Medical Tourism in Developing Countries

56 ● Medical Tourism in Developing Countriespersonal income are crucial in making present-day consumption decisionsbecause of the up-front, out-of-pocket expenses entailed in health careabroad.In addition, demand also depends on expectations about future pricesof medical services (both at home and abroad), as well as the price of travel.For example, expectations of the development of a new facility promisinga favorable package deal will result in less travel today.For medical tourists who want a tie-in with a vacation, expectationspertaining to the destination are also important. They monitor health conditionssuch as the spread of severe acute respiratory syndrome (SARS), theytake into account weather advisories, and they track political upheavals andterrorism reports. 61Demand for Medical Tourism in One Particular CountryWhy does a medical tourist pick one destination over another? Assumingperfect information and holding price constant, the following factors willinfluence an individual in favor of one country and away from another:cultural affinity, distance from home, medical specializations, and reputation.Clearly other factors are relevant, such as portability of insurance thatdetermines where one can receive care (this is a large component of Chile’sattraction for Bolivians). 62 However, insurance issues are not addressed herebecause they are subsumed in the price that is held constant, and anyway,they are addressed in chapter 6.Cultural AffinityMedical tourism in India began with demand from the Indian diaspora,especially the twenty or so million first- and second-generation patients whohave ties to their homeland. Patients from the diaspora feel comfortable athome as their cultural affinity to facilities, personnel, and interpersonal relationsis strong. When they engage in VFF (visiting friends and family) tourism,they take care of routine health care on their trip. To the extent thatthey are concerned with cutting their costs, they undoubtedly save moneynot only because medical services are cheaper than in their host countries,but also because they can pass themselves off as locals and pay even lowerfees (this is popular, for example, among nonresident Indians with dualpassports). To the extent that patients from the diaspora are inclined towardstraditional medicine, they are likely to purchase such services while on VFFtravel (Houyuan claimed this is one of the reason Chinese outside of Chinavisit their homeland 63 ). Other patients from the diaspora go home for medicalcare because they feel more comfortable with culturally determined