A new route to health

South Asian countries like India, Malaysia, Singapore, Thailand, and Hong Kong have transformed themselves into popular health care destinations, apart from being a tourist’s paradise. These countries welcome foreign guests from the European Union, the United States and the Gulf, not to mention their pounds, euros and dollars, with open arms. Patients from the developed countries find treatment here an effective and reliable alternative to expensive health care in their home countries.

The high cost of treatment, long waits and red tape in their countries have forced many US, EU and Gulf citizens to look East. Even though the USA spends $ 2.2 trillion annually on its health sector to cater to a population of less than 300 million, the services are inaccessible to the uninsured. The USA’s health system rests heavily on insurance and with the recent figures showing an estimated 50 million people uninsured there, the health benefits can be enjoyed only by those who can afford it.

Dr. Eugene Jacob, who has done his M.B.A. in medicine from Germany says, “This trend is good for India because of the awareness that the gold-standard health care can be provided at a reasonable cost in our country too, contrary to the western belief.”

Hospitals catering to foreign patients are upgrading their interiors to resemble five-star hotels. They make sure that their quality standards are up to the mark. From hassle free travelling to accommodation for the patients’ escorts, all is taken care of by the hospital and its partners.

Medical tourism in 2007 was a US$ 60 billion global industry and is expanding by 20% every year. Five major countries, India, Jordan, Malaysia, Singapore and Thailand reported about 2 million medical travellers in 2004. India alone catered to some 1,50,000 patients in the same year, mainly from the US, Britain, Gulf, Africa and South Asian Association for Regional Corporation (SAARC) countries. Speakers at the International medical tourism conference that took place in Las Vegas, USA, in 2007 said, “India will welcome some 500,000 patients this year and by 2012, medical tourism will pump $ 2.2 billion into that country’s economy.”

“Indian healthcare has been on an upswing ever since the world has put its faith in the magnitude of Indian doctors. Not only does it create the awareness of a rising medical economy, but satisfies the patient at a reasonable cost,” says Dr. Eugene.

In India, the Escorts Heart Institute, Apollo Group of Hospitals and Max Hospitals are the dominant players. Many private hospitals tie up with travel agencies and hotels to espouse medical treatments they pioneer.

Ms. Banasree Basu, Assistant Manager, Marketing of the International Patient Department of the Indraprastha Apollo Hospitals, Delhi, says, “We are one of the finest chains of hospitals that take care of the needs of the international patients. With our well trained medical and other staff, we have achieved great laurels in this area of service.”

Health care is now advertised as a business. Apart from their medical department, millions are now spent on the hospitals’ management.

Some of these private hospitals have gained expertise and credibility through the excellent services they have offered to their patients. For instance, Wockhardt Hospital and Heart Institute in Bangalore completed its 500th beating heart coronary artery bypass graft in an awake patient.

Even though these private players’ roles are growing by leaps and bounds, their running goes unchecked. A major worry for the foreign patients is the quality of health care offered by the developing nations. Who is accountable if things go wrong and what recourse do the patients have if they are unhappy with the treatment given to them?

Experts in this area believe that the load on the local doctors in the developed countries will expand as they will have to correct the mistakes made by doctors in the developing countries. A recent survey shows that 68 Australian doctors had to correct botched surgeries of more than 100 women coming from ‘cosmetic surgery holidays’ from Thailand and Malaysia.

Since these private hospitals go unchecked, there is no concrete data available about either their ‘unsuccessful’ medical treatments or about the training and certification of their staff. We can only hope that the market forces will oblige these hospitals to maintain the quality standards.

Dr. Anoop Nangia, working in a public hospital, says, “The private sector in India is gradually bringing a lifestyle shift. Public hospitals are slowly beginning to be referred as only for the poor. Anyone with a slightly better income now prefers to go a private hospital, without bothering to check the quality of treatment there.”

In a country like India, where public health, which is a state subject, could not hold stable ground since the birth of the nation, the mushrooming of these private health care providers can be devastating.
They very conveniently prioritize profit making and are available for only those who have deep pockets. With the above average services they claim to offer, they manage to smoothly slip into the vacuum created by the shrinking government role in health matters.

According to a WHO Report in 2005, there are only 5.9 doctors per
10,000 population in India, highly concentrated in the urban areas, while the corresponding figures for the European Union is 33.1. Out of the total medical practitioners in India, almost one-third are non-registered and lack formal training. The demand for specialists is shooting up, but their numbers remain stagnant at 10-15 per 1 lakh population.

The steady inflow of medical tourists in a way, manages to check the migration of Indian doctors to the western countries. Specialists and doctors from public hospitals are lured into these corporate hospitals by irresistible packages, resulting in ‘internal brain drain’.

Dr. Eugene adds, “The future of Indian medical tourism will remain shining, till the world realises international medical benchmarking and alters cost. The negativity of it is that the private sectors, has started giving more importance to the tourists, sacrificing the cost-to-health ratio of its own citizens.”

Whether this trend is self-sustainable or not, only time will tell. But as of now, the emerging medical hubs of the world are providing a safe haven to the people from the first world countries falling outside the ambit of their own medical care.


Sonal Matharu