By: Logan Connor – POSTED ON: May 19, 2016
Southeast Asia is a well-known medical tourism destination. Yet few realise it is regional patients, not those from outside, driving the industry
E very year, Indonesians leave their country in droves to access basic medical services they can’t find in their own country. According to media reports, the Indonesian government estimates that its citizens spend roughly $11.5 billion a year on healthcare abroad – much of it in Malaysia.
“What some Indonesian medical tourists are looking for is everyday care they can’t get back home,” said Meghann Ormond, a professor of cultural geography at Wageningen University in the Netherlands. “This oftentimes has a lot to do with a lack of access to quality medication or cutting edge technology – lab analyses, for example. They don’t have access in Indonesia to doctors they trust. That’s why they’re crossing the borders.”
However, it’s not just Indonesians who are traversing the region to seek medical care they cannot find at home.
Globally, medical tourism is huge, and Southeast Asia is an industry hotspot. Patients Beyond Borders, a US-based organisation that tracks trends in medical tourism worldwide, estimates that the global market is expanding by up to 25% each year and is worth upwards of $55 billion annually with more than 11 million consumers – nearly a third of whom are travelling to Southeast Asia.
Contrary to popular belief, though, many of Southeast Asia’s medical tourists come from within the region itself. Patients Beyond Borders estimates that Malaysia attracts more than 640,000 medical tourists from Southeast Asia each year; when compared to figures from the country’s health ministry, an estimate of 200,000 medical arrivals from outside the region can be extrapolated. Thailand follows with 550,000 intra-Asean medical tourists and then comes Singapore with 400,000.
There are the conventional reasons why Southeast Asians are travelling for healthcare: cost, shorter wait times for procedures, access to treatments unavailable in one’s home country and the added bonus of cheap travel. But sometimes people are travelling for medical care simply because they have no other choice.
“What’s emerging is south-to-south travel, from developing country to developing country,” said Ghazali Bin Musa, a professor of business strategy and policy at the University of Malaya.
“Most medical tourists in the region are coming from neighbouring countries – Laos to Thailand, for example. Cultural similarity is a big reason. Also, cost is important, so they prefer to travel shorter distances. Nowadays, they’re mostly travelling with cheap airlines.”
Josef Woodman, CEO of Patients Beyond Borders, said that patients often travel for specialised care they can’t access in their native country. “For example, Singapore is known for excellent diagnosis and treatment of oncology, as well as stem cell and regenerative therapies. Similarly, patients travel to Malaysia for comprehensive executive health screenings, and to Thailand for cosmetic surgery, including sex reassignment surgery – Thailand performs more transgender procedures than anywhere in the world.”
In theatre: medical staff perform a sex change operation at a Bangkok hospital. Photo: EPA/Rungroj Yongrit
Thailand has long been known as the industry’s top performer in the region when worldwide arrivals are included, with Asean saying that medical tourism brings in $2 billion for the country, as well as 40% of all medical tourist arrivals in Asia.
Some, however, say that such figures are inflated. Keith Pollard, CEO of Intuition Communications, which publishes the International Medical Travel Journal, credits Thailand’s staggering numbers to what he calls “creative accounting”.
“The issue around Thailand and its numbers is how they count medical tourists,” he said. “Thailand counts the same person several times over. If someone comes from one country to Thailand they may get counted five to ten times for every interaction in the healthcare system. Visits to the consultant, an x-ray, a CT scan, an operation – patients end up getting counted several times over for all of these.”
“Medical tourism is very much a business,” said Ghazali. He cited the 1997 Asian financial crisis as the catalyst for the explosion of medical tourism in the region. The more developed Asean countries, looking to diversify their sources of income, took advantage of cheap and high quality medical care to attract foreign patients and bring in revenue.
Malaysia is another regional success story. The country welcomed more than 850,000 global medical tourists and took in $230m of revenue last year, according to the Malaysian Ministry of Health. Malaysia’s health minister has said that the country aims to bring in more than $330m in 2016 through medical tourism.
Three hospitals in the region were selected among the top ten hospitals for medical tourists in 2014 by the Medical Travel Quality Alliance – its most recent evaluation – which is the kind of high rating that proves to attract numerous foreigners. Many make the trip from nations such as the US, the UK and China, in large part driven by cost factors. A US citizen can save up to 80% on medical procedures by travelling to Southeast Asia, as a 2014 report found US healthcare to be the most expensive and least effective compared to ten other industrialised nations.
While some travel out of necessity, others do so as an extravagance. “People like to combine plastic surgery with a holiday,” said Ghazali. “When they go back home, they don’t have to tell others that they’ve gone for a plastic surgery procedure. They can say they went for holiday. Suddenly they’ve changed, they’ve become younger.”