Tourism Sector in the Asian Countries - Case Study Example

Table of Contents Table of Contents 1 EXECUTIVE SUMMARY 2 INTRODUCTION 3 METHODOLOGY 5 THE CASE STUDIES 6 Medical tourism in India 6 Medical tourism in Thailand 7 Medical tourism in Singapore 8 ANALYSES OF THE MAJOR FINDINGS 10 CONCLUSION AND RECOMMENDATIONS 13 Conclusion 13 Recommendations 13 REFERENCE 14 Tuner L. 2007. First World Health Care at Third World Prices': Globalization, Bioethics and Medical Tourism Cambridge University Press, p. 21. 15 THE AIM OF THE CASE STUDY There are so many countries that are catering for the medical tourists in the world. The aim of this case study is to find out the situation of the medical tourism sector in the Asian countries. In addition the case study will find out the competitive advantage that some countries have over others in Asia. This will be achieved by reviewing all the available literature concerning the selected countries in the case study. EXECUTIVE SUMMARY Medical tourism is an international phenomenon of people travelling across the international borders seeking health care services that are otherwise not available in their countries of residence either due to high prices, poor facilities, unprofessionalism and long waiting lists. Previously, the medical tourism sector was dominated by the United States of America (US) and Britain. Currently, with the development of infrastructure and technology, many international patients prefer Asia to the US and Britain. The case study in this report was conducted on three countries from Asia: namely India, Thailand and Singapore. The main aim of the researcher was to find out the key issues and challenges in the medical tourism Industry in Asia. After a thorough research of journals, conference papers, books and online materials it was concluded that Asia has the most preferred medical tourism hubs which include India, Malaysia, Philippines, Taiwan, Thailand and Singapore among others. These medical tourism hubs are cost effective, have qualified medical personnel and use modern medical technologies. The main challenges facing the medical tourism industry in Asia include poor infrastructure, poor medical tourism facilities, unequal ratio between doctors and patients, overcrowding in the major cities and lack of government support. The main recommendations proposed by this paper include policy and institutional reforms, memorandum of understanding between the sending and the receiving country, code of ethics for professionals and improvement of the infrastructure. INTRODUCTION Every year patients from all over the world seek treatment for dreaded diseases like heart diseases, cancer, kidney diseases, orthopaedics, liver diseases, paediatric diseases, etc. These patients seek professional treatment from some of the specialised hospitals abroad. Medical tourism is an international phenomenon of people travelling across international borders seeking health care services that are otherwise not available in their countries of residence either due to high prices, poor facilities, unprofessionalism and long waiting lists. The main contributors to the improvement of the global medical tourism sector include increased foreign travel, joint ventures in the private health sector and readily available information to the consumers. Medical travel, however, is about expanding patients’ choices on where to find health care and increasing the tendency of people from developing countries to take medical travel as they combine it with other tourism adventures. Although medical tourism looks as if it is a new idea in the world it is more than a thousand years old (UNESCAP, 2008, p.1). Previously, patients from both developed and developing countries used to seek medical assistance from the United Kingdom (UK) and the United States of America (US). Although the services were expensive, these destinations had monopolised the medical tourism sector and patients were left with no other option at their disposal. Currently, the global medical tourism sector is developing, thanks to the emergence of other medical tourism destinations. However, people from developed and developing countries prefer hospitals in Asia to hospitals in the US and the UK. Many Asian countries have promoted the global medical tourism sector. The medical tourism sector in Asia is rapidly growing. In 2006, according to Hafidzah (2008, p.2), the sector outstripped the 4-6 % growth in general bookings that were predicted by the year 2006. The burgeoning medical tourism industry in Asia is expected to be worth more than US$4 billion by the end of 2012 (Hafidzah, 2008, p.2). The rationale for improvement of the medical tourism sector in Asia is its cost effectiveness and high quality that is attracting over 1.3 million tourists each year. The main medical tourism destinations in Asia include Malaysia, South Korea, Thailand, Singapore and India. The development of medical tourism sector in Asia gives the patients, especially from the developing countries, a better option where they are guaranteed professional medical service, which is cost effective. This essay is a report of a case study that the researcher has conducted on various countries in Asia. The main objective of the researcher is to find out the key issues and challenges that countries in Asia are facing in relation to the medical tourism industry. Three countries were selected on a random criterion and they represent the situation of medical tourism in Asia. These countries are Singapore, India and Thailand. METHODOLOGY The purpose of this Research paper is to develop a case study on medical tourism in Asia. The main research methodology that the researcher has relied on is the use of secondary sources. These sources include government reports of the selected countries i.e. Thailand, Singapore and India, the previous case studies of the countries in the region, online book libraries such as Google books and Google scholars. The researcher will thereafter analyse the gathered information through logic. After collection and analyses of the information, the researcher will then generalise the finding as a true representation of medical tourism in Asia. Finally, recommendations will be made concerning the way forward to improve the medical tourism sector in Asian countries and other developing nations. THE CASE STUDIES Medical tourism in India India is a recent destination that is being preferred by the medical tourists. It is catching up with its leaders such as the UK and the US. The recent statistics indicate that India is experiencing a thirty percent increase in the number of medical tourists per year. In 2004, the number of medical tourists in India was approximated to be half a million: whereas in 2002 the number was only 150000. India has increased the number of health care institutions, which offer high standard and international medical services. The Indian medical destinations include Delhi, Mumbai, Bangalore, Chennai and Thiruvananthapuram. Chennai, the southern Indian city, has been declared as the health capital of India. The city receives 45% of health travellers from abroad and more than 30% of domestic health travellers (UNESCAP, 2008, p.10). The medical tourism industry of India is known for its low cost and high quality medical procedures ranging from joint replacement, heart surgery, hip surfacing, dentistry, cataract operations and gallstone removal (UNESCAP, 2008, p.10). The medical costs for treatment of major diseases in India are estimated to be a sixth or even a tenth of what Europe and the UK are offering. For instance, open-heart surgery in the UK is estimated to be US$70000; in the US it is estimated to be US$150000. If such an operation is carried out in one of the best hospitals in India it could cost between US$3000 and US$10000. Secondly, knee surgery (on both knees) in India would cost US$7700; in the UK this costs more than twice as much. Eye, cosmetic and dental surgeries in Europe and the US cost more than three times as much as in India (Gopal, 2008, p.333). However, the medical tourism in India is being faced by a couple of challenges. To start with, the country has a negative sight where it has overcrowded public hospitals, garbage littered on streets and open sewers, which make most visitors, lack confidence in the sanitation standards of India (Marcello, 2003). The other challenges that India is facing are the fact that India does not receive foreigners from Europe and the US. Instead, it receives foreigners from Africa, Asia and the Middle East. It is believed that these countries prefer India because they lack quality hospitals in their countries. Thirdly, poverty and poor hygiene make many patients prefer other destinations. Finally, although India has qualified doctors, it cannot be compared to other destinations such as the US. The ratio of doctors to patients is low. According to World Bank, the ratio of doctors to patients in India is 4: 1000 while in the US the ratio is 27:1000. Medical tourism in Thailand Thailand experienced a financial crisis in 1997 (Monica et al, 2006, p.3). To make up for this significant drop that was specifically caused by the economic breakdown, the private hospitals explored business through the treatment of overseas patients. Since that time, some private hospitals have realised a considerable success in the medical tourism sector (Monica et al, 2006, p.13). The international patients’ number in Thailand has increased from half a million in 2001; to 630,000 in 2002; 1,103,095 in 2004 and an approximated 1.25 million in 2005 (Monica et al, 2006, p.17). Thirty private hospitals in 2006 hosted more than 1.4 million foreign patients and this generated an estimated total turnover of US$1billion. In 2007, the number of international patients increased to 2 million (Monica et al, 2006, p.17). There are several main factors that give a rationale for these emerging trends in the number of medical tourists in Thailand. First, the international accreditation of its health care industry. Secondly, there are competent professionals and advanced medical technology. The medical tourism destinations in Thailand include Samitivej Hospital, Chiangmai Ram Hospital, Bumrungrad International Hospital, Bangkok Hospital and BNH Hospital (Monica et al, 2006, p.14). The medical facilities in Thailand hospitals are better equipped than in India. There are over 400 hospitals, which are better equipped for international patients, and this means that there is no overcrowding in the hospitals, as is the case in India. In Thailand the hotels are modern and the infrastructure is relatively better developed in relation to India. Finally, the services offered by Thailand are cost effective. Although Thailand is relatively more expensive than India, its medical treatment costs are rated to be second, with India being the first. For instance, a heart bypass in Thailand is US$11000, US$10000 in India and US$130000 in the United States. Spinal Fusion in Thailand costs US$ 9000, US$5500 in India and US$62000 in the US. Knee replacement in Thailand costs US$13000, US$8500 in India and US$40000 in the United States. This means that the medical services in Thailand are slightly higher than India but a fraction of the medical costs in the United States (Monica et al, 2006, p.17). However, the main challenge faced by the medical tourism sector in Thailand is that it is mostly being practiced by the private hospitals only (Monica et al, 2006, p.15). This means that the development of this industry is mainly an effort of the private sector and not the government. Secondly, Thailand is facing competition from other destinations such as the US and Britain who offer higher quality service than Thailand, and India, which offers more cost effective service than Thailand. Medical tourism in Singapore Singapore is known for its complex neurosurgical procedures and other medical treatment such as heart and liver transplants. Its reputation of well trained doctors and high quality medical facilities attracted more than 370,000 medical tourists in 2005 and 410,000 medical tourists in 2006 (UNESCAP, 2008, p.13). These patients come mainly from Malaysia, Indonesia, china and the Middle East. Interestingly, even patients from the developed countries like the US are opting for Singapore for its relatively cheap health care services. The main hospitals in Singapore are Mount Elizabeth Medical centre, which covers more than 25 regions in Singapore (UNESCAP, 2008, p. 14). This medical centre has doctors who have internationally recognised qualifications. The other hospitals include Gleneagles Hospital, East Shore Hospital and Raffles Hospital, which have a Japanese clinic for medical tourists from Japan. Singapore medical tourism services are more expensive than India and Thailand but are cheaper than the US, the UK, Japan and other developed countries. For example, a heart valve replacement in Singapore is US$12500 while the same operation can cost US$160000 in the US. A hysterectomy costs US$6000 in Singapore while the same operation costs US$20000 in the US. Finally, angioplasty costs US$13000 in Singapore while the same operation costs US$57000 in the US (Home Base, 2010). This means that Singapore helps the international patients to save around 75% of their medical expenditure. Unlike India and Thailand, Singapore has an improved infrastructure, quality medical facilities and improved hygiene (Horowitz, 2007, p. 10). It has pristine streets, which are not comparable to the overcrowded cities of India. The cities in Singapore are clean. English is recognised as one of the national languages. This offers Singapore a competitive advantage over India and Thailand. In addition, Singapore has modern entertainment facilities and scenic beaches, which make it preferable to medical tourists who plan for post-medication vacations (UNESCAP, 2008, p.14). The main challenge faced by Singapore is the competition from Thailand and India. Although its prices are cheaper than in America and Europe, they are relatively expensive when related to other Asian countries such as India and Thailand. Secondly, Singapore is located near the Equator and this makes its temperatures too high. In addition, the air in summer is humid in Singapore. This makes it difficult for patients who plan to have a post-procedure holiday during summer (UNESCAP, 2008, p.13). ANALYSES OF THE MAJOR FINDINGS Medical tourism has become very popular all over the world as international patients seek medical assistance outside their countries of origin. The rationale for moving from one’s country to another to search for medical assistance may be lack of the required medical profession, long waiting lists and expensive services that are available in that country. Previously, the medical tourism sector was monopolised by countries such as the US and countries from Europe. Asia is a continent that is offering strong competition to the US and the UK. Medical tourists are now travelling to countries such as India, Thailand, Singapore, Philippines, South Korea, Taiwan and Malaysia as viable alternatives for their medical treatment rather than being treated in their own country: or travelling to countries which offer medical services which are not cost-effective. The main aim of this case study was to find out the key issues and challenges being faced by the medical tourism industry in Asia. Three countries, namely India, Thailand and Singapore represented other Asian countries in the case study. The following is an analysis of the major findings from the case study. It was found that Asia offers some of the major hubs of medical tourism destinations in the world. Asia has some of the best hospitals, which are being preferred by international patients. The Medical Travel and Health Tourism Quality Alliance (MTQUA) announced the best hospitals that promote medical tourism in the world. In order of merit, starting with the best, the list is as follows; Fortis Hospital, Bangalore, India Gleneagles Hospital, Singapore Prince Court Medical Centre, Kuala Lumpur, Malaysia Shouldice Hospital, Toronto, Canada Schoen-Kliniken, Munich, Germany Bumrungrad International, Bangkok Bangkok Hospital Medical Centre, Bangkok, Thailand Wooridul Spine Hospital, Seoul, Korea Clemenceau Medical Centre, Beirut, Lebanon Christus Muguerza Super Specialty Hospital, Monterrey, Mexico (Source: MTQUA, 2010) If we critically analyse the list it is evident that the best hospital is in India. In addition, six hospitals out of ten on the list are from Asia. This makes Asia the most preferred destination by many medical tourists. Secondly from the case study, it was found that countries in Asia, such as India, Thailand and Singapore offer cost effective medical services to international patients. From the statistics released by AMA, knee surgery would cost $8500 in India, $10000 in Thailand, $13000 in Singapore and $40000 in the US. Heart valve replacement surgery would cost $8000 in India, $10000 in Thailand, $12500 in Singapore, $90000 in Britain and $200000 in the US. Cosmetic Surgery would cost $2000 in India, $3500 in Thailand, $10000 in the UK and $20000 in the US (Health Base, 2010). This makes India, Thailand, Singapore and other medical tourism destinations in Asia the cheapest medical tourism destinations in the world. The relatively low price of the medical services does not compromise the quality of services offered by the doctors. The ratio of doctors to patients is less as compared to the US and Europe but these doctors are equally qualified. The Asian medical tourism sector is adopting modern technologies and facilities that improve the medical tourism sector. A good example is Singapore that has pristine streets and high quality hygiene, which makes many international patients prefer Singapore to other destinations. Medical tourism in Asia is faced by several challenges. To start with, most of the medical tourism destinations in Asia are developing countries. The usual problems such as poor infrastructure and relatively poor facilities are some of the main problems in these countries. For instance, India offers the cheapest medical tourism services, but international patients prefer other destinations because India is characterised as having poor infrastructure, open sewers, poor hygiene and overcrowded hospitals. Secondly, the best hospitals in Asia are private hospitals. This implicates lack of support from the countries’ governments to the medical tourism sector. Conversely, the institutions are being run by private sectors. The third challenge that is apparent in Asia’s medical tourism sector is the ratio of doctors to patients. In India, 4 doctors serve 10000 patients whereas in the US 27 doctors serve 10000 patients. This compromises the effectiveness and efficiency of medical services offered by hospitals in Asia. Finally, although Asia’s medical tourism sector offers cheap medical services, patients from the US and other developed countries are not considering these hubs as their solutions. This makes Asia a medical tourism destination for other developing countries. When the three countries are compared, more patients prefer India to the Singapore and Thailand. In 2007 there were more patients travelling in India than in Singapore and Thailand (Carabello, 2008, p. 292). There some advantages that the customers are subjected to when they travel to India. The main advantage is that they will pay less for the equal services that can be offered in other countries. The main disadvantage of seeking medical tourism in India is the relatively poor infrastructure (John, 2008, p. 8). The other destination that is preferred in order of importance is Thailand. The advantage of travelling to Thailand is the relatively low prices of the services being offered there. Although the prices are relatively higher when compared to India there is an improved infrastructure in Thailand (Carabello, 2008, p. 292). Singapore is the last in the list in the order of preference. However, Singapore has an advantage of the fact that it has pristine streets which are not overcrowded as in the case of India and Thailand. Singapore is preferred by those patients from the developed countries (Tuner, 2007, p.21). CONCLUSION AND RECOMMENDATIONS Conclusion The development of medical tourism in India, Thailand and Singapore is a true representation of how the situation is in the medical tourism industry in Asia. This shows how other developing countries can improve their medical tourism sector and compete with other players in the industry. Medical tourism sector is developed by having qualified and recognised medical personnel, adopting modern medical technology, developing infrastructure and medical tourism facilities. In addition, offering cost effective medical services provides the country with a competitive advantage in the industry. If other developing countries follow the footsteps of Asia’s medical tourism industry, they will automatically improve their medical tourism sectors. Recommendations The first recommendation on the improvement of the medical tourism sector is the development of infrastructure. Infrastructure development includes construction of roads, building of modern day hotels and upgrading existing medical tourism facilities. This will reduce overcrowding in major cities of the country; it will improve the standards of hygiene of the country and it will increase accessibility of the major hospitals that are within the country. There should be balanced policies and regulations that can be implemental in managing patient flows in a manner that is instrumental to both sending and receiving countries. Such policies include liberalisation of medical travel visa requirements, agreements to allow greater movement of medical professionals and tax benefits. Through country level agreements, there should be a regional cooperation between countries on medical professionals’ code of ethics. Good quality treatment should be ensured through memorandums of understanding signed by both sending and receiving countries. REFERENCE Carabello, Laura. 2008. A Medical Tourism Primer for U.S Physicians. p. 292. Gopal, R. 2008. The key issues and challenges in medical tourism sector in India. Conference on Tourism in India: IIMK. p.332-335. Horowitz, M. D. 2007, “Medical Tourism: Globalization of the Healthcare Marketplace.” MedGenMed Journal; 9(4): p. 10. IEnterpriseOne Business Information Services (EBIS) 2007, Ikbar, Hafidzah, viewed 10 November 2010, . Institute for Strategy and Competitiveness 2006, Harryono, Monica et al, viewed 8 November 2010, . John, Connell. 2006. Medical Tourism: Sea, Sun, Sand and Surgery Australia: University of Sydney, p. 8. Khan, Maryam. 2010. Medical Tourism:Outsourcing of Healthcare. International Chrie Conference: Howard University, p.2. Medical Travel & Health Tourism Quality Alliance (MTQUA): Announces the Top 10 World’s Best Hospitals for Medical Tourists 2010, viewed 10 November 2010, . UNESCAP. 2008. Medical Travel in Asia and the Pacific Challenges and Opportunities. Thailand: United Nations, p. 7-17. Yale Center for the Study of Globalization 2010, Marcelo, Ray, viewed 8 November 2010, . India Profile: Cost Comparison of Medical Treatments: India vs The World 2010, viewed 8 November 2010, . Tuner L. 2007. First World Health Care at Third World Prices': Globalization, Bioethics and Medical Tourism Cambridge University Press, p. 21. Read More