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Medical Tourism

Introduction

            Medical tourism is also defined as Medical Travel Or Health Tourism and the terms was in initially coined by the travel agencies as well as the media for describing the growing practice for travelling across borders to international nations for obtaining Health Care. The services in the medical tourism usually include various elective procedures such as complex and specialized surgeries, cardiac surgeries, dental surgeries and also cosmetic surgeries. Although there are other kinds of parallel health care such as psychiatry, convalescent care, alternative treatments that are included in the medical tourism facilities. Practically speaking, customers and providers also utilize informal channels for communication and connection contract. In such scenarios, this includes less regulation and lesser legal oversight for reduced formal recourse for assuring quality medical services and lesser level of formal recourse for redressal or reimbursement. It has been seen that more than 50 countries have accepted and identified the scope of medical tourism as national industry. However, in different nations, the accreditation and maintenance of quality differs. There are also certain associated risks as well as ethical issues that makes medical tourism and the services provided in it to be controversial and crucial at times. Moreover it has also been seen that medical tourism is often times is not supported by the destination and the medical tourists are also unable to contemplate that.

History of medical tourism

            The idea of medical tourism can be traced back to old ages and their originations was as age old as the invention and use of medicines itself. Much before the very first American stepped into India for its cardiac care, the country had a rich and established he ........

for obtaining Health Care. The services in the medical tourism usually include various elective procedures such as complex and specialized surgeries, cardiac surgeries, dental surgeries and also cosmetic surgeries. Although there are other kinds of parallel health care such as psychiatry, convalescent care, alternative treatments that are included in the medical tourism facilities. Practically speaking, customers and providers also utilize informal channels for communication and connection contract. In such scenarios, this includes less regulation and lesser legal oversight for reduced formal recourse for assuring quality medical services and lesser level of formal recourse for redressal or reimbursement. It has been seen that more than 50 countries have accepted and identified the scope of medical tourism as national industry. However, in different nations, the accreditation and maintenance of quality differs. There are also certain associated risks as well as ethical issues that makes medical tourism and the services provided in it to be controversial and crucial at times. Moreover it has also been seen that medical tourism is often times is not supported by the destination and the medical tourists are also unable to contemplate that.

History of medical tourism

            The idea of medical tourism can be traced back to old ages and their originations was as age old as the invention and use of medicines itself. Much before the very first American stepped into India for its cardiac care, the country had a rich and established heritage of Ayurvedic care and healing procedures that had people from all around the world seeking for medical care throng to Indian soils. However the first record of medical tourism was found in the Greek civilization when Greek pilgrims used to travel to a place called Epidauria in Saronic Gulf for medical care and thus Epidauria became the first centre for medical tourism. Following such needs of the people to look around other destinations for better medical care, it was witnessed that medical tourism has become a flourishing industry as more people travelled to other nations for availing better and sometimes economical health care services (Connell, 2013). In this manner many destinations as the major destinations for healthcare services or rather as medical tourism destinations.

Medical tourism: overview

            There are some factors that had contributed to the growing popularity of medical tourism in the recent times. Some such factors include soaring costs of the healthcare, the longer waiting times for various healthcare services at home nations (Han and Hyun, 2015). Other factors that have contributed to the radical popularity of medical tourism is the growing convenience and affordability of the international travel and also that some other nations were providing more improved technology and healthcare standards in some nations (Han and Hyun, 2015). There are many nations in the First World that have recently emerged as the popular spots of medical tourism. This list includes Middle East, Japan, Europe, United States and Canada. In the opinion of many experts it has been opined that such nations have large populations and comparatively higher wealth that they can think of availing medical tourism. Moreover, medical experts have also been of the opinion that many people move to other nations for availing better or cheaper and both kind of medical care if the expenses of health care in their own  nation is higher and that locally they are unable to avail good quality health care options. It has also been seen that if in a local population there is insufficient and unsatisfactory presence of doctors, medical experts, healthcare services then the people migrate to any other place that either they have knowledge of or have been referred by peers and friends for availing such services in any other destination. In many situations it has also been seen that people have expectations from their national system of healthcare and thus if the expectations are not met widely and satisfactorily then they have to look for better alternatives in the means of healthcare services, healthcare expectations and economies.

An expert in the Harvard Medical School has been of the opinion that “medical tourism is promoted much more heavily in the United Kingdom than in the United States". As per one of the forecasts done by Deloitte Consulting, in 2008, it was projected that the medical tourism that ahs originated in the United States could jump to over ten fold in the upcoming decade or even more (Hanefeld,  Smith, Horsfall and Lunt, 2014). About 750,000 Americans in 2007 reached abroad nations for availing heath service and this count increased to about a million and a half in the next year (Hanefeld,  Smith, Horsfall and Lunt, 2014). A great draw for the medical travel is the speed and convenience and it has often been seen that many times countries that are providing public healthcare services are taxed very heavily and that makes it difficult for them to avail non-urgent medical services and that causes incessant delay in time. To cite as an example, Canada, in 2005, it was estimated that about 782,936 Canadians had to face prolonged waiting time and the average of waiting time was 9.4 weeks (Hanefeld,  Smith, Horsfall and Lunt, 2014). To trace more instances, Canada has set high and disappointing benchmarks for waiting time such as 26 weeks for hip replacement and about 16 weeks for a cataract surgery in the category of non urgent medical services (Hanefeld,  Smith, Horsfall and Lunt, 2014). However, on the contrary it has also been seen that in nations such as Singapore, India, Thailand, Hong Kong, Colombia, a rich patient may avail such healthcare services instantly while the poor dies before they can even reach the hospital. Such is the tragedy of the medical situation (Wong, Velasamy and Arshad, 2014). Additionally, the patients find such insurance that either does not cover their facilities for surgery or in many other situations there are various unreasonable restrictions that are imposed on their choice of facility or surgery or any other medical procedure for which they wish to use their medical insurance. In the recent times, the medical tourism for hip or knee replacement has increased in among the most widely accepted process and the reason being the lower costs and also the lesser difficulties in the travelling costs and convenience for availing medical services (Wong, Velasamy and Arshad, 2014).

Medical tourism destination: overview

            Popular medical destinations around the world include Cuba, Hong Kong, India, Malaysia, Singapore, Thailand, and the recent names to be added in this list are UAE, South Korea and New Zealand (Noree, Hanefeld and Smith, 2016). It has been noticed that in recent times, ‘medical tourism’ as an industry has been taken to be in serious context as it has started promoting ‘medical safaris’.  However, it must also be noted that in many nations, the concept and scope of medical tourism is not considered to be very positive. In a nation such as US that has high standard of living, medical tourism is often considered to be a risky approach. There are many nations where there are political issues it might not be considered to be very safe for medical tourists. Thus health tourism providers have provided opportunities through creating intermediaries for uniting the potential medical tourists in the provider hospitals and other medical organizations (Avraham, 2015). Many companies have emerged that are offering options of global health care which would enable European patients and patients in North America to avail new opportunities for accessing healthcare globally and that too in a cost that is fraction of the cost that they would have to incur otherwise. Such companies that give medical travel value also provide nurse managers in most cases for assisting patients with pre as well as post tourism issues. They also give follow up programs after the return of the patients. Although it is seen that most companies providing facilities of medical tourism operate independently, there are many hospitals that have now developed their own their respective departments for attracting medical tourists (Han and Hyun, 2014). Various benefits have also been found if medical tourism coordinators are employed in the hospitals. The coordinator would be very familiar with the procedures of the medical tourism and this would help to provide better guidelines to the patients in the city and in the hospital. Thus this would reduce the non-medical complications in the process. Thus from this discussion various aspects of the medical tourism has been discussed. This would provide the basic framework for determining if the medical tourism is a boon or bane for the patients globally.

Medical Tourism as a boon

            Questions may arise as to why people would travel to any foreign land for receiving medical care? What advantages that people gain while placing the risks of their health in the hands of total strangers in a new nation. However there are various reasons that has supported the growth of medical tourism in recent times:

  • Affordable medical vaccinations: there are many procedures for which it is not cost effective to receive treatment at home than it is to avail the healthcare services in any other nation. This holds true in the case of nations such as Thailand, India and Singapore. As per the recent reports of a medical journal (New England Journal of Medicine), the estimated cost in the nearby hospital in England would be $200,000 approximately for mitral valve surgery (Hanefeld, Smith, Horsfall and Lunt, 2014). However, after some research it was found that in Texas, the same surgery could be performed at the cost of $40,000. However if the patient decides to fly to New Delhi, India then its surgery would cost $7,000 (Wong, Velasamy and Arshad, 2014).
  • Availability of alternatives: there are some countries that have their own elective procedures for complicated and crucial surgeries. For instance, the New England Journal of Medicine very recently approved of hip resurfacing although this surgery has been in vogue and has yielded successful results for many patients in many popular destinations for medical tourism.  In other situations, the treatment becomes prohibitive as it is available at great cost that makes it difficult to avail such services at home. For instance, in USA, a coronary bypass research might cost $80,000 or even more to the patient while for the same procedure, many renowned Indian hospital charges a little over $10,000 (Wong, Velasamy and Arshad, 2014). Thus medical tourism provides the opportunity to travel to different parts of the world where hospitals provide aforementioned procedures. If the medical tourism is planned from before then the cost can be further controlled.
  • Improved facilities and satisfaction: some nations such as USA might have a well developed healthcare system and the system might also be very systematic yet there is no guarantee that the doctors would have the best solution to the problem of the patients. However, on the other hand, it might be that the medical system might not be that developed  yet it may have well equipped doctors that can provide best facility for the patients. Thus patients can achieve greater satisfaction away from home.

Medical tourism: a bane

Medical tourism is such a trade off that has opened up new avenues for the patients to avail best medical services in this way. There are countless ways in which medical tourism has been found to be a boon for the patients all around the world. The affordable prices, convenience, better  quality healthcare, the opportunity for better diagnosis at the hands of experienced doctors have cast shadow on the negative aspects of the medical tourism. Since the aim of the medical tourism is better life care and security of the patients, it would be better if the negative impact of medical travel can be shed light upon:

  • Medical malpractices: although it is seen that the agencies of the medical tourism such as the hospitals, clinics, camps have insurance against the medical malpractices for adopting protection measures against unforeseen events and damages, such measures might not always be effective. Due to negligence, incompetence and misdiagnosis the insurance might fail. It is also difficult to settle large cash transactions since it becomes difficult for the tourists to undertake legal recourse against any malpractice (Cohen, 2014).
  • Variance in insurance law: the tourists might not be fully covered by the terms of insurance in the foreign land depending on the medical procedures and the type of insurance (Horner & Swarbrooke, 2016). The medical bill might not always be fully covered by the insurance provisions and that in turn might increase the overall costs. Thus it is very important to determine in the first hand about the insurance policies and its coverage of the medical bills.
  • Post operative treatments: in most cases it is seen that it is customary for the patients to visit the physician and doctor in regular basis so that it can be understood if they recuperating properly. However, if any patient has availed any surgery by means of medical tourism then it might become a prohibitively expensive procedure if they wish to consult with the doctor abroad (Connell, 2013). Moreover, in most cases it might also not be able to plan the schedule for visiting the doctors abroad in regular interval. In the long run, the process of medical tourism becomes a costly approach.
  • Legal issues: tourists may not always be fully aware of the legal complexities in the host nation that they are visiting. Since the litigation measures in USA are limited, the overseas cost for medical care is lower. Although it may so happen that many nations might be providing legal remedies so that their destination and agency look attractive to the tourists yet such legal remedies might trigger malpractices.

Conclusion

From the above discussion it has been made clear that the services in the medical tourism usually include various elective procedures such as complex and specialized surgeries. Over 50 countries have accepted and identified the scope of medical tourism as national industry. In this manner many destinations as the major destinations for healthcare services or rather as medical tourism destinations. Factors such as soaring costs of the healthcare at home, the longer waiting times for various healthcare services, growing convenience and affordability of the international has contributed to the radical popularity of medical tourism globally. In the recent times, the medical tourism for hip or knee replacement has increased in among the most widely accepted processes. On the other hand, the medical tourism has its own dangers that also cannot be ignored such as the medical malpractices, higher long run costs and also the lack of insurance coverage over the medical facilities abroad. Thus it is on the discretion of the patients that they should decide to avail the services of medical tourism and that medical tourism should be considered after well informed research and planning.