, southern China, Myanmar and Vietnam.  

Some seven of Penang’s 25 private hospitals are active in promoting medical tourism with most patients coming from Indonesia, followed by Japan. Hospitals in Penang are espcially keen to tap the Jakarta market - all of 17 million people.

Tourists from Italy, Germany, Sweden, Norway and England are coming in droves to Croatia’s glittering coast for its pristine beaches and natural beauty but also for dental surgery. Good dental surgeons, competitive prices and better transport links have led to this growth.

While a porcelain tooth crown costs about 500-600 pounds (730-800 euros) in Britain, the same is being offered for 200 euros in Croatia. Breast implants cost around 3000 euros in Croatia while in Italy they cost between 6,000 and 8,000 euros.

The country’s tourist officials have also recognized the immense potential of health tourism, especially during July-August peak travel season “when most of the eight million annual tourists - nearly twice Croatia’s population - visit.”

While dental surgery is highly popular, patients are also coming in for “rhinoplasty or nose jobs, liposuction, breast implants, and a growing number of men seeking face-lifts.”

Croatia is one of the many former eastern European countries which have become the hub for cut price dental surgery. However, there are no official figures on the number of foreigners coming to Croatia for dental services.   

Nice article in the International Herald Tribune on the mushrooming of low cost and discount airlines across Asia, Latin America and the Middle East. 

Air travel by being made afforadable and accessible has facilitated the movement of people, ideas and money - all pre-requisites for better business and price competitiveness. It has also forced state run and heaviy subsidized airlines to shake off their complacency, compete and offer better services to their customers or perish. Mediocrity has no takers beyond a point.

So where does medical tourism come in? The article starts off with the story of an American author who was in India last year to research for his book on medical tourism and came away with a favourable impression of the low cost airline(s) he used to crisscross the country.  

The airlines industry and medical tourism are inextricably linked. The former moves people - now at much lower costs to consumer than before, from which the latter benefits greatly. It would perhaps be a bit of a stretch to say that the low-cost airlines have spawned the medical tourism industry but they have helped in its growth in no small measure. Read our previous posts about this relationship here.

More on Argentina being a top destination for cut price good quality plastic surgery.

A breast implant surgery costs $2500 in Argentina whereas it can be three times as much in Los Angeles, Madrid or Paris. A high local demand for plastic surgery also means that the  doctors are well trained and competent. Even today, as much as 60 percent of all procedures are done on Argentinians.

Argentina’s stormed up the list of medical destinations after the peso was devalued in 2001 making travel and surgery a steal.

Read our previous posts on Argentina and plastic surgery here and here and also the one on Brazil.

China and Pakistan, leaders in transplant tourism are drafting laws which will make the harvesting of organs and their sale illegal.

Pakistan has had no laws allowing organ donations from the deceased, but in February the administration approved a draft transplantation law. Parliamentary approval is pending but in view of the recent WHO statement on the issue and the public outcry that followed, this should come through.

China approved in March a draft law for clearer guidelines on legal transplants. With the Beijing Olympics just over a year away and following the international outcry last year after news broke of organs from executed prisoners being sold to British patients, China has been forced to act.

…the tightening up in China had had “a domino effect” in countries that depended on transplant tourism to solve the problem of increasing kidney failure. South Korea, which used to depend on China for kidneys, was reassessing its policies now that Beijing is closing the door on foreign patients. Saudi Arabia, which sends about 700 patients abroad annually, was also rethinking…

According to WHO estimates, China hosted almost 2,000 “transplant tourists” in recent years, using mostly kidneys from executed prisoners. Pakistan hosted up to 1,500, the Philippines had up to 200 operations and Egypt 100.

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In my personal opinion, the chances of things changing are far greater in China than in Pakistan. Given the hidden and nefarious nature of the activity, lax enforcement of laws, massive demand for kidneys and the scores of poor and destitute people in Pakistan and China to prey on, government legislation though significant for its intent is not sufficient. Even India enacted laws in the 1990s after receiving a lot of bad press but a black market still exists. Pakistan is lawless and given its many problems and failings, fat chance that acting against transplant tourism and illegal organ sale is high on the list of priorities.

The reason I feel that China might be more successful than Pakistan is because the stakes are high. The Beijing Olympics around the corner and there is great concern for the country’s image, more so because of China’s delayed entry onto the world stage and the “fear” instilled by its economic growth. The eyes of the international media are trained on the country and this will only intensify as the Olympics near and with media hounds eagerly waiting to pounce on any failing and stories of human deprivation. But given the Chinese government’s concern about how the country and its people are perceived by the outside world and its demonstrated success at taking action and enforcing laws (the methods employed are open to questioning and debate), I’d place my bets on China.

In the last few days there has been considerable media chatter on the rise of transplant tourism across the world after the WHO issued a press statement on the matter on March 30. 

With demand for organs outstripping supply and poverty-stricken people in developing countries being preyed on by brokers and rich clients at home and abroad, the UN’s health agency has expressed its concern about quality, safety and efficacy issues related to transplantation procedures as well as the traceabilitiy and accountability of human materials crossing borders.

Transplantation is usually seen as the best solution for end stage organ failure and according to estimates submitted to WHO by 98 countries, the most sought after organ is the kidney. According to WHO data, sixty-six thousand kidneys were transplanted in 2005 representing a mere 10% of the estimated need. In the same year, 21 000 livers and 6 000 hearts were transplanted.

Last year news broke about Chinese authorities harvesting the organs of executed prisoners and putting them up on sale for British patients among other foreign nationals. In January this year, a few Indian publications broke the news of how tsunami affected families in the southern Indian state of Tamil Nadu, having fallen on hard times, were selling their kidneys to rich clients (1,2,3) from West Asia and South East Asia.  

Here’s some media coverage after WHO statement- 1, 2, 3

Useful article on how Singapore has built its reputation as the top destination for medical tourism.

Singapore Medicine, Singapore Tourism Board-Healthcare Services director Dr. Jason Yap, attests, “International patients come to Singapore for many reasons like heart and brain surgery, health screening and sometimes cancer treatment.” Why? “Because we assure them of world-class health-care system that focuses on safety and excellence,” Yap explains.