MINOR PROJECT

REPORT
ON

MEDICAL TOURISM
A Global Perspective

GUIDED BY:

SUBMITTED BY:

Mrs. SHAVITA

MUKUL ARORA
02814905012
BBA(TTM) 3RD SEM
Ist SHIFT
MAHARAJA SURAJMAL INSTITUTE
RECOGNISED BY UGC, U/S 2(F)

C-4, JANAKPURI, NEW DELHI-110058

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GUIDES CERTIFICATE

I have the pleasure to certify that Mukul Arora student of Maharaja Surajmal Institute
has pursued his research work and prepared MEDICAL TOURISM :A Global
Perspective under my supervision and guidance.

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ACKNOWLEDGEMENT
The study was conducted by the assistance of several individuals. We really appreciate
their help and hereby thank them. We would like to give special thanks to the following
people:
Firstly, I would like to thank Mrs. Shavita, who had supervised the study and was in
charge of the entire project. Her presence and assistant was remarkable and so I am
grateful to her.
Secondly, I would like to thank all other people who provided me with the resources to
conduct my study. Their help and assistance was very valuable and so I would like to
acknowledge them as well.
Overall all the above mentioned people had a great role in my study. Their direct and
indirect help indeed proved to be help.

MUKUL ARORA
02814905012
BBA(TTM) Ist SEM
Ist SHIFT

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DECLERARATION
I, MUKUL ARORA, REG NO- 02814905012 BBA, from MAHARAJA
SURAJMAL INSTITUTE hereby declares that this project report entitled
Medical Tourism: A Global Perspective, has been prepared by me
during academic session (2012-2015) under the guidance of my project
guide Mrs. SHAVITA.
I also declare that this project is result of my effort and has not been
submitted for award of any degree. All the details and analysis provided in
this project is true to the best of my knowledge.

Date:
MUKUL ARORA

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CONTENTS
Chapters

Particulars

Chapter 1

Introduction to the research topic

Chapter 2

Chapter 3

Chapter4

Page no.

Overview

Abstract

Literature review

Objectives

10

Research Methodology

10

Limitations

10

Profile

11

Getting to know Medical Tourism

11

Top Treatments and Destinations

14

Medical Tourism And Global Economy

19

Medical Tourism Association

21

Medical Tourism in Top 10 Countries

26

Data Analysis & Interpretation

57

Outbound & Inbound Medical Tourism

57

Cost comparison charts

58

Conclusion & Summary

60

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Chapter-1
INTRODUCTION

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OVERVIEW
Tourism is travel for recreational, leisure, or business purposes. The World Tourism
Organization defines tourists as people "traveling to and staying in places outside their
usual environment for not more than one consecutive year for leisure, business and other
purposes".
Tourism has become a popular global leisure activity. After slowly recovering from the
contraction resulting from the late-2000s recession, where tourism suffered a strong
slowdown from the second half of 2008 through the end of 2009, and the outbreak of the
H1N1 influenza virus,international tourist arrivals surpassed the milestone 1 billion
tourists globally for first time in history in 2012. International tourism receipts (the travel
item of the balance of payments) grew to US$1.03 trillion (740 billion) in 2011,
corresponding to an increase in real terms of 3.8% from 2010. In 2012, China became the
largest spender in international tourism globally with US$102 billion, surpassing
Germany and United States. China and emerging markets significantly increase their
spending over the past decade, with Russia and Brazil as noteworthy examples.
Tourism is important, and in some cases, vital for many countries. It was recognized in
the Manila Declaration on World Tourism of 1980 as "an activity essential to the life of
nations because of its direct effects on the social, cultural, educational, and economic
sectors of national societies and on their international relations." Tourism brings in large
amounts of income in payment for goods and services available, accounting for 30% of
the world's exports of services, and 6% of overall exports of goods and services. It also
creates opportunities for employment in the service sector of the economy, associated
with tourism. These service industries include transportation services, such as airlines,
cruise ships, and taxicabs; hospitality services, such as accommodations, including hotels
and resorts; and entertainment venues, such as amusement parks, casinos, shopping
malls, music venues, and theatres.

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Main Types of Tourism:

Adventure Tourism

Archeological Tourism

Channel Hopping

Rural Tourism

Medical Tourism

Heritage Tourism

Sports Tourism

Wildlife Tourism

Safari

Music Tourism

Water Tourism

Medical tourism (MT) is patient movement from highly developed nations to other areas
of the world for medical care, usually to find treatment at a lower cost. Medical tourism is
different from the traditional model of international medical travel where patients
generally journey from less developed nations to major medical centers in highly
developed countries for medical treatment that is unavailable in their own communities.
Services typically sought by travelers include elective procedures as well as complex
specialized surgeries such as joint replacement (knee/hip), cardiac surgery, dental
surgery, and cosmetic surgeries. Individuals with rare genetic disorders may travel to
another country where treatment of these conditions is better understood. However,
virtually every type of health care, including psychiatry, alternative treatments,
convalescent care and even burial services are available.
Over 50 countries have identified medical tourism as a national industry.

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ABSTRACT
Medical tourism is turning out to be a profitable business opportunity for many countries.
It is estimated that the general medical tourism market wealth is US $ 40 billion with an
annual growth rate of 20 percent according to the General Agreement on Trade in
Services (GATS). Asia gradually turns out to be a popular destination for medical
tourism. The paper focuses on the medical tourism development in Asia by starting with a
brief description of the history and development of medical tourism. The paper then
continues to analyze the reasons for conducting medical tourism. The paper also
summarizes the Economics issues of medical services in the major medical tourism
destinations in Asia and then further discusses the opportunities and challenges of
medical tourism industry.
Keywords: medical tourism, Asia, reasons for travel, opportunity, challenges

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LITERATURE REVIEW
The analysis of medical tourism in academic and policy literature is generally limited to
two streams. Some studies, such as Milstein and Smith (2006), Wachter (2006) and Ernst
(2006), consider medical tourism from the perspective of the foreign patients (mostly
from the United States), focusing particularly on issues of safety. Others, such as Mattoo
and Rathindran (2005), Teh and Chu (2005), and Mckinsey & Company (2002) that
examine the impact of medical tourism on the host economies focus mainly on the
income effect. For researches from the perspective of the foreign patients, Tse and Wilton
(1988) created a model in which consumer dissatisfaction is a function of the actual
performance regardless of consumers expectations. This model is effective when
customers do not know or do not have enough knowledge about service performance, and
only their actual experiences are evaluated to assess their satisfaction.
The general purpose of tourism is supposed to be relaxing, have fun, and to increase
ones well-being. The old idea of achieving better health while on holiday through
exercise, spa, and relaxation has been taken into a new level with the emergence of new
and distinct niche in the tourism industry: medical tourism. Medical tourism refers to the
concept of individual traveling, most of the time long distance, to access health
treatments not available in ones own country of origin due to the high cost, limited
health care capacity, or the long waiting list (Burkett, 2007). Although the idea of medical
tourism in its present form is new, medical travel is thousands of years old. One of the
historical records dates back thousands of years ago when people used to travel from the
Mediterranean to small land in the Saronic Golf to visit the sanctuary of the healing God
where they can relax in the water, enjoy the wine, and travel within the territory. Europe
has long history of medical tourism, going back to the healing water of the spas, where
mineral water offered some cures for most of the diseases. During the
Romanian period, patients used to visit the water at a Shrine Bath, a practice that lives
until today (Connell, 2006). Medical tourism develops over time. In 1970, medical travel

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consisted of rich people who traveled from developing countries to developed ones, like
the United States, United Kingdom, and France, to receive specialized medical cures.
During this era the main motivation of the medical travel is to receive better treatment.
The cost of those cures was expensive. At the end of 1980s and early 1990s, medical
tourism started its development into its current form when Cuba started to promote the
medical treatment targeting countries such Mexico, Argentina and Chili (Sobo, 2009).
Cuba is considered one of the first countries to make a huge transformation in the idea of
medical travel by providing a wide set of affordable medical services. During the period
1997-1999 the health services industry earned Cuba more than US $30 million. Medical
tourism is turning out to be a profitable business opportunity for many countries. It is
estimated that the general medical tourism market wealth is US $ 40 billion with an
annual growth rate of 20 percent. The International Trade commission in Geneva says
that the medical return could grow to a US$ 118 Billion by 2013(Vijava, 2010)

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Objectives of the study

Gathering information about Medical Tourism.

To explain the role of Medical Tourism in Global Economy.

Knowing top treatments for which people go abroad and their top treatments.

Getting to know Medical Tourism Association.

Preparing Cost comparison charts.

Research Methodology
Marketing research is a systematic gathering, recording and analysis of data. During the
course of conducting the study the information was gathered through Secondary source.

Sources of Data
Primary Data

A non-random convenience sampling from different job profile/income group.

Secondary Data

Internet
Magazines
Newspapers
Limitations of the Study

Due to the lack of time, was not able to study all the aspects.

Study is based on Secondary Data.

All the factors were not studied.

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Market research on my topic was not possible.

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Chapter 2-

PROFILE

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MEDICAL TOURISM
The concept of medical tourism is not a new one. The first recorded instance of medical
tourism dates back thousands of years to when Greek pilgrims traveled from all over the
Mediterranean to the small territory in the Saronic Gulf called Epidauria. This territory
was the sanctuary of the healing god Asklepios. Epidauria became the original travel
destination for medical tourism.
Spa towns and sanitariums may be considered an early form of medical tourism. In
eighteenth century England, for example, patients visited spas because they were places
with supposedly health-giving mineral waters, treating diseases from gout to liver
disorders and bronchitis.
Medical tourists can come from anywhere in the First World, including Europe, the
Middle East, Japan, the United States, and Canada. This is because of their large
populations, comparatively high wealth, the high expense of health care or lack of health
care options locally, and increasingly high expectations of their populations with respect
to health care. An authority at the Harvard Business School recently stated that "medical
tourism is promoted much more heavily in the United Kingdom than in the United
States".
A forecast by Deloitte Consulting published in August 2008 projected that medical
tourism originating in the US could jump by a factor of ten over the next decade.
An estimated 750,000 Americans went abroad for health care in 2007, and the report
estimated that a million and a half would seek health care outside the US in 2008. The
growth in medical tourism has the potential to cost US health care providers billions of
dollars in lost revenue.
A large draw to medical travel is convenience and speed. Countries that operate public
health-care systems are often so taxed that it can take considerable time to get non-urgent
medical care. Using Canada as an example, an estimated 782,936 Canadians spent time
on medical waiting lists in 2005, waiting an average of 9.4 weeks. Canada has set
waiting-time benchmarks, e. g. 26 weeks for a hip replacement and 16 weeks
for cataract surgery, for non-urgent medical procedures.

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Additionally, patients are finding that insurance either does not cover orthopedic surgery
(such as knee/hip replacement) or imposes unreasonable restrictions on the choice of the
facility, surgeon, or prosthetics to be used.
Medical tourism for knee/hip replacements has emerged as one of the more widely
accepted procedures because of the lower cost and minimal difficulties associated with
the traveling to/from the surgery.
Colombia provides a knee replacement for about $5,000 USD, including all associated
fees, such as FDA-approved prosthetics and hospital stay-over expenses. However, many
clinics quote prices that are not all inclusive and include only the surgeon fees associated
with the procedure.
According to an article by the University of Delaware publication, UDaily:
Popular medical travel worldwide destinations include: Argentina, Brunei, Cuba,
Colombia, Costa Rica, Hong Kong, Hungary, India, Jordan, Lithuania, Malaysia, The
Philippines, Singapore, South Africa, Thailand, and recently, Saudi Arabia, UAE, South
Korea, Tunisia and New Zealand.
A specialized subset of medical tourism is reproductive tourism and reproductive
outsourcing, which is the practice of traveling abroad to undergo in-vitro fertilization,
surrogate pregnancy and other assisted reproductive technology treatments including
freezing embryos for retro-production.
However, perceptions of medical tourism are not always positive. In places like the US,
which has high standards of quality, medical tourism is viewed as risky.
In some parts of the world, wider political issues can influence where medical tourists
will choose to seek out health care.
Unlike general tourists needing medical attention, medical tourists are people who cross
international borders for the exclusive purpose of obtaining medical services. Medical
tourism has increased in part because of rising health-care costs in developed countries,
cross-border medical training and widespread air travel. The medical tourism industry has
been growing worldwide. It involves about 50 countries in all continents and several
Asian countries are clearly in the lead. In Asia, medical tourism is highest in India,
Singapore and Thailand. These three countries, which combined comprised about 90% of
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the medical tourism market share in Asia in 2008, Thailand provided medical services for
as many as 1.4 million foreign patients, including medical tourists, general tourists and
foreigners working or living in Thailand or its neighboring countries. If we assume that
about 30% of all foreign patients that year were medical tourists a conservative figure
by comparison with the Boston Consulting Groups estimate of 50% in 20064 the total
number would have been about 420000. This was more than in Singapore, formerly
reputed to be the leading Asian medical tourist destination and the medical hub of Asia.
Although medical tourists are still a small fraction of the 1.5 million foreigners who
receive medical care in Thailand, they are the tourist group most likely to affect the
country in a major way. Unlike general tourists and expatriates, medical tourists are
increasing at a rapid pace from almost none to 450000 a year in less than a decade.
Moreover, medical tourists tend to seek more intensive and costly treatments than other
foreign patients, as a result of which their effect on the country is more profound.

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TOP TREATMENTS FOR WHICH PEOPLE GO

ABROAD

Infertility (IVF)
Plastic surgery
Cosmetic dentistry
Laser eye surgery
Organ transplant
Orthopedic surgery
Hair transplantation
Weight loss surgery
Heart surgery

AILMENTS

TOP DESTINATIONS

TOP TREATMENTS

Infertility (IVF)

India

ICSI

United Arab Emirates

Egg Donation

Thailand

Gender Selection

Armenia

PGD

Georgia

Microsort

Jordan

Surrogacy

Lebanon

Israel

Turkey

Cyprus

Russia

Ukraine

Greece

Czech Republic
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Plastic Surgery

Germany

Switzerland

Nigeria

United Kingdom

Spain

USA

Mexico

Colombia

Argentina

Panama
India

Breast Implants

United Arab Emirates

Tummy Tuck

Thailand

Facelift

Singapore

Nose Surgery

Malaysia

Liposuction

Lebanon

Buttock Lift

Turkey

Cyprus

Philippines

South Korea

Bulgaria

Lithuania

Hungary

Tunisia

Belgium

United Kingdom

Spain
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Cosmetic Dentistry

Laser Eye Surgery

Morocco

Dominican Republic

Brazil

Mexico

Colombia

Argentina

Panama
Oman

Dental Implants

United Arab Emirates

Dental Crowns

Thailand

Dental Veneers

Lebanon

Dentures

Turkey

Dental Bridges

Cyprus

Bone Graft

Egypt

Philippines

Bulgaria

Romania

Greece

Hungary

Croatia

Malta

Tunisia

Spain

Morocco

Dominican Republic

Mexico
Turkey

Lasik

Germany

Cataracts Surgery
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Organ Transplant

Weight Loss Surgery

Tunisia

Cornea Transplant

United Kingdom

Intralase Wavefront

Spain

Detached Retina Surgery

Mexico

Intralase Lasik

Turkey

Kidney Transplant

Liver Transplant

Bone Marrow Transplant

Gastric Bypass Surgery

Turkey
Dominican Republic
Mexico

Heart Surgery

(GBP)

Gastric Balloon

Gastric Banding

Lap Band Fills

Sleeve Gastrectomy

Duodenal Switch

Turkey

Coronary Angiography

USA

Angioplasty PTCA

Mexico

Angioplasty PTCA With

Intracoronary

Orthopedic Surgery

India

Aortic Valve Surgery

Pacemaker Surgery

Heart Bypass Surgery

Hip Replacement
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Hair Transplantation

United Arab Emirates

Knee Replacement

Turkey

Hip Resurfacing

Bulgaria

Carpal Tunnel Surgery

Tunisia

Elbow Anthroscopy

Spain

Hand Anthroscopy

Mexico

Thailand

FUT

Turkey

FUE

Philippines

Tunisia

Belgium

United Kingdom

Dominican Republic

Brazil

Mexico

Hair Loss Surgery For

Women

Strip Surgery Scar

Repair

Eyebrow Transplant
Beard Hair Transplant

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MEDICAL TOURISM AND GLOBAL ECONOMY

Every year, about 7 million people grab their passports and fly abroad looking for quality,
affordable medical care everything from dental work to weight-loss surgery to cancer
treatment. That's fuelling an industry worth as much as $40 billion, according to Patients
Beyond Borders, a publisher of international medical travel guidebooks. Here are the top
destinations for medical tourism:

Thailand
Long known for sex-change procedures, Thailand offers some of the world's best values
for a variety of health care. Major procedures can be 50-70% cheaper there than in the
US, and the country had as many as 1.2 million medical tourists last year, making it the
top destination.

Mexico
Mexico now attracts more than 1 million visiting patients, many of whom are Hispanics
from the US, according to Patients Beyond Borders. Dental work and weight-loss surgery
are popular procedures.

United States
The US, home to some of the world's top medical specialists, played host to as many as
800,000 international patients seeking help with the most diffi cult health conditions,
according to Patients Beyond Borders. Despite its high prices, the country's world-class
care for the hardest-to-treat cases made the US the third-most visited country for medical
tourists last year.

Singapore
The city state has one of the most sophisticated health care systems in the world,
especially for cancer treatment. As many as 610,000 medical tourists visited the country
in 2012, mostly from Indonesia. That makes the country the fourth-most visited place for
medical tourists. Singapore has 22 facilities certified by Joint Commission International,
the US-based quality and safety accrediting organisation. That's 14 more than all of
neighboring Malaysia.
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India
As many as 400,000 foreigners travelled to India in 2012 for health treatments, making it
the fifth most-visited country for medical tourists. High-diffi culty operations such as
coronary artery bypass graft surgery can be 90% less expensive in India than in the US.

Brazil
Brazil is one of the leading places for plastic surgery with more than 4,500 licensed
cosmetic surgeons. The country hosted about 180,000 medical tourists in 2012, making it
the sixth most-popular destination. A nose job can be had for about 60% less than the cost
of the procedure in the US; there's even plastic surgery available for your pet.

Turkey
Some 110,000 foreigners visited Turkey in 2012 for medical treatment. The country,
which has more American-accredited hospitals than any other nation, attracts many
foreigners seeking inexpensive eye check-ups and surgery. A major procedure such as
spinal fusion can be 60% cheaper than in the US.

Taiwan
Taiwan's health care facilities adhere to some of the highest standards in the world, which
helped it attract 90,000 medical tourists in 2012. Taiwan has 22 health care facilities
certified by Joint Commission International - that's only 6 fewer than all of China. Major
procedures such as a full facelift can be more than 50% cheaper in Taiwan than in the US.

MEDICAL TOURISM ASSOCIATION

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The Medical Tourism Association is a Global Non-profit association for the Medical
Tourism and International Patient Industry. The MTA works with healthcare providers,
governments, insurance companies, employers and other buyers of healthcare - in their
medical tourism, international patient, and healthcare initiatives - with a focus on
providing the highest quality transparent healthcare. The MTA is also committed to
raising consumer awareness of international healthcare options, and has specific
initiatives designed to educate and increase the number of consumers who travel for
healthcare. The MTA is also committed to educating consumers about their options
internationally for medical treatment. You can learn more about these initiatives below.

Education and Training

The MTA offers educational training, certification, and other brand-development
programs to hospitals, healthcare providers, and governments who actively work towards
developing a sustainable medical tourism program and increasing patient volume.

What is Medical Tourism Association ?

The Medical Tourism Association also referred to as Medical Travel Association, is the
first membership based international non-profit trade association for the medical tourism
and global healthcare industry made up of the top international hospitals, healthcare
providers, medical travel facilitators, insurance companies, and other affiliated companies
and members with the common goal of promoting the highest level of quality of
healthcare to patients in a global environment. Our Association promotes the interests of
its healthcare provider and medical tourism facilitator members. The Medical Tourism
Association has three tenets: Transparency in Quality and Pricing, Communication
and Education.

Transparency
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The Medical Tourism Association seeks to provide transparency in both quality of care
and pricing. Every day we see more and more that the globalization of healthcare has
created a very flat world. We exchange technology, information, communication,
physicians and patients. In order to ensure patient safety, it is our goal to create a
transparency about the quality of healthcare that can be found in each country. With this,
it is increasingly important to create a transparency in pricing as well so patients traveling
overseas for care can be sure of what they are receiving without hidden costs or
unforeseen expenses. The Medical Tourism Association is also working on the Quality
of Care Project, which will change the way we look at the reporting of global healthcare
statistics and the quality of care available at hospitals around the world.

Communication
The Members of the Medical Tourism Association agree that communication is the key
to success, particularly with respect to ensuring positive patient outcomes. The members
of the Medical Tourism Association have agreed to put competition aside and work
together to resolve the issues one by one and to work together to address them as they
arise. We have created a forum for communication for all of the actors in the global
healthcare environment.

Education
Although we live in a world where information is at our fingertips, there are so many
people who lack the information that they can receive the highest quality of care outside
of their home country. Some patients in countries like the United States, Canada, and the
United Kingdom have a lack of access to healthcare due to high cost and high wait times.
Patients in some other regions as in some parts of Africa and the Middle East do not have
access to high quality of care in their own country and need to look elsewhere. Some
patients just would like to travel outside of their country for healthcare to incorporate
high quality of care with a holiday and tourism. Regardless of the reason, patients need
education and information to understand what they should look for in finding a provider
overseas and considerations that should be taken seriously to ensure patients' safety. As
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insurance companies continue to incorporate global healthcare and medical tourism

options into their benefit plans and domestic healthcare providers are required to treat
patients for aftercare when patients return to their home country, education is required to
accomplish this seamlessly. The Medical Tourism Association strives to provide
education to anyone with any interest in this industry using various means: the media,
conferences, and through the Medical Tourism Magazine and Health Tourism Magazine.
The Medical Tourism Magazine and the Health Tourism Magazine are bi-monthly
medical tourism and health tourism trade journals aimed at providing a wealth of
information for anyone interested in or affected by the globalization of healthcare.

Mission

To raise awareness of the high level of quality healthcare available in various

countries.

To promote positive and stable growth of the Medical Tourism and Global
Healthcare Industry with a strong focus on Transparency and Communication.

To provide an unbiased source of information for patients, insurance companies

and employers about top hospitals, their quality of care and outcomes.

To protect the reputation of Medical Tourism from disreputable hospitals,

healthcare providers and medical tourism facilitators which may not have the
same level of quality healthcare and standards.

To serve as one voice for purposes of dealing with government organizations and
the media to protect the reputation of the Medical Tourism Association's
members.

To promote and provide a forum for communication and to increase connectivity

between patients, healthcare providers, and insurance companies.

To seek out future affiliated industries and technologies that will allow
international healthcare providers to operate more efficiently in the global
healthcare industry.

To educate patients, insurance companies, agents, brokers, consultants and

physicians from around the world about the growth of medical tourism and the
globalization of healthcare.
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Non-Profit Status
The Medical Tourism Association is an international non-profit organization which has
been designated for 501(C)(6) status by the Internal Revenue of the United States
Government. Section 501(c)(6) of the Internal Revenue Code provides for the exemption
of business leagues, which are not organized for profit and no part of the net earnings of
which inures to the benefit of any private shareholder or individual. The Medical Tourism
Association does not have shareholders or investors.
The MTA believes in transparency. As a non-profit, the MTA regularly files an annual
report

and

990

Tax

Return

with

the

US

Internal

Revenue

Service.

Medical Tourism Association Educate

The Medical Tourism Association focuses on education. The Medical Tourism
Magazine is a bi-monthly journal that is free for anyone wishing to receive a subscription
electronically. The revenues received through advertising are used to support the cost of
producing the magazine and for increasing the printed distribution. Other magazines and
newsletters have been created specifically to generate profits for private corporations and
do not represent the industry or the interests of the industry.
Members of the Medical Tourism Association speak internationally at conferences and
other venues to educate about the issues involved in the globalization of healthcare. This
includes speaking engagements for physician groups, employer groups, consulting firms,
insurance agents and brokers, and governmental organizations. Medical Tourism
Association regularly consults foreign governments about the growth of the industry in
other countries, the opportunities created through marketing and the benefits of ultimately
improving the quality of care within their national borders.

Impact of Medical Tourism Association on the Private and

Public Sector

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Many people believe medical tourism is a new phenomenon. This is just not true. People
have been traveling outside of their borders for decades. The potential for this growing
trend towards globalization is not designed to improve just the private sector. Raising the
quality of care internationally in the private sector can have extremely positive effects on
the public sector as well. The Medical Tourism Association connects hospitals and
countries with accreditation systems making the highest level of technology and
healthcare information available to people from around the world in both the private and
public sector.

The Medical Tourism Association has offices in the following

locations:

Florida, United States (Headquarters)

Georgia, Eastern Europe

United Kingdom

Dubai, United Arab Emirates

South Korea

Argentina

Greece

China

Brazil

Turkey

Costa Rica

Azerbaijan

Bermuda

Israel

Top 10 Countries for Medical Tourism

Brazil
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Costa Rica

Hungary

India

Malaysia

Mexico

Singapore

South Korea

Thailand

Turkey

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MEDICAL TOURISM IN BRAZIL

Tourists traveling for medical reasons spend between 40 and 60 billion dollars a year
and the market is growing around 20 percent a year. Brazil receives about 50 thousand
medical travelers a year from different parts of the worldmostly from neighboring
Latin American countries like Ecuador, Bolivia and Uruguay and mostly for cosmetic
surgery.
Reporter: Foreign patients who come to Brazil for treatment can be roughly divided into
two groups. There are those from rich countries mainly Europeans and North
Americans who come here because medical procedures are cheaper and there are those
from poor and developing nations, from Latin America and Africa, who come because of
the

top

quality

hospitals

that

exist

here

for

those

who

can

pay.

Currently Brazil has 25 hospitals accredited by the Joint Commission Internationalan

organization that certifies the quality of medical services worldwide. So Paulo is the
most sought after destination.
Bernardo Ignarra, So Paulo Turismo S.A., said, We have an occupancy rate between
80% and 100% in the eight JCI accredited hospitals of So Paulo. So this is actually
something that has to be sorted this health system needs to be expanded if we are to
grow in medical tourism. But we now these hospitals are planning to invest about one
billion dollars over the next two years to expand their facilities and services.
Brazil is still far from able to provide quality health care for most of its people, but in yet
another reminder of this countrys stark income inequality, Brazil has become a popular
destination for wealthy foreigners looking for good medical services.
Medical tourism (MT) is patient movement from highly developed nations to other areas
of the world for medical care, usually to find treatment at a lower cost. Medical tourism is
different from the traditional model of international medical travel where patients
generally journey from less developed nations to major medical centers in highly
developed countries for medical treatment that is unavailable in their own communities.
Services typically sought by travelers include elective procedures as well as complex
specialized

surgeries such

as joint

replacement (knee/hip), cardiac

surgery, dental

surgery, and cosmetic surgeries. Individuals with rare genetic disorders may travel to
another country where treatment of these conditions is better understood. However,
31 | P a g e

virtually every type of health care, including psychiatry, alternative treatments,

convalescent care and even burial services are available. Over 50 countries have
identified medical tourism as a national industry

COSMETIC SURGERY TOURISM IN BRAZIL

Brazil has the dubious honor of being the only country in the world to have a cosmetic
surgery procedure named after it. The Brazilian Butt Lift involves lifting and reshaping
the buttocks, often by sucking out fat from around the abdomen, flank and back areas and
injecting it back into the buttocks to create firmer, more voluminous cheeks known as a
bubble butt.

Cosmetic surgery in progress, photo courtesy of Michael Boeckle at Cosmetic Vacations.

Plastic surgery is a multi-billion dollar industry here in Brazil, and Rios obsession with
the body beautiful makes it a mecca for those in pursuit of perfection.
Medical tourism is the term coined by the media and travel industry to describe the act of
crossing international borders to obtain medical care. The concept is not a new one; spa
towns, sanatoriums and even some types of pilgrimage can be thought of as early forms
of medical tourism.
But while the pursuit of optimum treatment was once the primary motivation for
voyaging to find healthcare, todays cosmetic tourism is more often chiefly motivated by
financial incentives, with tourists traveling to the developing world to take advantage of
favorable exchange rates.
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Figures suggest that cosmetic surgery tourists in Brazil can make savings of between
thirty and fifty percent off prices in the U.S. for the same procedures. One woman said, I
could never afford all the procedures I want done back home in the States, but seeing the
prices here gives me hope.
However, price is not the only motivator she continues, What makes Brazil stand out
from the crowd is its reputation when I first came here I was worried about whether or
not to bring sterile needles! But even though its a developing country, they have great
facilities and some amazing surgeons.

The Doktor Day Hospital, a specialised plastic surgery facility in Barra,

photo courtesy of Michael Boeckle at Cosmetic Vacations.
In fact, Brazil is second only to the U.S. in terms of the proliferation of registered plastic
surgeons and the country has produced a number of world authorities in the field, among
them octogenarianProfessor Ivo Pitanguy. The godfather of Brazilian plastic surgery and
a household name in Brazil, his client list includes Sophia Loren and Gina Lollobrigida.
Statistics indicate that around 50,000 foreigners come to Brazil each year for medical
tourism, many in search of a new face or body. An increasing number of outfitters are
offering foreigners the chance to combine going under the knife with a break away from
home, emphasizing the lower prices, tropical climate, and the lure of post-op anonymity.
Cosmetic Vacations and MedNetBrazil are organizations which aim to take the worry out
of going under the knife abroad. Both companies offer packages which include
multilingual staff, in-country support, luxurious lodgings and hand-picked surgeons.

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However, for those of us whom travel plans stop short of going under the knife, Pello
Menos offers a smorgasbord of waxing options at eight different salons in the Zona Sul
where you can experience something of the pain and transformation of a medical
vacation without the permanency and frightening side-effects. Prices range from R$13 to
R$37 for the infamous Brazilian bikini wax.

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MEDICAL TOURISM IN COSTA RICA

Rising healthcare costs in the 1980s and 1990s lead patients to look overseas for more
affordable options. The close proximity and high standard of care in Costa Rica began to
attract medical tourists, especially for dental work. During this period, Americans began
traveling to Central America to get dental work that was not covered by their insurance or
that they could not afford.
Costa Ricas medical tourism industry continued to grow. Today, Costa Rica is one of the
most reliable, affordable and efficient countries for medical procedures. In 2011, San
Jos, the capital of Costa Rica, registered 46,474 foreign patients. The number of medical
tourists in Costa Rica is expected to continue rising. Nearly one-quarter of Americans
now have passports and flights to Central America are more affordable than ever.
Costa Rica has high-quality doctors and dentists, many of whom were trained in the U.S.
and are fluent in English. Although there are dentists and doctors throughout Costa Rica,
the majority of procedures are carried out in San Jos. San Jos has the countrys best
clinics and hospitals, including the CIMA, Catlica and Bblica hospitals.
The doctors on sites like HuliHealth a service that allows you to search for, review and
book doctors online are board certified and recommended by top specialists. This
allows potential patients to be confident that they will receive superior care.

TYPES OF PROCEDURES
From dental work to cosmetic surgery, there is a wide range of medical procedures
offered in Costa Rica. Weve boiled down some of the most common and listed them
here.
The specialties most sought by medical tourists include dentistry (42%), gynecology
(22%), preventive medicine (16%), plastic surgery (10%), orthopedics, and bariatrics.
Other specialties include general surgery and dermatology.
The following list compiles the most common specialties and procedures.
Dentists: implants, crowns, veneers, bridges, dentures
Plastic surgeons: plastic surgery, reconstructive surgery
General surgeons: gastric bypass, gastric sleeve
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 Orthopedic surgeons: hip, knee, and shoulder replacements

Dermatologists: laser removals, Botox
Costa Ricas doctors and dentists offer a number of other procedures.

SAVINGS AND COSTS

One of the best things about traveling to Costa Rica for medical care is that you save
money without cutting quality. On average, medical tourists save 40-70 percent by
getting a procedure done in Costa Rica. For example, a dental crown in the U.S. typically
costs around $1,000, while in Costa Rica it is $500; a dental implant runs around $3,000
in the U.S. and is $900 in Costa Rica. With more serious medical work, the price goes up
and the savings are larger.
The following list will give you an idea of how much some procedures cost.
In addition to the cost of the procedure, there are other costs that should be considered.
Flights from the U.S. or Canada to San Jos typically run around $400-$700 (flying from
Canada is usually more expensive). A mid-range hotel for two people will cost around
$115$140 a night.
In-country transportation costs are extremely variable and depend on if (and where) you
plan to travel after your procedure. If you plan to spend a week in Costa Rica and visit
popular destinations like Arenal, Monteverde or Manuel Antonio, a shared shuttle will
cost around $40 per person. Private transportation is a bit more expensive and is around
$150 for your own van and driver.
Food expenses are usually around $30$50 per person each day. Taking a few tours will
also increase the cost of a trip.
All that said, in most cases it is still more economical to travel to Costa Rica for medical
procedures than it is to have them done at home. In fact, many travelers save hundreds, if
not thousands, of dollars. Travelers often come to Costa Rica for more than one
procedure for example, your dental work might require four dental implants, which can
include crowns, a sinus lift and a bone graft. Some people combine a tummy tuck with a
breast lift, or liposuction with breast implants. The list of potential combinations is huge.

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In addition to saving money, there are other advantages that medical tourists should
consider.

ADVANTAGES
The second word in the phrase medical tourism is important. Traveling to Costa Rica
for a medical procedure also allows you to explore a foreign land. Costa Rica is a vibrant
country that draws people from around the world. They come to hike in its rainforests,
lounge along its beaches, and relax in its hot springs. It is also a place with more
biodiversity than most everywhere on Earthduring your time here, you may spot
monkeys hanging from trees or herons walking through estuaries.
Costa Ricans, known locally as ticos, are friendly and approachable. They welcome
visitors with a smile and are keenly interested in showing travelers their country. If
youve never practiced Spanish outside a classroom, this is a good place to start. The
people are patient and helpful with those who attempt to speak their language.
Aside from the natural and cultural attractions of Costa Rica, the country has top-notch
recovery facilities and spas. These places offer a comfortable and supportive environment
for patients to recover after a procedure. Many have 24-hour nursing services, allinclusive meal plans, and massage parlors.
The waiting time for medical procedures in Costa Rica is minimal. As opposed to places
like Canada where you may have to wait several months for surgery, procedures in Costa
Rica can be arranged to fit your schedule. The doctors and clinicians are flexible and are
sometimes willing to adjust their schedule to see a foreign patient. HuliHealth has a
convenient feature that allows patients to compare the availability of various doctors and
dentists.
Costa Rica also benefits from medical tourism. In 2011, the average medical tourist to
Costa Rica spent $7,000in total, the industry brought in $337.7 million USD in revenue
that year. Needless to say, this is a huge boon to the Costa Rican economy. Considering
the countrys small size, medical tourism can have a widespread impact. The added
revenue helps build better medical facilities and increases the funding for public services
like schools and hospitals.
Another benefit of medical tourism for Costa Rica is a phenomenon that some have
termed the reverse brain drain. This phrase refers to doctors and dentists who are
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trained at universities in the U.S. or Canada and return home to open a practice and
educate their peers.

MEDICAL TOURISM IN HUNGARY

Hungarian Tourism promotes medical tourism
Hungarian Tourism plc is now actively promoting medical tourism globally, but targeted
mostly

at

Western

Europe.

Hungary is one of the flagship countries of European medical tourism. A quarter of all
medical students at Hungarian universities come from abroad, and many Hungarian
specialists teach and practice internationally. The main reasons for Hungary's leading role
in European medical tourism are long experience and practice in the international market.
The success story began in the eighties, when Hungary was a popular destination for
German and Austrian patients seeking top-quality dentistry and dental prosthetic services
of Swiss standards. Since Hungary joined the European Union, medical tourism has
become

more

varied

and

more

international.

The cost of treatment is between 40% and 70% of the cost in the UK, USA and
Scandinavian countries. The most popular treatments and procedures for international
patients are dentistry, cosmetic surgery, orthopaedic surgery, cardiac rehabilitation,
fertility treatment, dermatology, anti-aging treatment, obesity treatment, addiction
programmes

and

eye

surgery.

Hungary is easily accessed by low-cost flights from all over Europe. It has the lowest
MRSA rates on the continent. Hungary has a number of accreditation and license
schemes applying to its institutions, such as the domestic accreditation schemes from the
Hungarian Ministry of Health, and the National Health Commission and Medical Service.
Several clinics run medical tourism programmes and packages, organising the entire trip
including

flights,

accommodation,

transfers

and

treatments.

There is no age limit by Hungarian law, so even single women can have fertility
treatment, and all sperm donors are anonymous. There is no waiting list for IVF. Most of
the patients have the first initial consultation with the fertility specialist within a month of
first

contact.

The country is trying to get away from its image as purely a dental treatment country, so
is heavily promoting cosmetic surgery, eye treatment, fertility treatment, anti-aging
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treatment,

and

more.

It is not forgetting the important and historic spa, wellness and health tourism angle too.
Linking

with

medical

tourism,

it

is

promoting

medical

spas.

Hungary has more medical spas than anywhere in Europe, A medical spa uses water rich
in minerals that medical tests clearly show has health benefits. Thermal water is any
naturally occurring spring that emerges at a temperature exceeding 30C. Balneotherapy
is the treatment of a medical condition with water from a medicinal spring particularly
water with high concentrations of dissolved minerals and sediment. Balneotherapy is
combined with physiotherapy, electrotherapy and therapeutic massage. This is
complemented by related treatments, including drinking cures and inhalation.
Budapest is a spa capital, and there are many type of spas from historic Turkish and
Roman to medical and party spas. The country sits on one of the richest geothermal and
medicinal water resources in the world. Hungarian springs have supported a bathing
culture dating back to Roman times.

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MEDICAL TOURISM IN INDIA

According to the Confederation of Indian Industries (CII), India is unique as it offers
holistic medicinal services. With yoga, meditation, ayurveda, allopathy, and other
systems of medicines, India offers a unique basket of services to an individual that is
difficult to match by other countries, says CII. Also, clinical outcomes in India are at par
with the worlds best centres, besides having internationally qualified and experienced
specialists. Statistics suggest that the medical tourism industry in India is worth $333
million (Rs 1,450 Crore) while a study by CII-McKinsey estimates that the country could
earn Rs 5,000-10,000 crore by 2012. The study predicts that, "by 2012, if medical
tourism were to reach 25 per cent of revenues of private up-market players, up to Rs
10,000 Crore will be added to the revenues of these players". According to the
Government of India, India's $17-billion-a-year health-care industry could grow 13 per
cent in each of the next six years, boosted by medical tourism, which industry watchers
say is growing at 30 per cent annually. Probably realizing the potential, major corporates
such as the Tatas, Fortis, Max, Wockhardt, Piramal, and the Escorts group have made
significant investments in setting up modern hospitals in major cities. Many have also
designed special packages for patients, including airport pickups, visa assistance and
board and lodging. The health care sector in India has witnessed an enormous growth in
infrastructure in the private and voluntary sector. The private sector, which was very
modest in the early stages, has now become a flourishing industry equipped with the most
modern state-of-the-art technology at its disposal. It is estimated that 75-80% of health
care services and investments in India are now provided by the private sector. An added
plus had been that India has one of the largest pharmaceutical industries in the world. It is
self sufficient in drug production and exports drugs to more than 180 countries. India has
top-notch centres for open-heart surgery, pediatric heart surgery, hip and knee
replacement, cosmetic surgery, dentistry, bone marrow transplants and cancer therapy,
and virtually all of Indias clinics are equipped with the latest electronic and medical
diagnostic equipment. Unlike many of its competitors in medical tourism, India also has
the technological sophistication and infrastructure to maintain its market niche, and
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Indian pharmaceuticals meet the stringent requirements of the U.S. Food and Drug
Administration. Additionally, Indias quality of care is up to American standards, and
some Indian medical centres even provide services that are uncommon elsewhere.
Earlier this month, the insurance company Well Point announced a program that will
allow employees of a Wisconsin printing company to get coverage for non-emergency
surgeries in India. It's a first for Well Point, but puts the insurer in good company. Over
the past few years, some U.S. insurance companies dismayed at losing income from
uninsured Americans who get cheap surgeries abroad or clients who choose to pay out of
pocket for discount foreign surgeries rather than expensive in-network co-pays have
announced plans to include foreign medical procedures among those covered by health
plans.
It's no wonder. The medical tourism industry has experienced massive growth over the
past decade. Experts in the field say as many as 150,000 U.S. citizens underwent medical
treatment abroad in 2006 the majority in Asia and Latin America. That number grew
to an estimated 750,000 in 2007 and could reach as high as 6 million by 2010. Patients
are packing suitcases and boarding planes for everything from face lifts to heart bypasses
to fertility treatments.
People have been traveling for centuries in the name of health, from ancient Greeks and
Egyptians who flocked to hot springs and baths, to 18th and 19th century Europeans and
Americans who journeyed to spas and remote retreats hoping to cure ailments like
tuberculosis. But surgery abroad is a fairly modern phenomenon. As health costs rose in
the 1980s and 1990s, patients looking for affordable options started considering their
options offshore. So-called "tooth tourism" grew quickly, with Americans traveling to
Central American countries like Costa Rica for dental bridges and caps not covered by
their insurance. (A large percentage of today's medical tourism is for dental work, as
much as 40% by some estimates.)

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Health Regulation Of Bureau Of Immigration

(A) For entry into India:Any person, Foreigner or Indian, (excluding infants below six months) arriving by air or
sea without a vaccination certificate of yellow fever will be kept in quarantine isolation
for a period up to 6 days if :

He arrives in India within 6 days of departure/transit from a yellow fever endemic

area.

Has come on a ship which has started from or transited at any port in a yellow
fever endemic country within 30 days of its arrival in India provided such ship has
not been disinfected in accordance with the procedure laid down by WHO.

(B) For leaving India:There is no health check requirement by Indian Government on passengers leaving India.
Persons leaving for a yellow fever infected area are advised in their own interest to get
themselves vaccinated and to be possession of valid yellow fever vaccination certificates
before they leave the country.
An administrative Arrangement for the health control of sea, air and land traffic exists
between the Government of India and the Government of Bangladesh. It implies that ,if
any aircraft or ship or land traffic from a third country arrives first at any airport or port
or border check post in either of the agreement countries and then directly (without
touching any other third country enroute) reaches the second country of the agreement,
all health checks will be completed in the country of first arrival and the travellers will be
exempted from any further health check on arrival in the second country.

Persons exempted from production of vaccination certificate :

The under mentioned persons are exempted from production yellow fever vaccination
certificate:

Infants below the age of six months.

Any person suffering from some chronic illness and has poor resistance and is
thereby exempted from being vaccinated.
42 | P a g e

Crew and passengers of an aircraft transiting through an airport located in yellow

fever infected area provided the Health Officer is satisfied that such persons
remained within the airport premises during the period of stay.

Countries regarded as yellow fever infected

The following countries are regarded as yellow fever endemic :

Africa:
Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad,
Congo, Democratic Republic of Congo (Zaire), Equatorial Guinea, Ethiopia, Gabon,
Gambia, Ghana, Guinea, Guinea Bissau, Ivory Coast (Cote DIvoire), Kenya, Liberia,
Mali, Niger, Nigeria, Rwanda, Senegal, Sierra Leone,Sudan (South of 15 N),Togo,
Uganda and Zambia.

South America:
Argentina, Bolivia, Brazil, Colombia, Ecuador, French Guyana, Guyana, Panama,
Paraguay, Peru, Suriname, Trinidad and Tobago.

A Yellow fever vaccination certificate is valid only if it conforms to the model.

The validity period of international certificate of vaccination or re-vaccination
against yellow fever is 10 years, beginning 10 days after vaccination.

Foreign nationals residing or who have passed through the Yellow fever endemic
countries during the preceding six days, are granted visas only after the
production of vaccination certificate of Yellow Fever. After checking the
vaccination certificate an entry reads as Valid Yellow Fever Vaccination
Certificate Checked is made in the passport of the foreigner.

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MEDICAL TOURISM IN MALAYSIA

The Malaysian tourism industry is a vibrant one. The Malaysian government through its
Ministry of Tourism Malaysia oversees tourism policies and tourism-related activities to
realize its vision of making Malaysia an international tourism destination.
According to the 2010 United Nations World Tourism Organization Report, Malaysia
ranked 9th in international tourist arrivals, welcoming 24.6 million visitors through its
doors. The impact of these efforts resulted in international tourism receipt of RM 56.5
billion in 2010 .
Therefore, in order to complement this achievement, the government plans to diversify
the portfolio of itstourism industry.
Various tourism products introduced by the Ministry of Tourism include education
tourism, sports tourism, rural tourism, agro-tourism, special tourism and medical tourism.

PERFORMANCE OF MEDICAL TOURISM IN MALAYSIA

Medical or Health tourism as it is described in Malaysia is managed by the Ministry of
Health. The vision of the Ministry of Health (MOH) is to develop Malaysia into the
preferred destination of world class health services.
However, the progress of health tourism as in other important sectors begins from the
governments policies on health-related issues.
One of the first steps was the setting up of Malaysian Healthcare Travel Council (MHTC)
under the MOH for the promotion of health tourism in 2009.
This was borne out of the focus of the Ninth Malaysia plan (2006 - 2010) a plan that
aims to position Malaysia as a developed country by 2020.
Thus, the council developed partnerships with the private sector to complement
governments efforts in developing the health sector.
Various private and government hospitals are invited and listed to participate in the health
tourism program after satisfying the MOH criteria.
For example, MOH criteria requires that hospitals must be licensed under the private
healthcare facilities and services Act 1998 and have a valid accreditation awarded by

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National or International body recognized bythe International Society for Quality in

Healthcare (ISQua).
The list of the participating hospitals and detailed criteria is posted on the MOH website.
The number of specialist hospitals and clinics has increased in Malaysia offering a great
variety of treatments including cosmetic and reconstructive surgery, dialysis and
Nephrology, fertility treatments and specialized medical packages for men and women
just to mention a few.
These have resulted in increasing visitors arriving Malaysia for treatments. According to
Deloitte Medical Tourism report 2008, healthcare cost can be as low as 25% of cost of
equivalent treatment in the United States of America.
Other favorable enablers for health tourism in Malaysia include favorable exchange rates,
multicultural and multiracial society, wide range of tourist attractions and world-class
practitioners with high success rates.
Additional strategy that makes Malaysian health tourism attractive includes the visa
extension provision for a health tourist for up to six months.

Future of Malaysian Health tourism and implications for

students
As Malaysia approaches its vision of becoming a developed country by 2020, health
tourism is considered a major driver towards this goal.
Medical tourists are observed to increase steadily in Malaysia due to the
governments promotion of Malaysia as an international healthcare destination resulting
in increased revenues for the country.
Furthermore,

these conditions have

encouraged

private,

local

and

international

participation in Malaysias health tourism sector.

Moreover, hotels and resorts have allied with hospitals to develop special health check
and health tourism related packages to encourage international clients and governments
to visit Malaysia.
Therefore, the Malaysia health tourism sector is poised for increased growth.
45 | P a g e

This has huge implication for students of various disciplines such as medicine,
nursing, hospitality and tourism management and other medical-related fields.
With reduced cost of healthcare in Malaysia, increased competence in medical expertise
and infrastructure and extended visa duration for medical tourist, the students can only
expect increased opportunities topractically demonstrate mastery of their skills after
graduation.
Therefore, students interested in the demanding health tourism industry will focus on
developing additional skills sets more than a passing grade that will provide the
distinction to ensure a place in the increasing Malaysian health tourism industry.
However, the lack of visible, quality and updated data of medical tourists in Malaysian
hospitals remains a challenge.
Unavailability of such data inhibits good planning for the future, allows for inefficient
organization of scarce resources, discourages research and mitigate proper control of the
industry.
Hence, a key recommendation would be for the authorities to develop a system that
provides a more consistent, visible, real time data of medical tourists where such data can
be incorporated into the future planning of the health tourism sector.

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MEDICAL TOURISM IN MEXICO

Mexico has more than a dozen destinations specialized in medical tourism, where
touristic providers join medical care of the highest quality to meet the fields of oncology,
orthopedics, cardiology, general surgery, plastic surgery and gastroenterology.
The International Joint Commission has accredited 7 hospitals in our country. In turn, the
Federal Ministry of Health has provided certification for 105 hospitals, 98 of which are
equivalent to international standards.
Medical Tourism in Mexico is staffed by highly qualified doctors and nurses to provide
care and service with worldwide quality through an extensive infrastructure with cuttingedge medical technology.
Medical checkups, preventive care, specialized surgery and the recovery process of our
tourists, are promoted and monitored with warmth and professionalism of our service
during your entire trip, making your stay comfortable and safe in our country. To
complete the process in optimal conditions, we have the best conditions for total
recovery: different climates by region, from warm to temperate, with healthy and
regulated environments, hotels and touristic destinations internationally recognized for its
diversity and appeal.
At first glance, Medical Tourism and healthcare in Mexico might seem like a similar
model to the United States. In the Mexican healthcare system, private insurance is
available to those who can afford it, while the government takes certain steps to subsidize
healthcare for those citizens who are too poor to afford any comprehensive healthcare of
their own.
However, the similarities end there. While American health care is undoubtedly one of
the worlds most expensive, healthcare in Mexico is wildly cheap in comparison and as a
result Medical Tourism in Mexico has been increasing for years and is a booming growth
industry for Mexico.
But this cheapness doesnt undermine the quality of healthcare in Mexico; in fact, several
world health organizations have rated the healthcare system in Mexico as excellent, with
many California policies even requiring patients to undergo specific health procedures in

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Mexico, where healthcare is cheaper and prescription medications are just pennies on the
dollar.
Additionally, the public healthcare system in Mexico rivals that of those found in
European countries like England and Switzerland. The Mexican constitution guarantees
that all citizens have the right to healthcare, and the federal government subsidizes all or
some of the costs of healthcare, depending on the employment status of the patient in
question.
As you can see, despite what some may think, healthcare in Mexico is among the best in
the world. In this article, well explore how this extraordinary commitment to healthcare
came about, and how both public and private healthcare in Mexico operates today.

THE HISTORY OF HEALTHCARE IN MEXICO

No examination of healthcare in Mexico would be complete without a comprehensive
look as to how this unique system came about. Mexican healthcare first started in the late
1700s, when the first hospital was founded in Guadalajara in 1791. The institution is now
a World Heritage Site, and also boasts some of the best researchers and medical
practitioners in all of Mexico.
Additionally, this institution is the largest of its kind in Mexico and in all of Latin
America, which is an impressive feat considering that the hospital just celebrated its
200th birthday only twenty years ago.
While the rest of the world was knee-deep in World War II, Mexico was undergoing a
major shift in terms of its attitude towards healthcare in its country.
In 1943, the federal government passed IMSS, a Mexican Social Security Institute that
guaranteed full access to public healthcare, social security payments, welfare and other
important societal benefits. As a result, the mortality rates in Mexico plummeted to alltime lows. Suddenly, the Mexican population had undue access to the kind of social
programs that allowed them to enjoy longer lives, better health and more access to a
better public education system.
In the 1990s, as part of a legislative overhaul that had lasting beneficial repercussions on
education, welfare and healthcare in Mexico, the federal government rolled out several
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policies that allowed it to subsidize healthcare for all Mexican citizens. This meant that
citizens who could not afford access to Mexican private insurance (which operates on a
free market basis, like in the United States) could enjoy free healthcare depending on
their employment status.
For example, if a Mexican citizen is unemployed, all of their healthcare costs are
subsidized; if a citizen makes just about the official poverty level, a majority of
healthcare is subsidized. Even wealthier citizens who enjoy private health insurance can
enjoy health benefits that are subsidized in part by the Mexican federal government.
If you believe that this kind of universal healthcare in Mexico means that hospitals
experience a significantly lower standard of care, then youll be surprised to learn that
public healthcare institutions are regarded as far better quality than private hospitals.
In fact, a recent survey indicated that while Mexico boasts about 3,000 private hospitals,
some of these institutions were only hospitals in name, as they had no laboratories and
only specific diagnostic services, so theses are closer to clinics where doctors practice
mostly specialized procedures for outpatient care and short term treatments and
noncritical recovery beds for patients.
This does not mean that healthcare in Mexico does not have improvements to make.
While recent studies indicate that mortality rates in Mexico are dropping faster than in
Cuba, Canada and the United States, the death per capita rate is still far too high, as its
over 40% higher than that of the US. However, the World Health Organization (WHO)
has indicated that these high mortality rates make less of a reflection on healthcare in
Mexico as they do on other factors that result in death.

THE UNITED STATES AND HEALTHCARE IN MEXICO

With such a liberal approach to universal healthcare, its not surprising that more US
citizens are visiting Mexico to receive cheaper medical and cosmetic treatments; in fact,
some private health insurance companies in California mandate that patients receive care
in Mexico, where care is astronomically cheaper which is a primary factor driving
Medical Tourism in Mexico.
Want to know just how cheap healthcare in Mexico is? The average visit to the doctors
office in Mexico costs $25 (US), while an overnight stay in a hospital costs just $35.
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Compare this to the hundreds of dollars required for a doctors visit in the United States,
and its easy to see why its estimated that up to 80,000 American citizens travel to
Mexico to receive healthcare.
Additionally, any United States citizen who has legal residency in Mexico may enroll in
the federal governments IMSS program, meaning that they can receive their healthcare
for much cheaper. Better still, a new law mandates that you only need to buy property in
Mexico to enjoy this healthcare benefit. So whats the cost for Americans to enroll in
IMSS? Just $400 a year, which is astronomically lower than the $5000 that the average
American spends to enjoy going broke for basic US health insurance. These facts are
another game changer for retirees looking for the benefits Medical Tourism in Mexico
offers.

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MEDICAL TOURISM IN SINGAPORE

The beautiful island city-state of Singapore has seen a boom in medical tourism over the
years. Many people club their Singapore holiday with healthcare. In 2011 alone, tourism
receipts from foreigners travelling for health care in Singapore stood at over $900
million.
The popularity of Singapore medical tourism can be attributed to a couple of factors. One
of these is the presence of a robust medical infrastructure and a world-class airport. An
integrated Singapore healthcare system is yet another reason why it has witnessed a huge
influx

of

foreign

medical

tourists.

In fact, Singapore comes in 6th on WHOs list of the 191 countries with the best health
systems. Even as Asia is buzzing as a medical tourism destination and there is a
competition amongst countries in the continent, people from across the world continue to
travel to Singapore in droves for high-quality and affordable treatments. The top
treatments sought in Singapore are liver transplant, kidney transplant and those associated
with blood disorders.
The Singapore medical tourism industry is going through a phenomenal growth phase,
offering immense opportunities for players involved in the business. After the global
economic downturn in 2009, the market is growing exceptionally in each and every field
of medical treatments. Healthcare expenses in developed countries together with the issue
of time are leading people to seek affordable yet world class healthcare services in
developing countries such as Singapore.
In their latest research study, Booming Medical Tourism in Singapore Outlook 2017, the
authors have identified and deciphered the market dynamics in important segments to
clearly highlight the areas offering promising possibilities for hospitals to boost their
growth. The market, which estimated at S$ 1,740 Million in 2013, is slated to grow at a
CAGR of around 30% during 2013-2017.
The report, in a thorough manner, studies the Singapore medical tourism market vis-a-vis
various grounds. A comprehensive study of the current market scenario along with the
existing medical infrastructure covering hospitals and healthcare human resources has
been done. Moreover, different drivers and characteristics of the market have been
discussed along with forecasts to provide an understanding of the market dynamics. This
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section intends to aid hospitals in designing their business strategies and provide them
with key insights that can help them boost their profits.
The report also covers an analysis of the healthcare industry, broken down into five major
procedures viz., Cardiac, Orthopedic, Neurological & Spinal Surgery, Cosmetic Surgery,
and Dental procedures. This has helped the analysts to clearly identify and highlight the
procedures offering maximum opportunity for growth. Moreover, for an analysis of the
costs of getting treatment in Singapore versus other countries, a primary research has
been conducted.
Besides, the report covers government regulations to provide a comprehensive picture of
the Singapore medical tourism industry to the authors clients. The study delves into a
detailed description and key statistics of the major hospitals in the industry. Accordingly,
through a primary research, the report highlights the participation of these hospitals in the
medical tourism industry by covering patients' visits by destination and the most popular
treatments that international patients avail.

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MEDICAL TOURISM IN SOUTH KOREA

Unlike its neighbor to the north, South Korea is perceived around the world as a gentle
and fun-loving country. Many tourists from around the world travel to this country to
experience its beautiful tourist spots, delicious cuisine, and very rich culture. Recently,
South Korea medical tourism has also grown to be one of the most popular in Asia,
because of their excellent-quality healthcare services and state-of-the-art facilities.
Advanced treatments for various spinal problems, other orthopedic problems, dental
issues, organ transplantation, cancer treatments, cyberknife surgery in Korea, etc. have
made this East Asian Country a hit among medical tourists from many western countries.
Here are some facts about South Korea:
It is officially known as The Republic of South Korea.
Neighbouring countries include Japan (East), North Korea (North) and The Peoples
Republic of China (West).
Climate in South Korea can range from very warm to cold, depending on time of the year.
Summers can go up to above 30 centigrade, while in winter seasons the temperature can
go below 0:.
The population is estimated at around 50 million people.
South Korea has the 4th largest economy in Asia, with large businesses in electronics,
robotics, petrochemicals, ships, and machinery.
The South Korean government is democratic, with executive, judicial, and legislative
branches.
Seoul is the capital of the country, and is the seat of most key players in the South Korean
medical tourism industry.
Other big cities in South Korea (based on population) are Busan, Incheon, and Daegu
South Korea has good international relations with other Asian countries as well as many
countries around the world. It became a member of the United Nations (UN) in 1991, and
is also a member of the World Trade Organization (WTO). It is also a founding member
of both the Asia Pacific Economic Cooperation (APEC) and the East Asia Summit (EAS).

HEALTHCARE IN KOREA
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South Koreas healthcare systems are among the best in Asia. The countrys general
health office is called the Ministry of Health and Welfare. This office works with the
government and other health agencies in the country in making and enforcing policies
regarding public health and safety. Public and private employees are covered by
healthcare insurance, as mandated by the government, and many hospitals continually
update their systems and facilities a big draw for medical tourists who go to South
Korea.
The office of Ministry of Health and Welfare of South Korea is responsible for finding
ways to enhance their quality of life, fostering health among children and adults, giving
long-term care insurance for the elderly, and enforcing preventive healthcare and
treatment programs.

GREEN SOUTH KOREA

Environmental health is also one of this countrys continuing focuses, addressing issues
like climate change, water pollution, and deforestation. In 2008, South Korean President
Lee Myung Myung-bak announced the countrys vision for development Low Carbon,
Green Growth a drive that aims to use green technologies and industries that
enhance efficiency in the use of its natural resources, while continually minimizing the
hazards they pose to the environment.
South Korea has invested a lot of money in this aggressive drive, ensuring that the
country does its part to conserve natural resources. They have taken huge steps to
significantly cut down on greenhouse gas emissions, invested in renewable energy
sources, and started to encourage the building of energy-efficient homes.

MEDICAL TOURISM IN THAILAND

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Thailand, along with its Asian neighbors Singapore and India, accounts for 90% of Asias
medical tourism market. Each year, over a million foreigners plan their medical travel
around a Thailand holiday clubbing sight-seeing with medical treatments. On the tourism
front, Thailand has been a popular destination for decades. In the past few years, Thailand
has gained a reputation as a high-quality and reliable medical tourism destination. In no
small part, Thailand owes it to the hospitality of the Thai people. Thailand has earned the
eponym of the 'Land of Smiles'. The Thais treat their guests with the utmost respect and
try to serve them the best way they can. On another hand, Thailand medical tourism has
seen its popularity rise owing to the fact that it is home to many internationally accredited
hospitals. These hospitals offer a gamut of treatments, right from cosmetic/plastic surgery
and dental tourism to organ transplants at affordable rates. Some procedures will cost
you 1/10th of the price it would take for similar medical procedures in the US, UK or
Australia. Hospitals here boast the latest technology, and are equipped with language
translators and exclusive international wings to cater to foreign patients. Many doctors
and physicians in Thailand have medical certifications from the UK and US, and attend to
patients with consummate professionalism and great care.
Widespread air travel, mounting healthcare costs in developed countries, long waiting
lists and an ageing world population have all contributed to a global explosion of medical
tourism in the past decade -- and Asia is leagues ahead in terms of world market share.
More than 89% of medical tourists travelled to Thailand, India or Singapore in 2010, with
Bangkok and Singapore leading the pack. But the cost of hotel rooms and treatment are
both far more expensive in Singapore than in the Thai capital, making Bangkok the most
popular place for medical tourism in the world. Even after the devastating floods of 2011,
19 million tourists visited Thailand in 2011, a 20% jump from 2010, with an estimated
500,000 travelling specifically for medical treatment, whereas of the 10.2 million tourists
that visit Singapore each year, only 200,000 go to receive medical care.
The trend is lucrative too. Medical tourism in Thailand is growing at a yearly rate of
16%, while in financial terms the foreign medical services sector is expected to make a
whopping 100 billion baht by 2015. Currently, medical tourism makes up 0.4% of the
GDP, while tourism overall accounts for 6% to 7%, the third most important economic

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driver in Thailand. To compare, the Thai automotive industry accounted for 12% of GDP
last year, while manufacturing led the way accounting for 36% of GDP in 2011.
Given Thailands reputation for graceful and attentive service, it is not hard to see why
Bangkok has quickly become the medical tourism hub of Asia. Suvarnabhumi Airport is
serviced by airlines from around the world, reasonably-priced hotel rooms abound, there
is reliable public transportation and 30-day visas for many nationalities are easy to get
upon arrival, all of which help to make a stay -- in a hotel or hospital -- easy. The
Tourism Authority of Thailand (TAT), which began promoting medical tourism in 2004,
has a detailed medical tourism website that highlights many of the most popular
treatments available, including dental work, dermatology and cosmetic surgery, as well as
listing reputed hospitals, making it easy for potential visitors to decide on a procedure.
Forward thinking in many of its approaches, TAT has also recently partnered with stateowned Krungthai Bank, the national bank of Thailand, to offer tourists a debit card called
the Miracle Thailand Card, which offers some medical and life insurance coverage in
case of an accident.
Western accreditation is also a vital component for confidence in undergoing foreign
medical treatments and Bangkoks Bumrungrad and Samitivej hospitals were among
Southeast Asias first recipients of the United States prestigious Joint Commission
International (JCI) certification, which is seen as the gold standard for healthcare service
providers around the world. Now Bangkok has no less than eight JCI-accredited hospitals
for medical tourists to book with. Singapore, on the other hand, has 13 JCI-accredited
hospitals.
Hospitals in Thailand are also very popular with those who travel from neighbouring
Asian countries to seek treatment. Bangkok Hospital, which specifically caters to medical
tourists, has an entire Japanese wing, while Phyathai Hospitals Group has translators for
22 languages, including Swedish, Khmer and Flemish, as well as a team of Englishspeaking staff. It is also well known that when Prime Minister Girija Prasad Koirala of
Nepal needed medical care in 2006, he chose to travel to Bangkok s Bumrungrad
Hospital for treatment.
The hospitals in Bangkok are some of the highest quality in the world, meeting or
exceeding US standards, said Steven Lash, CEO of Satori World Medical, a US-based
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medical travel company that sends patients to Bangkok as well as to seven other
countries, including Turkey and Mexico. All of the patients we have sent to these
hospitals have given us excellent feedback on their procedures and their experiences at
the facilities.
Committing to airfares, accommodation, out of network or uninsured medical bills and
time off work is a big decision for travelers to make. Yet it seems for many, the benefits
and savings outweigh the risks. For example, a hip replacement at Bangkoks
Bumrungrad hospital costs 575,834 baht on average, about half the price of the same
operation in the US, making it a worthwhile consideration for many who are openminded enough to take the plunge.

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MEDICAL TOURISM IN TURKEY

Turkey is rapidly expanding in medical tourism and has set itself some ambitious goals.
The Ministry of Health aims to make $7 billion in revenue from 500,000 foreign patients
in 2015, while it has set its sights on reaching $20 billion in 2023 from 2 million foreign
patients.
Within the health ministry is the Department of Health Tourism, which aims to promote
medical tourism and co-ordinate other government and private sector activity. It is also
responsible for providing emergency health services to Turkeys 34 million tourists.
By health tourism, Turkey means medical tourism, thermal/spa tourism, elderly tourism
and disabled tourism. The department operates a free 24/7 helpline plus free
interpretation service in English, Arabic, Russian and German; getting 700 calls a month.
In 2013 it will handle 2,000 calls a month and will expand the service to include Persian
and French. It has a website in four languages. Foreign patients treated in public or
private or university hospitals have to be registered with the health ministry. In 2012
Turkey had 210,000 medical tourists compared to 156,176 in 2011, 109,678 in 2010,
91,961 in 2009 and 74,093 in 2008. The Department of Health Tourism analyzes these
figures by province, hospital, and county of origin. It expects 2013 to produce at least
250,000 medical tourists. Medical tourists mainly seek eye treatment, hair transplants,
dentistry, and cosmetic surgery; plus orthopedic treatment, cervical herniated discs and
slipped disk treatment, gynecological and urological operations, plus treatment at ear,
nose and throat clinics. 91 % use private hospitals and the remaining 9 % use public
hospitals. Germany, Russia, Azerbaijan, the Netherlands, Iraq and France top the list of
the countries whose citizens visit Turkey for health tourism. In addition, a significant
number of visitors come from Ukraine, Belgium, Kazakhstan, Romania, Libya, Georgia
and the UK. Turkey attracts the largest health tourists from Germany, the Netherlands and
France, as the population of people with Turkish roots is high. The health ministry plans
new medical tourism regulation this year; including regulation of medical tourism
agencies, medical spa rules, rehabilitation service laws, plus general health tourism
regulation. The ministry also expects that the share of public hospitals in attracting
foreign patients will increase to 10 % in the years to come. The top five destinations for
foreign patients are Istanbul, Kocaeli, Ankara, Antalya and Mula.
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Chapter 3-

DATA ANALYSIS &

INTERPRETATION

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Medical Tourism is a fast growing industry worldwide and involves the movement of
people from one country to another country or from one state within a country to another
state to seek medical treatments that are either not available in the individuals state or
country, more advanced in the destination state or country or less costly in the destination
state or country.
This article seeks to discuss health tourism, the performance of Malaysian health tourism
industry, its development and future. Implications for students will also be discussed.
According to Deloitte Medical Tourism report 2008, this tourism sector was expected to
reach an estimated US$ 100 billion as at last year (2010) mainly due to cost savings,
comparatively same quality of medical care and quick access to treatments.
It estimated that by 2017, an estimated 15.75 million medical tourists will travel from the
United States alone to other countries for medical treatments compared to 750,000
tourists in 2007 according to the same report.

OUTBOUND MEDICAL TOURISM

According to the Deloitte Center for Health Solutions, there were 750,000 outbound.
American medical tourists in 2007, a number which may increase to up to 1.6 million by
2012 (Deloitte, 2009). A 2009 Gallup poll found that up to 29% of Americans would
consider traveling abroad for medical procedures (Edelheit, b, n.d.).

INBOUND MEDICAL TOURISM

According to the 2010 survey on inbound medical tourism by Stackpole & Associates,
the regions representing the greatest number of inbound patients were: Mexico (21.18%),
the Middle East (14%), South America (12.33%), Central America-excluding Mexico
(11.25%), and Europe (11.23%). Inbound medical tourists traveled to the U.S. for
medical care seeking better access, higher quality, and specialized care. The most
common treatments sought by inbound medical tourists included oncology (31.69%),
cardiology (14.17%), and

neurology (11.75%), followed by other specialties

(Stackpole & Associates, 2010). The Development of a Common Framework for

Academic Study of Medical Tourism The recent surge in interest in medical tourism has
led to efforts to develop common frameworks for studying the subject. Various models
and frameworks are emerging which serve as a guide for research. Although no one
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model has yet to emerge as an agreed-upon framework, the various models available can
be useful for key industry players in order to conduct market research or to engage in
feasibility studies for the development of medical tourism destinations. It should be noted
that the framework from a hospitality and tourism perspective would include aspects
which may not be present in models related to public policy or the healthcare industry
specifically.

Cost Comparison Charts

Procedure

Cost in United States Cost in Costa Rica

Porcelain crown/bridge

$1,050

$350

Veneers

$1,250

$350

Dental implant

$3,000

$1,000

Root canal

$800

$315

Teeth whitening

$700

$250

Crowns

$1,000 + per tooth

$400 +

Breast augmentation

$5,000$8,000

$3,000 +

Facelift

$7,000$9,000

$4,500 +

Abdominoplasty (Tummy Tuck) $6,000$8,500

$4,000 +

Procedure/Treatment

USA

India

Heart Bypass

$130,000 $10,000 $15,000

$19,000

Hip Replacement

$43,000

$15,000

$9,000

Thailand

$14,000

Singapore

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Knee Replacement

$35,000

$7,000

$11,000

$13,000

Liposuction

$8,000

$2,000

$2,700

$3,900

Breast Augmentation

$7,000

$3,000

$3,800

$4,500

Tummy Tuck

$9,000

$2,800

$3,600

$4,200

Metal Free Dental Bridge

$5,500

$300

$750

$800

Lasik Eye Surgery

$3,700

$500

$700

$900

Market Analysis of medical products in Thailand

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Stats of Medical Tourists for Plastic Surgery

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Chapter-4

SUMMARY AND
CONCLUSION

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Medical tourism is likely to increase over the next decade as more patients are able to
access the Internet and acquire information relevant to care offered overseas at an
affordable price. While some patients will benefit immensely from treatment as a medical
tourist, many legal and ethical issues will also arise. Nurses need to familiarize
themselves with the benefits of medical tourism while also acknowledging its inherent
dangers. Potential medical tourists will benefit from the services of a knowledgeable
health professional in their home country who can discuss the many issues that relate to
this medical tourism. It is expected that medical tourism will provide a new role for
nurses as this healthcare trend expands around the world.
Individuals have the right to travel, and, acknowledging various restrictions, liberal
democratic nations permit citizens to cross national borders. Increasing numbers of
patients are traveling in search of health care, and patients are free to travel abroad if they
wish to obtain health care outside their local community. However, there are risks
associated with cross-border medical care. Government ministries need to use legislative
powers to manage and reduce these risks. Accreditation bodies can help ensure medical
tourism agencies meet reasonable, prudent standards of practice. Government agencies in
nations from which patients depart for care abroad can work with regulatory authorities
in other countries but ultimately they cannot control licensing of health-care providers,
accreditation of health-care facilities and legislation governing malpractice and liability
in other nations. They can, however, use legislative powers, accreditation, regulation and
oversight mechanisms to impose standards on local businesses that arrange medical
procedures at international health-care facilities. To ensure that 'medical tourists' receive
competent care abroad as well as proper follow-up care upon their return, medical
tourism companies must be held to high standards of practice. Such an arrangement
would differ from current circumstances, in which most medical tourism companies
operate in a regulatory vacuum, use waiver of liability documents in an effort to avoid
legal and financial responsibility when their customers receive negligent medical care or
suffer serious post-operative complications and organize both medical services and travel
arrangements while not being held to the standards of either health-care facilities or travel
agencies. To protect patients engaging in cross-border health care, medical tourism
companies must be held to demanding standards of practice. Quality in health care is
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often addressed in relation to hospitals, health-care systems and health-care professionals.

As health care increasingly crosses national borders, efforts to improve quality in health
care must also attend to the proliferation of medical tourism companies and the role of
these businesses in promoting globalization of health services.

Bibliography

http://www.medicaltourismassociation.com/en

http://www.medicaltourismcongress.com/

http://en.wikipedia.org/

https://www.google.co.in/

https://news.google.co.in/

http://in.yahoo.com/

http://boi.gov.in/

http://www.forbes.com/

http://internationalliving.com/

http://medicaltourismmag.com/

Forbes magazine

Time magazine

Times of India Newspaper

Hindustan Times Newspaper

http://www.hbmsp.sipa.gov.tw:9090/

http://www.worldhospitaldirectory.com/

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