Covid19 Opportunity: Domestic Medical Tourism Sustainable Program

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May 17, 2020

gBy: Mr. Krishna Pandey, PhD Research Fellow, MBA (IB)

Chairman, Domestic Medical Tourism Organization

“Each and every country will give first priority to upgrade their own healthcare system to develop  international and domestic medical tourism destination”

On 17 May, 2020 there are 4,723,190 confirmed cases worldwide in 215 countries with 313,273 deaths worldwide. Europe has leading no. of 1,761,437 positive cases and 161,679 death cases. North America playing second position with no. of 1,662,905 positive cases and 101,951 death cases. Asia leading third position with no. of 780,950 positive cases and no. of 24,347 death cases. South America playing fourth position with no. of 425,165 positive cases and 22,436 death cases. Africa playing fifth position with no. of 83,365 positive cases and 2,726 death cases. Similarly, Oceania leading strong position with no. of 8,647 positive cases and 119 death cases.

The WHO director-general explains, “WHO has been assessing this outbreak around the clock and we are deeply concerned by the alarming levels of spread, severity and inaction. We have therefore made the assessment that COVID-19 can be characterized as a pandemic. Pandemic is not a word to use lightly or carelessly but if misused, can cause unreasonable fear or unjustified acceptance that the fight is over, leading to unnecessary suffering and death. We have never seen a pandemic sparked by the coronavirus before, that also can be controlled at the same time. We are deeply concerned that some countries are not approaching this threat with the level of political commitment needed to control it. As this is a controllable pandemic, so countries must strike a fine balance between protecting health, preventing economic and social disruption and respecting human rights.

The virus that causes COVID-19, infects people of all ages. However, evidence to date suggests that two groups of people are at a higher risk of getting severe COVID-19 disease, they are older people (people over 60 years old) and those with underlying medical conditions such as cardiovascular disease, diabetes, chronic respiratory disease, and cancer. The risk of severe disease gradually increases with age starting from around 40 years. It is important that adults of this age group protect themselves and in turn protect others that may be more vulnerable.

According to the World Economic Forum, “Pandemics top national risk-management frameworks in many countries and each outbreak of a potentially dangerous infection prompts authorities to ask a rational set of questions and dust off the menu of response options that can be implemented as needed in a phased manner. Reality is generally more disruptive, as national governments and supranational agencies balance health security, economic and social imperatives on the back of imperfect and evolving intelligence. It is a governance challenge that may result in long-term consequences for communities and businesses.”

While the virus is deadly for some, many who have it experience mild symptoms or no symptoms at all, making it much harder to detect. Approx 99% countries have responded by banning entry to travellers who have been to affected regions, barring flights to certain countries, communities, cities and changing visa requirements, and others have recommended that no citizens travel to another country.

The restrictions and virus fears have hit tourism hard, and medical tourism is expected to be hit the hardest.

People those who highly dependent on medical tourism may have facing struggles whereas the hospitals and clinics which are easily providing services to the local people.

Medical Tourism Concept:

Medical Tourism is the globalization phenomenon where people who live in one country travel to another country to receive medical and surgical care for quality treatment at lowest and affordable cost with choice of doctors, hospitals, geography and requirements.

Global Medical Tourism Economic overview:

The global medical tourism market size is expected to reach USD 207.9 billion by 2027, expanding at a CAGR of 21.1%, according to a new report by Grand View Research, Inc. Medical tourism generates direct foreign exchange income and contributes to the overall development of any economy.

Global medical tourism is increasing annually. The thing which is changing rapidly is each country’s share of the total, and the type of medical tourist they are attracting. It highlights those countries that are becoming major destinations, and what they are doing to promote their country.

Key Findings:

  • The demand for global medical tourism is changing
  • Some countries see increasing numbers but others struggle
  • This is a very fluid market
  • Some strategies and marketing policy has to be changed – focus on domestic medical tourism destination.
  • This market is not just price driven
  • Successful countries work hard to attract medical tourists – reduce package cost and value added services
  • Competitive healthcare market and margin will be come down
  • Cost of medicine will increase due to hike of Active Pharmaceutical Ingredient (API)
  • Huge investment in healthcare will be in made from govt. part globally
  • Most advance research laboratories will be open for CDC program globally – Pvt. Healthcare service providers will invest for capacity building, technology, upgrade and refine its healthcare system for sustainable in a competitive way.

Current Comparison Chart of Treatment Cost of Medical Tourism Countries:

Countries Angioplasty Heart Bypass Heart Valve Replacement Hip Replacement Dental Implant Brest Implant IVF Treatment Cataract Surgery Hysterectomy
Nepal* USD $3800 USD $6700 USD $9300 USD $7600 USD $650 USD $1950 USD $2000 USD $300 USD $1700
India USD $5700 USD $7,900 USD $9,500 USD $7,200 USD $900 USD $3,000 USD $2,500 USD $1,500 USD $3,200
Thailand USD $4200 USD $15,000 USD $17,200 USD $17,000 USD $1,720 USD $3,500 USD $4,100 USD $1,800 USD $3,650
Singapore USD $13400 USD $17,200 USD $16,900 USD $13,900 USD $2,700 USD $8,400 USD $14,900 USD $3,250 USD $10,400
Malaysia USD $8000 USD $12,100 USD $13,500 USD $8,000 USD $1,500 USD $3,800 USD $6,900 USD $3,000 USD $4,200
Turkey USD $4800 USD $13,900 USD $17,200 USD $13,900 USD $1,100 USD $4,500 USD $5,200 USD $1,600 USD $7,000
South Korea USD $17700 USD $26,000 USD $39,900 USD $21,000 USD $1,350 USD $3,800 USD $7,900 USD $10,400
Israel USD $7500 USD $28,000 USD $28,500 USD $36,000 USD $1,200 USD $3,800 USD $5,500 USD $3,700 USD $14,500
Colombia USD $7100 USD $14,800 USD $10,450 USD $8,400 USD $1,200 USD $2,500 USD $5,450 USD $1,600 USD $2,900
Jordan USD $5000 USD $14,400 USD $14,400 USD $8,000 USD $1,000 USD $4,000 USD $5,000 USD $2,400 USD $6,600
Costa Rica USD $13800 USD $27,000 USD $30,000 USD $13,600 USD $800 USD $3,500 USD $1,700 USD $6,900
Poland USD $5300 USD $14,000 USD $19,000 USD $5,500 USD $925 USD $3,900 USD $4,900 USD $750 USD $2,200
Mexico USD $10400 USD $27,000 USD $28,200 USD $13,500 USD $900 USD $4,500 USD $5,000 USD $2,100 USD $4,500
USA USD $28200 USD $123,000 USD $170,000 USD $40,364 USD $2,500 USD $6,400 USD $12,400 USD $3,500 USD $15,400

Source: Medical Tourism Association, USA

*New Medical Tourism Destination in Asia

Note: Above chart is basic rate only. For medical tourist will pay additional cost of flight, visa, hotel accommodation and foods.

Medical procedures ranging from cosmetic surgery, dental work, to orthopedic surgery can now be provided at high quality and affordable rates in many countries. As listed by Healthy Travel Media, publisher of Patients Beyond Borders, here are the top 10 medical tourism destination around the world.

INDIA

India is one of the key players in the medical tourism destination for the medical industry as it strives to provide health care services with cutting-edge technology. Healthcare in India saves patients between 60% -70% of money compared to the cost of similar service in the US, making India one of the most visited countries for health care. ‍Patients visit India not only for the quality and affordability of healthcare service but also for the beautiful scenery and architecture in India’s landscape. In India, medical travel brings a mix of pleasure, luxury, and quality healthcare for medical travelers.

350 hospitals in India are accredited by the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and 34 hospitals are accredited by Joint Commission International (JCI). Some private hospitals in India now provide health care packages for foreign patients which offer pick-ups from the airport to the hospital, medical rescue, free medical opinion, free in-room Wi-Fi, and private chefs. ‍Additionally, in India, there is close to zero waiting time, as scheduling surgery or intervention is done quickly once the diagnosis is confirmed.

BRAZIL

The World Health Organization (WHO) notes that Brazil ranks as the best in healthcare delivery in Latin America. Brazil has 43 hospitals accredited by the JCI and it boasts of having world-renowned surgeons. ‍Brazil is the hub of cosmetic and plastic surgery, being the third most visited country, below US and China, for patients needing those procedures. Brazil offers high quality cosmetic and plastic surgical services at affordable rates, drawing more and more health travelers to the country.

‍Brazil is also a favorite for patients who seek special procedures such as the Brazilian butt-lift or other specialty services from world-renowned surgeons. Health travelers from the US save 20% to 30% on health cost if they receive their health treatment in Brazil.

‍MALAYSIA

Malaysia has won the number one spot in the International Medical Travel Journal’s award for “Health and Medical Tourism Destination of the year” in 2015 and 2016. Malaysia ranks among the best providers of healthcare in all of South-East Asia. ‍Health travelers who visit Malaysia save 60% to 65% on health cost compared to the cost in the US. ‍Malaysia offers excellent patient comfort with five-star rooms that look more like hotel suites than hospital rooms. In Prince Court Medical Centre, for example, there are indoor pools for hydrotherapy. How exquisite!

‍At both Penang International Airports and Kuala Lumpur airports, is the Malaysia Healthcare Travel Council (MHTC) from the govt. part, which provide lounge and concierge services to medical tourists to ensure their comfort from the very minute they arrive in Malaysia.

THAILAND

Thailand is well known for its unique hospitality and exotic beaches. Having the highest number of internationally accredited hospitals in South-East Asia, Thailand draws a good number of medical travelers each year.

Thailand is most reputed for advanced dental work as well as cosmetic and dermatological procedures. ‍The rich culture and beauty of Thailand also afford patients private recovery gardens, Thai massage and other forms of relaxation therapies Thailand is known for. Medical services in Thailand saves a patient 50% to 60% on medical expenses they would have incurred for similar services in the US.

TURKEY

Turkey is a strong contender in the medical tourism market. Turkey boasts of zero waiting times, affordable and quality healthcare delivery. Specifically, in the areas of transplant surgery, radiation therapy for cancer, orthopedic surgery, neurosurgery, and genomic medicine. ‍What’s more? The country’s national carrier, Turkish Airlines, offers flight rates at discounted prices to medical travelers. Cost of receiving quality healthcare in Turkey is 50% to 65% lower in Turkey than in the United States.

MEXICO

Mexico is well known for its rich culture, delicious cuisine, and its good taste for art. Mexico has since opened its doors widely to medical travelers from around the world.

‍Mexico has 98 hospitals accredited by the country’s Federal Health Ministry and 7 hospitals which are JCI-accredited. Mexico is most reputed for advanced care in dentistry and cosmetic surgery. Medical care in Mexico saves a patient 40% to 65% compared to the cost of similar services in the US.

‍COSTA RICA

As Costa Rica rebuilds its economy following the damage that was done by the Tropical Storm some months ago, it is fast rising as a leader in the medical tourism market. ‍This Central American country has ranked high in dentistry and cosmetic surgery, above Canada and US, consistently in the last few years.

The country is also building a name in the fields of eye surgery, cancer therapy, and bariatric surgery. Cost of healthcare services in Costa Rica is 45% to 65% lower than in the US, saving patients a lot of money.

T‍AIWAN

Taiwan has experienced gradual expansion in medical tourism destination in recent years. With advances in the treatment of cardiac diseases and orthopedic conditions in the country, Taiwan is on the verge of becoming a hub in these medical fields. ‍Taiwan boasts as the first in kidney transplant in Asia. The National Taiwan University Hospital, where the procedure was performed, provides affordable and high-quality treatment for medical tourists.

‍Also, the first ever pediatric liver transplant in Asia was performed by surgeons in Taiwan. ‍Patients generally save 40% to 55% in healthcare cost in Taiwan compared to the cost of similar services in the United States.

‍SOUTH KOREA

South Korea is one of the most tech-savvy and technologically advanced countries in the world. In South Korea, patients receive advanced healthcare services with cutting-edge technology from well-trained staff. ‍Another reason medical tourists are attracted to South Korea is the insurance coverage offered to medical tourists.

The insurance covers injury, stress disorders, and death of a patient due to the procedures or treatment they receive. ‍South Korea reduces health cost by 30% to 45% for patients, compared to cost in the United States.

S‍INGAPORE

Singapore is one of the most developed countries in the world, maintaining the top spot in the World Health Organization’s ranking of healthcare in Asian countries. According to Bloomberg, Singapore ranked at the top of countries with the most efficient healthcare systems in 2014, above 50 other countries. Seeking health care in Singapore saves a patient 25% to 40% of what they would have spent on the same services in the United States.

‍As the medical tourism market becomes more competitive and countries invest more in it, these countries are likely to remain at the top while more countries spring up in the race to being key players in the industry of medical travel. ‍Patients seeking medical treatment abroad should not look far away from these countries, as each promises quality care and a relaxing ambiance at an affordable cost. However, patients are advised to make adequate research on the countries and hospitals they seek to visit for treatment checking for international accreditation of the hospitals, quality and standard of care provided, and the skills of the needed medical professionals.

NEPAL

Nepal is developing a new Medical Tourism Destination in Asia to provide quality healthcare services with cutting-edge technology. Healthcare in Nepal saves patients between 70% to 80% of money compared to the cost of similar service in the US. Nepal is one of the most favorite countries for travel & tourism for foreigners.

Nepalese healthcare service provider needs to convert normal tourist package to medical tourism package. Nepal is world’s no. 1 in Ophthalmology and Cataract Surgeries at just USD $50 to $300. Nepal, known as rich in natural herbs. Country having more than 600 species of medicinal herbs found in wild. Most of the common diseases recovered by these herbs rather than taking medications.

However  the cost of treatment and recovery of serious disease and illness is very high in Nepal, but there is zero waiting time, as scheduling surgery or intervention is done quickly once the diagnosis is confirmed. Patients visit Nepal not only for the quality and affordability of healthcare service but also for the beautiful of scenery, -10 to +45 degree temperature in just 184 km distance and architecture in Nepal’s landscape. In Nepal, medical travel brings a mix of pleasure, luxury and wellness & heal of body, mind & soul and quality healthcare for medical travelers.

Nepal having 20 Medical Colleges & 13 Dental Colleges. 1 hospital is accredited by the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and more than 15 hospitals are offering foreign patients are accredited by Nepal’s government standards. Some medical tourism companies working to provide for foreign patients which offer pick-ups from the airport to the hospital, medical rescue, free medical opinion, visa invitation, international insurance claim settlement, accommodation, local transportation and geriatric nursing services at home.

“Now the current situation has changed due to covid19 pandemic, each and every country should think about their own health system development, upgrade quality, capacity and technology”

POST COVID19 IMPACT, CHANGES & CHALLENGES IN HEALTHCARE SECTOR:

People’s changed the way of thinking in Healthcare: Most of the govt. hospitals participating to rescue and treatment procedures for coronavirus. None of the private hospitals offering coronavirus treatment. The way of thinking of common people has changed to further treatment in govt. hospitals instead of private hospitals.

Changes of way of lifestyle: During this pandemic, most of the people stay at home with homemade foods. Avoided junk foods, drinking alcohol and smoking. Due to these changes, mortality rate that means the budget for healthcare of common people may reduce.

Govt. gives first priority for Healthcare system and infrastructure development: Most of the countries will initiates, many new govt. hospital will be establish, capacity building, upgrade healthcare system, adopt new healthcare technologies and promote subsidize healthcare packages to the common people on the behalf of government. There will be more competitive environment between the govt. sector and private sector hospitals in terms of quality of care, technology, expertise and price.

Focus on Health Insurance & TPA: The cost of medical is very expensive. Health Insurance Policies and TPA will be promoted to the common people and settlement of policies. TPA is mandatory for hassle free payment settlement for patient’s medical bill. TPA authorized to limitation, and release of pre and post medical expenses.

Medical Tourism National Program: Medical Tourism is the largest service export industry in all over the world, every country should initiate national level program for foreign patients to make standard guidelines for their security, transparency and make a robust hassle free visa processing services online for free of cost. Government should make policy, guidelines and regulations to operate hospitals, and facilitators.

Digital Health Program: Every country will focus on digital health program for legalization and regulation of tele medicine, tele radiology, tele icu, tele medical conferences.

Reduce cost of treatment and more competitive: Post covid19, most important impact is reduce of cost of treatment. Each and every country will offer subsidize healthcare packages. The paying capacity is for next 4-5 years which is very less due to financial crises, jobless, cutoff govt. health incentives. If the supply is over, affects overall medical tourism and packages. The expected treatment cost will come down upto 20-30% from 2020 to 2024.

Increase of cost of Medicine: Due to the hike of API, pharmaceutical companies will increase the cost of medicine by 20-30%.

Trending of Treatment into AYUS: People with priority of treatment in Ayurvedic, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUS) instead of Allopathic.

Priority of Domestic Medical Tourism:  Most of the private hospital will focus on domestic patient acquisition instead of foreign tourist because of the long term global financial crises due to this Covid19 Pandemic.

Regulation of Healthcare Facilitator: Most of the countries will make regulation for healthcare facilitator / agents.

Medical Tourism Council / Board: Most of the countries will create Medical Tourism Council/Board from the govt. part. Now Malaysia has already implemented and promoted the medical tourism industry globally. Currently Malaysia having top five medical tourism destination in Asia.

MEDICAL TOURISM COMPANIES IN NEPAL:

Explore Healthcare Pvt. Ltd., is an ISO 9001: 2015 Certified Healthcare Management Company having corporate office in Putalisadak, Kathmandu, Nepal. Explore Healthcare is the top most medical tourism destination for medical company in Asia. For more details logon to www.explorehealth.com.np

The company provides comprehensive healthcare management services as below;

  1. Manage Surgical Camp and Multi Organs Transplants Programs in association world’s renowned transplant surgeon worldwide. For more details logon to www.organstransplant.com
  2. Global Healthcare BPO for overseas patients. For more details logon to www.organscare.com
  3. Worldwide Medical Rescue. For more details logon to www.airambulancenepal.com
  4. International Medical Fellowship Program. For more details logon to www.medicalfellowship.org
  5. Managing platform for health research journals. For more details logon to www.healthsansar.com
  6. The company initiated the medical tourism development in Nepal to create a competitive and new medical tourism destination in Asia. The company successfully performed two international level Medical Tourism Asia Summit in 2018 and 2019 to develop the medical tourism destination with the theme of global b2b network. For more details logon to www.nemto.org
  7. The company is open to collaboration and manage information centers for international standards hospitals in Nepal, Uzbekistan, Europe and others.
  8. The company manages medical conferences, cme, rtm and exhibitions worldwide through its subsidiary company – Explore Productive Chamber of Commerce. For more details logon to www.epccglobal.org

Past activities:

References:

  • Medical Tourism Association, USA
  • World Economic Forum
  • World Health Organization
  • World-o-meters databank