Article #7 | Medical Tourism In The World To Fly Or Not To Fly?

Oct 17 2018
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Medical Tourism In The World To Fly Or Not To Fly?
By Raza Siddiqui, Chief Executive Officer, Arabian Healthcare Group.

For years, Switzerland has been the mecca of medical tourism. Patients, particularly the affluent class travelled miles for treatment, preferring this exotic locale for its superior technology and achievements in medical science.
However, with the turn of the century medical tourism space has evolved rather differently. What’s changing is the profiling of countries and emergence of new age destinations that specialise in different fields. Korea, for instance, is emerging as a destination for plastic surgery; Europe for hip and knee replacement surgeries; Philippines and Thailand for cosmetic surgeries and India for heart surgeries.
Globalisation of information and word of mouth referrals, especially in the virtual world, are the new drivers of this industry and are changing the dynamics in the favour of emerging markets. Over six million people travel abroad for medical treatment every year. If we consider people who travel domestically too for treatment, the number of medical tourists swells to about 10 million.

Why the shift?
The number of people willing to hop on a plane and fly to a different timezone for treatment is increasing incrementally yearon-year. This is especially true for patients in the US and the UK where either the treatment cost is exorbitant or the wait time is too long for procedures. With the ease of air travel, patients from these countries have benefitted from improving technology and standards of care in many countries, chiefly some European nations and Asian countries. Many surgery procedures performed in medical tourism destinations cost a fraction of the price they do in the developed world. To get a perspective let’s compare the cost of a heart surgery in India and the US. A by-pass surgery in the US costs around Rs 30 lakh (Dh200,000) but in India surgeons conduct the surgery for only Rs 3 lakh (Dh20,000) — one-tenth of the cost. Better standards at the hospitals and significant savings in the treatment cost are therefore attracting a number of patients to India. Another striking comparison is of a
liver transplant in US and Taiwan. In the US the procedure costs $300,000, and comparatively it is just $91,000 in Taiwan. Besides the cost, time is also one of the defining aspects of the shift in medical tourism. A large number of patients willingly travel for convenience and speed. Countries that operate public health-care systems, such as Canada, US, UK and the likes, often have long wait times for certain operations. A recent report, ‘Leaving Canada for Medical Care’ by Fraser Institute of Canada estimates that over 53,000 Canadian left the country to receive non-emergency medical treatment in 2014 – an increase of more than 25 per cent from last year. In 2014, the average patient in Canada could expect to wait almost 10 weeks for medically necessary treatment after seeing specialist. As per industry experts, this wait time is more than three weeks longer than what physicians consider to be clinically reasonable. Additionally, lack of insurance cover or its limitations are also driving demand for medical tourism. Patients in some western countries are finding that insurance either does not cover orthopedic surgery (such as knee or hip replacement), or slaps steep deductibles, or limits the choice of the facility, surgeon, or prosthetics to be used. The local media in the western world is increasingly publishing reports of patients travelling to Europe or India for elective and other emergency procedures. Many countries have invested heavily in upgrading their healthcare institutions and systems to attract medical tourists. There is a greater emphasis on securing international accreditation that underlines the institution’s credibility and focus on quality. JCI accreditation, a group devised in 1994 in the US, is considered one of the hallmarks in the industry and is trusted worldwide, along with UK’s Trent Accreditation Scheme.

Circumvention tourism
Circumvention tourism refers to travel to access medical services that are legal in the destination country but forbidden in the home country. This list is long and varies as per country of origin, but largely people travel for fertility treatments, abortion, and doctor-assisted suicide, also known as euthanasia. Abortion tourism can be found most commonly in Europe, where travel between countries is relatively simple. Ireland and Poland, two European countries with highly restrictive abortion laws, have the highest rates of circumvention tourism. In Poland especially, industry experts say that an estimated 7,000 women travel to the UK every year, where abortion services are free through the National Health Service (NHS). Efforts are also being made by independent organisations and doctors, such as with Women on Waves, to help women circumvent draconian laws in order to access medical services. With Women on Waves, the organisation uses a mobile clinic aboard a ship to provide medical abortions in international waters, where the law of the country whose flag is flown applies.

What are the popular destinations?
Popular medical travel worldwide destinations include: Costa Rica, India, Israel, Jordan, Malaysia, Mexico, Singapore, South Korea, Taiwan, Thailand, and Turkey. Patients looking for cosmetic surgery often head to countries such as Argentina, Bolivia, Brazil, Colombia, Costa Rica, Cuba,
Mexico, Korea, Japan, Turkey, Thailand and Ukraine, for its cost-effective and efficient elective treatments. Other destination countries include Belgium, Poland, Finland, Slovakia, Ukraine and South Africa. Medical tourists who are looking for assisted pregnancy, such as in-vitro fertilisation, or surrogacy, or freezing embryos for retro-production often travel to Asia for such procedures. Jordan was awarded the Medical Destination of the year by IMTJ Medical Travel awards in 2014 for attracting 250,000 international patients and generating revenue of more than $1 billion. India, on the other hand, is registering a growth of over 30 per cent in its year-onyear number of medical tourists, potentially making it a $2 billion industry by the end of 2015. Last year, more than 150,000 people travelled to India as medical tourists. As per industry experts, India attracts medical tourists chiefly from its neighbouring countries, SAARC, Middle East, and a large chunk from Afghanistan and Iraq, Africa and very few from Europe and the US. Some of the most common surgeries include aesthetic and plastic surgeries, bariatric surgeries, dental surgeries and IVF treatments. India is also a popular destination for cardiology, joint replacements, spine surgeries, cosmetology and plastic surgeries, IVF, oncology and a small number of organ transplants.

The rising demand and trend for health tourism has opened doors to another service industry called intermediaries, which unite potential medical tourists with provider hospitals and other organisations. Companies that focus on medical value travel typically provide nurse case managers to assist patients with pre- and post-travel medical issues. They may also help provide resources for follow-up care upon the patient’s return. In Europe, for instance, the European Medical Travel Alliance, routes a lot of traffic of medical tourists into the continent. The idea is to make it easier for patients from overseas (chiefly North America, Russia, or the Middle East) to see Europe as a solution because of its high quality and reasonable prices (medical expenses?) in countries such as Belgium, Poland, Finland, etc. Interestingly, people from the East Coast
of the US prefer heading to Europe, while many from the West Coast opt for Asian countries like South Korea, Thailand or India.

UAE as a medical hub
The UAE is working aggressively to build expertise in medical field and emerge as one of the hotspots for medical tourism in the region. The government has announced a number of steps and is working closely with the private sector to develop this space. In April 2014, His Highness Sheikh Hamdan bin Mohammed bin Rashid Al Maktoum, Crown Prince of Dubai and Chairman of Dubai Executive Council, approved the Dubai Medical tourism strategy. The Dubai Health Authority (DHA) is responsible for the initiative and entrusted with the responsibility to promote the UAE in this field. The emirate is looking to build expertise in the following areas: Orthopedics and Sports Medicine, Plastic Surgery, Ophthalmology, Dental Procedures, Dermatology and Skin Care, Aesthetic Practices and surgeries, Preventive health check-ups and wellness. RAK Hospital, a 65-bed hospital in Ras Al Khaimah, is among the most soughtafter institutions by patients flying into the UAE for medical procedures. The hospital is accredited by Joint Commission International and Swiss Leading Hospitals, and is managed by Sonnenhof Swiss Health Ltd, a Switzerland-based healthcare company. It specialises in respiratory medicine, anesthesiology and intensive care unit, cardiac surgery, internal medicine, podiatry, spine and orthopaedic surgery, pain management clinic, endocrinology, pediatrics and neonatology, urology, surgery, etc. It is well supported by a distinguished team of doctors from different countries. The hospital has 65 beds, of which eight are in the Intensive Care Unit; six in the nursery and four in the NICU. The hospital is equipped with five operating theatres, 26 Out Patient Clinics with state-of-the-art accident and emergency services; a 24-hour pharmacy and European Café. RAK Hospital is setting an example for institutes in the region as an epitome of excellence in strengthening UAE’s position as a medical hub. Its rising number of patients from abroad is testimony of increasingly popularity for its procedures and warm hospitality.

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