Medical Tourism in Developing Countries

2 ● Medical Tourism in Developing CountriesUnited States travel to Asia for organ transplants, plastic surgery, and artificialinsemination; patients from South America, the Middle East, andother parts of Asia travel for services their local hospitals do not provide.West Europeans and Canadians bypass the long waiting periods that arepart of their national health plans by getting medical care elsewhere.Everyone, coming from everywhere, is shopping for a doctor in the internationalhealth services market and, as a result, enjoys a cost savings overthe alternative at home. Moreover, the travelers who buy health care usuallyget a package deal that typically includes their treatment plus air transport,transfers, accommodations, and a postoperative vacation. The vacation as atie-in is described by Chi Kin Yim in his study of health-care destinationsin Asia: “As part of the health care package, customers receive the bonus ofvacationing and sightseeing in a foreign country and an exotic culture.” 1People want exotic vacations, but not exotic health care. They want firstworld treatment at third world prices. That has become the slogan.While medical tourism is presently small in comparison to the overallservice trade or the consumption of medical services worldwide or even thetrade in tourism services, it cannot be dismissed as either temporary orinsignificant (for example, in destination countries such as Thailand,Malaysia, and India, health tourism is the fastest-growing segment of theirtourist markets 2 ). According to the World Health Organization (WHO),it is a growing trend with enormous economic implications. 3 As early as1989, an Organisation for Economic Cooperation and Development(OECD) report noted that trade in health services provided developingcountries with a competitive opportunity in this arena, given their abundanceof labor and availability of capital and skills in medicine. 4 As longas they can maintain quality levels, they might be able to generate significantgrowth. In 1997, the United Nations Conference on Trade andDevelopment (UNCTAD), which monitors trade between countries, notedfor the first time that trade in services, including health services, could bebeneficial for developing countries. 5 A growing number of these countrieshave the requisite manpower, the investment capital, the know-how, andthe motivation to supply medical tourist facilities. They are hopping onthe highly competitive medical tourism bandwagon. India and Malaysia arejoining the already-established destinations in Thailand and Singapore. ThePhilippines is not far behind. In the Western hemisphere, Cuba has beena medical leader for decades and sets an example for Costa Rica andArgentina with respect to the research and development that is linked tomedical tourism. The countries of the former Soviet bloc, as well as theBaltic states of the former Soviet Union, are using their highly skilled laborforce to lure West Europeans to their health-care facilities. South Africa