Medical Tourism in Developing Countries

58 ● Medical Tourism in Developing CountriesTo answer that question, scholars have studied the role distance plays inmedical tourism. Vega found that it was important, as elderly and ill patientstraveled to Mexico from the United States and Canada, although they preferredto buy health-care services close to the border. 68 Houyuan found thatdistance is relevant in China as most patients come from Taiwan, Hong Kong,and Macau (because of their location, Fujian and Guangdong have moreforeign patients than Beijing and Shanghai 69 ). Gupta, Goldar, and Mitra alsofound proximity to be an important issue for patients coming to India fromneighboring countries like Bangladesh, Mauritius, Nepal, and Sri Lanka. 70Evidence from numerous countries supports the contention that foreignpatients are not indifferent to the travel time they spend seeking care (the roleof distance is especially large in border medicine but, for reasons explainedabove, such medical tourism is not discussed here). Western expatriates acrossSoutheast Asia traditionally opted to be treated in Thailand because it is closerthan their home countries. Patients come to India for treatment from theGulf States as well as neighboring countries (each year, some 50,000Bangladeshis come to India for specialized treatment 71 ). Chile, with itssophisticated health-care system, attracts patients from Ecuador and Peru. 72Americans go to Mexico for routine checkups and Italians go to Romania fordental work. Costa Rica has an advantage for American tourists as it does notrequire a long flight. It is a few hours away from the United States and enablesa patient to leave home in the morning and be a postoperative that same day.For years, Americans have been buying medicine in Canada and Mexico.Jordan is the accepted medical center of the Arab world, although it is likelyto be superseded in the next decade by Dubai’s Healthcare City, which aimsto attract “the 1.6 billion inhabitants covering the Middle East to theSubcontinent, North Africa to the Caspian region.” 73 South to south exportof health services is rising in the Western Hemisphere, as Latin American andCaribbean residents travel across borders to partake of each other’s health-caresystems. 74As a result of the distance factor in medical tourism, the founder ofEscorts Heart Institute in India, Naresh Trehan is considering building alarge health-care complex in the Bahamas modeled on the Medicity underconstruction in India. He wants to “deliver better medical care thanAmerica at half the price and half an hour away [italics mine].” 75While geographical proximity is important in health service trade, distanceis not a deal breaker. The fact that long-haul medical tourism isgrowing indicates that international patients are willing to forgo a nearbylocation for one that, while distant, is preferable according to other criteria.The advent of low air fares and frequent flyer miles have made the obstacleof distance easier to overcome. As a result, Thailand continues to be the