Medical tourism: on the growth track in India

ABSTRACT

India’s growth story as a medical tourism hub is a relatively newer one. With significant cost advantages, availability of quality medical treatment with the most-advanced medical technology coupled with India’s well-known tourist destinations and rich cultural heritage,medical tourism does provide a motive sufficient enough to allure those foreign patients who either want to avoid the long waiting list for medical treatment in the West or, in absence of any health insurance coverage, seek lower cost treatment. India’s strength in advanced and life saving healthcare such as organ transplants, cardio-vascular surgery,etc, as well as in alternative systems of medicine(i.e. ayurveda, naturopathy,etc) offer significant competitive advantages. Cashing in this opportunity, The National Health Policy 2002 declared that treatment of foreign patients is legally an “export” and deemed “eligible for all fiscal incentives extended to export earnings”. Besides, a new category of visa, “Medical Visa” has been introduced by Ministry of Home Affairs, Govt. of India. On the other hand, setting up of Bio-Technology Parks Society of India, grant of SEZ status to them, coming up Medicities, entry of private players in health insurance in India along with Indian hospitals looking for international accreditation glitter further hopes of accelerated medical tourism, a growth engine for foreign exchange earnings.

However, the poor infrastructure of the country, shabby streets, pity state of our public hospitals shakens our confidence,despairs for this much hype of medical tourism and calls for serious attention wherein much more efforts are needed. Definitely,public-private partnership is one way ahead which can revamp public hospitals and bring them at par with other private hospitals.Further, there is still no Medical Tourism Policy either formulated by the Central or any of the States Governments. As the medical tourism industry is growing exponentially, government and the private players need to join hands in order to act as a catalyst to build infrastructure for hospitals, create specialty tourist packages to include medical treatment, promote accreditation and standardisation, enable access and tie-ups with insurance companies, provide state of art facilities and improve quality of in-patient care and service to meet the requirements of foreign patients and to attain sustainable competitive advantage.

-Ambuj Gupta is Senior Lecturer at University of Petroleum and Energy Studies, Dehradun

-Vinay Sharma is Professor at IILM-Academy of Higher Learning, Lucknow.

There has been a remarkable growth in recent years in foreign tourists arrival to India due to the various efforts made including promoting India through the“Incredible India” compaign in overseas markets. India is rated amongst the world’s top four “must see destination” by Conde Naste Traveller, an international magazine with lot of reputation. Further,the ‘Incredible India’ compaign has been the winner of PATA Gold Award for Best Print Ad compaign and PATA Gold Award for Best Destination Marketing Compaign. The ‘Incredible India’ compaign has been ranked as the highest Recall Advertisement Worldwide by Travel and Leisure. Out of this phenomenal success,Medical Tourism is the latest stint of India Inc.Medical Tourism or as often called as Health Tourism or Medical Travel has emerged as million-billion dollar industry. Medical Tourism, in fact, mixes healthcare, wellness,rejuvenation with leisure, fun and relaxation. With global revenues of approximately US$ 20 Billion (2005), the medical tourism industry is one of the world's largest industry. India's cost effective treatment makes it an important player in this industry.One of the optimistic outlook in this context is provided by a report entitled, “Healthcare in India: The Road Ahead”, produced by the Confederation of Indian Industry and McKinsey & Co. in 2002. According to it, the medical tourism industry in India is growing at 25-30% annually, contribute up to Rs 10,000 crore additional revenue to upmarket tertiary hospitals and will account for 3 to 5 per cent of the total healthcare delivery market and set to become $2billion by 2012. ''A patient opting for medical tourism not only gets the best medical treatment the Indian doctors have to offer, but also as a post-treatment fare, he or she gets to see the best of India's destinations,'' said Ms Leena Nandan, Joint Secretary, Tourism . Probably realising this as a big potential, major corporates such as the Tatas, Fortis, Max, Wockhardt, Piramal, and the Escorts group have made significant investments in setting up modern hospitals in major cities. Many have also designed special packages for patients, including airport pickups, visa assistance as well as boarding and lodging. Dr. Prathap C. Reddy, Chairman, Apollo Hospitals quips, “One way is to get valuable foreign exchange through medical tourism, giving the patient the best of the west and the east; cardiac or neuro surgery with results comparable to the best in the west, while also exposing him to the natural beauty of our country."

Destination India: “First World Treatment at Third World Prices”:

The Indian success story is the outcome of low cost advantages vis-à-vis quality medical treatment. Whereas the cost of treatment in other developed nations especially in the U.S.,U.K.,etc is very high, India can provide quality healthcare at very low cost due to the availability of relatively cheaper but quality manpower, low-priced drugs,and other infrastructure. Whereas a liver transplant costs you 5,00,000 US$ in USA,it can only be done with 40,000 US $ in India. Further, a heart surgery can be done with 5,000-7,000 US $ in India as against 30,000 US $ in USA. ( See Figure 1).

FIGURE 1

Procedure Costs India vs US

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Source: IBEF Syndication Studies

This cost effectiveness does make India a destination where “First World Treatment at Third World Prices” (Gupta, 2004) has rather become a reality to reckon with for foreign as well as Non-resident Indians. Adds Dr. Naresh Trehan, "Now we do over 4,000 heart operations a year, and the mortality, which is an index of how well things are, is 0.8 % which is even better than most places in the world. The other thing that we measure is infection rate. Ours is 0.3 % as compared to the world average of 1%."

In terms of advanced medical technology, Indian corporate hospitals now excel in all sorts of critical treatment. Indian surgical techniques are similar to those carried out in the west. Each test is carried out by professional M.D. physicians, and is comprehensive yet pain-free.There is also a gamut of services ranging from General Radiography, Ultra Sonography, Mammography to high end services like Magnetic Resonance Imaging, Digital Subtraction Angiography along with intervention procedures, Nuclear Imaging. The diagnostic facilities offered in India are comprehensive to include Laboratory services, Imaging, Cardiology, Neurology and Pulmonology. The Laboratory services include biochemistry, hematology, microbiology, serology, histopathology, transfusion medicine and RIA.All medical investigations are conducted on the latest, technologically advanced diagnostic equipment. Stringent quality assurance exercises ensure reliable and high quality test results. Studies show that medical technology constitutes around 60 percent of corporate hospital’s investment.Hospitals in the country made use of technology to get an edge over their competitors through use of the state-of-the-art technologies(Bhat,1994).

Out of the people coming to India for medical treatment, on the one side, there are non-resident Indians who wish quality affordable medical treatment along with a trip back to their hometown,whereas the patients coming from underdeveloped countries like Nepal,Bangladesh,etc. do come to avail of such medical treatment over here which is still a nightmare in their home country.(See Figure 2)

Another large group of patients who come from the UK are covered by the National Health Service. They do have an insurance cover but they encounter long waiting lists. The wait for surgeries can be even as much as two years. These patients come for mainly joint replacement and spine surgeries. Another huge group comprises about four million US patients, who do not have insurance cover. And they mostly get heart and orthopedic surgery done.

Further,the commonest treatments for which medical tourists from all over the world are flocking to India are cosmetic procedures like liposuction, tummy tuck, breast implants and breast reduction, nose reshaping, facelift, Botox injection, filler injections and dental treatments which cannot be covered under insurance anywhere in the world and people look for places with good facilities and low cost.

FIGURE 2

THE CONSUMER PROFILE

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Another USP of India is that it provides ‘healing holidays’ through Ayurveda and rejuvenation packages in Naturopathy. Most of these packages are offered at resorts in Kerala(the God’s Own Country, as its corporate slogan speaks of), to some extent in Karnataka, Tamil Nadu and a couple of them in Western Uttar Pradesh. Kerala,The Ayurveda State, declared 2006 the year of medical tourism. “Kerala is targeting one lakh medical tourists by 2010 and the Government aims to make the State one among the top five global players in medical tourism as part of its Vision 2010”, says,Mr Kodiyeri Balakrishnan, the State Tourism Minister,Kerala.

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