India becomes West’s favourite destination for cheaper cosmetic surgery

Many people from US and other western countries are travelling to India for less-expensive cosmetic surgeries such as rhinoplasty or breast augmentation procedure, a new study has found.

Prompted by the ease and relatively low costs of travel, more patients from these countries are travelling to the developing world to access less-costly medical and surgical procedures, researchers said.

Because cosmetic plastic surgery procedures aren’t covered by insurance, they make up a major part of the burgeoning medical tourism market.

India alone may have more than one million medical tourists per year, according to the study.

Other countries with growing medical tourism industries include Mexico, Dubai, South Africa, Thailand and Singapore.

Prices for cosmetic surgery in these countries are typically much lower than at home. For example, a breast augmentation procedure that would cost $ 6,000 in the US can be done for $ 2,200 in India, researchers said.

Even after the costs of airfare are factored in, having an operation in these countries can be much less expensive.

The trend is having an impact on the market for cosmetic plastic surgery, according to an article in Plastic and Reconstructive Surgery-Global Open, the official medical journal of the American Society of Plastic Surgeons (ASPS).

“The rapid globalisation of the industry also marks a fundamental shift in the world’s perception of elective procedures: patients are becoming consumers and these medical services are being viewed as commodities,” Dr Kevin C Chung and Lauren E Franzblau of the University of Michigan, said.

Travelling for medical care is nothing new – but in the past, people were more likely to travel from poor countries to obtain higher-quality care in wealthier countries, researchers said.

In many countries, governments are working actively to foster their medical tourism industry. Some destinations even market procedures performed in resort-like settings, encouraging patients to combine a vacation with cosmetic surgery, they said.

Travelling abroad also lets patients recuperate privately, without anyone at home knowing that they’ve had plastic surgery, researchers noted.

The growth of medical tourism may have a significant impact on the cosmetic surgery market in the US, but also raises concerns over physical safety and legal protection.

Although destination countries promote the quality and safety of their procedures and facilities, there is often little evidence to support these claims, researchers said.

“Because the practice of medical travel does not appear to be going away in the foreseeable future, plastic surgeons must understand the international market and learn to compete in it,” Chung and Franzblau said.


India emerges as new destination for Russian medical tourists

Asian countries are seriously challenging Europe, US and Israel as attractive destinations for medical tourists: people who travel across international borders to obtain healthcare.

India, Thailand and Singapore are three countries in Asia that receive the maximum number of medical tourists, because of the quality of healthcare infrastructure and the availability of highly skilled doctors, as well as lower cost of treatment.

India hosts thousands of medical tourists from the US, Canada, Australia and UK, as well as from African countries and Asian neighbours, like Bangladesh, Sri Lanka and China yearly. According to ASSOCHAM, in 2011 India saw 850,000 medical tourists and by the end of this year this number may rise to 3.2 million.

Indian medical tourism market is expected to expand at a CAGR of 27 per cent to reach US$3.9 billion in 2014, from US$1.9 billion in 2011, according to the “Medical Value Travel in India” report by KPMG and FICCI. Globally the medical travel industry is estimated at US$ 10.5 billion and is expected to grow to US$ 32.5 billion over the next five years at CAGR of 17.9 per cent.

Multiple factors

Despite Russia being known in India particularly for the quality of its medical education – consider that eight out of ten Indian students in Russia are enrolled in medicine or dentistry courses – there are multiple factors that make Russian patients seek better healthcare options abroad, and more recently, in India too.

The Indian healthcare sector amounted to US$ 78.6 billion in 2012 and is expected to reach approximately $158.2 billion by 2017, according to KPMG. The Russian healthcare sector in the same period, according to PWC, stood at US$86 billion. The difference between the two countries is that while in India the healthcare industry has, since the 1990s, emerged as a huge segment with dynamic private sector involvement, in Russia it has been dominated by only government for about 100 years. Today more than 60 per cent of the Russian healthcare market belongs to the government sector, although the share of private healthcare is growing, rapidly.

Russian industry analysts stress that, despite Russia doctors being highly qualified, their numbers are not enough, thus leaving smaller regional medical centres poorly staffed and equipped. Misdiagnosis and delayed diagnosis and medical errors are common in the Russian healthcare system as bureaucratic hurdles abound and long queues of people wait for prescribed treatment and quotas for free treatment. Patients, especially children and elderly people, are often considered non-responsive to treatment and are thus denied medical services. Outside Russia, they get medical help in most cases.

Additionally, not all kinds of healthcare services are available in Russia. For example, Cyberknife Radiosurgery, a non-invasive treatment option for tumours, has recently become available only in two hospitals in Russia

A difference of views between African government and patients.

Africa is estimated to lose over $1b in medical tourism abroad, according to World Bank statistics (2015).

Prof.  Khama Rogo, the lead Health Sector Specialist with the World Bank and Head of the World Bank Group’s Health in Africa Initiative said that much as the continent is heavily resource constrained, a lot of money is spent on treatment abroad which could have instead helped develop capacity on the continent. He was speaking at a recent forum by East African Health Federation Conference in Kampala.

Africa, according to Rogo, is exporting money and sickness to the East, especially India, which has largely contributed to a flourishing private health sector at the expense of Africa’s.

“Indian private sector is enjoying the benefits of sickness from the African continent. Young people in Africa have instead started clinics as conveyor belts for the Indian hospitals,” he said.

Much to the chagrin of the continent, 25% of the passenger loads on major airlines namely; Kenya Airways and Ethiopian Airlines according to Rogo is sickness.

He argues that since most governments cannot absorb all the experts in their countries, it is an opportunity for the private sector to help retain such talent in the region. This will attract clients from other countries and not necessarily seeking care abroad.

In the case of Uganda, according to the executive director of Uganda Healthcare Federation, Grace Ssali Kiwanuka, the amount of money lost in medical tourism abroad can be placed at about $3m.

The figure could be higher since there is largely no central body that co-ordinates who goes out. Health insurance companies that give international benefits make direct payments, there are individual using own savings and then the numerous sponsors such as the Indian Association in Uganda that sponsors a number of people for heart surgeries.

Such countries as India, South Africa, Thailand and Turkey according to Ssali remain major destinations for Ugandans.

Capacity and quality still remain a major undoing for the region and Uganda in particular. For any hospital to build the confidence of clients for major procedures, it must have a history of success. Most referrals abroad are such cases as oncology, cardiovascular and joint or spinal surgeries.

But this will largely depend as Ssali explains on partnerships between government and private healthcare providers since these acting independently have proved inadequate.

The private sector as Ssali expresses is eagerly waiting for the operationalisation of the public private partnership policy (PPP). Though it is in place, no guidelines have been developed yet for the different stakeholders to know how to do business.

“We need guidelines to tell us how we can be contracted by government, the process and the parameters,” she says.

Currently most CT and MRI scans in Uganda are carried out by the private health providers since most public facilities do not have this equipment. But this is left at the expense of the patient. If according to the experts such services are streamlined, more people will be able to access quality health services.

In Tanzania according to Dr Samuel Ogillo, the CEO of The Association of Private Health Facilities in Tanzania (APHFTA), just this year, a total of 145 private facilities had signed agreements to provide free health services to the population with support from their government.

The Federation currently made up of Uganda, Kenya, Tanzania, Rwanda, Ethiopia and South Sudan is proposing an insurance fund for the region that can be accessed by clients from the region.

Where chinese are heading for Medical Tourism?

Rising wealth, an increasingly top-heavy population pyramid, more non-communicable diseases (NCDs), and cultural factors have combined to fuel a boom in outbound Chinese medical tourism.

By 2024, the population for urban Chinese aged 40-64 will increase by 108 million from 2014, and 57 million more aged 65 and above, according to Global Demographics. As these groups suffer increasingly from lifestyle diseases that demand cardiovascular and cancer treatments, many of the wealthy among
them will seek procedures in the United States or Europe. And many more will use their new-found wealth to take advantage of plastic surgery, dentistry and wellness programs in Korea or Southeast Asia.

Plastic Surgery in Korea

Chinese medical tourists see the United States as the pinnacle of quality for major procedures, such as cancer treatment and cardiac surgery, alongside locations, such as the United Kingdom and Singapore. Korea is very popular for plastic surgery and has seen a 35 percent annual increase in volumes since 2009, primarily patients from China who are lured by the Hallyu or “Korean Wave” cultural phenomenon (hanliu in Mandarin) created by Korean TV and music exports.

Southeast Asian countries also report double-digit increases in the number of mainland medical tourists in recent years, thanks to an influx of Chinese, who make up the fastest growing segment of the market and fourth largest in Malaysia where plastic surgery, dentistry and non-surgical health programs are

Singapore is also a common destination, thanks to the quality of care, Mandarin language capabilities, and value. Although competitive prices can now be found in other Southeast Asian countries and India, Chinese millionaires are most concerned about securing the best possible care and medical outcomes.

How Can Hospitals Tap into this Opportunity?

The Stanford Research Institute reports Chinese medical tourists spent USD10bn in 2014, which is only 2.3 percent of the global total of USD430 bn, suggesting that there is a huge potential for further growth in the market.

Hospitals hoping to tap into this opportunity will need to provide Mandarin speaking staff and nurses, and train clinicians about Chinese perceptions of healthcare, which are still influenced by millennia-old concepts of Traditional Chinese Medicine. On a more practical note, they will also benefit from accepting Chinese credit cards, such as UnionPay and RMB.

Bumrungrad Hospital in Bangkok goes a step further, offering a range of premier and VIP suites, a 24-hour hotline, and embassy contact, airport transfer, reception and a visa application assistance services to create a 5-star hotel-like medical tourism experience.

At the government level, as competitors as diverse as Turkey, India and the Philippines compete for Chinese medical tourists, electronic visa applications, special multiple entry visas, dedicated medical tourist channels at airports, and freedom to transfer money into the country to pay for treatments will all
boost a country’s share of what could become the biggest new wave in medical tourism ever.

Slump in Middle East affecting Thailand Medical Tourism



Bangkok’s Bumrungrad Hospital, known as the grand-daddy of all internationalhospitals, has slumped 17% since early March after patient volumes from the United Arab Emirates (UAE), its second-biggest source of overseas visitors, fell 20% in the first quarter of the year.

More than one in three foreigners treated at Bumrungrad are from the Gulf states and Kasikorn Securities says declining growth in the region and a rise in competition fromclinics in the UAE, where the government is encouraging its citizens to stay home formedical care, are curbing demand.

Kasikorn Securities downgraded its earning forecasts for Bumrungrad by 8% to 13% in 2016 to 2018 to reflect the weak economic outlook in the Gulf and rising competitionfrom Abu Dhabi’s Al Noor Hospitals Group, according to a May 19 note by analystJitima Ratanatam in Bangkok. The UAE’s economy has been hit by the plunge in oil since mid-2014 and is forecast to expand 2.5% this year, from more than 7% in 2012.

Other Thai hospitals are also under pressure. Chiang Mai Ram Medical Business reported a 41% slump in first- quarter profit. Bangkok Dusit Medical Services, the largest company in the Thai medical tourism sector, was downgraded to neutral from outperform by Credit Suisse Group AG last week.


Recognising the importance of health care to the Thai economy, Prime Minister Prayut Chan-o-cha’s military government has drafted a 10-year plan to promote the sector.

As part of the plan, the staying period for medical treatment for patients from China, Laos, Cambodia, Myanmar and Vietnam has been tripled to 90 days.

Even if Middle East demand keeps declining, growth in patients from Southeast Asian countries with less-advanced medical technology such as Myanmar will support theindustry say some experts.

Fortis adjudged hospital of the year in India

Fortis Healthcare was adjudged Hospital of the Year in India and Digital Savvy Hospital of the Year at the 2016 APAC Healthcare and Medical Tourism Awards held recently at Bangkok, Thailand.

The awards event was part of the 2016 Asia Pacific Healthcare & Medical Tourism MindXchange Conference whose objective was to address the challenges and future of smart technologies in healthcare and the evolving role of healthcare service providers.

A joint collaboration between Frost & Sullivan and the Global Health and Travel (GHT) publication, it started as the premier healthcare conference in Asia. With core themes around healthcare delivery, hospital efficiencies, hospital experience and Medical Tourism, this conference provided expert insight into the main trends that are expected to transform healthcare delivery in the years to come.

The 2016 Asia Pacific Healthcare & Medical Tourism Awards instituted jointly by Frost & Sullivan and Global Health and Travel aim to give recognition to organizations in healthcare and medical tourism across Asia Pacific. The key criteria for the winners included those who have maintained consistently high standards in delivering customer value and demonstrated outstanding performance in terms of initiatives that can improve the way healthcare is delivered through leadership, technological innovation, customer service and strategic product development.

“The awards are a recognition of the values we strive for through our continued efforts towards patient-centric healthcare. We believe in challenging ourselves to bring about greater accessibility, affordability and reliability in delivering quality healthcare,” said Bhavdeep Singh, CEO, Fortis Healthcare Limited.

Currently, Fortis operates its healthcare delivery services in India, Dubai, Mauritius and Sri Lanka with 54 healthcare facilities including projects under development, with approximately 10,000 potential beds and 314 diagnostic centres.

Lawmakers in Phillipines to promote medical tourism for more jobs

Incoming 1-Pacman Party-list Rep. Mikee Romero said on Monday he is helping the incoming Duterte administra-tion in crafting measures that can generate millions of job for Filipinos for the next six years.

Among the priorities of Romero is medical tourism that makes Thailand famous and now contributing USD25 billion in government’s coffer annually.

He said that they had already well-trained and internationally renowned doctors who were just waiting for gov-ernment support to open the medical tourism in the country.

“Imagine if we can get a share of at least USD10 billion worth of medical tourism from Thailand, that would trans-late to about 500,000 additional job opportunities for Filipinos,” Romero said.