Medical Tourism

Russia’s medical tourism up, but domestic industry in need

Rising costs and long waits for quality healthcare are pushing millions of people each year into medical tourism.

In the developed world, healthcare forms a significant part of a country’s economy. According to the U.S. Census Bureau, the annual revenue of that country’s industry in 2012 was roughly $1.688 trillion. World Bank figures show that public health expenditures in the European Union could jump to 14 percent of GDP in 2030, from 8 percent in 2000.

By traveling in search of quality at a lower price, medical tourists seek alternatives to their own countries’ healthcare offerings. Depending on the destination and treatment, a medical vacation can cost 50, 30 or even 10 percent of what patients would pay at home.

The number of wealthy Russians traveling abroad for treatment is making the trend especially noticeable.

“At the moment, there are roughly 200,000 Russians traveling for medical purposes each year, and they leave approximately $2.5 billion during their stays,” said Alexei Kamenev, president of the First All-Russian Association of Private Medical Practitioners, in his opening speech at last week’s Medical and Health Tourism Mart in Moscow.

The meeting is the first-ever direct sales platform set up in the global medical and health tourism industry.

Israel a top location

Israel is Russian health tourists’ favorite destination, Kamenev said, with 50,000 traveling there in 2012 – doubling the amount in 2011 and contributing more than $1 billion to the country’s economy.

He outlined three main groups of people who seek medical treatment abroad. The first strand travels from countries with less developed healthcare systems to more developed ones, for example from Russia to Israel or Germany.

The second strand is citizens of countries with good but expensive healthcare going to places with high quality but more budget-friendly options, such as Americans traveling to Asia. The third strand looks for alternative medicine in locations such as Tibet because mainstream treatments have proven insufficient.

Countries that are just emerging onto Russian tourists’ radar were also present at the event, hoping to crack the Russian market – such as Spain.

Hungary is already popular for some Western European patients, especially for dentistry, plastic surgery and its world-famous thermal baths and spas, but Angelina Strizhkova, the director of the Prestige Haz hotel and spa in the western city of Heviz, lamented that it has little advertising on the Russian market.

“The doctors [in Heviz] are wonderful, they’re all highly skilled professionals and at the same time they charge much less than German or Austrian doctors, but, unfortunately, Hungary lacks advertising and marketing on the Russian market,” she said. “I’d like to see that situation change.”

Profits in the middle

The growing popularity, though, has given rise to several problems, Kamenev told The Moscow News – such as middlemen, who he said are making heavy profits off of Russian patients.

“I met with a very respectable Israeli doctor recently and asked him why the prices our patients are shown are so ridiculous,” Kamenev said. “He said to me, ‘Alexei, these prices are five times higher than what we charge!’ So where’s the money? The profiteers have it all.”

His organization is attempting to make the industry more transparent and consumer-oriented by creating a new international online platform called MedOkey, comprised of some of the most prominent doctors and clinics worldwide. It is set to start work at the end of the year.

A single flow of Russian patients through accredited international agents will help “remove all profiteering and non-medical components from the industry,” Kamenev said, by displaying comprehensive price lists, thus putting middlemen out of business.

MedOkey already has the backing of the World Health Organization and the World Medical Association. Kamenev has also been in negotiations with Israel to allow Russian citizens to use their public healthcare services, reaching agreement on a 10 percent quota that he believes will save thousands of lives.

Care begins at home

Kamenev’s organization has also agreed with Israel on a deal whereby Russian doctors can visit on educational exchanges, to learn about advanced technologies that Russia does not yet have and eventually improve domestic care.

Approximately 90 percent of Russia’s top medical facilities and doctors are located in Moscow, where only 10 percent of the population lives. Russia’s experience with medical tourism, Kamenev believes, will allow it to try to apply international best practices at home.

A glimpse of this future comes from RZD Zdorovye, a subsidiary of state rail monopoly RZD, which has a chain of spas, medical resorts and sanatoriums throughout the country. The company’s Daria Sokolova and Dmitry Mishin said that many of its doctors have trained abroad, including in traditional Chinese medicine, and that its sanatoriums have attracted some patients from Western Europe and North America.

One benefit of domestic medical tourism is lower prices, because they include travel, accommodation and treatments, Mishin said. In Israel, for example, only consultation costs are included.

Even the lack of a language barrier brings the price down, and a cultural sympathy can make treatments more effective.

“Russian doctors understand the specifics of our mentality and our illnesses, so we treat what needs to be treated, avoiding losing things in translation,” Sokolova said.

Source : The Moscow News

 

Medical tourism driving health care disparity in Thailand

medical tourism

The rise of medical tourism in Thailand has left the country’s health care system facing a critical test. As the government looks to attract ever higher numbers of overseas patients, there are concerns that access to health care for its own population of 67 million may suffer, admit Thai health officials.

In January, the Ministry of Public Health will launch its latest medical tourism strategy, a four-year plan to cement Thailand as the leading medical hub in Asia, with a target to make $6 billion per year by the end of 2017. But cracks are already starting to show in the other side of what the Thai government calls its “dual-track policy,” which aims to develop both the public and private health sector.

Although still little understood, there are mounting fears medical tourism may be fueling brain drain to the private sector, causing a lack of doctors and nurses in state hospitals and in turn widening Thailand’s health gap.

“Some [nongovernmental organizations] and reporters said that our policy impacts on Thai citizens accessing medical services, on the price and quality standards,” said Dr. Saowapa Jongkitipong, deputy director of the Department of Health Service Support, which created the new medical hub strategy.

The Ministry of Public Health has not ignored these criticisms, she said. The aim is to also train more doctors and nurses to meet public health care staffing shortages, according to the ministry’s new strategy, though details remain vague.

Furthermore, plans for a National Health Statute aimed at supporting nonprofit hospitals and primary care services with financial backing by the Thai Board of Investment have stalled, said Dr. Tipicha Posayanonda, a public health expert at the National Health Commission Office, which was charged with devising the plan.

Part of the problem was a change of government in 2011 amid a bitter political divide in the country. For more than two years, the draft plan has been held up and the Board of Investment’s board of directors has still not seen it, meaning there is no strategy in place to fix the deficiencies of Thailand’s health services in less developed areas of the country, said Posayanonda.

“We’re lacking some doctors so we need to get a balance,” she said. “We’re trying to help poorer people.”

As Thailand moves ahead with plans to further increase medical tourism, the effects of catering to the needs of hundreds of thousands of additional patients every year are only just being understood, say researchers and medical professionals.

Medical tourism adds an estimated 0.4% to Thailand’s economy every year, which raises income for the medical services sector, concluded Anchana NaRanong and Viroj NaRanong in their 2011 study of the impacts of the industry. Other positive effects include a higher standard of medical hardware courtesy of the best private hospitals. Overall, however, Thailand’s medical tourism drive is causing growing disparity when it comes to access to health care, the study concludes.

“Negative effects are evidenced by both a shortage of physicians and by increased medical fees for self-paying Thais, which are likely to undermine their access to quality medical services,” the paper added.

In other words, for Thais who can afford to pay for private health care, costs are being driven up by medical tourism. For those who rely on basic, government health schemes — more than 80% of the population — staffing levels in state hospitals are being undermined by private sector brain drain.

The number of Thai medical graduates was expected to climb from 1500 to 2300 after 2010, but the NaRanong study found that foreign patients take up more physician time, so the distribution of doctors in underprivileged, remote areas remains low.

In response, the Ministry of Public Health has recently required new and existing private hospitals to provide data on the number of current and intended employees so that manpower can be better planned.

As Thailand leads the way in the fast-growing medical tourism market, it could provide lessons for other developing countries, such as India and Mexico. But it is only just learning what those lessons might be, said Dr. Nima Asgari, public health administrator in the World Health Organization’s Thailand office.

Data at the local level on the burden of diseases and availability of services remain inadequate, said Asgari. “The impact of medical tourism on the public health sector is currently being investigated by the Ministry of Public Health but it is still too early to say anything definitively.”

Source: CMAJ

S. Korea says medical tourists likely to reach 1 mln in 2020

The number of foreign medical tourists in Korea by 2020 could reach 1 million and churn out revenue of 3.5 trillion won (US$3.2 billion), the Korea Tourism Organization said Tuesday.

The organization said the number of people from abroad who visit the country for medical treatment is expected to grow from about 399,000 this year to 998,000 in 2020.

Per capita health spending in Korea by a foreign patient could hit 3.56 million won in 2020, up from 2.53 million won this year, it added. Earnings from foreign patients could reach 3.5 trillion won in 2020, up from just 1 trillion won this year.

Korean medical services, noted for their high quality and cheaper than those of the West, are getting more popular abroad, especially China. China Daily last month said 62 percent of the estimated 31,000 Chinese who visited Korea on 15-day medical tourism visas last year sought cosmetic surgery.

Source: The Korea Observer

New Medical Township in Kerala beckons foreign health tourists

A medical township comprising nine super speciality hospitals — offering the latest state-of-the-art technology to treat a host of diseases including cancer — is coming up in Kochi with an eye to promote Kerala as a top medical health tourism destination.

Aster Medcity, which is being built on what was a huge garbage dump yard, is to start functioning by March 2014. D M Healthcare, a big name in healthcare in Gulf countries, is building the complex on 38 acres of land at Cheranallur in Kochi.

Phase I of the complex, being built at a cost of $150 million, would have on offer 540 beds across the nine hospitals, Harish Pillai, chief executive officer of Aster Medcity, told IANS.

The Medcity plans to add another 500 beds later in Phase II. The township will have residential quarters, hotels, a convention centre, cafeterias, guest rooms and later also a home for the elderly, said Pillai.

“We are aiming to attract foreign health tourists to Aster Medcity. We have the latest facilities, including minimally invasive treatment and diagnostic techniques for the diagnosis and treatment of various cancers and heart diseases,” Pillai told IANS.

India gets 150,000 medical tourists every year, and it is expected to grow by 15 per cent annually, he said.

Among the latest technology that Aster will boast of is the ‘True Beam’ that provides radiation treatment in a shorter time and minus most of the usual side effects of current treatment, said Pillai. The ‘True Beam’ technology is a radio-surgery treatment in which high-energy X-rays are used to destroy tumours.

“Conventional therapy takes a very long time, but this system delivers concentrated radiation with pinpoint accuracy on the tumour,” Pillai said.

“As it is a concentrated high-dose treatment, the process is over in a few minutes for patients,” he added.

An added advantage of the new system is that it uses 25 per cent lower X-ray dosage compared to conventional ones. This reduces greatly the radiation exposure for patients.

“The conventional radiation therapies are accompanied by various side effects, but with True Beam the impact of radiation is greatly minimized and it also doesn’t impact the normal tissues,” Pillai said.

The Medcity will also have cardiac cath labs or catheterization laboratories — diagnostic imaging equipment used to visualise the arteries of the heart to detect any abnormalities. The cath labs will have an added advanced technology, called ‘clarity’, to reduce the radiation levels for patients, doctors and lab technicians, said Pillai.

This has been introduced keeping safety and efficiency as the hospital’s top priority, he said.

“You would be surprised to know that so far there has been no study of how many cardiologists in the country acquire cancer due to long exposure to radiation. So this is the reason the cardiac cath labs with option of ‘clarity’ are being introduced,” Pillai said.

The ‘clarity’ cardiac cath lab reduces radiation exposure by almost 73 per cent.

“This is the newest technology that is being introduced in India for the first time,” he said.

Another new technology being introduced is the hybrid biplane cath lab that can convert the imaging and diagnostic device into an operation theatre for any emergency surgery.

“Besides cardio, this technology would be used in interventional neuro-radiology cases. We will be bringing experts trained overseas for using this technology,” Pillai said.

The medical township also has a large artificial lake in the complex, which adds to the pleasing environment of the township.

Source: India Medical Times