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Flying for treatment: an introduction to health care tourism

Sometimes the treatment you need is just a flight away.

Completely blind after three failed eye operations, Lin Yu Shan boarded a flight from her home in Taiwan to Singapore, for an appointment with world-class ophthalmologist, Dr. Leonard Ang. A week later, following surgery to reconstruct her right eye, the 41-year-old could see again. The operation was life changing.

Lin’s story is an example of health tourism — patients who travel internationally for medical procedures. She isn’t alone. Leading authority on health tourism, Patients Beyond Borders, estimates that 14 million people globally travel for medical treatments every year, driving an industry worth $45.5-72 billion, and a market that’s growing by 15-25% annually.

The pros and cons of travelling for treatment

For patients without a national health service or international private medical insurance (iPMI) there are clear cost benefits to travelling for treatment. A report by the Organisation for Economic Co-operation and Development (OECD) put the price of a knee replacement in the U.S. at $48,000. Travel to India and the same operation will cost $8500, more than 80% cheaper. A heart bypass that costs $113,000 in the U.S. can be bought for just $3250 in Mexico, while operations in Malaysia are typically 65-80% cheaper.

But while those figures are attractive, they only represent the base cost of the surgery. The actual costs can be considerably higher. Self-funding patients need to find specialist clinics that can handle the treatments they need, organise and pay for flights, find suitable accommodation, arrange pre-admission checks, and spend time recuperating if they can’t return home immediately. And although increasing numbers of patients have helped build better awareness around health tourism, there remains a degree of uncertainty in seeking treatment in another country.

Removing the uncertainty

This is where iPMI companies have stepped in, and where the careful management of medical tourism is coming from. Global private health insurance organisations and wellness partners like Aetna International are well placed to help patients in the event they need to travel for treatment, removing many of the uncertainties and providing end-to-end support. Local doctors can refer members requiring treatment to Aetna for preauthorisation checks. Aetna’s International Care and Response Excellence (CARE) team will decided if it’s medically necessary for that treatment to happen in a different country.

“We have a pre-trip planning program designed to help patients before, during, and after their travel,” explains Dr Charushila Thadani, Aetna’s Associate Medical Director in the Middle East. “We help patients find providers for their treatment in other countries, we help coordinate both complex and routine medical care, and we’re on hand to answer questions about the health care system of the country they’re travelling to, such as vaccination requirements, or specific laws around transporting medication.”

The emphasis is on ensuring patients receive the right treatment for them, above and beyond location or cost, although cost is still considered. Dedicated case managers are on hand to organise travel and accommodation. And if a patient needs to travel to a specialist that isn’t part of the Aetna network, they’ll arrange direct billing so patients can focus on recovering rather than paying bills. On their return, patients and their primary physician can liaise with the CARE team so that any follow-up treatments are put in place.  

End-to-end services like these are helping to build patient confidence in travelling for treatment, which in turn is driving demand. To take advantage of that demand, medical institutions and governments around the world have been active in trying to develop international reputations for excellence.

Striving for excellence

Singapore, as Lin Yu Shan would no doubt attest, has one of the best health care provisions in the world. A 2014 report by Bloomberg ranked it first out of 51 countries for most efficient health care system. Recognising the enormous value of an industry that was worth S$832 million 2014, the Singapore government has continually invested in its medical system, helping the tiny island state rank in the top five of all destinations for health tourists, according to the medical tourism index.

Close neighbour, Malaysia, swept the board in the International Medical Travel Journal Awards in 2016. Named destination of the year, the country also won international hospital of the year, as well as awards for its dentistry, fertility, and cosmetic surgery services. Other countries are developing their own specialisms: Bulgaria and Poland are popular choices for dentistry; India is an established provider of orthopaedic surgery, including knee and hip replacements; while the Spanish health care system has a growing reputation in providing fertility treatments.

Dr. Thadani says that Dubai has quickly become a key destination for orthopaedics and sports medicine, plastic surgery, ophthalmology, and dental procedures. “The United Arab Emirates is a hub for global talent. It has a vast number of highly qualified medical professionals and renowned health amenities that draw patients from nearby Middle Eastern countries and Africa, as well as some from Asia.”

Dubai has plans to increase its appeal to health tourists further. Backed by both the Crown Prince and the government, the United Arab Emirates is looking to double or triple the number of medical tourists in the next five years. “Medical tourism has been developed specifically to contribute to the economic development of the Emirate of Dubai,” says Dr. Thadani.

Crucial in establishing an international reputation is accreditation. While each country will have its own health standards, hospitals and clinics also look for further recognition through the Joint Commission International (JCI). Established in 1999 as a response to increasing demand for medical procedures abroad, the JCI sets global standards for health care providers and has approved more than 600 institutions to date, including 21 in Singapore alone.

Patients travelling to access the best medical treatment isn’t a new phenomenon. Health tourism developed in nineteenth century Europe, with the establishment of natural spa resorts and sanatoriums where patients could recuperate from chronic illnesses. But fast and cheap transport has pushed health tourism far beyond its origins. Global investments in international health care, a worldwide field of highly trained medical staff, and expert guidance from iPMI companies and health care providers will ensure that health tourism continues to grow, eventually making life-changing operations like Lin Yu Shan’s commonplace.

If you’re an employer or broker looking for international Private Medical insurance for clients or staff, find the right telephone number for your area, here. If you’re looking for expat insurance you can get a quote here.

The information included in this email is provided for information purposes only and it is not intended to constitute professional advice or replace consultation with a qualified medical practitioner.

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