MEDICAL TOURISM THE NEW FACE OF TOURISM

HEALTHCARE INDUSTRY The health care industry is considered an industry or profession which includes peoples exercise of skill or judgment or the providing of a service related to the preservation or improvement of the health of individuals or the treatment or care of individuals who are injured, sick, disabled, or infirm. The delivery of modern health care depends on an expanding group of trained professionals coming together as an interdisciplinary team. MEDICAL TOURISM Medical Tourism refers to movement of consumers to the country providing the service for diagnosis and treatment. During the past few years, the number of people going out of their home country to consume health services has significantly increased. The size of this market is estimated to be $40 billion based on a Saudi Report in 2000. During the past four years, the market grew at a whopping rate of 20-30% and is expected to grow further. Considering this growth the current market size is estimated to be $100 billion. Medical Tourism industry offers tremendous potential for the developing countries because of their low-cost advantage. The advantages of medical tourism include improvement in export earnings and healthcare infrastructure. WHY INDIA? The countries where medical tourism is being actively promoted include Greece,

South Africa, Jordan, India, Malaysia, Philippines and Singapore. India is a recent entrant into medical tourism. According to a study by McKinsey and the Confederation of Indian Industry, medical tourism in India could become a $1 billion business by 2012. The report predicts that: "By 2012, if medical tourism were to reach 25 per cent of revenues of private up-market players, up to 2,297,794,117 USD will be added to the revenues of these players". The Indian government predicts that India's $17-billion-a-year health-care industry could grow 13 per cent in each of the next six years, boosted by medical tourism, which industry watchers say is growing at 30 per cent annually. Price advantage is a major selling point. The slogan, thus is, "First World treatment' at Third World prices". The cost differential across the board is huge: only a tenth and sometimes even a sixteenth of the cost in the West. Table No.1 The Comparative rates of surgeries Surgeries Open Heart Surgery (CABG) Total Knee Replacement Hip Resurfacing LA Hysterectomy Lap Cholcystectomy Spinal Decompression Fusion India ($) 7,500 6,300 7,000 4,000 3,000 5,500 USA ($) 100,00 0 48,000 55,000 22,000 18,000 60,000 UK (GBP) 21,400 25,700 24,100 11,800 9,600 32,100

Obesity Surgery (Gastric Bypass)

9,500

65,000

34,800

Dental, eye and cosmetic surgeries in Western countries cost three to four times as much as in India. India has a lot of hospitals offering world class treatments in nearly every medical sector. MEDICAL INDUSTRY TOURISM AS AN

Medical tourism can be broadly defined as provision of cost effective private medical care in collaboration with the tourism industry for patients needing surgical and other forms of specialized treatment. This process is being facilitated by the corporate sector involved in medical care as well as the tourism industry - both private and public. BENEFITS TOURISM Tangible Foreign exchange earrings which enable economic wealth of nation Cost Advantage in Tariff over the Developed countries Improve information sharing Increase in efficiency of patient care process, cutting edge treatment. Improvement in hospital supply chain efficiency Strategic alliances with business partners within and outside the country Technology and Knowledge Transfer Better logistics performance both in internal and external OF MEDICAL

Creation of employment opportunities in the industry Better utilization of Infrastructure and skilled manpower Opportunity for development in Infrastructure in Health, Tourism and Travel. Economies of scale. Connectivity with air, road, rail and information and communication industries Clustering of medical Travelers Health opportunities for foreign patients may lead to better standards at home. Scope for Research and Development to offer comprehensive medical solutions. Intangible International acceptance of country as a global healthcare provider Social and cross cultural experience International customer relations Global Marketing and Medical Trade relations Brand image of nation as worldclass healthcare destination. Competitive advantage Better coordination among the partners i.e. hospital and hospitality industry. Public and Private Partnerships Patient satisfaction MEDICAL TOURISM IN INDIA THE CURRENT SCENARIO Medical Tourism is poised to be the next Indian success story after Information Technology. According to a MckinseyCII study the industrys earning potential estimated at Rs.5000-10000 Crores by 2012. Worldwide, healthcare is said to be a $3-trillion industry, and India is in a

position to tap the top-end segment by highlighting its facilities and services, and exploiting the brand equity of leading Indian healthcare professionals across the globe. Medical Tourism", the term refers to the increasing tendency among people from the UK, the USA and many other third world countries, where medical services are either very expensive or not available, to leave their countries in search for more affordable health options, often packaged with tourist attractions. More importantly, Medical Tourism is growing rapidly and turning out to be an immense business opportunity for nations that are positioning themselves correctly. Last year, just five countries in Asia Thailand, Malaysia, Jordan, Singapore and India- pulled in over 1.3 million medical travelers and earned over $1billion (in treatment costs alone). In each of these nations, medical travel spends are growing at 20% plus year-onyear. Elsewhere around the world, Hong Kong, Lithuania and South Africa are emerging as big medical/healthcare destinations. HEALTH TOURISM IN INDIA ADVANTAGES AND OPPORTUNITIES The inflow of health tourists from the West, especially the UK, US and some of the European countries has been on the rise for the last couple of years. Price difference or affordability of the treatment, coupled with quality of doctors are the main reasons for the growing western traffic.

The quality of Indian hospitals has improved significantly and now matches with the best in any part of the world. India has more than 100 healthcare institutions, which are of international standard. Many hospitals in India today have the infrastructure and equipment that match with the best centers in the world, be it transplantations(liver/kidney/heart or bone marrow), cancer treatment, including radiotherapy, neurosurgery, including sterotactic surgery., angioplasty and cardiac surgery (bypass and paediatric) Public-Private Partnership combines internal hospital expertise with supply chain and logistics expertise. The SWOT analysis of Indian medical tourism business is: Table No.2 Weaknesses 1) Lack of infrastructure 1) Quality of service 2) Lack of uniform 2) Exquisite Locationspricing policy 3) Alternative medical 3) Poor infrastructure in cures like Yoga, Govt. Aided hospitals Homeopathy and 4) Lack of proper Ayurveda. Institute on medical Instrumentation. Opportunities Threats 1) Impact on Forex reserve 1) Foreign players may 2) Contributions in enter into the market GDP 2) Lack of foreign 3) Sharp rise in accreditation medical as well as tourism Industry. Strength

ROLE OF GOVERNMENT The role of Indian Government for success in medical tourism is two-fold: Acting as a Regulator to institute a uniform grading and accreditation system for hospitals to build consumers trust. Acting as a Facilitator for encouraging private investment in medical infrastructure and policy-making for improving medical tourism. For facilitating investment the policy recommendations include: Recognize healthcare as an infrastructure sector, and extend the benefits under sec 80-IA of the IT Act. Benefits include tax holidays for five years and concessional taxation for subsequent five years. The government should actively promote FDI in healthcare sector. Conducive fiscal policies providing low interest rate loans, reducing import/excise duty for medical equipment Facilitating clearances and certification like medical registration number, antipollution certificate etc. The above measures will kick-start hospital financing, which is struggling now due to capital intensive and low efficiency nature of healthcare business. For facilitating tourism the government should:

Reduce hassles in visa process and institute visa-on-arrival for patients Follow an Open-Sky policy to increase inflow of flights into India Create Medical Attachs to Indian embassies that promote health services to prospective Indian visitors

GOVERNMENT PLANS FOR ATTRACTING MEDICAL TOURISM TO INDIA To promote growth in the Indian medical travel industry, the Indian government has plans to improve health infrastructure. The government is currently in the process of increasing the number of hospitals, clinics, and clinical laboratories in urban as well as rural parts of the country. Incentives and tax holidays are being offered to hospitals and dispensaries providing health travel facilities. The Indian medical travel and health care sector offers plenty of opportunities for businessmen, medical equipment manufacturers, healthcare service providers, and tourist agencies, and the government is encouraging them to invest in therapeutic and preventive health services so as to increase medical travel to India. The government has published analytical reports on the available opportunities in the Indian health care industry so corporate houses can make informed decisions regarding the Indian medical tourism sector. PRICE The price range offered by the Indian medical industry is unbelievable because

India offers the most reasonable prices. India is not only cheaper but the waiting time is almost nil. This is due to the outburst of the private sector which comprises of hospitals and clinics with the latest technology and best practitioners. Table No.3 PROCEDURE US India CHARGES IN (USD) (USD) INDIA & USA Approx Approx Bone Marrow USD USD Transplant 2,50,000 69,200 Liver USD USD Transplant 3,00,000 69,350 Heart Surgery USD USD 30,000 8,700 Orthopedic USD USD Surgery 20,000 6,300 Cataract USD USD Surgery 2,000 1,350 Smile USD USD Designing 8,000 1,100 Metal Free USD USD Bridge 5,500 600 Dental Implants USD USD 3,500 900 Porcelain Metal USD USD Bridge 3,000 600 Porcelain Metal USD USD Crown 1,000 100 Tooth USD USD Impactions 2,000 125 Root Canal USD USD Treatment 1,000 110 Tooth USD USD Whitening 800 125 Tooth Colored USD USD 30 Composite 500 Fillings / Tooth USD USD 90

Cleaning

300

PROCEDURE CHARGES IN INDIA & UK Significant cost differences exist between UK and India when it comes to medical treatment. Accompanied with the cost are waiting times which exist in UK for patients which range from 3 months to over months. Table No.4 UK India (USD) (USD) Procedure Approx Approx Open Heart USD USD Surgery 18,000 4,800 Cranio-Facial USD USD surgery and 13,000 4,500 skull base NeuroUSD USD surgery with 21,000 6,800 Hypothermia Complex USD USD spine surgery 13,000 4,600 with implants Simple Spine USD USD Surgery 6,500 2,300 Simple Brain Tumor USD USD1,200 - Biopsy 4,300 USD - Surgery USD 4,600 10,000 Parkinsons - Lesion - DBS USD 6,500 USD 26,000 Hip USD Replacement 13,000 USD 2,300 USD 17,800 USD 4,500

PROMOTIONAL ACTIVITIES TO PROMOTE MEDICAL TOURISM CME ( Continuous medical education for doctors) Patient Education Progress Free health Checkup camps. Tie ups with various hospitals and insurance companies abroad. Participation in Health Expos abroad. Tie ups with Embassies. Advertisement campaigns. Nodal centers in other countries. Reduction of Excise duty from 17% to 8% on all goods produced in the pharmaceutical sector as per the Budget 20082009.

Source: Business World India and Indian Brand Equity Foundation As the table above shows, India has significant cost advantages in several health procedures making it a preferred destination b)The Service Spectrum India offers a variety of services for overseas patients. The table below presents a classification of the service spectrum. Fig.2

FACTORS ENHANCING MEDICAL TOURISM IN INDIA a) Cost Competitiveness The Key driver The main reason for Indias emergence as a preferred destination is the inherent advantage of its healthcare industry. Today Indian healthcare is perceived to be on par with global standards. Some of the top Indian hospitals and doctors have strong international reputation. But the most important factor that drives medical tourism to India is its low cost advantage. Majority of foreign patients visit India primarily to avail of First World Service at Third World Cost. Fig.1

KEY CHALLENGES BEFORE INDIAN MEDICAL TOURISM: 1) Lack of Government support to promote medical tourism 2) Lack Of medical Infrastructure 3) Lack of international accreditation 4) Perception among the foreign tourist as an unhygienic country 5) Strong competition from Malaysia, Thailand and Singapore CONCLUSION c) Consumer Profile The demand for Indian healthcare services primarily comes from three types of consumers. The table below presents the profile of these three consumer groups: Fig.3 However, Medical tourism is the next best thing for India. According to the CII Mackinsey report, Medical Tourism in India is expected to bring revenue of over $2 billion by 2012.The object is to capitalise the low cost advantage and to attract medical tourist by providing attractive packages. Medical Tourism in India is booming and can be witnessed by the huge number of International tourist visiting this region. India is one of the worlds most preferred region of the world in the case of medical tourism due to the low cost of treatment, no waiting time, approachability, tourists spots in India and other value added services. As the Indian economy of growing so worlds best hospitals are coming to India to encash the opportunity. The healthcare industry has successfully managed to maintain the interest and attention of not only the Indian government, but also the common man. The top Indian hospitals such as Apollo, Escorts, Max, etc, are investing immense time, effort, manpower and money in their R&D. As a matter of fact, several new innovative products have been launched in the Indian market and have been patented. 7

Though tourism is not the primary need of these consumers, it offers additional attraction particularly for people traveling for cosmetic surgery and less complicated procedures.

The Indian consumer has ready access to new innovations in the field of health and medicine. The companies are constantly acquiring latest technology either through partnerships or developing them indigenously. The government is fully supporting the cause of state of the art infrastructure by providing support in setting up new hospitals and financing them. BIBLIOGRAPHY Alvarez, David P.; Connecting people to the promise of healtchare, No. 15 (2000) CII and Mekinsey, Healthcare In India The Road Ahead, (2006) Daschle Tom, Achieving Universal Health Coverage, (2007) Davenport Karen, Health Care Benefits, (2007) Hautea, Dr. Randy A.; Krattiger, Dr. Anatole F. And Van Zanten, Ir. Jasper E; Healthcare costs comparisons, No. 18 (2000) http://en.wikipedia.org/wiki/Healthcare_ in_India http://timesofindia.indiatimes.com/More _options_for_health_insurance/articlesh ow/1982238.cms http://www.cbc.ca/news/background/hea lthcare/medicaltourism.html http://www.deloitte.com/dtt/whitepaper/ 0,1017,sid%253D34239%2526cid %253D71669,00.html http://www.indiatogether.org/2007/jan/hl t-hltcare.htm http://www.nature.com/nm/journal/v9/n4 /full/nm0403-377a.html http://www.who.int/mediacentre/factshe ets/fs172/en/index.html Seshamani Meena, Opportunity Costs and Opportunities Lost: Businesses Speak Out About Health Care, (2007)

Sonam Jagasia, A Report on Medical Tourism in India Issue 2 (2008)