Asian destinations cash in on 'medical tourism'

Catch some sun, take in a few golden temples, and get a new hip. It’s an unlikely but increasingly popular itinerary for foreign visitors who are flying into Thailand in ever greater numbers to get quality hospital care at bargain prices, part of a “medical tourism” boom that is turning into a multibillion-dollar industry in Asia.

The kingdom is one of several countries in the region cashing in on its ability to use cheap but highly skilled labour, affordable hospital accommodation and offer specialist treatments.

With budget air travel and the internet providing access to information about cheap or specialist treatment overseas, medical centres across Asia are doing battle to become regional, or even global, hubs for healthcare.

Singapore is aiming to attract one million foreign patients per year by 2010 while India is gunning to be a top medical tourist destination, benefiting from its huge base of medical professionals and low costs.

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Thailand is proving popular for everything from dental work to sex change operations.

Many Thai private hospitals employ staff fluent in English and translators for Arabic, Bengali, Chinese, Japanese, Korean and Spanish in the cut-throat competition against rival hospitals in India and Singapore.

“We see patients from 189 different countries,” says Mack Banner, chief executive officer at Thailand’s top private hospital, the Bumrungrad International Hospital, in central Bangkok.

With its entrance decorated with the flags of all nations and a fountain in the lobby, Bumrungrad looks more like a five-star hotel and has a food court that features chains such as Starbucks, Au Bon Pain, and McDonald’s.

Banner says what draws foreigners to the hospital is easy access to quality medical service at bargain-basement prices.

“We do enjoy a significant cost advantage over both the US and Europe. We are much, much less than the US, anywhere from five to 10 times less than the US,” he says.

Of a total of one million patients each year at Bumrungrad, nearly 50% are foreigners with Americans making up the biggest group, followed by patients from the United Arab Emirates, Bangladesh, Oman, Britain, Japan, Australia, Cambodia and Myanmar.

Among Americans, back surgery and hip and knee replacements are the most popular procedures at Bumrungrad, while many Australians seek plastic surgery.

Darryn Kimpton, a 37-year-old Australian, had Botox injections in his forehead and eyes at Bumrungrad to remove facial lines and says he is happy with both result and cost.

“The service was impeccable. Compared to what it would cost me in Australia, I saved over $1 000” including the air fare, Kimpton says.


Sightseeing and check-up packages

Apart from the economic reasons, Bumrungrad’s Banner said patients were coming to Thailand because of its tourism charm.

“Thailand is a welcoming destination for tourists. People like to come to Thailand because it has many tourist attractions to go to,” he said.

To boost medical tourism, Bumrungrad tied up with Thai Airways International in 2000 to offer package tours that combined a one-day stay at the hospital for a comprehensive check-up along with sightseeing in Bangkok.

The packages were so popular that Thai Airways expanded them to Chiang Mai, northern Thailand, in 2002 and to the holiday island of Phuket this year.

“We would like to position Thailand as one of the medical hubs in the region. Also Thailand has a diversity in terms of tourism” that makes it an appealing destination for foreign patients, says Kumari Ratanadib, manager of tour planning and development department at Thai Airways.

“Demand is increasing. We are pretty sure demand is very high, especially from Middle Eastern countries,” she said.

At Bumrungrad, the number of Middle Eastern patients skyrocketed to over 70 000 this year, 14 times as many as 5 000 just five years ago.

Banner attributed the staggering increase to the September 11 attacks in the United States in 2001.

“September 11 had an unfortunate impact on the US and on the Middle East. It became much more difficult for Middle Easterners to get visas to go to the US after 2001,” he said.

“September 11 sort of encouraged Middle Easterners to look at alternative places to get their health care other than the US because the US became harder to get visas.”

Banner said Middle Easterners get “basically everything” at Bumrungrad—including heart surgery, cancer treatment, orthopaedic surgery and eye treatment—and the hospital now has a large Muslim prayer room and special Arabic menus.

With medical tourism becoming more popular, Thailand’s public health ministry expects foreign exchange earnings from the medical service sector to reach 23-billion baht ($561-million) in 2005, up 16% from 2003.

India’s medical tourism, meanwhile, could add as much as two billion dollars to its economy by 2012, according to a 2004 study by the Confederation of Indian Industry and the McKinsey consulting firm.

Indian health services are among the cheapest for foreign visitors compared with other health destinations in Asia.

“If I talk about angioplasty, in the US it’s costing $30 000. At Max Healthcare, it costs between $4 000 to $5 000,” says Sanjiv Malik, CEO of Max Hospital, an upmarket private hospital, in New Delhi.

“India is turning out to be the cheapest as far as health delivery is concerned.”


Selling expertise

Singapore may not be as cheap, but last year the city state’s largest private medical group cut charges for key services to make a stake for Southeast Asia’s lucrative expatriate patient market.

Singapore is aiming to attract one million foreign patients a year by 2010, but with India and Malaysia offering cheap healthcare, doctors are pushing US-standard ethical and professional standards as well as cost.

Raffles Hospital, for instance, has gained fame in recent years for highly publicised operations to separate conjoined twins, exemplifying the highly skilled expertise available.

“There’s always concern over whether Singapore can attract foreign patients, but I think we’ve shown that it’s not a problem,” Dr Loo Choon Yong, executive chairperson of Raffles Medical Group, said on August 10 when the group’s second quarter results were released.

“Foreign patients are drawn to Singapore not because of costs but because of the expertise that we offer,” added Loo, after Raffles announced a year-on-year revenue increase of 9,5% to 27,7-million Singapore dollars ($16,3-million) in the second quarter to June from a year ago.

The 380-bed hospital treated around 25 000 foreign patients in 2003.

Meanwhile, the number of foreign patients at Bumrungrad, which is listed on the Thai stock market, more than doubled to 353 000 in 2004 from 2000.

But Banner says the decision to go global began out of necessity, not choice.

Private hospitals including Bumrungrad were hard pressed following the 1997 Asian economic crisis, which hit Thailand hard with the baht sharply losing its value against the dollar.

“At that time, everybody in Thailand was tightening their belt. They went to government hospitals. There was a huge decrease in demand for private health care in Thailand,” he says.

With local demand dried up, Banner says Bumbrungrad looked for patients abroad.

“That was a big impetus to go international. Also we became amazingly inexpensive to anybody trading US dollars. The team said ‘Well, let’s go out and bring in international patients with US dollars,’” he says.

“The management and owners here had foresight. It helped sustain the hospital and allowed it to develop into a strong service it offers today.” - AFP

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