Thailand is popular with tourists for its exotic beaches and breathtaking temples. Now this “Asian tiger” is luring another kind of tourist: patients. The Thai Investment Board reports that Thailand treated over one million foreign patients in 2006. More than just mishappen holidaymakers, these patients were part of an expanding global trade in medical tourism which the board valued at US$40 billion worldwide and with global growth potential of some 20% per year. Some estimates go higher still. A 2008 report by the Deloitte Center for Health Solutions estimated that the value of the world medical tourism market in 2008 was around $60 billion, and they expected double digit growth rates in the years ahead. And while a follow up report in 2009 suggested that the recession would slow this growth–a trend which recent reports from Thailand appear to echo–it still forecast that the number of US outbound medical tourists would reach 1.6 million by 2012.
The health sector has not been slow to respond to this phenomenon. An increasing number of countries or individual hospitals and clinics have actively marketed themselves as medical travel destinations, hoping to attract patients from neighbouring countries and further afield, through the promise of high quality, technologically advanced and competitively priced health services.
In fact, travelling abroad for healthcare is nothing new. Since early times people have travelled far and wide in search of cures and healing. The 19th century was the heyday of spa towns and health resorts throughout Europe. And in more recent times, wealthy patients from around the globe have traditionally sought the latest technology and highest quality service in exclusive private clinics, travelling wherever they felt necessary.
Nowadays, medical tourism is the most visible part of a generalised growth in the globalisation of health–which essentially comes down to international trade in health services. Most people prefer to receive healthcare close to home. But under certain circumstances it can make more sense for a patient to receive healthcare abroad. In some cases the nearest health facility may in fact be across a border. In others, certain specialists or state of the art treatments are simply not available at home, or subject to a long waiting list. And of course, cost plays an important role, and many health tourists merely seek equivalent treatment in countries that are able to provide it more cheaply. Legal and ethical obstacles, such as for stem cell or donor-related treatments, have also been major driving forces behind the increase in health tourism.
Internet has also played an important role. The number of web sites dedicated to medical tourism has mushroomed in recent years, providing patients with a wealth of information and choice of services around the world. In Norway, a study of Internet use for health purposes showed that, by 2007, 67% of the population was using the Internet for health information in some way, and this figure was forecast to rise to more than 80% by 2010. Growing economic and political co-operation is also promoting international movement of patients and healthcare professionals.
Some countries already allow patients to travel to other European countries for treatment that is covered by their own national health services. Patient mobility in Europe could receive a further boost as the European Commission has sought to clarify patients’ rights for treatment coverage in other member states. A European directive has been proposed, seeking to meet three objectives: to guarantee that all patients have access to safe and good quality care; to support patients in the exercise of their rights to cross-border healthcare; and to promote cooperation between health systems.
Hard statistics on the value of healthrelated travel remain patchy and tend to underestimate activity. They show that OECD countries consumed more than $5 billion worth of healthcare services abroad in 2008. An OECD project funded in part by the European Commission is now seeking to improve measurements of international trade in healthcare goods and services.
What is probably true is that, despite all the public interest, for most countries, medical tourism is small when compared to the size of the health sector as a whole. It is also important to bear in mind that many people seeking health services abroad may be regular visitors in need of medical attention, such as tourists, business travellers and seasonal or border workers. And while travel to regions such as Southeast Asia by European and US patients tends to grab newspaper headlines, the vast majority of medical tourism still takes place closer to home. For Europeans, places like Hungary and the Czech Republic have become renowned for services such as dental and cosmetic surgery.
Still, the trend is rising. As globalisation reaches further into our lives, so medical tourism looks set to expand further. Policy settings should be ready to adapt too.
Deloitte (2008) “Medical Tourism: Consumers in Search of Value”, Deloitte Center for Health Solutions. See www.deloitte.com/centerforhealthsolutions
Deloitte (2009), “Medical tourism: Update and implications”, Deloitte Center for Health Solutions, 2009. See www.deloitte.com/centerforhealthsolutions
Thai Board of Investment (2008), “A Medical Trade Valued at US$40 billion with a 20% Annual Growth,” See www.boi.go.th/english/why/Medical.pdf
Wangberg, S., Andreassen, H., Kummervold, P., Wynn, R. and Sørensen, T. (2009), “Use of the internet for health purposes: trends in Norway 2000–2010” in the Scandinavian Journal of Caring Sciences, 23: 691–696.
©OECD Observer No 281, October 2010