World Medical Tourism Review

Africa and Middle East

Countries in this region involved in medical tourism include Saudi Arabia, South Africa, and Tunisia.

Israel

Israel is emerging as a popular destination for medical tourists. In 2006, 15,000 foreigners travelled to the country for medical procedures, bringing in $40 million of revenue.

Jordan

Jordan is an emerging medical tourism destination, with related revenues exceeding one billion dollars in 2007. More than 250,000 patients from other countries sought treatment in Jordan that year.

This included an estimated 45,000 Iraqis and approximately 25,000 patients each from Palestine and Sudan.

An estimated 1,800 US citizens, 1,200 UK citizens, and 400 Canadians also sought treatment in Jordan that year. Treatment costs can be as low as 25 percent of costs in the US.

Some have American-sourced international healthcare accreditation, while others are looking towards the UK, Australia and Canada for accreditation services.

The Americas

Countries in the Americas that are treating foreign patients include Argentina, Bolivia, Brazil, Colombia, Costa Rica, Cuba, Dominican Republic, Guatemala, Mexico, Panama, Peru and Uruguay.

Brazil

Brazil has long been known as a destination for cosmetic surgery. For non-cosmetic procedures, Brazil is only now entering the global market.

However, Albert Einstein Jewish Hospital in São Paulo was the first JCI-accredited facility outside of the US, and more than a dozen Brazilian medical facilities have since been similarly accredited.

Canada

Canada has entered the medical tourism field. In comparison to US health costs, medical tourism patients can save 30 to 60 percent on health costs in Canada.

Costa Rica

Costa Rica's popularity in the medical tourism industry has been growing steadily over the years. Currently there are 3 Joint Commission International accredited (JCI) Hospitals all of which are currently located in San Jose, Costa Rica. For a total there are over six major private hospitals and 22 public hospitals.

Costa Rica offers these levels of care ranging from Intermediate Life Saving capabilities, Complex Life Saving Treatment Capabilities, Advanced Life Savings Treatment Capabilities, and Life Style Treatment Services (Full range of dental work and cosmetic surgery).

Because of Costa Rica's close proximity to the USA, the country is able to attract over 20,000 US patients a year. It is also the prices of medical services that are quite attractive to consumers seeking quality care at an affordable price.

The Deloitte Center for Health Solutions, in their 2009 report "Medical Tourism Consumers in Search of Value" reported cost savings average of between 30-70% of US prices.

Cuba

Cuba has been a popular medical tourism destination for more than 40 years. Thousands of patients travel to Cuba, particularly from Latin America and Europe, attracted by the "fine reputation of Cuban doctors, the low prices and nearby beaches on which to recuperate."

In 2006, Cuba attracted nearly 20,000 health tourists.

Medical treatments included joint replacement, cancer treatment, eye surgery, cosmetic surgery and addictions rehabilitation. Costs are about 60 to 80 percent less than US costs.

Cuba has hospitals for Cuban residents and others that focus on serving foreigners and diplomats.

In the 2007 American documentary film, ''Sicko'', which criticizes the US healthcare system, producer Michael Moore leads a group of uninsured American patients to Cuba to obtain more affordable medical treatment. ''Sicko'' has greatly increased foreigners' interest in Cuban healthcare.

A recent Miami Herald story focused on the high quality of health care that Canadian and American medical tourism patients receive in Cuba.

The Cuban government has developed Cuban medical tourism to generate income for the country. Residents of Canada, the UK and most other countries can travel to Cuba without any difficulty, although a tourist visa is generally required.

For Americans, however, because of the US trade policy towards Cuba, travelers must either obtain US government approval, or, more frequently, travel to Cuba from Canada, Mexico, the Bahamas, Jamaica or the Dominican Republic. Cuban immigration authorities do not stamp the passports of US visitors so that Americans can keep their travels a private matter.

To date no Cuban facility has achieved JCI Accreditation.

Mexico

Americans, particularly those living near the Mexican border, now routinely cross to Mexico for medical care. Popular specialties include dentistry and plastic surgery.

Mexican dentists often charge one-fifth to one-fourth of US prices, US doctors point out that the Mexican legal system makes it almost impossible to sue Mexican doctors for malpractice.

However, many who travel to Mexico for care report that they are satisfied.

Panama

In Panama, health and medical tourism is growing rapidly. Factors drawing medical tourists include Panama's tourist appeal, position as a hub for international travel, and use of the American dollar as the official currency.

Many of Panama’s doctors are bilingual, board certified, and accustomed to working with the same medical equipment and technology used in the United States and Europe.

On most procedures, Panama offers savings of more than 50% compared to the US and Europe. the same McKinsey study estimated that 750,000 American medical tourists traveled from the United States to other countries in 2007 (up from 500,000 in 2006).

The availability of advanced medical technology and sophisticated training of physicians are cited as driving motivators for growth in foreigners traveling to the U.S. for medical care. Many of these organizations offer service coordinators to assist international patients with arrangements for medical care, accommodations, finances and transportation including air ambulance services.

Many locations in the US that offer medical care comparable in price to foreign medical facilities are not Joint Commission Accredited.

Uruguay

Uruguay recently entered the medical tourism market. A private medical tourism initiative, Uruhealth, has been created with support from the Ministries of Tourism and Public Health.

The initiative involves the infrastructure, human resources and experience of two healthcare companies: MP Personalized Medicine (Montevideo) and SEMM-Mautone Hospital (Punta del Este).

Asia/Pacific

Many Asian Pacific countries are medical tourism destinations.

China

China is fast emerging as a desirable destination for individuals seeking medical care in a wide range of medical specialties, including cardiology, neurology, orthopedics and others.

A number of private and government hospitals in major cities have established international departments.

Many leading hospitals provide treatments integrating Traditional Chinese Medicine with Western medical technology and techniques.

China is home to leading stem cell research and treatment hospitals that offer Westerners who want to take advantage of stem cell treatments that are still considered experimental or have yet to be approved in their home country..

Hong Kong

As of 2006, Hong Kong had 12 private hospitals and 39 public hospitals, providing 3,124 and 27,755 beds respectively. A wide range of health care services are offered.

All 12 of Hong Kong's private hospitals have been surveyed and accredited by the UK's Trent Accreditation Scheme since early 2001.

This has been a major factor in the ascent of standards in Hong Kong's private hospitals. The Trent scheme works closely with the hospitals it assesses to generate standards appropriate to the locality (with respect to culture, geography, public health, primary care interfaces etc.), and always uses combinations of UK-sourced and Hong Kong-sourced surveyors.

Some of Hong Kong's private hospitals have now gone on to obtain dual international accreditation, with both Trent and JCI (and have therefore attained a standard surpassing some of the best hospitals in Thailand and Singapore).

Others are looking towards dual international accreditation with Trent and the Australian group.

Hong Kong public hospitals have yet to commit to external accreditation.

India

India’s medical tourism sector is expected to experience an annual growth rate of 30%, making it a Rs. 9,500-crore industry by 2015.

Estimates of the value of medical tourism to India go as high as $2 billion a year by 2012.

Advantages for medical tourists include reduced costs, the availability of latest medical technologies and a growing compliance on international quality standards, as well as the fact that foreigners are not likely to face a language barrier in India.

The Indian government is taking steps to address infrastructure issues that hinder the country's growth in medical tourism.

Most estimates claim treatment costs in India start at around a tenth of the price of comparable treatment in America or Britain.

The most popular treatments sought in India by medical tourists are alternative medicine, bone-marrow transplant, cardiac bypass surgery, eye surgery and orthopedic surgery.

India is known in particular for heart surgery, hip resurfacing and other areas of advanced medicine.

Ministry of Tourism India(MoT) is planning to extend its Market Development Assistance (MDA) scheme to cover Joint Commission International (JCI) and National Accreditation Board of Hospitals (NABH) certified hospitals. A policy announcement of this effect is likely soon.

The south Indian city of Chennai is regarded as the healthcare captal of India.

Korea, Republic of

Listed on CNN.com as one of the “hot destinations” for medical tourism, Korea is quickly establishing itself in the field of medical tourism..

However, ''The Korea Times'' reported in a series of articles that Korean hospitals have adopted a discriminatory pricing policy, charging foreigners two to three times more than the full-fee for locals.

The paper revealed that the price disparity in medical fees for foreign patients is extremely high, considering that the difference between the lowest and highest fees for the most-sought-after procedures exceeds more than 10 times on average.

It claims the government is overlooking soaring medical fees on foreign patients, who are unprotected from malpractice, discriminatory charging, overpricing and patient privacy rights under the Korean Medical Law.

In 2008, Korea had 27,480 foreign-based patients and the Korean health ministry expects that number to increase to 140,000 by 2015.

Due to legislation passed in May 2009, state-licensed clinics and hospitals are now allowed to directly seek out foreign patients through various promotional activities.

Korean hospitals and clinics provide a variety of medical services for medical tourists including comprehensive health screening, cancer treatment, organ transplantation, joint/rheumatism care, spinal treatment, ophthalmology, dental care, infertility treatment, otorhinolaryngology, and Korean traditional medicine.

Currently, the most popular treatments for medical tourists are cosmetic procedures such as eyelid surgery, nose jobs, facelifts, and skin lightening. However, while Malaysia has a national accreditation healthcare scheme (MSQH) and many Malaysia's hospitals are currently firmly on the way to achieve international healthcare accreditation.

Malaysian hospitals International Specialist Eye Centre, Penang Adventist Hospital and many others such as Gleneagles Hospital Kuala Lumpur have or are going to be JCI accredited.

The Ministry of Health has launched a medical tourism page with medical tourism portals such as Wellness Visit.

New Zealand

New Zealand is a relatively new destination to medical travel. It has all the hallmarks of a very successful destination especially for North American based patients.

This includes being a first world, developed economy with a sophisticated and comprehensive medical system. It is first and foremost English speaking with a rich heritage of producing world class doctors and medical research.

Many of its private hospitals are internationally accredited, state of the art and offer an integrated package of care.

The surgeons in New Zealand are trained both in New Zealand and abroad, usually spending years of their training in either North America or Western Europe.

While New Zealand is aligned medically and culturally to North America, the cost of the surgical care is significantly cheaper. On average it is considered that New Zealand’s surgical costs are around 15 to 20% the cost of the same surgical procedure in the USA.

One patient who had his prosthetic hip replaced in New Zealand said the total cost including travel, lodging and the surgery at a private hospital was $20,000, as opposed to the $80,000 - $140,000 he was told the operation would have cost at home.

Added to this the personalized level of medical care, the world renown natural beauty and tranquility, the fact that New Zealand is one of the safest places in the world and only 12 hours direct flight from the west coast of North America, then New Zealand as a medical travel destination looks set to develop.

Pakistan

Pakistan has mentioned its keenness on working towards medical tourism and has considered it as a key element in its recent tourism policy.

Despite suffering several setbacks, due to insecurity and instability in the region, medical tourism in Pakistan has been arranging potential trips for many medical health and care procedures.

A number of modern hospital facilities exist in Islamabad, Karachi and Lahore which are fully equipped and facilitated. Many doctors and surgeons in Pakistani hospitals tend to be foreign qualified.

A number of patients from neighbouring Afghanistan and Iran have traveled to Pakistan for treatment.

Philippines

The Philippines has been growing as a destination for medical tourism. The US Medical Tourism Association magazine reported that this services sub-sector grew 8.0% in 2007.

The number can be expected to grow as American health-care costs rise, or if pending legislation results in an increase in patient wait times for surgical procedures (as has been seen in other countries where care has been nationalized), due to the traditional political, economic and cultural connections between the United States and the Philippines.

The Philippines is one of a few countries that sends qualified nurses, physicians and dentists to the US, the thousands serving in American medical facilities being a testament to its quality of medical education.

According to year 2000 WHO rankings of the world's health systems, the Philippines takes its position on no.60.

Singapore

Singapore has a dozen hospitals and health centers with JCI accreditation. In 1997 (published 2000), the World Health Organization ranked Singapore's health care system sixth best in the world and the highest ranked system in Asia.

"SingaporeMedicine" is a multi-agency government-industry partnership committed to strengthening Singapore's position as a medical hub and promoting Singapore as a destination for advanced patient care.

Patients come from neighboring countries, such as Indonesia and Malaysia, and patient numbers from Indochina, South Asia, the Middle East and Greater China are growing. Patients from developed countries such as the United States and the UK are also beginning to choose Singapore as their medical travel destination for relatively affordable health care services in a clean cosmopolitan city.

Taiwan

The Taiwanese government has declared its determination for the country to become a medical tourism center.

In 2007, the Department of Health launched a campaign to promote inbound medical tourism, focusing on integrating the resources of the government and academia to build Taiwan's brand as a medical tourism destination.

Costs for procedures remain comparatively low. Taiwan is known for liver transplants, joint replacement surgery, bone marrow transplants, and reconstructive and plastic surgery.

Thailand

Medical tourism has been a growing segment of Thailand's tourism and health-care sectors. In 2005, one Bangkok hospital took in 150,000 treatment seekers from abroad. In 2006, medical tourism was projected to earn the country 36.4 billion baht.

Treatments for medical tourists in Thailand range from cosmetic, organ transplants, cardiac, and orthopaedic treatments to dental and cardiac surgeries.

Treatments also include spa, physical and mental therapies. One patient who had coronary artery bypass surgery at Bumrungrad International hospital in Bangkok said the operation cost him US$12,000 (8,200 euros), as opposed to the $100,000 (68,000 euros) he estimated the operation would have cost him at home.

Bumrungrad treated approximately 55,000 American patients in 2005 alone, a 30% increase from the previous year.

Hospitals in Thailand are a popular destination for other Asians. Bangkok Hospital, which caters to medical tourists, has a Japanese wing, and Phyathai Hospitals Group has interpreters for over 22 languages, besides the English-speaking medical staff. When Nepal Prime Minister Girija Prasad Koirala needed medical care in 2006, he went to Bangkok.

Many Thai physicians hold US or UK professional certification. Bumrungrad International hospital states that many of its doctors and staff are trained in the UK, Europe and the US. Bumrungrad International was accredited most recently in 2005 by the Joint Commission.

Some of the country’s major hospitals have also achieved certification by the International Organization for Standardization’s ISO 9001:2000. However, ISO 2000 is not an accreditation scheme.

The World Health Organization's 2000 ranking put the Thai healthcare system at number 47, below the USA's ranking at 37 and the United Kingdom's ranking at 18.

Serious political problems during late 2008, including mass demonstrations and the complete closure of major airports, have made travel to Thailand less appealing than in the past, and the US State Department has issued a travel alert for the country.

Europe

Countries in Europe that have active medical tourism sectors include Turkey, Cyprus, Germany, Hungary, Lithuania, Malta, Poland, Portugal, Czech Republic, Slovakia, Spain, and Ukraine.

Czech Republic

Czech Republic has built its medical tourism on spas and medical care equaling the world standards (for example Ostrava University Hospital).

Germany

Germany is a destination for patients seeking advanced medical technology, high standards, safety, and quick treatment.

All German citizens have health coverage, resulting in a high hospital density, with twice as many hospitals per capita as the United States. The high hospital density results in shorter waiting lists for treatment.

Costs for medical treatment compete well with other developed European countries and are commonly 50% of those in the USA.

Germany is an attractive destination for patients from the Middle East since traveling to the USA has become more difficult for them since the September 11 attacks.

US citizens sometimes travel to Germany to seek treatments such as artificial cervical disc replacement that are not US Food and Drug Administration (FDA) approved.

Poland

Since 2004, when Poland joined the European Union, it has become another locale for people seeking cheaper medical treatments. The quality of care in Poland must comply with EU standards.

Turkey

Turkey has since many years attracted medical tourists from Europe and the Balkans, the United States, Eurasia and the Middle East.

The Turkish private healthcare system is striving to become a strategic global health service provider manufacturing center. Web site www.healthinturkey.org has been established by the DEİK-Foreign Economic Relations Board of Turkey Healthcare Committee and the Accredited Hospitals Association of Turkey.

The site contains information on prices and hospital statistics, information about the healthcare, pharmaceutical and insurance environments as well as an international patient guide.

Turkey has the highest number of JCI accredited healthcare institutions in the world except for the US.

The German Hospital in Istanbul operates the country's first ISO-certified IVF center, while Memorial Hospital was the first private hospital to receive American JCI accreditation.

Since then, over 34 hospitals and medical institutions have achieved Joint Commission International accreditation.