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March 31, 2014, Economic growth potential from medical tourism | The guardian
NEW YORK—The Caribbean region can boost its bottom line by developing a medical tourism product that takes advantage of its brand as a great vacation destination, its proximity to North America as well as its tourism facilities, beaches and of course, the year-round warm weather of the region. That’s according to Dr Paul Angelchik, founder of American World Clinics, and Collin Childress, CEO of Global MedChoices.
Their comments come as both prepare to discuss the potential of medical tourism for the Caribbean in-depth at a panel at Invest Caribbean Now 2014. ICN, the biggest global investment summit on the Caribbean outside of the region, is set for the Harvard Club in New York City from 11.30 am to 6.30 pm June 4 under the patronage of Hollywood Actor Malik Yoba.
“The opportunity for the Caribbean in general is that it carries a positive connotation in the view of many for having friendly people, natural beauty and a reputation as an enjoyable, upscale destination with great visitor amenities in many locations,” said Dr Angelchik. “I have no doubt that the Caribbean can be a major region for MT activities if there is follow through on the initial buzz of enthusiasm that has defined the industry to date.”
“Creating the opportunity for economic diversification through introducing a sustainable development and growth industry, such as medical tourism, to the Caribbean can help soften the impact of cyclical North American economic downturns in tourism on the Caribbean market and leverage the supply and demand issues that are driving patient flow offshore from Canada and the US,” added CEO Childress.
In 2011, the total impact of the medical tourism industry contributed nine per cent of global GDP and accounted for 255 million jobs in the world. In the next decade, medical tourism is expected to grow by an average yearly of four per cent, contributing up to 10 per cent of future global GDP. Eventually, by 2022, it is estimated that 328 million jobs will be created in the medical tourism industry: equal to 10 per cent of jobs in the world.
June 24, 2014, Medical
tourism generates millions in revenue: Ontario health minister
TORONTO -- The treatment of so-called medical tourists at a few hospitals in Ontario generates millions of dollars of revenue for the health system and benefits patients in this province, the health minister said Wednesday.
No public money can be used to care for those international patients and any revenue generated -- about $13 million per year -- must be reinvested to benefit Ontario patients, for example to open new hospital beds or hire nurses, Eric Hoskins said.
"There are clear economic benefits...but my job is to ensure that Ontarians come first, that there is no queue jumping, that it has no impact on wait times, that staff that are funded through our public system are not spending their time on international patients," he said.
The Registered Nurses' Association of Ontario, along with several other health-care organizations, urged Hoskins to ban medical tourism, aside from humanitarian cases, saying the practice promotes queue jumping.
"Canadians, Ontarians, did not make a deal with government of funding the health-care system through their taxes to treat people from abroad that simply get ahead of the line because they have money," Doris Grinspun, the CEO of the nurses' group, said at a news conference.
"It took a long time in this country to build a health system that is universal for all based on need, not on the size of our wallets and we the health-care professionals that are sitting here representing doctors, nurses, midwives and all others are not going to stay silent and allow it to happen."
The Ministry of Health and Long-Term Care is currently reviewing the practice to ensure that Ontario patients are coming first, Hoskins said. Only a small number of hospitals in the province treat medical tourists and the proportion compared to Ontario patients is quite small. Ninety per cent of the international patients Ontario sees are through the Hospital For Sick Children and University Health Network hospitals in Toronto.
Sick Kids saw 207 international patients in 2013-14, which accounted for 1.3 per cent of its total inpatient admissions and University Health Network saw 174 such patients, accounting for 0.1 per cent of its total, according to the Ministry of Health. Ministry staff weren't immediately able to say if those numbers included humanitarian patients.
The New Democrats said medical tourism is one step toward two-tiered medicine.
"It's unacceptable," said party leader Andrea Horwath. "There's no way that people should be able to pay to get services ahead of everybody else. It should be the people that get services get services because they are the ones that are most in need. That's the way our system works."
Oct. 29, 2014, Ban medical tourism: RNAO speaks out for medicare
A number of Toronto-area hospitals have engaged in medical tourism – raising millions of dollars by actively seeking and treating international patients on a pay-for-care basis. RNAO worries this represents a shift to for-profit health care, creating a system where those who pay access care ahead of others.
RNAO has reached out to politicians, the media, and called for action from its membership. Our message is clear: the government must immediately ban medical tourism in order to protect and strengthen our public health system.
Frequently Asked Questions
What is medical tourism?
Medical tourism refers to a practice where patients travel across international borders to receive health care on a pay-for-treatment basis, as a means to generate revenue. This practice puts paying patients ahead of Ontario residents who are waiting for care, jumping the queue and displacing Ontarians who need care.
Is this happening in Ontario?
Yes. According to staff, media reports, and online documents, some Ontario hospitals have actively engaged in medical tourism.
The Hospital for Sick Children, the University Health Network hospitals, and Sunnybrook Health Sciences Centre, all in Toronto, have operated international patient programs. Minister of Health Eric Hoskins has acknowledged that these programs have generated revenue.
What is the harm?
Medical tourism is the beginning of the end of Canada’s publicly funded not-for-profit health system. It contradicts the very nature of our Medicare system, turning health into a commodity.
This is the first step toward two-tiered Medicare, where a parallel for-profit system provides care to those who can pay. Once we set the precedent that international patients can get preferential care for a fee, what’s to stop wealthy Canadians from demanding the same?
Our health system is funded by Ontarians, yet many of them languish on wait lists and in emergency departments due backlogs in that very system. RNAO believes that Ontario’s health resources should be used to improve care for its ailing citizens. Our public hospitals and their services should be driven by need and not the size of our wallets.
Shouldn't we use our health-care system to help people in need from other countries?
Canada has some of the best hospitals and health professionals in the world. We should, and do, provide humanitarian and emergency care to people from across the globe. Medical tourism, however, is a much different matter – it is driven by a for-profit mentality, marketed actively and puts priority on ability to pay over the needs of Ontarians.
Where does the Ontario government stand on this issue?
Until recently, the provincial government had turned a blind eye to medical tourism. At the insistence of RNAO and a coaltion including Canadian Doctors for Medicare, the Association of Ontario Midwives, and the Association of Ontario Health Centres, Minister of Health Eric Hoskins announced he was putting the brakes on medical tourism.
In November, Hoskins announced he had asked all Ontario hospitals to stop soliciting and treating international patients, except for humanitarian work and activities related to existing contracts. In the interim, he has asked hospitals not to enter into new international consulting contracts that include the treatment of foreign nationals in Ontario.
While the coalition is pleased Minister Hoskins listened to its concerns, it is adamant that a full ban on all medical tourism is the only way to ensure our Medicare system is protected.
Ontario's opposition parties have also taken a stand on this issue. In October, NDP Health Critic France Gelinas pressed Eric Hoskins to ban medical tourism, saying it "goes against every principle of medicare."
In December, PC Health Critic Christine Elliott told Hoskins asking hospitals to not “market to, solicit or treat international patients” wasn't enough, and an outright ban is required.
What has RNAO done?
RNAO was approached in 2012 by a veteran RN and RNAO member working at UHN, who was concerned about what they had seen within the international patient program. In 2013, RNAO’s board of directors unanimously passed a motion that the association do all it can to end medical tourism in Ontario.
Since then, we have repeatedly engaged the premier and minister of health, spoken out in the media, and mobilized our membership toward stopping this dangerous trend. We formed a coalition with Canadian Doctors for Medicare, the Association of Ontario Midwives, and the Association of Ontario Health Centres to urge the end of this practice. We will continue with this commitment to protect our universal health system until medical tourism is fully banned.
Political advocacy
Letter to Minister Hoskins: Protect Medicare with legislated ban on medical tourism, Feb. 5, 2015
Open letter to Minister Eric Hoskins: Ban medical tourism, August 18, 2014
Joint letter to Premier Kathleen Wynne on medical tourism, April 11, 2014
Government Action
Ban Medical Tourism Completely: Elliott, PC Health Critic Christine Elliott, Dec. 9 2014
Statement by Ontario Health Minister on International Patient Care in Ontario Hospitals, Minister of Health Dr. Eric Hoskins, Nov 21, 2014
Medical Tourism is already in Ontario, NDP Health Critic France Gelinas, Oct. 29, 2014
Media coverage
Canadian hospitals profiting from foreign patients raises questions of ethics, Day 6, March 21, 2015
Public hospitals profiting from foreign patients, 16 x 9, March 7, 2015
Ontario moves to restrict hospitals’ freedom to solicit, treat medical tourists, The Globe and Mail, Nov. 21, 2014
Medicare is a public trust, not a business venture: Goar - Toronto Star Nov. 3, 2014
Health groups urge Ontario to ban 'medical tourism' - The Sudbury Star, Oct. 29, 2014
Ontario health organizations want to put an end to medical tourism - Global News, Oct. 29, 2014
Letters: medical tourism - Doris Grinspun, The Windsor Star, Oct. 14, 2014
Medical tourism fees for international patients return little cash to hospital The Globe and Mail, Oct. 10, 2014
Nurses attack Windsor Regional’s ‘medical tourism’ foray - The Windsor Star, Sept. 30, 2014
Nurses group asking Ontario for records on medical tourism - Canadian Press, Sept. 30, 2014
Medicare advocates decry medical tourism – Canadian Medical Association Journal, Aug. 21, 2014
Ontario hospitals urged to stop pursuing ‘medical tourists’ – Antonella Artuso, Toronto Sun, Aug. 21, 2014
Medical tourism ‘inviting a lawsuit’ – Theresa Boyle, Toronto Star, Aug. 5, 2014
Nursing association calls for ban on inbound medical tourism – International Medical Travel Journal – July 23, 2014
Medical tourism: the beginning of the end of Medicare – Doris Grinspun, Registered Nurse Journal, May/June 2014
Chipping Away at Medicare – Toronto Star, April 4, 2014
Toronto hospital courts wealthy ‘medical tourists’ – Kelly Grant, The Globe and Mail, April 1, 2014
Ontario’s health-care system should serve need, not greed – Doris Grinspun, Toronto Star, April 1, 2013
Media releases
Health organizations call for ban on medical tourism, Oct. 29, 2014
Nurses launch freedom of information request to get to the bottom of medical tourism, Sept. 30, 2014
Open letter from Ontario's RNs, health centres and midwives calls on Minister of Health Eric Hoskins to immediately ban medical tourism, Aug. 20, 2014
Health groups urge Premier Wynne to stop medical tourism, April 16, 2014
Other resources Ban Medical Tourism Poster
RNAO - Registered Nurses' Association of Ontario
Nov. 21, 2014, Ontario moves to restrict hospitals' freedom to solicit, treat medical tourists
Ontario is moving to severely restrict the freedom of hospitals to solicit and treat international patients after health-care groups raised concerns that well-off or well-insured “medical tourists” from abroad might displace Ontario patients.
Health Minister Eric Hoskins has sent a letter to the province’s more than 150 hospitals asking them not to “market to, solicit or treat international patients,” unless the hospital has already agreed to as part of an existing international consulting contract.
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Dr. Hoskins’s predecessor, Deb Matthews, ordered an informal review of the practice last spring after The Globe and Mail reported on the international patient programs at a handful of Toronto hospitals, and a coalition of health-care groups, led by the Registered Nurses’ Association of Ontario (RNAO), called for a ban on what it deemed medical tourism.
VANCOUVER -- Jeff Dolinsky, a dentist in Golden, B.C., travelled to India in the spring -- and he didn’t go to sightsee, meditate or contort his body in front of a yoga master. Dolinsky’s goal was more prosaic -- hip surgery.
When Mr. Dolinsky went under the knife in a hospital in Chennai (formerly Madras), he felt reasonably confident he had made the right decision.
After all, six other residents from the Rocky Mountain town of Golden also had undergone successful hip surgery in the same hospital with the same physician during the previous three years.
The patients from Golden are among the small but slowly growing number of Canadians flying to foreign countries for treatment -- a for-profit phenomenon known as medical tourism.
Frustration over the long list of 875,000 Canadians awaiting for surgery and other procedures is what is driving people to “outsource” their treatment overseas.
Mr. Dolinsky, 48, had spent many months in severe pain from osteoarthritis. He sought treatment and was told that hip resurfacing -- a less invasive alternative to hip replacement surgery -- was his best option. He also was told he might have to wait a year if he wanted the procedure performed in B.C.
A long pain-ridden wait would have forced Mr. Dolinsky to scale back his dental practice and temporarily give up downhill skiing and mountaineering, the sports that drew him originally to the Golden area.
But instead of waiting, Mr. Dolinsky flew to India. The hospital picked him up and ushered him into what it called its “platinum ward,” which was more like a posh hotel, with its marble floors, big-screen satellite TV and laptop computer with WiFi.
“And from the time I woke up from surgery until now, I haven’t had to take more than a couple of painkillers,” recalled Mr. Dolinsky recently.
North Vancouver’s Gloria Creighton is similarly pleased with her decision to forgo treatment in Canada and fly to Chennai. Doctors here told her she needed a hip replacement. She feared this would end her career as a dance specialist with the Burnaby school district.
Her husband learned about the less invasive hip resurfacing from the Internet. He also learned the procedure could be purchased at the clinic in Chennai. They decided to fly to the sub-continent and many months later, they have no regrets about the $15,000 cost.
“When I came home I started walking around the park down the street and going swimming,” said Mr. Creighton.
“It’s a miracle. Before that, I’d thought that I was gone, done-in. Now I can keep teaching and not have to go on disability and be a burden to the government.”
There are about 15 medical tourism companies based in Canada. Their clients are seeking elective surgeries for such things as joint replacement (knee/hip), cardiac surgery, dental surgery, cosmetic surgery, cancer and transplant surgery.
These firms arrange treatment in Latin America, Europe and Asia, where countries such as India and Thailand are vigorously promoting medical tourism.
Critics have said it’s morally wrong for these developing countries to foster a private health care sector for wealthy westerners when the majority of their own citizens have poor access to health care.
But these attacks haven’t stopped the governments of many Third World countries from trying to attract wealthy western patients. The website of the Royal Thai Consulate in Vancouver provides an overview and pricing for its medical tourism sector, which attracted 600,000 foreign patients in 2004.
Many of the Canadian medical tourism companies are based in B.C., including Surgical Tourism Canada, which brokers surgeries for Canadians in affiliated high-tech private health facilities in India, Mexico, U.S. and Abu Dhabi.
Yasmeen Sayeed, chief executive officer of Surgical Tourism Canada, said her client list has steadily increased since she opened shop in July 2005.
But Ms. Sayeed acknowledged that medical tourism is far less of a big deal in Canada than it is in the U.S., where 500,000 Americans went overseas for treatment in 2005.
The reason for the difference is cost. Americans are used to paying for medical care, said Ms. Sayeed. Canadians aren’t because of their country’s universal publicly funded health care. Medical care overseas for Canadians means money out of their pocket, she added.
But for millions of Americans who are either uninsured or underinsured, purchasing medical care overseas can be cheaper than buying it at home.
Another obstacle in Canada for medical tourism, added Ms. Sayeed, is the refusal so far of provincial governments to reimburse people who get treated abroad.
While medical tourism in Canada is on the increase, the number of people going abroad for care appears to be insignificant.
Ms. Sayeed’s Surgical Tourism Canada is one of the largest medical tourism firms in the country, but it has only sent about 100 people abroad since its inception in July 2005.
Leigh Turner, a McGill University biomedical ethics professor, recently wrote that little is known about how many Canadian do go abroad but that the number is probably relatively modest.
Also modest is the number of Canadians heading to the United States to avoid long waiting lists. There was a flurry of media reports a few years ago about Canadians heading south for private care, but a 2002 study by health-care researchers at the University of B.C. found surprisingly few Canadians travelled to the U.S.
The report, entitled “Phantoms In The Snow,” said Canadian travel tourism to the U.S. was “more myth than reality” and that the numbers involved “appear to be handfuls rather than hordes.”
There seemed to be a jump in recent years in the number of Canadians, mostly ethnic Chinese or South Asians, going to Asia for organ transplants.
Ken Donahue, a spokesman for the B.C. Transplant Society, said 136 British Columbians have received transplants overseas since 1990.
But Dr. David Landsberg, medical director of transplantation at Vancouver’s St. Paul’s Hospital, said the number of Canadians seeking organs overseas is on the wane because many countries have recently placed restrictions on the practice.
“I haven’t had any patients who have gone away and come back in the last six months.”
Dr. Brian Day, head of the Canadian Medical Association, is a big fan of a reverse form of medical tourism -- he wants the tourists coming here.
Dr. Day believes Canada could make millions of dollars off mostly American medical tourists, then plow the money back into the Canadian health system.
But a prerequisite to tapping into the global medical tourism market, which he estimates at US$40-billion, is the elimination of waiting lists in Canadian hospitals.
Dr. Day said, “we are losing all of that potential trade and the only reason we are losing it is because we have wait lists.”
He believes B.C. could attract many medical tourists from Asia. Dr. Day said he visited an orthopedic hospital in Cuba that generates $20-million in revenue annually treating medical tourists.
But Dr. Day’s opponents in the debate over the future of Canadian medicine are less enamoured with the prospect of medical tourism in Canada.
Dr. Michael Rachlis, who has written extensively about the Canadian health-care system and is a sharp critic of private medicine in this country, said: “Do we really want the administrators in our system spending their time luring Americans? Or do we want them to fix the problems faced by Canadians?”
Dr. Rachlis said the money available from medical tourism would only amount to tens of millions of dollars -- minuscule compared to the $150-billion spent on health care annually in Canada.
“It’s just a complete diversion.”
dward@png.canwest.com
ECONOMIC ANALYSIS OF INDIAN MEDICAL TOURISM.pdf (International Healthcare Destination) 1NTK Naik and 2B. Suresh Lal 1Professor, Department of Economics, Rayalaseema University, Kurnool-AP 2Programme Coordinator, National Service Scheme, Kakatiya University, Vidyaranyapuri Warangal-506009. AP, E-mail: lalbsuresh@yahoo.co.in Tourism is an imp The tourism industry is closely linked to other industries factors such as promotion of tourism, medical industrial growth, globalization and liberalization of trade have given a burst to the health industry and made it competitive. Indian tourism provides employment opportunities, growth of GDP, promotion of healthcare and earning foreign exchange. THE ORIGIN OF THE CONCEPT health. In this 21st Century, half a million people travel across the globe for health purposes. Spirituality has been a strong motivation for travel and is the case 260 NTK Naik and B. Suresh Lal even now. People from developed and affluent countries are moving out of their own countries to other destinations, seeking solitude, natural and holistic remedies, and eco-friendly experiences. Tourism is evolving into a more defined activity while developing various niche areas. Medical tourism is on The paper is organized as follows: The first section provides meaning and significance of medical tourism. The second section deals with world wide market trends in the medical tourism. The third section presents Tourism policy initiatives. Medical cost comparison with Western countries is presented in the section four. The section five is followed by medical tourism trends in India. Also presents major road bocks in the tourism sector. The last section discusses the future prospects of the medical tourism in India and some measures’ initiated for policy. SECTION-I The Meaning and Significance of Medical Tourism Medical tourism can be broadly defined as provision of ‘Cost-effective’ private medical care in collaboration with the tourism industry for patients, needing surgical and other forms of specialized treatment. This process is being facilitated by the corporate sector involved in medical care as well as the tourism industry – both private and public. Medical or health tourism has become a common form of vacationing and covers a broad spectrum of medical services. It is a combination of leisure or pleasure, fun and relaxation or rest together with perfectness and healthcare. Significance Tourism is an imp economy. The tourism industry is closely linked to other industries factors such as promotion of tourism, medical industrial growth, globalization and liberalization of trade have given a burst to the health industry and made it competitive. Tourism is an activity with very strong backward and forward linkages. The travelers spend money to enjoy a variety of goods, services and experiences. The income and employment generating capacity of this sector is immense. In 2005, India’s travel and tourism market was valued at $ 42 billion, and this is growing rapidly, India emerged as the fifth most preferred destination by the world’s travelers in a survey conducted across 134 countries (3). In 2006, tourism as an industry offered employment to 41.8 million people, and accounted for 59 per cent of the GDP. (4). Also, tourism benefits are conferred on all classes, sections and regions. Economic Analysis of Indian Medical Tourism 261 Tourism in India is the third largest foreign exchange earner, accounting for 2.5 per cent of the G.D.P. Medical tourism, according to some estimates, had the potential to bring in an additional Rs.100bn in Foreign exchange into the country annually. According to Confederation of Indian Industries (CII) report, the numbers are growing at 15 percent per annum and by 2012. Medical tourism is expected to generate $ 2.3 bn annually in India (5). Medical tourism is likely to the next major foreign exchange earner for India as an increasing number of patients, unwilling to accept long queues in Europe or high costs in USA, are traveling to India to undergo surgery. Government and private sector studies in India estimate that medical tourism could bring between $1 billion and $2 billion into the country by 2012. Medical tourism to India is growing by 30 per cent a year. According to study conducted by the confederation of Indian Industry and McKinsey consultants, the size of the Indian Medical tourism sector is thought to be about 1,00,000 to 1,50,000 patients a year. The Indian Health Care Federation, consortium of non-governmental hospitals, diagnostic centres, medical equipment manufacturers and pharmaceutical industries say that about 1,00,000 foreign patients are visiting India for treatment, with the number rising by 15 per cent a year. The CII-McKinsey report estimates that the annualized growth of the medical tourism market was about 30 per cent in 2000, up from 15 percent in the five previous years. The growth has been limited. CII-Mc Kinsey also forecasts up market private care in India to be worth anywhere from Rs.15,000 crore to Rs.10,000 crore. Medical tourism represents 25 percent of revenues of private up market care in this estimate and three to five percent of the total delivery market (6). The Indian government also predicts that India’s $17 billion of the earning healthcare industry could grow 13percent in each of the next six years, boosted by medical tourism with growth rate of 30 percent annually (7).CIIMcKinsey say, that the allopathic system can offer treatment in specialties such as cardiac, liver and orthopaedic procedures. While Indian systems of medicine could attract from even the developed world to treat “Lifestyle diseases” such as stress and rheumatism. The Ministry of Tourism along with the Ministry of Family Welfare had set up a task force to chalk out a strategy in this regard. A new category of Visa, the M-visa, which allowed a medical tourist and his or her companion along stay in the country, was introduced in 2005. However, an integrated communication effort was still required to provide a boost to medical tourism. The global health industry worth $ 4.5 trillion is the second largest industry today, next to the agro industry. The world’s third largest employers are the National Health Services of the UK. So, on 262 NTK Naik and B. Suresh Lal employment of the healthcare industry in India. Over the year, more than 90 percent of the jobs in the healthcare sector have been found to be ideally suited for women, especially from the lower socio-economic strata. The IT Industry requires less than 10 people for a turnover of Rs. 1crore, while the healthcare industry will require 200-250 people, typically from lower economic strata, ensuring all round socio-economic development. In fact, in the US, healthcare is the on last five years (8). India will with no doubt become the global health destination. It aims to replicate the Thai model, which is still the first Asian destination for International patients. The reality is that Indian private facilities offer advanced technology and high quality procedures on par with hospitals in developed nations. India is the leading country promoting medical tourism in the world. It is even moving into a new area of “Medical out sourcing” where sub contractors aim to provide services to the over burdened medical care systems in western countries. Medical tourism to India is growing by 30 percent a year and the Indian education system is churning out an estimated 20,000 to 30,000 doctors and nurses each year. Thus, India could earn more than $1 bn annually and create 40 million new jobs by sub contracting worth from the British National Health Service. SECTION-II World Wide Market Trends in Medical Tourism It is ironic of neo-liberal economic reforms that inspite of fundamental policy failures in public health, India has increasingly been an attractive international healthcare destination. Yet, India’s tertiary healthcare sector is on the road to global fame. A growing number of spotlessly clean private hospitals are on the threshold of a boom in medical tourism, positioning themselves as the best destinations for procedures ranging from coronary by passes to orthopaedics surgery at the most affordable costs. These hospitals offer high quality care for international patients, whose numbers are reportedly rising @ 15 per cent annually. The prices that they charge are a fraction of what prevails in the developed world. India’s Corporate hospitals are fully equipped upmarket and efficient with their toll free lines, help interactive websites, on bound treatment access etc. They appear to be world apart from the over burdened often badly managed and poorly funded health system. There are three major corporate hospital groups such as; ? Forties Healthcare ? Wackhardt. ? Apollo. These hospitals run 26 hospitals in the sub-continent and its numbers is ever growing. They are forming partnerships with international insurance and Economic Analysis of Indian Medical Tourism 263 tourism companies that will send both insured and uninsured patients for low cost treatment. With friendly policies from the Government. The private healthcare sector can transform the potential of medical tourism into a very profitable reality. On outlook is ‘jiltcare’ in India. The Road Ahead produced by the Confederation of Indian Industries and McKinsey Company. It puts a number to the promise tertiary hospitals, with a 25 per cent growth care in revenues from foreign patients. Foreign nationals undergoing complicated surgery in the country are frequently featured in the media, those who come now are not just from the developing countries, but also from the UK, Europe and North American countries. The first lady of Guyana brought a group of 15 patients for cardiac treatment to Frontier Life Line Hospital in Chennai, Tanzania and Lira have a Memorandum of Understanding with Madras Medical Mission (MMM), many opt to undergo surgery in India for reasons that range from long waiting time in the UK, high costs or lack of insurance coverage in the US. The island nation Singapore is focusing on medical tourism. Its three agencies, The Economic Development Board (EDB), Singapore Tourism Board (STB) and the International Enterprise Singapore (IES) have joined hands to form a new initiative called Singapore Medicine to transform the nation as Asia’s leading two-in-on that actively promote medical tourism include Cuba, Costarica, Hungary, India, Israel, Jordan, Lithuania, Malaysia and Thailand. Belgium, Poland and Singapore are now entering the field. South Africa specializes in medical safarisvisit the country for a safari with a stop over for plastic surgery. Countries like India, Thailand, Singapore, Malaysia and the Philippines are aiming at becoming Asia’s medical tourist hub. India is pitted against Thailand, Singapore and Some other Asian countries, which have good hospitals, salubrious climate and tourist destinations to attract patients from Europe, USA and other affluent nations. While, Thailand and Singapore, with their advanced medical facilities and built-in medical tourism options, have been drawing lakhs of foreign patients per annum, the rapidly expanding Indian corporate hospital sector has bee able to get a few thousands for treatment. Tourist Competence and the Ease of Foreign Travel International tourism has expanded because tourists, in general, are more competent at the business of International travel, with changes – both within the industry and in the wider contexts of contemporary economy and society – making foreign travel a much easier process than was on 264 NTK Naik and B. Suresh Lal ? Post-1945 improvement in educational levels and better training of personnel within the hospital industries mean that language is less of a barrier. ? Travel procedures (customers, airport-check inc, etc.) are rapidly becoming minimized, standardized and familiar. ? Computerized Reservation Systems (CRS) bring instant access to up to date information on availability of flights, rooms or holiday packages and the option of immediate, confirmed bookings. ? Credit cards that are valid world-wide simplify financial transactions and purchases whilst minimizing the need to carry foreign currencies. ? Improved telecommunications make it simpler to keep in touch with home, and ? Standardized forms of accommodation and other services in international hotels, restaurant chains and car hire offices reduce the sense of dislocation that foreign travel might otherwise generate (10). SECTION-III Indian Tourism Policy Initiatives The Indian Government (2002) regularly formulated policies and prepared pamphlets and brochures for the promotion of tourism. However, it did not support tourism in a concerted fashion for the tourism policy initiatives of the Government of India. As result, the country attracted very few tourists. In 2004, in addition to launching a centralized electronic media campaign under ‘Incredible India’ the Government of India announced its intention to make efforts to improve tourist information facilities at imp destinations and circuits, upgrade hotel infrastructure, improved approach roads to imp In this year also the campaign covered emerging economies like China and those of Northeast-Asia and Southeast Asia. The Tourism Ministry also organized road shows in Europe (11). In March 2005, the Ministry of Tourism announced its proposal to form a panel of ad agencies that would be responsible for the literature, brochures, website, and other works related to the “Incredible India” campaign. In the same year, a TV campaign “Let us go to India” was launched in Japan and a campaign “Walk with Buddha”, in Thailand and China several road shows were also organized as part of the campaign. It reportedly became the talk of the town (Refer Table:1) for the top ten countries of origin for tourists to India. Economic Analysis of Indian Medical Tourism 265 Source:Bureau of Immigration, Govt. of India 266 NTK Naik and B. Suresh Lal In the year (2005) the tourism ministry launched several innovative schemes such as “Athithidevo bhava”, ‘rural tourism “Priyadharshini” under the “Incredible India” Umbrella. The ‘Athithidevobhava’ (The Guest is God) programme was a social awareness initiative of the ministry to sensitize the general Indian public to the imp and courtesy. In early 2006, the tourism ministry organized an on to paradise”. The contest, co-sponsored by the domestic airline, India, required participants to answer questions on the airline and on the Indian State of Jammu and Kashmir. The ministry also engaged the services of Media Mindscapes (Bangalore based out of home media service provider). For the display of “Incredible India” advertisements in out of Home media in several cities around the world. The advertisements would be based on what the company (CNN) called the ‘Six pillars” of Indian tourism, namely, health and beauty, modern art, golfing, fashion and shopping, cuisine and night life and ‘hip’ hotels. Tourism is on focus for us and the Department of Tourism is a big client. After the Incredible India Campaign, Department of Tourism is focusing on the six pillars of tourism. As a result of ‘Incredible India’ campaign, the foreign tourist arrivals increased to 44,29,915 in 2006 up from 39,18,610 in 2005, and 34,57,477 in 2004. The foreign exchange earnings from tourism were Rs. 216,030 million in 2004, Rs. 251,720 million in 2005 and Rs. 2,96,030million in 2006. The number of Indian nationals going abroad is also rising. It was 1.9 millions in 1991, 4.1 millions in 1999, and 6.2 millions in 2004. Tourism has been a 14 percent growth in 2006-07, accounting for a Forex inflow of $14 million. Around 4.4 million foreign tourists arrived in India in 2006-07 (12). SECTION-IV Medical Cost Comparison with the Western Countries The factors influencing the patients going to different countries for medical treatment or medical procedures differ from country to country. Medical tourists encounter many problems such as long waiting periods for surgery and treatments that are very expensive in their home countries. Many medical tourists from USA are seeking treatment at a quarter or sometimes even a tenth of the cost at home. From Canada, it is often those people who are frustrated by long waiting times. From Great Britain, the patients can’t wait for treatment by the National Health Service but also can’t afford to see a physician in private practice. For others, becoming a medical tourist is a chance to combine a tropical vacation with elective or plastic surgery. More Economic Analysis of Indian Medical Tourism 267 patients are coming from poor countries like Bangladesh where treatment may not be available. Instead of paying $200,000 for a mitral value surgery in USA, a patient could travel to India and receive the same treatment for $6700. Similarly, rather than paying 15,000 pounds sterling for hip resurfacing in the UK, a patient can get the same procedure for 5000 pounds in India, including surgery, air fair and hotel stay (13). Refer Table 2 for the Medical cost comparison among India, USA and UK. Price advantage is, of course, a major selling point. The slogan thus is ‘First- World Treatment at Third world prices. The cost differential across the board is huge, on benefits from a large staff of world class experts and the ultra-competitive cost advantage it offers. While a heart surgery costs $30,000 in US it costs $6,000 in India. Similarly, a bone marrow transplant $26,000 here compared to $2,50,000 in the US. You can add to this that Indian doctors are among the best in the world (14). Open heart surgery could cost up to $70,000 in Britain and up to $150,000 in USA. In India’s best hospital it would cost on Knee surgery (on both knees) Costs Rs. 3,50,000 ($7,700) in India. In Britain this costs ?10,000 ($16,950) – more than thrice as much Dental eye and cosmetic surgeries in western countries cost there to four times as much as in India. It is estimated that medical tourism can alone contribute a good sum of Rs. 500 million to Rs. 100,000 million of additional revenue by way of super-specialty hospitals by the year 2012. India can earn over $ 2 billion annually from medical tourism. India’s healthcare industry is growing fast at 30 percent annually (15). Thus, the Indian medical sector is attracting many foreign patients. They are coming to India for bypass surgeries, dental problems, orthopaedic ailments and even plastic surgery. A primary reason for this is cost effectiveness. For instance, open heart surgery costs $4,500 in India, whereas in other healthcare destinations, it may cost around $18,000. Analysts say, around 1,50,000 medical tourists visited India in 2005. The number is likely to go up by 15 percent a year. Significant cost differences exist between the UK and India when it comes to medical treatment. Accompanied with the cost are waiting times existing in the UK for patients, which range from 3 months to over 10 months. India is not on of the private sector, which comprises hospitals and clinics with the latest technology and best practitioners. The estimate for hospital care alone was nearly $1,00,000. The cost of the surgeon, the cardiologist, the anaesthesiologist, the radiologist and the pathologist, along with the cost of a heart value and prescription drugs, has brought the total upto a staggering $ 2,00,000 – assuming no complications. For instance, Escorts Hospital in New Delhi, where the estimate cost was under $10,000 including airfare, surgery and rehabilitation (16). SECTION – V Medical Tourism Trends in India Health or Medical tourism is perceived as on in marketing. Destination India today, while this area has so far been relatively Economic Analysis of Indian Medical Tourism 269 unexplored, now the Ministry of Tourism, various state tourism Boards and even the private sector considering of travel agents, tour operators and hospitality industry are all eying health and tourism as a segment with tremendous potential for future growth. India’s health policy declares that treatment of foreign patients is legally an ‘export’ and ‘eligible’ for all financial incentives extended to export earnings. Ayurveda State Kerala and Ayurveda have virtually become synonymous with each other. Kerala or God’s own country’s as its corporate slogan goes, has pioneered health and medical tourism in India. They have made a concerted effort to promote health tourism in a big way, which has resulted in a substantial increase a visitor arrivals into the state. However, though Kerala has strongly focused on Ayurveda and its wide array of treatments and medications, good facilities are also available in the other traditional forms of medicine as well as in medical treatment. The bias towards health tourism in Kerala is so strong that Kerala Ayurveda centres have been established at multiple locations in various metrocities, thus highlighting the advantages of Ayurveda in health management. The health tourism focus has seen Kerala participate in various trade shows and expos where in the advantages of this traditional form of medicine are showcased. Resort Vacations Emerald Kerala, rich in natural and herbal bounty is the ideal place for Ayurveda therapeutics, meditation and Yoga. Kerala Ayurveda Resort vacations with Kerala India vacations takes you to some of the most celebrated Ayurveda resorts located indifferent parts of unusually beautiful Kerala. Rejuvenate and feel a flush of new life in every part of your body, feel stronger and mentally relaxed after being pampered by experienced ayurveda therapists at during your Kerala Ayurveda Resort vacations with Kerala India Vacations. Experience the magical cleaning of Ayurveda that seems to drain all the exhaustion from your veins and infuses a new, natural and fresh life into your mind, body and soul. Stay at the Kerala Ayurveda Resort vacations with Kerala India vacations and consult very well trained Ayurveda practitioners before being treated with an assortment of ayurveda therapeuctics that can help cure various illness. You realize the imp more than 3,000 years now and the fact that ayurveda is way of life. It is a system that believes in preventing diseases. Today there are various schools of Yoga around the world including Iyengar Yoga and Bikaram Yoga. The practice of Yoga by celebrities has added to its popular image. You can experience the healing powers of yoga in yoga ashrams 270 NTK Naik and B. Suresh Lal in Kerala. On Kerala tours with Kerala backwaters (17). Many visitors who come for such de-stressing and health building treatment may also choose to visit tourist spots. Such tourism potential holds the key to Kerala’s plans. The Ayurveda state has declared 2006 as the year of ‘Medical Tourism’ and is actively supporting its well known traditional medicine and tourism sectors, as they reach out to more potential visitors. Golden Palms Spa & Resort State Government of Karnataka, the Department of tourism has ambitious plans for the state. The idea is to make Karnataka a top health tourism destination not on to Karnataka to avail of sophisticated facilities and subsequently induce them to enjoy multiple tourism offerings. This endeavour will have a positive impact on the entire economy of the state. Infact, the government is setting up a Bangalore International Health City Corporation which will cater to patients for a wide variety of health care products and treatments. The recent operations of children from Pakistan, who have sought medical treatment in Bangalore have not on more imp India and Pakistan. Without doubt, Indian doctors are among the best in the world and given the right atmosphere and environment, they can enhance the image of Incredible India as a health and tourism destination. The state also boasts of having the unique property, Golden palms Spa & Resort, which is the on Diagnosis. To Crown it all, there is even a mini-operation theatre for cosmetic surgery performed by world renowned surgeons in the field (18). Development plans, both state led and in the private sector are being pursued activities. Karnataka State, which gets about 8,000 patients a year forecasts an annual growth rate of 25 per cent, purposes to promote a massive health park near a new international airport in Bangalore. Non-Resident Indians (NRIs) have formed a medical tourism Company Vadodara and International Property elopers are venturing into the healthcare sector to participate in the construction boom. Wackhardt hospital in Bangalore, which has a medical International tie up with Harvard gets half of its foreign patients (about 900) from the UK. Another 35 percent of Wackhard’s patients come to Bangalore from the U.S. and the rest from the European Union and South-East Asia. Another Healthcare Institution in Bangalore, Narayana Hrudalaya has, a record of 15,000 surgeries performed on patients from 25 foreign countries, half of them children. Using ISRO satellite connectivity, Narayana Hrudalaya has treated over 22,000 heart patients in India through telemedicine and some of them are Economic Analysis of Indian Medical Tourism 271 foreigners. This concept is based on the fact that in 99 percent of the cases of illness, there is no need for surgery. So, unless an surgery is required, the doctor does not need to be physically present to treat the patient. Technology as a solution to disease and pain is gaining imp of ECG machines costing Rs.10,000 each, in clinics in the remotest, parts of Karnataka. Thus precious life being saved by simple technology that takes advantage of the infrastructure of teleconnectivity. Ironically, even a century after the first heart surgery less than eight percent of the world’s population can afford it. About 6.5 lakhs heart operations are performed world wide every year, out of which the United States accounts for 5.4 lakh surgeries. It is estimated that India requires over 25 lakh heart operation in a year. However, records show that on being performed across the country annually (19). This gap can be met on manufacturing products and other requirements for heart surgery. To make this possible, the government should devise policies to promote investment in this sector. The gestation period in the medical industry is particularly long, which makes concessions even more imp number of doctors, nurses, and medical technicians lack of financial support is a major hindrance to the health industry. With micro health insurance becoming popular, this scenario should change soon. Tremendous Potential State The State Government of Maharashtra is part of the medical tourism council that has members from association of Hospitals and FICCI and Western Regional Council. It is indeed gratifying to note that well established chambers of commerce are now seriously looking at medical tourism and infact, the Federation of Indian Chambers of Commerce and industry, (FICCI) Western Region Council (WRC) has taken the lead by setting up a task force for the promotion of health and medical tourism in Maharashtra. This task force has representatives from the Maharashtra Government. The medical educational institutions and the drugs department, Maharashtra Tourism Development Corporation, Pharmaceutical Companies, travel agents and tour companies. Maharashtra, as a gateway to India, offers tremendous potential to develop medical tourism. The latest addition in Mumbai is the Asian Heart Institute at Bandra Kurla Complex, which offers state of the art facilities for all types of heart complications and even offers preventive cardiological treatment to avoid heart ailments and also to keep under control a host of heart problems. This institute which is in collaboration with the Cleveland Institute, USA, Offers 272 NTK Naik and B. Suresh Lal ‘Five-Star’ services at reasonable prices. There are even provisions for financial assistance which is offered through various trusts associated with the Institute. There are wide range of hospitals which help to promote medical tourism in the state. Some of these are Lilavathi Hospital, Jaslok Hospital, Bombay Hospital, Hinduja Hospital, Wackhardt Hospital, and Apollo NUSI Wellness Retreat. Hotels like Hyatt Regency, JW Marriott, Renaissance and Resort, also offer extensive Spa facilities aimed at rejuvenating both the domestic and international tourists (20). It is estimated that foreigners account for around 12 percent of all patients in top hospitals of Mumbai. Other States of India In other states of India also, a number of private hospitals offer packages designed to attract wealthy foreign patients, with airport to hospital bed car service, in room. Internet access and private chiefs. An other trend is to combine surgery in India with Yoga or holiday trip to the World Famous Taj Mahal, Ellora etc., The Escorts Hospital group in Delhi completed 4200 heart operations for foreign patients during 2004. Global and Apollo Group of Hospitals The Apollo Hospitals Group which hospitals are located at Delhi, Chennai, Hyderabad and Madurai, is today recognised as the “Architect of Healthcare” in India. It’s history of accomplishments, with its unique ability of resource management and able deployment of technology and knowledge to the service of its patients, justifies its recognition in India and abroad. Their mission is “to bring healthcare of international stands within the reach of every individual. Private Hospitals in Hyderabad (Global Hospitals) some of which get 10 percent of their patients from abroad, are planning to open separate wards/ wings for foreigners. The Apollo Hospitals already has a ward and wants to upgrade it to an international multi-speciality block. The Asian Institute of Gastroenterology plans to create a separate wing for foreigners. Ventures such as these draw encouragement for the National Health Policy- 2002 which endorses provision of health services on a payment basis to service seekers from overseas. The Corporate healthcare sector views such support as critical, considering that it is competing with Thailand, Singapore, Malaysia and South Korea for a bigger share of Asia’s medical tourism market. Medical Tourism can be a much bigger business, if we have infrastructure and networking among hospitals hotels and tourism agencies. The Central and State Governments must extend tax and other concessions, on the lines available Economic Analysis of Indian Medical Tourism 273 to IT and BPO sectors. The key to a significant increase inpatient arrivals, however, lies in becoming globally accredited. Corporate hospitals have begun factoring this requirement into their medical tourism plans. The corporate hospitals have not failed to recognize the opportunity. Many of them are upgrading to offer the latest of medical diagnostic facilities to medical tourists, which may also be packaged with vacations in a tie up with airline companies. Some analysis believes that the input of this, phenomenon on national healthcare needs careful study. Some observes fear an exodus of highly skilled doctors from the trophied public health system to high paying private hospitals. Many states are not even ready to fill vacancies in Government medical service, compounding the problem. Major Road Blocks in the Tourism Sector It is often forgotten that in the last few years, more Indian traveled abroad than to the inflow of foreign visitors, leading to a net outflow of foreign exchange Our tourism plans keep in view on governments gave more priority to airports than railway stations and bus terminals, Luxury hotels get priority over budget accommodation. The progress of the tourism industry is tardy. Out of the 1310 tourism projects undertake in the tenth plan, 740 projects are still incomplete (21). India wants to increase medical tourism, but it lacks the necessary tools to impress patients looking abroad for healthcare. There are major problems in drawing patients from abroad. Although the Incredible India campaign was generally well received, industry observers differed in their opinions on the positioning of India. ? On customers disappointed with their trip to India, Said “Indian should first set its house in order before showcasing itself as an incredible destination. Otherwise it will simply end up being an incredulous place to visit” (22). ? On awareness of its true tourist potential. You would be surprised how many people from developed countries still think of India as a country with a billion poor people mixed in disease hunger and suffering. (23). ? Other analysts felt that, the need of the hour was not an experience ad campaign but fundamental improvements in both general as well as tourism related infrastructure. These infrastructure problems not on inconvenienced tourists who actually choose to visit the country but also caused negative word of mouth”. 274 NTK Naik and B. Suresh Lal ? On This was typical of most of our driving experiences in India. The roads are in varying states of disintegration and must be driven very slowly to keep passengers from being bounced out of the car windows” (no seat belts) (24). ? Most tourist operators felt that, “tourist related infrastructure was not existent of many tourist destinations in India. Even, wherever it did exist, it was inferior quality” ? Bureaucratic hurdles in the issuing of ‘visas’ also worked to keep the number of tourists down. Tourists from West European countries, however, faced fewer problems. Also politically sensitive areas like the North-East required special entry permits. Which caused problems for genuine tourists. ? The Government of India was aware of the problems that the tourism industry in the country faced. The Indian Planning Commission’s (IX plan) eloquently states that India’s tourism woes were caused by “a lack of professionalism, unhygienic conditions, lack of easily available information: poor infrastructure; lack of safety; poor visitor experience; restrictive air transport policy; inadequate facilitation services, multiplicity of taxes, and low priority accorded to tourism”. ? Ravi Raghavendra, creative Director, contract an advertising agency, said,’ on not a question of budget or innovation, but it is a matter of creating a serious brand out of India as tourist destination. There are countries such as Thailand, Malaysia, Singapore etc. which are extremely aggressive in promoting the tourism options of the region. This drive is lacking in India, and should be spearheaded by the Government”. ? Subhash Goyal, Chairman, Stic. Travels Group, and President, Indian Association of Tour Operators (IATO) said, “India’s failure to compete successfully withour neighbors is not so much because of our failure on marketing front as it is because of poor infrastructure, multiplicity of taxes. Complexities and complications involved in issuance of ‘Visa’ and general poor law and order and order situation besides the undue publicity that the country get’s due to incidents of terrorism in some parts of the country,” (25). SECTION – VI Concluding Observations and Some Measures Initiated for Policy The analysis of the study reveals that the Information Technology (IT) which is the part of globalization has brought about certain changes in healthcare sector. Economic Analysis of Indian Medical Tourism 275 Today, India is in a position to extend its medical services to other countries particularly, the Gulf and European countries. Further, US and the European countries are depending on Indian Information Technology (IIT) sector, for outsourcing of medical expertise. Due to the globalization of Indian economy there is an enormous increase in the Foreign Direct Investment (FDI) from 39 per cent to 100 per cent in India. This has also given scope for establishment of Pharmaceutical industry and corporate hospitals. Priority for research on certain diseases like cancer, AIDS has also boosted up. Transplantation of heart, eyes, kidneys, cosmetic surgeries and exchange of medical expertise between different countries, extension of medical services and development of medical tourism. All these factors are contribution for extension of better healthcare services not on but also foot other countries. In India, the service sector is growing very fast. It now accounts for 55 percent of the GDP. India has made rapid progress in respect of biotechnology and IT related services. It has now become famous from healthcare too. Medical tourism is a concept that is attractive to visitors who lone comprising well-being and life style healthcare services with the strong desire to travel overseas. With the cost of medical care being about 10 times cheaper in India, health tourism is also emerging as an imp According to government sources, the country’s $17 billion a year healthcare industry could grow at 13 per cent annually during the next five years. Medical tourism is said to be growing at 30 per cent annually. It could provide the biggest boost to the healthcare industry and become a $2 billion industry in the next five years. India offers world-class medical facilities with state of the art hospitals and the best qualified doctors; with the proper infrastructure in place; and the best possible medical facilities; accompanied with the most competitive prices; the patients can get the treatment done in India at the lowest charges; and enjoy the Indian tourist and pilgrim destinations. By earning accreditations, standardizing medical practices; and getting the support of the government; hospitals and tourism agencies; India can increase its medical tourism industry to $2.2 billion per year. Policy Initiatives Encouraging the prospects for the Medical Tourism: the public sector, the private sector also needs to be focused in the growth and development of medical tourism. There is a fair measure of political stability, changing and cheaper flights this can be attributed to the entry of low-cost carries in India and liberalized aviation policies. The growth of the health sector requires well integrated and coordinated 276 NTK Naik and B. Suresh Lal policies and stability in approach, There are insufficient connections to the medical tourism destinations, the number of regional airports could open up as international airports, The lack of a visa on arrival regime on account of security considerations places India at a disadvantage vis-à-vis its competitors, the need for medical tourism development and reviews its ‘visa’ policy to permit tourists from its major source markets to obtain visas on arrival, The Government may introduce a new category of ‘Medical Visas’ to promote medical tourism, Telemedicine provides clinical support and acumen along with remote radiology and pathology facilities to far-off places, Tour operators market, the products, sell the packages including services like travel documentation, reservations, assistance at the airport transfers, accommodation in selected hotels or resorts, escorting, coordination with the hospital, local assistance, etc. the services of the tour operators and hospitals should be synchronized, The lack of quality infrastructure, uncompetitive rates, in different or poor product quality, difficulty, in getting access to information on travel and tourist destinations, Accreditation of health providers is a critical requirement for enabling quality benchmarking of services and healthcare facilities, All hospitals that want to be centres for Medical tourism need to increase their exposure and be constantly updated on internationally accepted standards of health care services delivery to the international clientele, With virtual absence of a public health security system and a high proportion of nation health spending being met by households, the need for a widespread World Health Insurance System (WHIS) is urgent and pressing. References The 5 best countries for medical tourism and overseas healthcareby Andrew Henderson | Jan 5, 2014 Medical tourism is on the rise, and dozens of countries around the world – from Asia to South America to eastern Europe – are getting in on the act. Agencies are being set up to promote less expensive health care costs to potential foreign visitors from developed countries where health care costs are through the roof. And with Obamacare, this trend is sure to continue. Like anyone else we discuss on this site, the best countries for medical tourism – or anything else – are often those you would have never thought of. Emerging countries have built great health care infrastructure while minimizing costs, allowing them to deliver care for as little as five to ten cents on the dollar in some cases. Procedures that cost into the six figures in the US or the UK cost as little as four figures in these countries. All the while, the best hospitals in these medical tourist hot spots have highly-trained, English-speaking doctors just like you’d find at home. So, where are the best countries to get that expensive surgery, the routine checkout, or the plastic surgery makeover? To be honest, there are so many potential countries that it was hard to narrow it down to just five. Let’s find out which made the cut… Singapore, while expensive, has on 5. Singapore You will pay more in Singapore than in places like Thailand, but the quality of life in Singapore is second to none. On Brazil is the world capital for plastic surgery medical tourism, owing to the country’s image-conscious culture. 4. Brazil Brazil has the least efficient medical system on this list, although it is nearly tied with the United States in terms of medical efficiency. Costs for plastic surgery can be as much as 60% less than in western countries, and surgeons can handle just about any procedure you can dream up. There are even veterinarians offering cosmetic surgeries on pets. Brazil is home to perhaps the world’s most renowned plastic surgeon, Ivo Pitanguy, and prices for top doctors can be as high as those in the US, so make sure to shop the lesser-known clinics if you want to save money. However, Brazil’s beauty consciousness surely can’t hurt anyone looking to save money on a nip and tuck. India specializes in inexpensive bypass surgeries and other high-end medical procedures for medical tourists. 3. India India is widely known for its advanced medicine services and advanced equipment. Doctors tend to be highly trained due to large medical tourism cities like Chennai and Noida having foreign patients fill half their hospital beds. Also, the language barrier is lower for English speakers, and Indian hospitals are bringing in translators for non-English speaking foreigners. Health care costs in India can run as low as ten cents on the dollar compared to the US or the UK. Popular treatments include bone-marrow transplants, eye surgery and hip grafting and replacement. India is also a top destination for cardiac bypass surgery at facilities like the Asian Heart Institute; the procedure can cost less than $10,000 as compared to more than $100,000 in the west. Thailand has long been on 2. Thailand Ever since the crash of the baht in the nineties, Thailand used its currency crisis to attract medical tourists from around Asia, mainly for cosmetic surgeries. Today, Thailand is a haven for inexpensive plastic surgery, but also non-elective procedures. A facelift that might cost $15,000 in The Land of the Free would cost $2,500-3,000 in Thailand. Meanwhile, bypass surgery could cost around $25,000, an 80% discount over US prices. Experts recommend sticking to Bangkok rather than the coastal resort towns for access to the best doctors and care. Malaysia has built medical facilities that rival Singapore at much lower price points, and has set up agencies to attract hundreds of thousands of medical tourists for procedures from burns to heart conditions. 1. Malaysia Like other countries in Asia, Malaysia saw medical tourism as a way to diversify its economy during the Asian financial crisis. Prince Court Medical Center, where I easily saved $2,000 when I got sick in Kuala Lumpur, was ranked the number on Other countries are joining in to grab their share of foreign patients, as well. Jordan has seen millions of patients cross into its borders, and has received a top five ranking for medical tourism from the World Bank, while Colombia is fast rising as a medical tourism hub. Would you go overseas for inexpensive health care? Share your comments below. 医疗旅游:又一个“印度辉煌” |
除了瑜伽、软件业之外 医疗旅游:又一个“印度辉煌” ■吴永年 印度的瑜伽文化已被世界所接受,并赞言不绝。而它的国际医疗文化,如今也进入国际舆论的视线,并被津津乐道。椐有关资料显示,近年来,印度医疗旅游文化业的收入以15%的速度持续增长,2012年已达400亿美元,2015年保守估计可达600亿美元,故被舆论称之为印度优质产业群中的一朵奇葩。也有舆论认为,这是继印度软件业后的又一个“印度辉煌”。 作为一个经济还比较落后的发展中国家,印度何以能吸引成千上万的西方国家的富人来治病或疗养?笔者在经过了一番调查研究之后认为,印度国际医疗旅游业成就如此骄人事出有因。 印度医学自古闻名于世 据记载,早在公元前2500-1700年的哈拉帕文化年代,古印度己用五灵脂治消化不良、肝病,乌贼骨外敷治耳、眼和咽喉等疾病;利用头盖骨穿孔术治疗头痛和脑外伤等疾病。 在古吠陀年代,在《阿达婆吠陀》与《爱达罗氏奥义书》等书中,印医入药的植物有2000多种,动物有200多种,矿物药也有数十种。那时印医以摸脉、看舌苔、望气色来诊断疾病,与中国中医治病类似。后吠陀年代,古印度己建有专门的印医学校,阿特里亚的医学著作《阿特里雅集》最为著名,还有人体健康与自然界结合的三活力与七要素之说。公元2世纪的《妙闻集》是古印度最为著名的外科医学著作,其中的病理学、解剖学、胚胎学等至今仍用,其中还有121种类型的外科医疗器械,300种手术方法,42种外科处置方法。另外,公元八九世纪的《八科精华》和《疾病研究》对今日世界医学界产生了不可低估的重大影响。 医术高收费低最吸引人 有人认为.印度经济不发达,老百姓生活水平普遍低下,其医疗技术不可能与西方发达国家相比。可出人意料的是,事实恰恰相反。早在英国殖民时期,印医开始吸收西方医术,融会贯通,医术有了长足的进步。如今,印度各大医院的医生大部分从欧美国家的医学院取得博士学位后归国工作。这批精英人才将印医传统和现代先进技术相结合,使得印度的医疗技术水平不仅不落后于西方国家,有些指标甚至还遥遥领先。比如,据报道,2004年印度的斯科特医院完成的4200例心脏手术中,死亡率只有0.8%,感染率0.3%;而同比西方发达国家,心脏手术死亡率则高达1.2%,感染率1%。近几年斯科特医院的手术死亡率、感染率仍在世界属最低的,其死亡率和感染率不会高于0.9%与0.4%。 除了高超的医疗水平,印度医院便宜的手术费或许是吸引西方国家病人源源不断来印度就医的最吸引人的因素。在西方发达国家,做一例心脏手术、血管成形手术、脊柱融合等大手术,一般费用都要在10万至27万美元之间,而在印度的费用只有它们的十分之一,有的甚至更低。另外,印度护士小姐温柔的服务态度,精心的呵护照料,也为病人带来一种不同文化的精神享受。 除此之外,印度已是除了美国之外的世界第二大生物药品制造国。目前印度具有世界级的大型生物制药企业350多家,小型的生物制药厂及仿制制药企业5600多家。这些药厂生产的药品,疗效好,价格便宜,有的仅是西方同类药价格的十分之一。可见,如果一个国家独特的文化底蕴,若能够与现代科技和社会需求紧密地结合在一起,那么,其迸发出的力量和形成的硕果也一定是耀眼的。(作者系上海外国语大学南亚东南亚研究所首席顾问、教授) |
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