Rama Baru, Professor, Centre of Social Medicine and Community Health, JNU and Adjunct Fellow, ICS and Madhurima Nundy, Associate Fellow, ICS.
Health tourism includes travelling for medical care, wellness and relaxation. According to UNESCAP (2007) medical travel refers to international phenomenon of individuals travelling, often great distances, to access health services that are otherwise unavailable due to high costs or limited supply. The reasons for the rise of health tourism is located in the rising cost of medical care in developing countries and the overall crisis that has affected health service systems in developed and developing countries. Incomplete insurance coverage, long waiting lists for interventions, poor care services after hospitalization are all important reasons for rise of this industry. Another important segment for medical travel is dental, optical and cosmetic surgery. Five distinct industries come together to form the complex for health tourism. These include tourism, hospitality, airlines, insurance, medical care and wellness services.
Globally health tourism is a multi-million industry and the major global players are India, Thailand, Singapore and Malaysia. These countries mostly get patients from UK, US, Canada, Bangladesh, Maldives and the Middle East. High cost of insurance, medical care, rise of uninsured and under insured are important reasons for health tourism. China does not figure as one of the prominent destinations for medical travel although there are efforts by the government to promote it. It is indeed interesting to note there is a lot of outbound medical travel from China to neighbouring countries like South Korea, Singapore and other South-East Asian countries. The reasons cited are that there is a class of Chinese from the middle, upper middle and upper classes who have disposable incomes and prefer not to wait for treatment in their public hospitals. In our interactions with the Shanghai Municipal Health Bureau, the rich Chinese have private insurance cover for travelling abroad for medical treatment. The public insurance does not cover these expenses.
India alone earned foreign exchange worth $1.8 billion dollars in 2012 and this doubled to $3.6 billion in 2015. Services for which people seek care include cardiac surgeries, orthopaedic (Knee and Hip replacement), cosmetic and dental surgeries. According to recent estimates 30% of medical tourists come for cardiac treatment, 15% for orthopaedic related, 10% for nephrology, 11% neurosurgery and cancers respectively and 22% for cosmetic surgery. The treatment in India is also facilitated through the partnerships between American and British insurance companies with Indian corporate hospitals.
In terms of cost of procedures, India has an advantage compared to other countries. The table below shows the cost comparison for select procedures.
Apart from medical care, there is a market for indigenous systems- ayurveda, yoga and massage in India. This is very well developed industry with the hospitality sector by packaging wellness and relaxation by promoting indigenous systems. There is no such organised effort visible in China at the moment. A very important advantage that India enjoys compared to China is the fluency in English which is a critical factor for marketing India as a destination for health tourism.
China is exploring the possibilities of expanding its health tourism industry as a revenue earner. Informally, the traditional medicine and the wellness sector of China sees many tourists but the medical care is yet to make its mark as a tourism industry. Our recent interactions with the Chief Advisor and Deputy Director of the Shanghai Health Development Research Centre, the research wing and think tank of the Shanghai Municipal Health Bureau showed that health tourism is clearly an area they are studying carefully and see it as one of the important source of revenue earning in the future.