Unless you’re on a comprehensive insurance plan, health care can be either horrifically expensive or require excruciatingly long waiting times under national systems. “Medical tourism” – travelling across international borders for health care – has emerged in recent years as a cheaper, viable alternative for those looking to take their health into their own hands, with Asian nations leading the charge.
But what was once associated with a secret “nip and tuck“, conveniently timed with a holiday, has entered a new era. Today, some of best medical treatment available is taking place not in Western hospital wards, but in places like Bangkok, Kuala Lumpur, New Delhi and Singapore. Asia presently boasts 212 hospitals with the coveted seal of approval from the Joint Commission International (JCI) – the gold standard in health care. And the region is changing the face of global health care.
Just last month in India, a mechanical heart known as the Heart Mate II, was transplanted into a 29-year-old Iraqi man at the Fortis Memorial Research Institute in Gurgaon, south-west of New Delhi.
“This is currently the most sophisticated FDA-approved technology available in the world, and a permanent solution to heart failure,” said surgeon Sandeep Attawar in a report published online last month. Attawar believes that this device could soon replace conventional heart transplants altogether and provide a lifeline for the thousands of people who die each year while waiting in vain for a donor heart.
Indian doctors are also leading the world in other breakthrough surgeries. Earlier this year the Medanta Hospital (also located in Gurgaon), together with the Henry Ford Hospital in Michigan, US, announced a major breakthrough in robotic kidney transplants after successfully transplanting the vital organ into 50 patients via a robot-assisted procedure.
Elsewhere in Asia, the trend continues. Thailand, one of the early pioneers of medical tourism, is unofficially known as the best place in the world for cosmetic surgery, but it has also become one of the top destinations for eye and dental surgery. Established medical destination Singapore specialises in organ transplants, cancer treatment, cardiac surgery and fertility treatment. Meanwhile newcomer Malaysia is making its mark in cosmetic surgery and comprehensive health checks, as is Korea, which also specialises in stem cell treatment and spine surgery.
For the discerning international medical tourist and those living in Asia, this is good news. A broad range of medical treatments are available on request and often only a short plane ride away. Travellers can also use the cost savings – up to 80 per cent compared with western treatment – to enjoy a holiday at the same time, without scrimping on service or quality. While you may not associate visiting the dentist with lying on a beach in Thailand, you have to admit, the proposition is an attractive one!
Indeed, medical tourism is booming. An estimated 11 million health care consumers pumped US$438.6 billion into local and national economies overseas this year alone – that’s 14 per cent of the world’s tourism dollars, according to the Medical Tourism Association (MTA). Next year the MTA predicts that around 10 million of these medical tourists will travel to Asia due to the quality of health care on offer.
“Travelling to Thailand for post-pregnancy breast augmentation was a no brainer” says Emma Richards*, a British mother of two based in Hong Kong.
“I wanted the best doctor possible – if someone is going to mess with your appearance you want to make sure that doing this operation is about as routine to them as brushing their teeth,” she says. She had weighed up her options in the United Kingdom and Hong Kong, but settled on the Bumrungrad International Hospital in Thailand for the exceptional treatment available close by.
“Bangkok is very close to Hong Kong; it’s a short-haul flight, I only needed to stay five days, and I can easily go back if I need to. The doctor there was also one of the very few American Medical Board-certified surgeons and had years of experience,” she says. “He was ultimately the reason I chose to go.”
High-end health screenings are another popular treatment around the region for convenience, cost and quality. At the Bumrungrad, for example, you can schedule an “Executive Health Screening” the day after you arrive in Bangkok and get your results the same day. Specialists, cardiologists, radiologists and screening specialists pour over you while their in–house laboratory – that processes 3 million tests each year – quickly turn over your results. The cost? Between US$200 to US$600, depending on what tests are taken. Comparative testing in the United States would cost thousands of dollars.
There are, of course, potential downsides to being a medical tourist: having to go on the road, time away from family and friends, culture shock, potential post-treatment complications and a lack of continuity from the health care provider. Plus many people might be put off by the nightmare medical stories that have emerged over the years, (although these appear to be limited to bogus providers and are largely unheard of at reputable hospitals in the region).
Richards admits that although the service she received medically was “exceedingly high”, she would have preferred a procedure closer to home had the quality of service been available. “You lack the luxury of post-op care that you might get in your own country.”
“Luckily I haven’t needed any, but follow up and complications may be harder to manage if you travel abroad… It’s not a personal experience. It’s not for people who want a more in-depth doctor-and-patient rapport.”
“In the end, [health care] destination is determined by what procedure is available, the price, the expertise, accreditation, and accessibility to that location,” says Renée-Marie Stephano, president of the Medical Tourism Association. “No one wants to spend more time on a plane or in an airport terminal than they have to,” she explains.
“It boils down to feeling comfortable – it’s your body and your health after all,” advises Richards. “I chose a location that I know … I’ve visited Bangkok many times,” she says.
Culture shock is another important consideration. The poverty and lack of development in certain parts of India, for example, or the pollution and chaos of Bangkok, may be less appealing than the salty sea breeze of Phuket, or the sanitised streets of Singapore.
And although medical tourism in Asia is comparatively cheap, costs are rising. At the same time domestic health costs are falling in response to an awareness of the increasing need to be competitive in the global market. Service quality in Asia will, however, continue to be a distinguishing feature, as well as a drawcard. Ultimately, it’s about making the choice: where in the world would you prefer to get your medical treatment?
Asking this very question, Tony Smith opted for laser eye surgery treatment in Thailand, and not Hong Kong where he resides, even though Thailand was actually the more expensive option. He received ReLex treatment, an advanced form of the procedure, which was unavailable in Hong Kong at the time, at a price of around HK$30,000 (US$3,864), compared to HK$18,000 (US$2,319) for Lasik treatment.
“Sounds crazy I know but I went for the most advanced technology which was not available in Hong Kong a year ago…. ReLex will not flap your cornea and is a lot less invasive [than Lasik]. I only needed to cover my eye for one night, then I had to avoid having water in my eyes for three days. After one week, I was back to normal,” he says.
The experience was impressive, he says. “Service quality is their top priority [in Thailand]. The day before the operation, I was assigned a personal consultant who I could reach ‘24/7’.”
Just how has Asia – a region of developing nations – become the leader in health services? Put simply, it’s a case of supply and demand as the world’s health care has gradually moved to a globalised, privatised system. And as Asia steps up to satisfy global demands, with the added lure of a holiday and significant cost savings, the sheer volume of patients attracted to the region is helping to raise the standard of treatment. As they say, practice makes perfect.
After the Asian financial crisis of 1997, governments looked at ways of building their economies. In Thailand, the government directed its tourism officials to market the country as a destination for plastic surgery and the country quickly became the go-to country for comparatively inexpensive operations. Over the years, the service offerings have expanded as the numbers of providers have increased. The Bumrungrad, for example, is a five– star medical facility offering over 900 physicians across 55 specialities seeing around 1,000 international patients every day. Being more like a five-star hotel than a hospital, it has helped to spawn the use of a brand-new term: “hotel-spital”.
One of the world’s freest economies with a highly developed medical system, Singapore has long been a medical tourism hub for both Asians and westerners for years. The World Health Organisation ranks Singapore the best health care system in Asia, and sixth in the world. The Singapore Tourism Board claims that in 2012, the country had 850,000 foreign patients, including visitors and expats, signaling an annual growth of 15 per cent.
Encouraged by the success of their Asian neighbours, Malaysia and South Korea have followed suit by developing their medical industries for international tourists in recent years. “Malaysia is one of the few countries where medical tourism has been “actively promoted by the government” and is overseen by the Ministry of Health (rather than a tourism board),” explains Dr Mary Wong Lai Lin, chief executive of the Malaysia Healthcare Travel Council (MHTC).
“We envision positioning Malaysia as the preferred destination for world-class health care services,” says Dr Wong, head of the MHTC. And it’s working – with the 330,000 patients that visited in 2010 more than doubling to 770,000 in 2013.
South Korea, too, has been actively campaigning for medical tourists, having established the Council for Korea Medicine Overseas Promotion and introducing a new class of medical visas for foreign patients, accounting for the annual growth of 38.4 per cent since 2009. The official South Korean tourist organisation, the KTO, expects medical tourist numbers to reach 598,000 in 2015 and 998,000 in 2020 – equating to US$3.4 billion in revenue by 2020, up from US$970 million in 2013.
Meanwhile in India, as economic policies gradually saw a decrease in health funding towards the end of the 20th century, demand grew for private medical facilities, encouraging the rise of the corporate hospital. Today, corporations like Fortis Healthcare, Narayana Health and The Apollo Group are multi-billion dollar organisations with private hospital chains around the region. Fortis, for example, flaunts 65 health care facilities (including projects under development), throughout India, as well as Singapore, Dubai, Mauritius and Sri Lanka with over 10,000 potential beds, over 240 diagnostic centres and more than 17,000 employees.
And it’s not just the western market that these countries are targeting. As competition for the medical tourism dollar heats up between these developing nations, the potential lies less in luring foreign medical tourists as it does in capturing the burgeoning middle class in Asia.
Taiwan, for example, is hoping to capture a greater proportion of the Chinese medical tourism market, and South Korea aims to appeal to nearby neighbour?Japan with cheaper costs. Singapore has also reported receiving more patients from China and India on top of its traditional sources in neighbouring Malaysia and Indonesia.
India, meanwhile, has experienced an influx of patients from surrounding countries with less developed health care systems, such as Pakistan, Bangladesh, Myanmar and central Asia, explaining the exponential growth in medical tourism revenues to US$3.9 billion this year, from US$1.9 billion three years ago, according to a 2014 report from Deloitte.
Whether or not you wrinkle your nose at the thought of jumping on a plane to an emerging market for health care, the message is clear: credible, if not better, alternatives to expensive treatments and long-waits exist in Asia. What’s more, you might just be part of one of the most significant changes in health care the world has ever seen.
