Competition in Medical Tourism

MEDICAL tourism has become an international battleground as western countries join the rush to lure travellers seeking self-improvement at a bargain price.
Packages including flight discounts, hotel stays and airport transfers are being offered to Australians by dental and medical clinics in countries like Hungary, Germany, Greece and Canada, in order to compete with those in Thailand and Malaysia.
Surgeries in Spain, Belgium and New Zealand are also getting in on the act, as medical tourism shapes up to be one of the boom sectors of the travel industry in coming years.
Already a $400 billion a year industry, a recent International Travel Insights report by Visa predicted a 25 per cent increase in medical tourists every year for the next decade.

By examining cross-border spending for medical services in 176 countries, the report found the US to be the single largest hub for medical tourism.
“Thailand, Singapore, Germany, Korea, and Spain are quickly catching up, increasingly attracting visitors from around the world,” said the report.
Medical Tourism Abroad Manager Kanika Gupta said their clinics in India, Thailand, Malaysia and Singapore were facing significant competition from Europe and North America.
But she said 60 per cent of medical tourists from Australia went to Asia, because of the proximity and savings of up to 75 per cent on the same treatment down under.
Hospital stay? Chiva Som Spa in Hua Hin in Thailand hosts medical tourists. Picture: Supplied
Hospital stay?


“It’s not only for the price but the quality of the service they get,” said Ms Gupta.
“We tell our patients (doctors’) qualifications are matched to Australian doctors but their experience is greater and that tends to lead to better results especially for cosmetic surgery.
“They just see so many more patients.”
Consumer law expert Thomas Janson of Shine Lawyers said countries where the Australian dollar was doing well were proving most attractive to medical tourists but there was also growing interest in dental and medical services in English-speaking countries.
“I would look as a first choice at Europe, North America or New Zealand, and perhaps consider going through a medical tourism agent,” Mr Janson said.
“If the agreement is signed in Australia, you would be covered by Australian Consumer Law if things go wrong.”
Dental capital? Budapest in Hungary is muscling in on the competitive medical tourism market. Picture: Supplied.
Dental capital? Budapest in Hungary is muscling in on the competitive medical tourism market. Picture: Supplied.Source:Supplied
In one case handled by Shine, a young woman suffered a severe infection after having breast implants in Thailand.
Despite being reassured by the Thai doctor her black nipples, soreness and fever were normal, the woman had to seek treatment in Australia — where the implants were removed.
Medical law department manager Clare Eves said the woman was left with poor health, disfigurement and a psychiatric injury.
“Due to the difficulties in succeeding in the claim against the hospital or surgeon involved, a claim was pursued against the medical tour operator only,” said Ms Eves.
Travel insurance expert Michelle Hutchison of said Australians currently spent an estimated $300 million a year on cosmetic surgery overseas.
“Globally, only a handful of insurers have introduced specialist medical travel insurance cover,” said Ms Hutchison.
“Going overseas for a cheaper procedure is nothing new, but we are only just starting to see Australian insurance companies jump on board to offer cover.”
She said Go Insurance was one of the first to offer Australian travellers cover for dental procedures carried out overseas, and US firm Custom Assurance Placements provided cover for medical complications up to six-months after surgery.

Africa’s loss is Asia’s Gain in Medical Tourism

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.

Roundtable discussion about Medical Tourism in Hungary

The Roundtable ‘Exploring Health Tourism’ gathered a group of international experts in Budapest, Hungary, to better understand and explore the growing segment of wellness and medical tourism. The meeting was convened by the World Tourism Organization (UNWTO) and the European Travel Commission (ETC), as part of their joint research programme, with the support of the Hungarian Tourism Agency.

The two-day event held in Budapest gathered experts from the World Health Organization (WHO), the European Union (EU), the World Travel and Tourism Council (WTTC), the European Spas Association, the Global Wellness Institute and Spaincares among others. Representatives from the health-related tourism sector from Hungary, Lithuania, Malaysia and Mexico attended the event.

Gusztáv Bienerth, Hungarian Commissioner for Tourism, highlighted the importance of health-related tourism in Hungary’s tourism sector, as well as the role of the country in the global market of health tourism, while underlining the relevance of the event.

Discussions were based on the ongoing ETC and UNWTO research on health tourism, a complex and not yet well-defined segment. This report is the first attempt to set a coherent conceptualization of health tourism and define the motivations behind travelers looking for health-related services.

“The need to better understand an emerging, global, complex and rapidly changing phenomenon such as wellness and medical tourism has become essential to tap into its growth potential”, said Márcio Favilla, UNWTO Executive Director for Operational Programmes and Institutional Relations.

“For ETC and UNWTO it is very important that we provide tourism authorities, managers and experts with a better understanding of the health tourism phenomenon and jointly cooperate to identify and provide a consistent terminology that lays the foundations for this promising sector”, said Eduardo Santander, Executive Director of ETC.

Participants debated the taxonomy proposed in the research to agree on a consistent terminology to define and describe the system of travelling for health purposes. Furthermore, the Roundtable explored the latest trends shaping health tourism and how tourism destinations can tap into these opportunities.

The final report establishing common grounds for a health-related tourism taxonomy will be published by the end of 2016.

Additional information:
Full list of participants: the World Health Organization, the European Commission, the European Parliament, the World Travel and Tourism Council, the European Spas Association, the Global Wellness Institute, Spaincares, the Malaysia Healthcare Travel Council, the Mexican Council for the Medical Tourism Industry, the Lithuania Medical Tourism Cluster, the Lithuania State Department of Tourism, the Hungarian Tourism Agency, the Hungarian Hotel Association, the Danubius Hotels, Xellum and Intuition Communication.

The research ‘Exploring Health Tourism’ commissioned by ETC and UNWTO was prepared by László Puczkó and Melanie Smith (Xellum), with the support of the International Medical Travel Journal (IMTJ).

Malaysian Medical Tourism

Medical tourism to Malaysia is expected to increase according to a report released, last week, by Malaysia’s M&E Research.

The report identified KPJ Healthcare Bhd (KPJ Healthcare) as a leader in the expansion claiming it has leveraged medical tourism to improve its healthcare revenue.

Local media reported, earlier, that KPJ was planning to build three new hospitals in Malaysia due to open over the next two to three years.

inside no 5The three hospitals will have a 420-bed capacity, catering for patients in Johor, Melaka and Klang Valley.

The government intends to promote three healthcare hubs in Penang, Melaka and Johor Bahru as part of the 11th Malaysia Development Plan.

The initiative, M&A Research believes, will attract more medical tourist to visit private hospitals in Malaysia.

The average bill spent by medical tourists was 20% higher than the average local healthcare spend. Medical tourists probably represent less than 5% of the country’s total private hospital revenue.

M&E noted that the higher spend by medical tourists could be attributed to them under taking more value added services such as complete body check-up and other health screening.

Medical tourism is likely to grow due to a weakening ringgit and the price ceiling on consultation fees in Malaysia.

The research firm noted that demand for healthcare services will expand in the future with an estimated population growth of 1.5% in Malaysia.

Medical Tourism strategy by Top Hospitals

New-age doctors from corporate hospitals have been winging out of Hyderabad in dozens for consultations abroad and returning to city with ready-to-treat patients.

The result is a multi-fold increase in arrival of international patients, especially from over 25 countries in Africa, West Asia and SAARC countries, for treatment including surgeries. An estimated 800-1,000 foreign patients are being treated or operated in the erstwhile Nizam city every month.

So much so, Apollo Hospitals has set up a dedicated international block in its Jubilee Hills campus only to treat overseas patients, thanks to the referrals made by its 37-40 member expert team from Hyderabad each month when they attend clinics in these host countries.

“The year-on-year growth of foreign patients at Apollo Hospitals is about 11% to 12%,” said Radhey Mohan, vice president, International Business Development, Apollo Hospitals.

He said that from their entire group of hospitals, including at Delhi, Chennai and Hyderabad, about 75-80 doctors visit about 75-80 countries each month. The scene is similar at Continental Hospital, a Joint Commission International (JCI) accredited facility that boasts of 1 international patient out of every eight patients that it treats in Hyderabad in a day.

“Our growth in international patients too is in double digits. At least 10 of our doctors fly abroad every month to attend health camps in specialities like orthopaedics, cardiology, oncology in countries as far as Somalia and the selected patients follow the doctors to Hyderabad for procedures,” said Gokul Prem Kumar, head, international business, Continental Hospitals.