Information AboutMedical Tourism |
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Such services typically include elective procedures as well as complex specialized Surgeries such as Joint Replacement ( Knee / Hip ), Cardiac Surgery , Dental Surgery , and Cosmetic Surgeries . The provider and customer use informal channels of communication-connection-contract, with less regulatory or legal oversight to assure quality and less formal recourse to reimbursement or redress, if needed. Leisure aspects typically associated with travel and tourism may be included on such medical travel trips. HISTORY 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 Town s may be considered an early form of medical tourism. DESCRIPTION Factors that have led to the recent increase in popularity of medical travel include the high cost of health care or wait times for procedures in industrialized nations, the ease and affordability of international travel, and improvements in technology and standards of care in many countries of the world. Medical tourists can come from anywhere in the world, including Europe, the UK, Middle East, Japan, U.S. 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. 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. The time spent waiting for a procedure such as a hip replacement can be a year or more in Britain and Canada; however, in Singapore, Hong Kong, Thailand, Cuba, Colombia, Philippines or India, a patient could feasibly have an operation the day after their arrival. In Canada, the number of procedures in 2005 for which people were waiting was 782,936.1 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. "Medical tourism growing worldwide" by Becca Hutchinson, ''UDaily'', July 25 , 2005 , retrieved September 5 , 2006 Medical tourists may seek essential health care services such as cancer treatment and brain and transplant surgery as well as complementary or 'elective' services such as aesthetic treatments (cosmetic surgery). According to research found in an article by the University of Delaware publication, UDaily: To understand the phenomenon of medical travel, we can compare the average costs of cosmetic surgeries between the industrialized nations and Latin America countries where medical tourism and cosmetic surgery tourism are becoming popular, such as Argentina, Bolivia, Brazil, Costa Rica, Colombia, Philippines, and Mexico. Prices quoted in the table below are from offices affiliated with the ministries of health in the U.S., Europe (France, Spain, Switzerland), Argentina, Bolivia, Brazil, Costa Rica, Cuba, India, and Mexico. Popular medical travel worldwide destinations include: Brunei , Cuba , Colombia , Hong Kong , Hungary , India , Israel , Jordan , Lithuania , Malaysia , The Philippines , Singapore , South Africa , Thailand , and recently, UAE . Popular cosmetic surgery travel destinations include: Argentina , Bolivia , Brazil , Colombia , Costa Rica , Cuba , Mexico and Turkey . In Europe Belgium , Poland and Slovakia are also breaking into the business. , 2004 , retrieved September 5 , 2006 However, perceptions of medical tourism are not always positive. In places like the U.S., where most have insurance and access to quality health care, 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; for example, in late 2006, some patients from the Middle East were choosing to travel to Singapore or Hong Kong for health care rather than to the U.S. because of international tensions. While the tourism component might be a big draw for some Southeast Asia countries that focus on simple procedures, India is positioning itself the primary medical destination for the most complex medical procedures in the world. India's commitment to this is demonstrated with a growing number of hospitals that are attaining the U.S. Joint Commission International accreditation. Singapore positions itself as a medical hub for health care services, medicine, biomedical research and pharmaceutical manufacturing converge. Singapore has made international news for many complex surgeries in specialties such as neurology, oncology, and organ transplants procedures. Currently Singapore boasts the largest number of U.S. Joint Commission accredited hospitals in the region. In South America, countries such as Argentina, Bolivia, Brazil and Colombia lead on plastic surgery medical skills relying on the vast experience their surgeons have in treating the style-obsessed. It is estimated that 1 in 30 Argentineans have had plastic surgery procedures, making this population the most operated in the world after the U.S. and Mexico. In Bolivia and Colombia, plastic surgery has become quite common. According to the "Sociedad Boliviana de Cirugia Plastica y Reconstructiva", more that 70% of middle and upper class women in the country have had some form of plastic surgery. Colombia also provides advanced care in cardiovascular and transplant surgery. Companies are beginning to offer global health care options that will enable North American and Eurpean patients to access world health care at a fraction of the cost of domestic care. Companies that focus on 'Medical Value Travel' typically provide experienced nurse case managers to assist patients with pre- and post-travel medical issues. They also help provide resources for follow-up care upon the patient's return. While these services will initially be of interest to the self-insured patient, several studies indicate that the rapid growth of Health Savings Accounts in the U.S. will also drive interest to health care in other countries.
CUBA For more than 40 years, Cuba has been a popular medical tourism destination for patients worldwide that seek high quality medical care at lower costs. In 2006, Cuba attracted nearly 20000 Commentary: A Novel Tourism Concept Caribbean Net News Aug 18 , 2007 , retrieved Aug 18 , 2007 Health Tourists . Cuba is especially attractive to many North American, European and Latin American patients given its close proximity, and tropical and relaxed setting. In 2001, the BBC News reported that thousands of patients come to Cuba from as far away as Latin America and Europe, attracted by the "fine reputation of Cuban doctors, the low prices and nearby beaches on which to recuperate." [http://news.bbc.co.uk/2/hi/americas/1535358.stm BBC News Sept. 10 , 2001 , retrieved July 20 , 2007 A wide range of medical treatments are provided including joint replacement, cancer treatment, eye surgery, cosmetic surgery and addictions rehabilitation. Costs are about 60 to 80 percent less than U.S. costs. For example, Choice Medical Services, , a health tourism provider, provides a hip replacement in Cuba for US$5,845/C$6120/€4227. Cuba has hospitals for Cuban residents, and others that focus on serving foreigners and diplomats. Cubans receive free healthcare for life. In the 2007 American documentary film, "Sicko," which criticizes the U.S. healthcare system, producer Michael Moore leads a group of uninsured American patients to Cuba to obtain more affordable medical treatment. Sicko has greatly increased foreigners' interest in Cuban healthcare. Healthcare in Cuba is very good compared to many countries worldwide. The chance of a Cuban child dying at five years of age or younger is 7 per 1000 live births in Cuba, while it's 8 per 1000 in the US, says the World Health Organization (WHO). Cuba has nearly double the number of physicians than the U.S. -- 5.91 doctors per thousand people compared to 2.56 doctors per thousand, according to WHO. And WHO reports that Cuban males have a life expectancy at birth of 75 years and females 79 years. In comparison, the US life expectancy at birth is 75 and 80 years for males and females, respectively. Cuba's infant mortality rate is equal to the US at 6 percent. [http://www.who.int/countries/cub/en WHO , retrieved Aug 1 , 2007 The Cuban government has significantly developed its Medical Tourism capabilities as a key means to generate income for the country. There is an ongoing program that sends thousands of Cuban doctors to Venezuela to help its poor residents, and this helps Cuba to pay Venezuela for oil. Residents of Canada, the UK and most other countries can travel to Cuba without any difficulty, and a tourist visa is generally required. For Americans, however, because of the US trade policy towards Cuba, travelers must either obtain U.S. government approval, or, as in most cases, they travel there via Canada, Mexico, the Bahamas, Jamaica or Dominican Republic. North Americans can reach Cuba easily via daily flights from Toronto, Montreal, Cancun, Mexico City, Nassau (Bahamas), Kingston (Jamaica), and Santo Domingo (Dominican Republic). Cuban immigration authorities do not stamp the passports of US visitors so that Americans can keep their travels a private matter. Few Cubans speak fluent English, so foreign guests who do not speak Spanish and that want to avoid the paperwork and hassles may want to use a health tourism service that provides English-speaking assistance and guides patients through the process to arrange their trip. JORDAN Jordan has become a hot spot for health tourism in the Middle East. Palestinians, Iraqis, Syrians, South East Asians and native Jordanians alike are frequent visitors. Heads of state like Jalal Talabani prefer to be treated in Jordan's word-class hospital mainly because their country might have inadequate healthcare or no healthcare at all. ISRAEL Israel too, is becoming a hotspot for health tourism attracting visitors from all over the world to be treated in Israel's hospitals. COLOMBIA Colombia has been treating patients from all over the world for years, especially for cosmetic and eye surgery. Colombia has also become a recognized provider of advanced cardiovascular and transplant surgery. What often compels persons to seek transplant surgery offshore is not only cost considerations, but waiting lists (such as in the U.S.) or the lack of an organized organ inventory and donor system in the home country. Colombia has such an organ donor and banking system which makes organs available to foreigners with certain legal restrictions. Orthopedic surgeries, such as knee and hip replacements, are done in Colombia with U.S.-made ( FDA -approved) prosthetics at a fraction of the cost. Colombia has many surgeons that have either trained and/or practiced in other countries such as the U.S. and Europe. Salaries for doctors, nurses, and supporting personnel in Colombia are about 20% of U.S. salaries for similar occupations even though they are required to have the same level of education and job skills. Real estate costs related to medical care facilities are also only a fraction of what they are in the U.S. One advantage of Colombia for those from the U.S. and Canada is ease of travel and close proximity. Colombia offers cheaper airfares from the U.S. and Canada (and some European countries) than other destinations, such as those in Asia, and does not have the visa restrictions of other countries currently in the medical tourism marketplace. PHILIPPINES The Philippines has been growing as a destination for medical tourism because of world-class physicians and modern technology, with procedures delivered at a fraction of the cost of those in developed countries. The country has excellent hospitals and stand-alone specialty clinics. INDIA India is known in particular for heart surgery, Hip Resurfacing and other areas of advanced medicine. The government and private hospital groups are committed to the goal of making India a world leader in the industry. The industry's main appeal is low-cost treatment. Most estimates claim treatment costs in India start at around a tenth of the price of comparable treatment in America or Britain.''Indian medical care goes global'', Aljazeera.Net, June 18, 2006 accessed at {Link without Title} Nov 11, 2006 Estimates of the value of medical tourism to India go as high as $2 billion a year by 2012. "Just what the hospital ordered: Global accreditations" by Zeenat Nazir, Indian Express, Sept 18, 2006 retrieved September 29, 2006]. The Indian government is taking steps to address other infrastructure issues that can serve as a deterrant to the country's growth in medical tourism. The south Indian city of Chennai has been declared India's Health Capital, as it nets in 45% of health tourists from abroad and 30-40% of domestic health tourists. SINGAPORE Singapore is Asia's leading medical hub, with advanced research capabilities as well as nine hospitals and two medical centers that have obtained Joint Commission International (JCI) accreditation. This could be part of the reason why JCI chose to set up its Asia Pacific office in Singapore in 2006. "http://www.jointcommissioninternational.com/23070/?view=ViewArticle&articleId=23199" In time, Singapore hospitals may look towards other European or Asian-based hospital accreditation systems in an attempt to broaden their market, as JCI's principal appeal is to the U.S. market, only a portion of the potential global clientele. SingaporeMedicine is a multi-agency government initiative that aims to develop Singapore into a leading destination for health care services. In 2005, some 374,000 visitors came to Singapore purely to seek healthcare. "www.SingaporeMedicine.com" Many patients come from neighboring countries, such as Indonesia and Malaysia. Patient numbers from Indochina, South Asia, the Middle East and Greater China to Singapore are also seeing fast growth. Patients from developed countries such as the U.S. are beginning to choose Singapore as their medical travel destination for relatively affordable health care services in a clean cosmopolitan city. Singapore has made news for many complex and innovative procedures, such as the separation of conjoined twins and tooth-in-eye surgery. The successful separation of 10-month-old Nepalese conjoined twins in 2001 put Singapore's medical expertise into headlines around the world. Singapore has since accomplished many more milestones both in Asia and in the world arena. THAILAND Medical tourism is a growing segment of , 2006 , retrieved September 12 , 2006 One patient who received a '', September 4 , 2005 , retrieved September 12 , 2006 Roundtrip airfare from Europe, North America and other parts of the world to Thailand can range from $500 to well over $2500 per person, so consumers should expect that extra cost. Hospitals in Thailand are a popular destination for other Asians. Another hospital that caters to medical tourists, , 2006 , retrieved September 12 , 2006 Bumrungrad International Hospital makes much of the fact that many of its staff are accredited in the UK, Europe and the U.S. The origins of the U.S. medical system are British, with the American Medical Association acknowledging that Manchester Physician Dr Thomas Percival is responsible for modern medical ethics, and even the founder of Harvard University , John Harvard , was born in Southwark , London . The modern Thai medical system shares in this Anglo-U.S. inheritance, as Prince Mahidol Of Songla , the King's father, earned his MD degree from Harvard Medical School in the early 20th century. Prince Mahidol and another member of the Thai Royal Family paid for an American medical education for a group of Thai men and women Prince Mahidol also convinced the Rockefeller Foundation to provide scholarships for Thai citizens to study medicine and nursing[source? Dubious given that Rockefeller was in Thailand from the early 1920's and Mahidol was a low-ranked royal, not in Thailand most of the time . Funds from the Rockefeller Foundation were also used to help build modern medical training facilities in Thailand. The men and women who studied medicine and nursing as a result of Prince Mahidol's efforts [source?] became the first educators for the modern Thai medical system. Today many Thai physicians hold U.S. or UK professional certification. Seveal Thai hospitals have relationships with educational facilities in the U.S. and UK (for example, Sheffield Hallam University has links with Bangkok }. The U.S. consular information sheet gives the Thai health care system high marks for quality, particularly facilities in Bangkok. The UK's Foreign and Commonwealth Office web site states "There are excellent international hospitals in Bangkok but they can be expensive". Thailand offers everything from cardiac surgery to organ transplants at a price much lower than the U.S. or Europe, in a safe, clean environment. However, there is indisputably a major HIV/AIDS problem in Thailand, as acknowledged by the World Health Organisation "HIV/AIDS in Asia Pacific Region" , ''World health Organization'' and dengue is becoming increasingly common. Thailand has a growing number of hospitals with JCAHO accreditation. Again, international hospital accreditation may be one way for hospitals to demonstrate their worth, and increasingly Thai hospitals competing for business in this sector may need to expand their international accreditation. HONG KONG Hong Kong possesses a superb medical infrastructure. A former British Colony and now a Special Administative Region (SAR) within China , it has 12 private hospitals and more than 50 public hospitals. Among the widest range of health care services throughout the globe are on offer, and some Hong Kong private hospitals are considered among the best of their type in the world. -sourced surveyors. This has led to a uniquely co-operative approach toward improvement of hospital standards. Some Trent Hospitals have now gone on to obtain dual international accreditation, with both Trent and JCI (and have therefore attained a standard surpassing even that of some of the best hospitals in Thailand and Singapore). Others are looking towards dual international accreditation with Trent and the Australian group. Unlike Singapore , the Hong Kong public hospitals are yet to commit to external accreditation. Roundtrip airfares from North America, South America and Europe can vary from about US$600 to more than US$2000, so calculate that into your medical costs. RISKS AND REWARDS Medical tourism carries some risks that local medical procedures do not. Should complications arise, patients might not be covered by insurance or able to seek compensation via Malpractice lawsuits. However new insurance products are available that do protect the patient should a medical malpractice occur overseas. "eworld press release- Aos Assurance Company limited" The most outspoken critics of medical tourism are U.S. malpractice lawyers who see this emerging trend as a threat to their livelihood. Some countries currently sought after as medical tourism destinations provide some form of legal remedies for medical malpractice. However, this legal avenue is unappealing to the medical tourist. Advocates of medical tourism advise prospective tourists to evaluate the unlikely legal challenges against the benefits of such a trip before undergoing any surgery abroad. Some countries, such as India, Malaysia, Costa Rica, or Thailand have different infectious diseases than Europe and North America, and different prevalences of the same diseases compared to nations such as the U.S., Canada, and the UK. Exposure to disease without having built up natural immunity can be a hazard for weakened individuals, specifically for gastrointestinal diseases (e.g Hepatitis A, amoebic dysentery, paratyphoid) which could weaken progress, mosquito-transmitted diseases, influenza, and tuberculosis (e.g., 75% of South Africans have latent TB). International hospital accreditation with Trent or JCI, mentioned earlier, may be of value here when people are trying to choose a destination for their procedure. Also, travel soon after surgery can increase the risk of complications, as can vacation activities. For example, scars will be darker and more noticeable if they sunburn while healing. "Incision Care" , ''American Academy of Family Physicians'', July , 2005 , retrieved September 18 , 2006 Long flights can be bad for those with heart (thrombosis) or breathing-related problems. However, because in poor tropical nations diseases run the gamut, doctors seem to be more open to the possibility of any infectious disease, including HIV, TB, and typhoid, there are cases in the West where patients were consistently misdiagnosed for years because such diseases are perceived to be "rare" in the West.2 REFERENCES EXTERNAL LINKS |
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