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THE most recent trend in privatization of health services is medical tourism, which is gaining prominence in India. Globalization has promoted a consumerist culture, thereby promoting goods and services that can feed the aspirations arising from this culture. This has had its effect in the health sector too, with the emergence of a private sector that thrives by servicing a segment of the population that has the need and want to "buy" high end quality medical care at competitive rates that was previously perceived to be available in the Western countries only.
However, this has changed and is gaining momentum. Even people from western countries such as USA and UK, where timely and affordable medical care is becoming a luxury for increasing masses of the population, are seriously considering or seeking treatment abroad in countries such as India for medical treatment. This is the genesis of the "medical tourism" industry.
MEDICAL TOURISM AS AN INDUSTRY
Medical tourism can be broadly defined as provision of 'cost effective' private medical care in collaboration with the tourism industry for patients needing surgical and other forms of specialized treatment. This process is being facilitated by the corporate sector involved in medical care as well as the tourism industry - both private and public. In countries such as India, it is being actively promoted by the government's official policy. India's National Health policy 2002, for example, says: "To capitalise on the comparative cost advantage enjoyed by domestic health facilities in the secondary and tertiary sector, the policy will encourage the supply of services to patients of foreign origin on payment. The rendering of such services on payment in foreign exchange will be treated as 'deemed exports' and will be made eligible for all fiscal incentives extended to export earnings". The formulation draws from recommendations that the corporate sector has been making in India and specifically from the "Policy Framework for Reforms in Health Care", drafted by the prime minister's Advisory Council on Trade and Industry, headed by Mukesh Ambani and Kumaramangalam Birla.
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GROWTH OF THE MEDICAL TOURISM INDUSTRY
Medical tourism in India is being actively promoted to expand this offering from traditional countries such as Greece, South Africa, Jordan, India, Malaysia, Philippines and Singapore, to patients in USA and UK. According to a study by the US based McKinsey Group and the Confederation of Indian Industry, medical tourism in India could become a $1 billion business by 2012. The Indian government predicts that India's $17-billion-a-year health-care industry could grow 13 per cent in each of the next six years, boosted by medical tourism, which industry watchers say is growing at 30 per cent annually. In India, just one medical group has so far treated upwards of 95,000 international patients, It attracts patients from Southeast Asia, Africa, and the Middle East. The group has tied up with hospitals in Mauritius, Tanzania, Bangladesh and Yemen besides running a hospital in Sri Lanka, and managing a hospital in Dubai. Another corporate group running a chain of hospitals, claims it has doubled its number of overseas patients - from 675 in 2000 to nearly 1,200 this year. Recently, a hospital in Kolkata signed a contract with the British insurance company. The management is expecting an increase in British patients from the queue in the National Health Services soon. Analysts say that as many as 150,000 medical tourists came to India last year. The medical tourism clientele is expected to become more diversified and include patients from more regions off the world. For example, Afro-Asian people spend as much as $20 billion a year on health care outside their countries - Nigerians alone spend an estimated $1 billion a year.
WHY MEDICAL TOURISM IS POPULAR IN INDIA?
The key "selling points" of the medical tourism industry are its "cost effectiveness" and its combination with the attractions of tourism. The later also uses the idea of selling the "exotica" of the countries involved as well as the packaging of health care with traditional therapies and treatment methods. Price advantage is, of course, a major selling point. The slogan, thus is, "First World treatment' at Third World prices". The cost differential across the board is huge: only a tenth and sometimes even a sixteenth of the cost in the West. Open-heart surgery could cost up to $70,000 in Britain and around $100,000 in the US. In India best of the class medical treatment could cost between $3,000 and $10,000.
THE COST OF THE OPEN HEART SURGERY APPROXIMATELY COSTS LESS THAN $8,000 IN INDIA WHICH IS APPROXIMATELY 1/12TH THE COST IN US.
Dental, eye and cosmetic surgeries in Western countries cost 5 to 6 times as much as in India. A generic problem with medical tourism is that it reinforces the medicalised view of health care. By promoting the notion that medical services can be bought off the shelf from the lowest priced provider anywhere in the globe, it also takes away the pressure from the government to provide comprehensive health care to all its citizens. It is a deepening of the whole notion of health care that is being pushed today which emphasises on technology and private enterprise.
The important question here is for whom is 'cost effective' services to be provided. Clearly the services are "cost effective" for those who can pay and in addition come from countries where medical care costs are exorbitant - because of the failure of the government to provide affordable medical care. It thus attracts only a small fraction that can pay for medical care and leaves out large sections that are denied medical care but cannot afford to pay. The demand for cost effective specialized care is coming from the developed countries where there has been a decline in public spending and rise in life expectancy and non-communicable diseases that requires specialist services. Medical facilities available in India are seriously competing and providing more value to clients in most areas of medical treatment. Patients in other countries particularly USA and UK are already familiar with, and are comfortable with medical professionals of India origin who had migrated to these countries in the past. WHY HelloMD.com IS THE RIGHT CHOICE?
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