Medical Tourism And Public Health Economics Essay

A THE most recent tendency in denationalization of wellness services is medical touristry, which is deriving prominence in developing states. Globalization has promoted a consumerist civilization, thereby advancing goods and services that can feed the aspirations originating from this civilization. This has had its consequence in the wellness sector excessively, with the outgrowth of a private sector that thrives by serving a little per centum of the population that has the ability to “ purchase ” medical attention at the rates at which the “ high terminal ” of the private medical sector provides such attention. This has changed the character of the medical attention sector, with the entry of the corporate sector. Corporate tally establishments are seized with the necessity to maximize net incomes and expand their coverage. These aims face a restraint in the signifier of the comparatively little size of the population in developing states that can afford services offered by such establishments. In this background, corporate involvements in the Medical Care sector are looking for chances that go beyond the limited domestic “ market ” for high cost medical attention. This is the generation of the “ medical touristry ” industry.


A Medical touristry can be loosely defined as proviso of ‘cost effectual ‘ private medical attention in coaction with the touristry industry for patients necessitating surgical and other signifiers of specialised intervention. This procedure is being facilitated by the corporate sector involved in medical attention every bit good as the touristry industry – both private and public.

A In many developing states it is being actively promoted by the authorities ‘s official policy. India ‘s National Health policy 2002, for illustration, says: “ To capitalize on the comparative cost advantage enjoyed by domestic wellness installations in the secondary and third sector, the policy will promote the supply of services to patients of foreign beginning on payment. The rendition of such services on payment in foreign exchange will be treated as ‘deemed exports ‘ and will be made eligible for all financial inducements extended to export net incomes ” . The preparation draws from recommendations that the corporate sector has been doing in India and specifically from the “ Policy Framework for Reforms in Health Care ” , drafted by the premier curate ‘s Advisory Council on Trade and Industry, headed by Mukesh Ambani and Kumaramangalam Birla.



The states where medical touristry is being actively promoted include Greece, South Africa, Jordan, India, Malaysia, Philippines and Singapore. India is a recent entrant into medical touristry. Harmonizing to a survey by McKinsey and the Confederation of Indian Industry, medical touristry in India could go a $ 1 billion concern by 2012. The study predicts that: “ By 2012, if medical touristry were to make 25 per cent of grosss of private up-market participants, up to Rs 10,000 crore will be added to the grosss of these participants ” . The Indian authorities predicts that India ‘s $ 17-billion-a-year health-care industry could turn 13 per cent in each of the following six old ages, boosted by medical touristry, which industry spectators say is turning at 30 per cent yearly.

A In India, the Apollo group entirely has so far treated 95,000 international patients, many of whom are of Indian beginning. Apollo has been a precursor in medical touristry in India and attracts patients from Southeast Asia, Africa, and the Middle East. The group has tied up with infirmaries in Mauritius, Tanzania, Bangladesh and Yemen besides running a infirmary in Sri Lanka, and pull offing a infirmary in Dubai.

A Another corporate group running a concatenation of infirmaries, Bodyguards, claims it has doubled its figure of abroad patients – from 675 in 2000 to about 1,200 this twelvemonth. Recently, the Ruby Hospital in Kolkata signed a contract with the British insurance company, BUPA. The direction hopes to acquire British patients from the waiting line in the National Health Services shortly. Some estimations say that aliens account for 10 to 12 per cent of all patients in top Mumbai infirmaries despite barriers like hapless air power connectivity, hapless route substructure and absence of unvarying quality criterions.

A Analysts say that every bit many as 150,000 medical tourers came to India last twelvemonth. However, the current market for medical touristry in India is chiefly limited to patients from the Middle East and South Asiatic economic systems. Some claim that the industry would boom even without Western medical tourers. Afro-asian people spend every bit much as $ 20 billion a twelvemonth on wellness attention outside their states – Nigerians entirely spend an estimated $ 1 billion a twelvemonth. Most of this money would be spent in Europe and America, but it is hoped that this would now be progressively directed to developing states with advanced installations.



The cardinal “ merchandising points ” of the medical touristry industry are its “ cost effectivity ” and its combination with the attractive forces of touristry. The latter besides uses the gambit of selling the “ exotica ” of the states involved every bit good as the packaging of wellness attention with traditional therapies and intervention methods.

A Price advantage is, of class, a major merchandising point. The motto, therefore is, “ First World intervention ‘ at Third World monetary values ” . The cost differential across the board is immense: merely a ten percent and sometimes even a sixteenth of the cost in the West. Open-heart surgery could be up to $ 70,000 in Britain and up to $ 150,000 in the US ; in India ‘s best infirmaries it could be between $ 3,000 and $ 10,000. Knee surgery ( on both articulatio genuss ) costs 350,000 rupees ( $ 7,700 ) in India ; in Britain this costs ?10,000 ( $ 16,950 ) , more than twice as much. Dental, oculus and decorative surgeries in Western states cost three to four times every bit much as in India.

The monetary value advantage is nevertheless offset today for patients from the developed states by concerns sing criterions, insurance coverage and other substructure. This is where the touristry and medical industries are seeking to pool resources, and besides seting force per unit area on the authorities. We shall turn to their deductions subsequently.

A In India the strong tradition of traditional systems of wellness attention in Kerala, for illustration, is utilized. Kerala Ayurveda Centres have been established at multiple locations in assorted metro metropoliss, therefore foregrounding the advantages of Ayurveda in wellness direction. The wellness touristry focal point has seen Kerala take part in assorted trade shows and expos wherein the advantages of this traditional signifier of medical specialty are showcased.

A generic job with medical touristry is that it reinforces the medicalised position of wellness attention. By advancing the impression that medical services can be bought off the shelf from the lowest priced supplier anyplace in the Earth, it besides takes away the force per unit area from the authorities to supply comprehensive wellness attention to all its citizens. It is a deepening of the whole impression of wellness attention that is being pushed today which emphasises on engineering and private endeavor.

The of import inquiry here is for whom is ‘cost effectual ‘ services to be provided. Clearly the services are “ cost effectual ” for those who can pay and in add-on come from states where medical attention costs are extortionate – because of the failure of the authorities to supply low-cost medical attention. It therefore attracts merely a little fraction that can pay for medical attention and leaves out big subdivisions that are denied medical attention but can non afford to pay. The demand for cost effectual specialized attention is coming from the developed states where there has been a diminution in public disbursement and rise in life anticipation and non-communicable diseases that requires specialist services.




Medical touristry is traveling to merely cover with big specializer infirmaries run by corporate entities. It is a myth that the grosss earned by these corporates will partially return back to finance the populace sector. There is ample grounds to demo that these infirmaries have non honoured the conditionalities for having authorities subsidies – in footings of intervention of a certain proportion of in patients and out patients free of cost. If anything, increased demand on private infirmaries due to medical touristry may ensue in their enlargement. If they expand so they will necessitate more professionals, which means that they will seek to court physicians from the populace sector. Even today the top specializers in corporate infirmaries are senior physicians drawn the populace sector. Medical touristry is likely to farther devalue and divert forces from the public sector instead than beef up them.

A Urban concentration of wellness attention suppliers is a well-known fact – 59 per cent of India ‘s practicians ( 73 per cent allopathic ) are located in metropoliss, and particularly metropolitan 1s. Medical touristry promotes an “ internal encephalon drain ” with more wellness professionals being drawn to big urban Centres, and within them, to big corporate tally forte establishments.

A Medical touristry is traveling to ensue in a figure of demands and alterations in the countries of funding and ordinances. There will be a greater push for promoting private insurance tied to systems of accreditation of private infirmaries. There is a immense concern in the developed states about the quality of attention and clinical expertness in developing states and this will force for both insurance and regulative governments. The possible for gaining grosss through medical touristry will go an of import statement for private infirmaries demanding more subsidies from the authorities in the long tally. In states like India, the corporate private sector has already received considerable subsidies in the signifier of land, reduced import responsibilities for medical equipment etc. Medical touristry will merely farther legalize their demands and set force per unit area on the authorities to subsidize them even more. This is worrying because the scarce resources available for wellness will travel into subsidizing the corporate sector. It therefore has serious effects for equity and cost of services and raises a really cardinal inquiry: why should developing states be subsidizing the wellness attention of developed states?

The term Medical Tourism has emerged from the pattern of citizens of extremely industrialised states such as the United States, Canada, Great Britain, Western Europe etc. going to other states around the Earth to have a assortment of medical and health care services, chiefly due to continually lifting costs of the same services and processs in their ain states. In add-on, these people besides take on the function of tourers, holidaying and taking advantage of all the major sites and attractive forces that these states have to offer, in concurrence with having medical intervention.

In add-on to the lifting costs of health care in topographic points like the United States and Great Britain, the increasing easiness and affordability of international travel via air and sea, every bit good as the rapid promotion of medical engineerings in lesser-developed states all around the universe have all contributed to the turning planetary involvement in Medical Tourism.

Topographic points like India, the East Indies, Mexico, and South America are going really popular when it comes to Medical Tourism. Not merely do these states provide a high degree of quality medical attention at significantly lower rates, but they besides offer an abundant figure of touring, site-seeing, shopping, dining, and relaxation options as good. Other Medical Tourism hot musca volitanss are the West Indies, the Philippines. Africa, the Middle East, and Mexico.

Ample informations by virtuousness of studies is available on the Medical Tourism construct and increasing figure of people are fall ining this bandwagon every twelvemonth.

Top Narratives

Sunday February 15, 11:05 AM

India ‘s wellness touristry woos British patients

By Prasun Sonwalkar, Indo-Asian News Service

London, Feb 15 ( IANS ) Enterprising circuit operators here are planing an resistless bundle for British patients: wing down to India for state-of-the- art intervention and so recuperate in the many lusters of unbelievable India.

Thomas Cook, a taking travel company that began operations from Leicester, is taking the manner by offering surgery and intervention in Mumbai infirmaries and so retrieving on the silvan beaches of Goa or with visits to peaceable temples in the southern India.

Patients in Britain frequently face drawn-out waiting periods to acquire intervention on the National Health Service ( NHS ) – many of them die waiting for their bend on the operation tabular array.

Some enterprising people have gone to India and returned mightily satisfied and are promoting others to take the first flight to Delhi or Mumbai for a state-of-the-art medical intervention.

Arthritic James Campbell preferred to travel to India for a articulatio genus operation instead than confront a biennial delay on the NHS. The 69-year-old from Braemar, Aberdeenshire, was in so much hurting he was forced to walk backwards down stepss to ease the force per unit area on his articulations.

He was appalled when he was told he would hold to wait two old ages merely to acquire on the waiting list for surgery. So he flew to India for the operation last October.

“ I find it gross outing. I ‘ve worked all my life and paid my revenue enhancements all that clip. I ‘ve ne’er asked for anything back, ” Campbell said. “ But the first clip I did I was forced to go forth this state and travel elsewhere. It ‘s a damnatory indictment of our wellness service. ”

Campbell thought about holding the surgery in private but could non afford the ?20,000 measure.

He picked the Krishna Heart Institute in Gujarat from the Internet for his intervention, which cost ?8,000, and has since returned to what he says is a ‘new life ‘ after having top intervention.

A big Numberss of British Asiatics have been going to Mumbai and elsewhere for old ages for intervention, but industry experts believe the potency is much greater.

The freshly formed Medical Tourism Council of Maharashtra is at the head of this the enterprise to procure wellness touristry concern from the West, and offer Indian infirmaries as a cheaper, choice alternative to a long delay on the NHS.

Doctors estimate that bosom surgery costs an mean ?30,000 in the private sector in Britain but merely ?6,000 in Mumbai.

Under the new bundles, patients would be able to take their physician and infirmary on a web site in Britain and will be met at the airdrome on reaching in Mumbai and other topographic points in India and taken attention of.

Cox and Kings, an upmarket specializer travel company, and Taj Hotels, besides program to establish bundles with the backup of the Maharashtra touristry and wellness ministries.

India ‘s infirmaries are besides offering to transport out operations for the NHS. A squad of Indian medical experts besides met senior functionaries in the wellness section in this context.

Medical Tourism

What ‘s called medical touristry – patients traveling to a different state for either pressing or elected medical processs – is fast going a worldwide, multibillion-dollar industry.

The grounds patients travel for intervention vary. Many medical tourers from the United States are seeking intervention at a one-fourth or sometimes even a 10th of the cost at place. From Canada, it is frequently people who are frustrated by long waiting times. From Great Britain, the patient ca n’t wait for intervention by the National Health Service but besides ca n’t afford to see a doctor in private pattern. For others, going a medical tourer is a opportunity to unite a tropical holiday with elected or fictile surgery.

And more patients are coming from poorer states such as Bangladesh where intervention may non be available.

Medical touristry is really 1000s of old ages old. In ancient Greece, pilgrims and patients came from all over the Mediterranean to the sanctuary of the healing God, Asklepios, at Epidaurus. In Roman Britain, patients took the Waterss at a shrine at Bath, a pattern that continued for 2,000 old ages. From the eighteenth century affluent Europeans travelled to spas from Germany to the Nile. In the twenty-first century, comparatively low-priced jet travel has taken the industry beyond the affluent and despairing.

States that actively promote medical touristry include Cuba, Costa Rica, Hungary, India, Israel, Jordan, Lithuania, Malaysia and Thailand. Belgium, Poland and Singapore are now come ining the field. South Africa specializes in medical safaris-visit the state for a campaign, with a way station for plastic surgery, a nose occupation and a opportunity to see king of beastss and elephants.


India is considered the taking state advancing medical tourism-and now it is traveling into a new country of “ medical outsourcing, ” where subcontractors provide services to the overburdened medical attention systems in western states.

India ‘s National Health Policy declares that intervention of foreign patients is lawfully an “ export ” and deemed “ eligible for all financial inducements extended to export net incomes. ” Government and private sector surveies in India estimation that medical touristry could convey between $ 1 billion and $ 2 billion US into the state by 2012. The studies estimation that medical touristry to India is turning by 30 per cent a twelvemonth.

India ‘s top-rated instruction system is non merely churning out computing machine coders and applied scientists, but an estimated 20,000 to 30,000 physicians and nurses each twelvemonth.

The largest of the estimated six medical corporations in India functioning medical tourers is Apollo Hospital Enterprises, which treated an estimated 60,000 patients between 2001 and spring 2004. It is Apollo that is sharply traveling into medical outsourcing. Apollo already provides nightlong computing machine services for U.S. insurance companies and infirmaries every bit good as working with large pharmaceutical corporations with drug tests. Dr. Prathap C. Reddy, the president of the company, began dialogues in the spring of 2004 with Britain ‘s National Health Service to work as a subcontractor, to make operations and medical trials for patients at a fraction of the cost in Britain for either authorities or private attention.

Apollo ‘s concern began to turn in the 1990s, with the deregulating of the Indian economic system, which drastically cut the bureaucratic barriers to enlargement and made it easier to import the most modern medical equipment. The first patients were Indian exiles who returned place for intervention ; major investing houses followed with money and so patients from Europe, the Middle East and Canada began to get. Apollo now has 37 infirmaries, with about 7,000 beds. The company is in partnership in infirmaries in Kuwait, Sri Lanka and Nigeria.

Western patients normally get a bundle trade that includes flights, transportations, hotels, intervention and frequently a post-operative holiday.

Apollo has besides reacted to unfavorable judgment by Indian politicians by spread outing its services to India ‘s 1000000s of hapless. It has set aside free beds for those who ca n’t afford attention, has set up a trust fund and is open uping distant, satellite-linked telemedicine across India.

Health Checkup

Many common and dangerous conditions can be treated successfully if detected early. Many taking infirmaries in India have wellness check-up programmes that screen every portion of the organic structure meticulously and professionally. A proper wellness check-up scans your bio-history, interprets signals and provides the chance for the proverbial “ stitch in clip ” . A bosom check-up representing echocardiography, audience by a senior heart specialist, blood trial, general trial and haemogram can travel a long manner in guaranting a healthy bosom. The trial can be done at any of the taking cardiac infirmaries or private clinics.

Whats Involved

A comprehensive wellness check-up contains the undermentioned trials:

Doctors audience and full medical scrutiny

Blood trials

Complete Haemogram ( hemoglobin, TLC, DLR, ESR, Haemotocrit, Peripheral Smear )

Blood group ( ABO, RH )

Blood Sugar

Blood Urea

Serum Uric Acid

Serum Creatinine

Serum Cholesterol

Lipid Profile

Urine and Fecal matters Exmimation

X-Ray Chest PA


Exercise Stress Test ( TMT )

Stress Screening by Psychologist

Eye Examination

Gynaecologist Consultation and Pap Smear Test

Post Check-up consulation

Optional Trial

Back Ground to a new construct of Indian Medical outsourcing

India can gain $ 1 billion from medical touristry

India could gain more than $ 1 billion yearly and make 40 million new occupations by sub-contracting work from the British National Health Service, the caput of India ‘s largest concatenation of private infirmaries.

Houston-trained Dr Prathap C Reddy, president, Apollo Hospitals, besides said he was waiting for a answer to his proposal to transport out operations at a fraction of what they would be in the United Kingdom. They include surgery for hip and articulatio genus replacings and coronary beltway that would cut down waiting times dramatically, cut downing the waiting lines of British patients waiting to see their physicians. “ We have good equipped, state-of-the-art infirmaries and we can offer the same degree of attention as anyplace else in the universe, ” Dr Reddy said. “ There is no ground why we should non go the healthcare finish of the universe. ”

India ‘s health care industry is turning at 30 per cent yearly and the Apollo group entirely has so far treated 95,000 international patients, many of whom are of Indian beginning. Reddy cited two recent instances of UK subjects who opted for private health care at the Apollo web. One of them — Cyril Parry, a 50-year-old adult male from Birmingham — successfully underwent hip replacing surgery at Apollo, Chennai. The other — Buckingham Palace employee Elaine Ackrill — was besides treated at the Chennai Apollo for malignant neoplastic disease of the uterine neck.

Medical intervention in the UK is free under the NHS, but because of the long waiting times some patients opt for expensive private attention. The advantage of Reddy ‘s offer is that is that it would cut down force per unit area on the NHS and offer sub-contracted health care at immensely cheaper rates.

Earlier this twelvemonth, Apollo was represented at a London meeting that was besides attended by a UK authorities wellness advisor and private health care suppliers from South Africa, Australia, India and the UK. The consensus at the London meeting was that the UK needed advisers and registrars to come over on short-run contracts before returning to their place states. The Apollo squad responded with a counter offer of a medical touristry bundle that would cut waiting times for surgery in the UK. “ They have a one million waiting list for all sorts of things, particularly orthopedic surgery, ” explained an Apollo spokesman.

“ After this million people, there are 1000s of exiles. Not needfully Indian, but exiles who may be given the chance to come and acquire themselves operated in India where we are be aftering to give them what is called wellness touristry. ”

“ The orthopedic surgery we are offering is chiefly knee and hep replacing. I ca n’t state you how many are involved, but they have done a pilot survey and given assorted break-ups. ”

Indian Medical outsourcing

What function can ACG play?

We have been concentrating on wellness attention for past about four old ages, though marginally with a little function to get down with. We developed a batch of web sites for makers & A ; exporters of Herbal heath attention merchandises. We so worked for their export publicity through assorted avenues including hunt engine optimisation, interchanging links etc. Upon having good response we got the entry into other Fieldss related with wellness attention. We worked for natural or processed stuff required for fabrication of assorted merchandises. This included assorted indispensable oils every bit good. In the mean while we started working with physicians for on-line audience. This has so far resulted that on an norm we are having around 3-4 questions daily, which included both domestic every bit good foreign people. We have covered many fortes including

Parkinson ‘s disease




Systemic Lupus Erythematosus ( SLE )

Wilson ‘s disease


Nephrotic syndrome

Uterine Fibroid tumors

Ulcerative Colitis

Acquired immune deficiency syndrome

Other countries may be considered as per the demands or facility/expertise available.

Possible Alliance with ACG

Our working protocols are

For Platinum Membership Rs.35,000.00

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