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Medical Tourism, an uncertain Prescription for Asian economies

The East Asian region led by Thailand and other countries such as Singapore, India and Malaysia is a dynamic and evolving destination for ‘medical tourists’, home to many of the most visible and well known hospitals currently serving medical tourists from across the world.

The remarkable success of established East Asian medical tourism providers in marketing their services to international patients has spurred interest among other countries in the region who aim to join these larger players. Medical tourism is a practice where patients travel abroad to purchase medically necessary services, such as heart surgeries and hip replacements; elective treatments, such as cosmetic surgeries or reproductive services; and experimental treatments, such as stem cell therapies.

The enthusiastic embrace of medical tourism by East Asian hospitals and governments is, in theory, well justified. Health services exports could potentially diversify regional economies.

Industry promoters say it can increase foreign direct investment into the private health sector, help countries retain their existing health workforce, increase training opportunities for health workers, and ensure that the local health sector has access to the latest technological advances.

Taken together, these benefits can provide local populations with the opportunity to access cutting-edge and high-quality health services at home.

But medical tourism also creates social and health risks for countries investing in the sector

Investment in medical tourism can drain resources from the public health sector and divert attention away from the less profitable health needs of the local population.

For example, high paying jobs in the medical tourism sector can increase the flow of workers from the public to private sector and from rural to urban areas, as has been the case in Thailand and Malaysia. New, high-tech equipment and highly trained health workers will certainly be a boon to wealthy patients within these countries. But there is little reason to think that these services, targeted at privileged locals and foreign patients, will be accessible or relevant to the vast majority of the local population.

Rather, medical tourism may actively worsen health inequities in these countries.

For example, increased investment in the private health sector in India has been accompanied with decreased public sector investment and promised public access to private facilities through public-private partnerships have generally not been realized. And the promised economic benefits of medical tourism are far from guaranteed. Growth in the sector has come through the lowering of trade barriers in the health services industry.

Large regional players in this industry have the power to play governments in the East Asian region off one another, seeking the regulatory and tax environments most favourable to their bottom lines.

This competitive environment is doubtlessly favourable to those investing in the medical tourism industry, but it is less clear whether the host countries will experience similar economic benefits if tax concessions and other benefits are not matched by economic returns or if medical tourism developments fail to materialise. Countries considering marketing their private health sector internationally should be cautious and aware that industry stakeholders have an incentive to inflate numbers about the market’s potential and exaggerate the potential benefits of this industry.

As East Asia already hosts some of the most developed and high-profile destinations for medical tourists, it is unclear if new markets in the region can successfully compete for the limited number of medical tourists, especially those from outside East Asia.

source: http://www.thailand-business-news.com / Thailand Business News / Home> Health/India/Malaysia / by Somchai Sakayathya / Tuesday – February 25th, 2014

Iran gradually becoming prime destination for Muslim medical tourists

Tehran, Iran :

Thanks to its geographical position, the conditions in neighbouring countries, economically reasonable prices and advanced medical facilities, Iran is gradually becoming a destination for Islamic and regional medical tourists. Hospitals in Iranian cities offer medical and health care services for foreign medical tourists. Medical services in Iran are comparable with those offered in advanced countries.

Geographical closeness and cultural and religious similarities have turned Iran into one of the best and most economically reasonable destinations for the Islamic world and regional countries for health tourism. Iran has a highly educated workforce and is a local leader in scientific and health development. Iran is one of the top five countries in the world in biotech and nine out of 15 high usage biotech molecules are produced in Iran.

Image via Reuters/IRNA

Image via Reuters/IRNA

So Iran has a great opportunity to attract medical tourists of Islamic and regional countries. The existence of mineral fountains in many parts of the country, targets one market. Other markets include fertility treatment, stem cell treatment, dialysis, heart surgery, cosmetic surgery, and eye surgery. It also produces unique medicines such as the anti-AIDS drug IMOD, and other high-tech drugs.

The foreign medical tourists can be sub-divided in two groups. The first group is those who travel from advanced countries to other parts of the world seeking high-level medical service at considerably lower prices. The other type of medical tourists are those who come from less advanced and less developed countries where the medical services are not satisfactory and Iran can offer them greater health services at very reasonable prices.

30,000 medical tourists enter Iran annually; there are also some 200,000 health, wellness and spa tourists. The Health Tourism Committee sees the neighbouring countries as achievable target markets. Iran has already produced rules and regulations for tourist health care service centers so that hospitals and clinics that want to offer health tourism services to foreign citizens need to acquire licenses from both the Ministry of Health and Iranian Tourism Organisation.

Offering health service training to employees of tourism agencies and opening international patients’ wards at the hospitals are among the other already adopted measures by the Health, Remedy and Medical Training Ministry. Iranian hospitals that hold a medical tourism license from the Ministry of Health arrange airport transfers as well as accommodation. In addition, a nurse can be assigned to each patient.

In addition to the GCC, many patients come from Azerbaijan, Turkey, Iraq, Pakistan and India. Iranian ophthalmologists are renowned throughout the region; we also have specialty services in cardiology, kidney transplants, urology and general surgery. Iran attracts patients from neighbouring states mostly for transplants, ophthalmology, orthopedics and dentistry. The reasonable cost of medical treatment in Iran compared to Europe and the high quality of medical facilities are important factors for attracting foreign patients to Iran. In addition, Iran has highly experienced and professional doctors.

Based on studies conducted by Iran tourism organisation ICHHTO-Iraq, Afghanistan, Persian Gulf states, Central Asian nations and Iranians residing abroad are the main targets. ICHHTO provides travel agencies active in health tourism with special facilities such as a pavilion for them in overseas fairs. ICHHTO has also specified certain provinces for health tourism with the co-operation of the Ministry of Health:

— Tehran province for treating tuberculosis and lung disorders.

— Khorasan Razavi for ophthalmology, skin care, heart surgery and orthopedics.

— Fars for liver, kidney and marrow transplants.

— Yazd for treating infertility.

— Qom for its sun and desert potential.

— Hamedan, Ilam and Zanjan as centres of herbal medicine.

Medical treatment in Iran is safer, more knowledge-based and cheaper. Until 8 years ago, many Iranians travelled abroad to receive medical treatment, while now we are medical tourists. Iran has taken great strides in science and technology, particularly in medical and medicinal fields, in recent years.

source: http://www.eturbonews.com / eTN Global Travel Industry News / Tehran – Iran / February 11th, 2014

Australia vying to be destination for medical tourism

Every year millions of people around the world travel overseas for medical treatment, including a growing number of Australians.

But now Australia is fast becoming a destination for the growing Asian middle class seeking the latest technology and high quality health care.

It’s a lucrative export market which both Australia’s hospitals and the Government are keen to exploit, but doctors warn the country’s medical facilities may not be able to cope.

Reporter: Kesha West

Speaker: Steve Hambleton, Australian Medical Association President; Professor John Catford , medical director at Epworth, Victoria’s largest private hospital group; David Davis, Victorian Health Minister; Lynne Pezzulo, Deloitte Access Economics

WEST: Over the last decade, Australians have been heading overseas in droves, to places like Thailand, India, South Korea and Malaysia for medical treatments.

It’s often cheaper… and patients can combine a holiday with plastic surgery or dental work.

But as Australians fly out, a growing number of medical tourists are flying in… from New Zealand, the United States and increasingly from Asia.

CATFORD: I think what we’re seeing in SE Asia/Asia is a burgeoning middle class, tens of millions of people actually for the first time having resources they can use to improve their well-being.

WEST: Professor John Catford is the medical director at Epworth, Victoria’s largest private hospital group.

At the moment it looks after around 600 international patients every year from over 30 different countries including the Pacific Rim, Singapore and Indonesia.

And it’s Australia’s high quality, hi-tec healthcare which is most in demand such as robotic surgery, IVF fertility treatments and cancer care…

WEST: It’s difficult to assess how many patients actual travel to Melbourne specifically for treatment, but Professor Catford believes the numbers are growing and the economic potential could be enormous.

CATFORD: If you think of international education how important that is to the Australian economy, in Vic its the number one export in Australia its the 3rd leading export, I think international health care could rival that in a decade or two.

WEST: In 2011 Australia’s Department of Resources, Energy and Tourism commissioned Deloitte Access Economics to conduct a study on Australia’s viability as destination for medical tourism.

Lynne Pezzulo was the lead author.

PEZZULO: We’ve got over ten thousand people coming to Australia for medical tourism, so it was 12,800 in fact in our estimates in 2011 there are though 5.5 million tourists a year in Australia so that only represents 0.23 percent of our total tourist base so clearly there would be a lot of work to do to expand that in to a really sizeable market.

WEST: The Victorian State Government, in particular, is keen to market Melbourne as a health care mecca.

Health Minister David Davis.

DAVIS: We see inbound tourism of that type as just one part of a broader health export strategy that the state is developing and that would include conferences and would include inbound research support and inbound investment.

WEST: Professor John Catford says red tape could obstruct those seeking to take advantage of Australia’s high quality healthcare…

CATFORD: We need a supportive government framework that actually encourages it and actually sorts out particular barriers or obstacles, a typical one would be visas so people can come in easily with their families support to receive medical care.

WEST: But Steve Hambleton, the President of the Australian Medical Association says it would be a mistake to grow the industry too quickly.

HAMBLETON: It is entirely appropriate that a first world country should be thinking about exporting expertise just like this but we have a problem here about training the next generation of doctors for our own domestic needs and when we have surplus capacity is when we should be looking overseas

WEST: While the growth of medical tourism in Australia would bring with it obvious financial benefits, for public hospitals the challenge will be ensuring that with that influx of wealthy international private patients there’d be no reduction in the level of service and quality of care available for local public patients.

The AMA says there’s also a risk that medical tourists could bring with them drug resistant “superbugs” prevalent in many Asian countries.

HAMBLETON: The reality is that if you like there its a good chance you will be carrying those multi-resistant organisms and when you go internationally you will take them with you. Now the problem occurs when you have surgery, major surgery, maybe a hip replacement or knee replacement and therefore you’re quite sick or quite stressed by that physically, that organism that you could be carrying with you could become invasive and if it does we won’t be able to treat it either and of course there’s a chance that organism will be left behind and we’ll actually see those multi-resistant organisms take up residence here too.

source: http://www.radioaustralia.net / Radio Australia / Home/Radio / Reporter: Kesha West / February 10th, 2014

Medical Tourism has become a Thriving Business in Mexico

By Kent Paterson 

Price. Quality. Technology.

That was the triple message Dr. Octavio Gonzalez had for attendees at the Medical Matters 2014 conference held [last] week in Puerto Vallarta, Mexico. The veteran dentist was among dozens of exhibitors at an event catering to expatriates, snowbirds and tourists in the Mexican coastal city.  

Gonzalez estimated that 95 percent of his customers hail from the United States, Canada and Europe, mostly from North America.  

Under the worst scenario,” Gonzalez told FNS, the prices of his Dental Avant Garde company might reach a third of comparable costs in the U.S. and Canada.  

Gonzalez’s firm specializes in dental implants and full mouth functional rehabilitation.  

Apart from pocketbook savings, a visit to Dental Avant Garde has other advantages over seeing a dentist north of the border, Gonzalez insisted.  

“Many of the dentists in the states don’t have the same technology we have. We have Swiss and German and French technology,” he said. “The materials are the finest on the world market.”  

Joining Gonzalez on the floor of the Marriott Casa Magna Hotel were representatives of plastic surgeons, clinical dermatologists, local hospitals, the Banderas Bay American Legion Post, air ambulance providers, and private health insurance brokers, among others. Local physicians and medical experts gave presentations on topics ranging from breast cancer to varicose veins.  

Adriana Ramirez, spokeswoman for the Amerimed Hospital, said patients at the three-year-old facility can expect to pay 70 percent or less than in the U.S. Ramirez said the patient rolls change seasonally, with foreigners making up the majority of admissions from about November to April, and Mexican nationals filling in the rest of the year.  

For her part, Dr. Norma Carrion said she was actively seeking more foreign patients, who currently constitute 5 to 10 percent of her patient load, as well as donors for grants to assist children with problems like cerebral palsy.  

Carrion’s Clinica de Rehabilitacion Vallarta-Santa Barbara, or Vallarta Rehabilitation Clinic, is a non-profit organization that offers treatments for half the cost of private businesses, according to the specialist.  

Working in an internationally-popular tourist destination can sometimes be a challenging task, the bilingual Spanish-English speaker said, recalling occasions when Carrion and her assistant were forced to communicate with and treat French speakers from Quebec via sign language.  

Healthcare-related concerns come up often in the work of Puerto Vallarta’s U.S. Consular Agency, said Consular Agent Kelly Trainor.  

“We do help people find adequate medical facilities in the event of medical emergencies,” Trainor said.  

In addition, the Consular Agency distributes informational sheets on issues like dengue fever, which occurs in Puerto Vallarta and other tropical zones. Trainor urged potential visitors to plan ahead and consider possible medical contingencies and insurance coverage before coming to Mexico.  

The brisk turnout for Medical Matters 2014 was a sign of Puerto Vallarta’s rebounding tourism this winter high season, as well as the growth of the expatriate population from the north.  

Although the final numbers are not yet in, many of Puerto Vallarta’s restaurants are packed with foreigners, cruise ship visits are up, and some business persons report the best season in years.  

Pamela Thompson, a Puerto Vallarta health care consultant and conference organizer, said the now annual event grew from 300 attendees for its first edition to 1,500 at last year’s gathering. Interviewed early in the afternoon of the one-day conference, Thompson said she calculated about 2,000 people would walk through the doors by the end of the day.  

“I haven’t had room for everybody,” Thompson told FNS. “I’ve had to turn so many people away from the (presentation) rooms.”  

According to Thompson, she’s seen a “record” year of doubling in the number of consultations, admissions and surgeries performed by the more than two dozen doctors with whom she works.  

Asked whether the Affordable Care Act in the U.S. impacted medical tourism in any way, Pamela Thompson said that at least in Puerto Vallarta the field “hasn’t seemed to decrease at all with Obamacare.”  

In a recent story, the Mexican daily La Jornadareported that Mexico is number two in the global ranking of medical tourism, falling only behind Thailand.  

Official numbers cited by the newspaper reported that approximately 1,000,000 residents of the U.S. alone, mainly persons of Latino heritage from California, Arizona and Texas, seek medical assistance in Mexico.  

Earnings from medical tourism reportedly jumped from $1.5 billion in 2006 to $2.85 billion in 2013, with an annual projected growth rate in the ballpark of 7 percent.  

The market is so promising, La Jornadareported, that Mexico’s Economy Secretariat is pitching medical tourism as a good niche investment for foreign capitalists, alongside the automobile, mining and aerospace sectors.  

The latest numbers suggest that the highly-publicized narco-violence in Mexico had no overall medium or long-term effect on the decisions of people who come to a country for medical or dental treatments they cannot obtain or afford at home.  

Carlos Alaniz also views great potential for the sector of Mexican health care serving the foreign-born.  

Brought up in El Paso, Texas, Alaniz moved to Seattle 25 years ago, where he pursued a career as an occupational therapist. While he still lives full-time in Seattle, Alaniz maintains a home he purchased in Puerto Vallarta nine years ago.  

“(Puerto Vallarta) is a great town,” the former borderlander said. “It’s a vibrant community — both the local community and expats. I think there is mutual respect. I have friends like me who are thinking about moving down here.”  

Alaniz said he was considering getting certified in Mexico so he can practice his profession and spend time volunteering, perhaps teaching CPR to others who can “save lives.”  

“As a therapist, I can work for a temp agency and earn good money in Seattle, and work for 6 months and come here and not work so much,” he said.  

“They are off to a good start,” Alaniz said of Puerto Vallarta’s healthcare infrastructure. “But there are a lot of services that can be expanded. For example, they don’t have a hospice here. There need to be more clinics.”  

Alaniz said a future growth area rests with what he termed “continuum of care,” or the systemic linking of independent, assisted and nursing home living for the elderly, a booming slice of the North American population.  

“I think there will be a great opportunity to do it here,” Alaniz added. “People in the states are paying a lot of money for that, and for probably a fraction they can come here.”  

——————————
Frontera NorteSur (FNS)
Center for Latin American and Border Studies
New Mexico State University
Las Cruces, New Mexico

Kent Paterson is the editor of Frontera NorteSur.  Reprinted with authorization from Frontera NorteSur, a free, on-line, U.S.-Mexico border news source.

source: http://www.mexidata.info / Monday – February 17th, 2014

India grants free visas to Maldivian medical tourists

INDIA is now offering Maldivian nationals free 90-day visas for medical tourism in a reversal of last year’s tightening of visa regulations for this segment.

Medical visa holders will no longer be required to report to the Foreign Regional Registration Office for visas with under 180 days’ validity.

Parvez Dewan, secretary at the Ministry of Tourism said: “It is a major visa liberalisation measure for Maldivian nationals. Only two other countries, Nepal and Bhutan, are provided free visas.

“We expect the move will benefit south Indian cities like Bengaluru, Hyderabad, Chennai and Trivandrum the most, because of the robust medical facilities available there and because the region is known for Ayurveda (wellness treatments).”

Relations between the two countries soured after the Maldives prematurely terminated the contract with India’s GMR Group for the management of Ibrahim Nasir International Airport.

India retaliated by tightening visa restrictions on the Maldives’ medical tourists (TTG Asia e-Daily , January 09th, 2013 ).

Mohamed Nasser, Maldivian ambassador to India, remarked: “There are more than 20,000 Maldivians living in south India. Even last year, though we had visa issues, it didn’t deter Maldivians from travelling to India. However, with the help of this new visa regime, the number of Maldivians arriving in India will certainly increae as most of the Maldivians travelling to India are medical tourists.”

India registered 40,000 Maldivian arrivals in 2013.

source: http://www.ttgasia.com / TTG Asia / Home> Daily News Archives / by Rohit Kaul / New Delhi – February 05th, 2014