HealthAbroad.net: Point of View

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.   

With Western heathcare systems urgently needing to reinvent themselves as medical tourism booms, a German internet start-up is offering e-auctions for medical treatment.

The e-auction site offers a competitive platform for the service seekers and providers.

It is up to the patients to chose an offer from those submitted by the participating doctors. Savings between the original quote received by the patient and the lowest on-line offer is usually around 50%.  

A report published by Doctors for Reform which says that more patients will have to pay a “top up” fees for private care because of budget cuts in the NHS and long waiting time, says BBC online. In essence, if you wish to step out of the que and get half decent service, cough up or keep standing.

The report goes onto say that the idea of a completely free service is a mirage and sets out three key questions

It asks whether the NHS can guarantee a universal service in future, whether doctors inform patients of ‘top-up’ options as part of their general duty of care and how can access to healthcare be made fairer.

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.

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.

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.

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