HealthAbroad.net: Point of View

With the medical tourism industry estimated to be worth $188 billion by 2013, Philippines is eager to levearage its cost effectiveness for medical surgery along with tourism potential to tap into the pie. A somewhat late entrant into the race, it faces stiff competition from other Asian countries such as Thailand, Singapore, Malaysia and India who have already stolen a march over it.

Coronary bypass surgery that costs an average of $50,000 in the US, costs between $10,000-25,000 in the Philippines. Lasik eye surgery which costs $3000 in the US comes for $1000 in the Philippines and breast augmentation costs $2000 while the same costs approximately $5,000 in the US.

Although larger hospitals are logging into medical tourism and modernizing their equipment and facilities, Philippines has a fair distance to cover and sort out the structural weaknesses of the health industry. Another problem is the growing flight of well qualified medical professionals to the West and the Middle East. Unless medical professionals see any value for themselves in staying back and having a good quality of life in the Philippines, brain drain will be irreversible and detrimental to the planned growth in medical tourism.  

It’s my birthday today and I’m in negotiations with HealthAbroad.net to send me to Japan so I can get myself a facial. A pure gold facial! 

The facial which places gold leaf on the face to accelerate cell growth in the basal layer of the skin is supposed to rejuvenate the skin and helps remove wrinkles and blemishes. The treatment is available at 30 salons and spas across Japan and a session which lasts between one and two hours costs $170.

After the facial, I plan to go to Tokyo’s Ritz-Carlton for a “diamond-tini”, a cocktail with a hint of lime and chilled Belvedere vodka over a 1.06 carat stone. Only for $3760. Fantastic stuff. Such Luxury. Only in Japan.  

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.

Philippines is planning to relax rules and increase the quota for kidney transplant for foreigners. At present the country has a 10% ceiling for foreign beneficiaries of kidney transplants, a limit that is often breached.

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.

With the National Health Service (NHS) in the doldrums, Brits are going abroad in large numbers for medical treatment. New figures put out by a research firm say that overseas trips for cosmetic surgery, operations and post-op relaxation are worth 60 million pounds per year. Furthermore, medical tourism enjoys the largest cut of UK spending on health breaks.

In addition, British holidaymakers splashed out around pounds 25 million last year on going abroad for yoga holidays, holistic healing, health farms beauty treatments and spa visits.

Spending rose to pounds 50 million for similar types of breaks taken within the UK.

According to the report, the entire market for health and wellness holidays, including overseas medical tourism, is set to increase as much as 150% by 2011. Up, up and awwaaaay!!

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.

Like it or not, medical tourism is here to stay. And unless medicare in the West becomes cheaper and more responsive to the needs of the customers the numbers of foreign patients coming to low cost medical tourism destinations will only go up in the future.  

Cost is obviously a big consideration. An open heart surgery that costs upto $150,000 in the US costs about $10,000 in India with flights, in-country transportation and postoperative vacations thrown in. Foreign patients frustrated with long wait times for non-elective surgery are also going abroad for medical treatment.  

Another big plus for low cost medical tourism is a big cost savings on malpractice insurance. While doctors in many medical destinations pay as little as $4,000 a year for malpractice insurance while American doctors can pay 25 times that amount.

The market for medical tourism is hotting up with many countries awakening to the dollars tourism and good healthcare can bring into their economies. The latest entrant is Taiwan, well known for dentistry, cranio-facial surgery, medical checkups and treatment of hepatitis.

The Tainwanese Ministry of Foreign Affairs has also been brought on board and “has agreed to issue medical visas to those seeking medical treatment” in the country.

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.