Jigsaw Puzzle::::::

Apollo game plan

2005-02-22T02:27:00.004-08:00

KOLKATA: Indian healthcare major Apollo Hospitals Group is restructuring its medical tourism initiative. Instead of floating company-owned telemedicine and information centres in international markets, Apollo is now going to club the two with the clinics that are floated through the franchisee route. The entire business will now be under its wholly-owned subsidiary, Apollo Health and Lifestyle Ltd (AHLL). Apollo’s game plan is two-fold. It will highlight the standards of its medical care through these clinics. Moreover, the company will be relieved from the huge investment and other operational difficulties in running telemedicine and information centres on foreign shores. Apollo has already identified the potential markets where it can set-up a clinic. “We are now looking at markets where there is a sizeable Indian population. The Indian population will help the company in effective brand building in overseas market,” Mr Ratan Jalan, chief executive officer of AHLL, told ET. Apollo is looking to branch in South-east Asia, West Asia, Africa, UK and USA through this model. The company has already finalised five overseas clinics at Kuwait, Qatar, Saudi Arabia and two in Bangladesh. “We are in advanced stage of negotiation for another 5-6 set-up in Bangladesh, two in Pakistan, one each in Dubai, Bahrain, Nigeria, Tanzania, Ghana, Singapore, Philippines, London and Chicago. By the end of this fiscal, we are looking to set-up about ten clinics in international market,” Mr Jalan added.

Surgeries, Side Trips for 'Medical Tourists'

2005-02-22T02:27:00.003-08:00

NEW DELHI -- Three months ago, Howard Staab learned that he suffered from a life-threatening heart condition and would have to undergo surgery at a cost of up to $200,000 -- an impossible sum for the 53-year-old carpenter from Durham, N.C., who has no health insurance.
So he outsourced the job to India.
Taking his cue from cost-cutting U.S. businesses, Staab last month flew about 7,500 miles to the Indian capital, where doctors at the Escorts Heart Institute & Research Centre -- a sleek aluminum-colored building across the street from a bicycle rickshaw stand -- replaced his balky heart valve with one harvested from a pig. Total bill: about $10,000, including round trip airfare and a planned side trip to the Taj Mahal.
"The Indian doctors, they did such a fine job here, and took care of us so well," said Staab, a gentle, ponytailed bicycling enthusiast who was accompanied to India by his partner, Maggi Grace. "I would do it again."
Staab is one of a growing number of people known as "medical tourists" who are traveling to India in search of First World health care at Third World prices. Last year, an estimated 150,000 foreigners visited India for medical procedures, and the number is increasing at the rate of about 15 percent a year, according to Zakariah Ahmed, a health care specialist at the Confederation of Indian Industries.
Eager to cash in on the trend, posh private hospitals are beginning to offer services tailored for foreign patients, such as airport pickups, Internet-equipped private rooms and package deals that combine, for example, tummy-tuck surgery with several nights in a maharajah's palace. Some hospitals are pushing treatment regimens that augment standard medicine with yoga and other forms of traditional Indian healing.
The phenomenon is another example of how India is profiting from globalization -- the growing integration of world economies -- just as it has already done in such other service industries as insurance and banking, which are outsourcing an ever-widening assortment of office tasks to the country. A recent study by the McKinsey consulting firm estimated that India's medical tourist industry could yield as much as $2.2 billion in annual revenue by 2012.
"If we do this right, we can heal the world," said Prathap C. Reddy, a physician who founded Apollo Hospitals, a 6,400-bed chain that is headquartered in the coastal city of Chennai and is one of the biggest private health care providers in Asia.
The trend is still in its early stages. Most of the foreigners treated in India come from other developing countries in Asia, Africa or the Middle East, where top-quality hospitals and health professionals are often hard to find. Patients from the United States and Europe still are relatively rare -- not only because of the distance they must travel but also, hospital executives acknowledge, because India continues to suffer from an image of poverty and poor hygiene that discourages many patients.
Taken as a whole, India's health care system is hardly a model, with barely four doctors for every 10,000 people, compared with 27 in the United States, according to the World Bank. Health care accounts for just 5.1 percent of India's gross domestic product, against 14 percent in the United States.
On the other hand, India offers a growing number of private "centers of excellence" where the quality of care is as good or better than that of big-city hospitals in the United States or Europe, asserted Naresh Trehan, a self-assured cardiovascular surgeon who runs Escorts and performed the operation on Staab.
Trehan said, for example, that the death rate for coronary bypasspatients at Escorts is 0.8 percent. By contrast, the 1999 death rate for the same procedure at New York-Presbyterian Hospital, where former president Bill Clinton recently underwent bypass surgery, was 2.35 percent, according to a 2002 study by the New York State Health Department.
Escorts is one of only a handful of treatment facilities worldwide that specialize in robotic surgery, which is less invasive than conventional surgery because it relies on tiny, remote-controlled instruments that are inserted through a small incision.
"Our surgeons are much better," boasted Trehan, 58, a former assistant professor at New York University Medical School, who said he earned nearly $2 million a year from his Manhattan practice before returning to India to found Escorts in 1988.
Although they are equipped with state-of-the-art technology, hospitals such as Escorts typically are able to charge far less than their U.S. and European counterparts because pay scales are much lower and patient volumes higher, according to Trehan and other doctors. For example, a magnetic resonance imaging (MRI) scan costs $60 at Escorts, compared with roughly $700 in New York, according to Trehan.
Moreover, he added, a New York heart surgeon "has to pay $100,000 a year in malpractice insurance. Here it's $4,000."
In addition to patients from other developing countries, top Indian hospitals derive a significant share of foreign business from people of Indian origin who live in developed countries but maintain close ties to their homeland. But the same hospitals now are starting to attract non-Indian patients from industrialized countries, and especially from Britain and Canada, where patients are becoming fed up with long waits for elective surgery under overstretched government health plans.
"If you can wait for two years for a bypass surgery, then you don't need it or you're dead -- one of the two," Trehan said. "Similarly, if you're wobbling on your frozen joints for two years because of a waiting list, it's a human tragedy."
One such patient is Tom Raudaschl, an Austrian who lives in Canada and earns his living as a mountain guide. Suffering from osteoarthritis in his hip, Raudaschl last year decided to undergo "hip resurfacing," a relatively new procedure that involves scraping away damaged bone and replacing it with chrome alloy. He learned he would have to wait as long as three years if he wanted to have the operation under Canada's national health plan, a delay that would have cost him his job, Raudaschl said. In the United States, the procedure would have cost $21,000, he said.
So this month, Raudaschl flew from Calgary to Chennai, on India's east coast, where a surgeon at Apollo Hospital performed the operation Wednesday for $5,000, including all hospital costs, Raudaschl said by telephone from his hospital bed.
"As soon as you tell people that you're going to India, they frown,"Raudaschl said. But he said he could not be more pleased with the service."They picked me up at the airport, did all the hotel bookings, and the food is great, too," said Raudaschl, whose private room was equipped with Internet service, a microwave and a refrigerator. Most important, Raudaschl said the surgeon told him he would be "skiing again in a month."
To cope with its backlog of cases, Britain's National Health Service has begun referring patients for treatment to Spain and France, although for now, the health service limits referrals to hospitals within three hours' flying time, according to Anupam Sibal, a British-trained pediatrician and Apollo's director of medical services.
"Nobody even questions the capability of an Indian doctor, because there isn't a big hospital in the United States where there isn't an Indian doctor working," he said.
Before they would admit him for surgery, Staab, the heart patient, said hospital officials at Durham Regional Hospital asked for a $50,000 deposit and warned that the entire cost of treatment could run as high as $200,000.
Katie Galbraith, a hospital spokeswoman, confirmed in an e-mail that hospital costs in such cases typically are in the neighborhood of $100,000; the surgeon's bill, which is charged separately, would have added tens of thousands more. Patients such as Staab who do not qualify for charity care often are offered a payment plan, she said.
Staab was discharged from the Indian hospital Monday and was recuperating at a nearby hotel. He planned to return to Durham after visiting the Taj Mahal

India can attract 1m health tourists

2005-02-22T02:27:00.002-08:00

With internationally recognised healthcare professionals, holistic medicinal services and low cost of treatment, India can attract over one million health tourists every year, according to industry body CII. The country offers a unique mix of indigenous systems such as yoga, ayurveda and meditation and western medicinal systems like allopathy. This, along with world class experts and the cost advantage, can help attract over a million patients and earn $5 billion every year, a CII release said. While a heart surgery costs $30,000 in the US, it costs $6,000 in India. Similarly, a bone marrow transplant costs $26,000 here compared to $250,000 in the US, the release said adding that India should leverage its competitive strength to promote medical tourism. About 1.5 lakh patients had come to the country last year and the chamber along with Indian Healthcare Federation is working with tour operators for promoting packages to attract more medical tourists. CII and IHCF would also suggest a list of reputed hospitals in major cities with details of service and an indicative uniform price band in major specialities, it said. This would facilitate foreign patients seeking treatment in the country, the release said. Citing the example of Thailand, CII said India should aggressively publicise its traditional medicinal system and health services in association with the tourism authorities. However, the country would have to improve its healthcare infrastructure, connectivity between major cities and streamline immigration procedure for medical visitors, CII said. Accreditation of Indian hospitals is also essential for attracting such tourists, it added.

Check it out:

2005-02-22T02:27:00.001-08:00

http://www.sunway.com.my/sunmed/medical_tourism/medical_tourism.asp

India Fosters Growing 'Medical Tourism' Sector

2005-02-22T02:27:00.000-08:00

India is hoping to expand its tourist industry – to include visitors with heart conditions and cataracts. Indeed, medical tourism, where foreigners travel abroad in search of low cost, world-class medical treatment, is gaining popularity in countries like India. The field has such lucrative potential that Indian finance minister Jaswant Singh called for India to become a “global health destination.” And, with prices at a fraction of those in the US or Britain, the concept will likely have broad consumer appeal – if people can overcome their prejudices about health care in developing countries. Though the quality of health care for the poor in countries like India is undeniably low, private facilities offer advanced technology and procedures on par with hospitals in developed nations. One Indian hospital director maintains, "In a corporate hospital, once the door is closed you could be in a hospital in America.”

Sector
Ray Marcelo
The Financial Times, 2 July 2003
India is promoting the "high-tech healing" of its private healthcare sector as a tourist attraction.
The government hopes to encourage a budding trade in medical tourism, selling foreigners the idea of travelling to India for low-cost but world-class medical treatment.
Naresh Trehan, executive director of Escorts Heart Institute and Research Centre, a leading private healthcare provider, says India has established world-class expertise in practices such as cardiac care, cosmetic surgery, joint replacements and dentistry.
Merging medical expertise and tourism became government policy when finance minister Jaswant Singh, in this year's budget, called for India to become a "global health destination".
If foreigners respond, a new medical tourism industry could be generating revenues of Rs100bn ($2.1bn, €1.9bn, £1.3bn) by 2012, according to a report by McKinsey Consultants and the Confederation of Indian Industry, a business group.
There is no doubt that the Indian medical industry's main appeal is low-cost treatment. Most estimates claim treatment costs in India start at around a tenth of the price of comparable treatment in America or Britain.
For example, in April Madras Medical Mission, a Chennai-based hospital, successfully conducted a complex heart operation on an 87-year-old American patient at a reported cost of $8,000 (€7,000, £4,850) including the cost of his airfare and a month's stay in hospital. The patient claimed that a less complex operation in America had earlier cost him $40,000.
Other procedures such as diagnostic services offer significant cost-savings.
Take the rising popularity of "preventive health screening". At one private clinic in London a thorough men's health check-up that includes blood tests, electro-cardiogram tests, chest x-rays, lung tests and abdominal ultrasound costs £345 ($574, €500). By comparison, a comparable check-up at a clinic operated by Delhi-based healthcare company Max Healthcare costs $84.
Yet cost-savings may not be enough to foster a trade in medical tourism. Unfairly or not, most foreigners would not think of India as a land of good health.
The sight of the country's overcrowded public hospitals, open sewers and garbage-littered streets would unsettle most visitors' confidence about public sanitation standards in India.
Private healthcare providers argue that foreigners can be sheltered from such nastiness, and that the quality of India's corporate hospitals are world-class. "In a corporate hospital, once the door is closed you could be in a hospital in America," says P.V.R.K. Prasad, director-general of the Dr Marri Channa Reddy Human Resource Development Institute.
Vishal Bali, vice-president of Wockhardt Hospitals, points out as proof of quality that the US private health insurers Blue Cross and Blue Shield insure patients treat-ed at his group's hospitals.
The British health insurer Bupa also insures the costs of treatment at Wockhardt hospitals.
Mr Bali adds that Wockhardt is in talks with Britain's National Health Service about outsourcing the treatment of British patients to India.
According to Hari Prasad, vice-president of Apollo Hospitals in Hyderabad, foreigners should have confidence in India's medical system because many Britons and Americans are accustomed to being treated by expatriate Indian doctors.
In any case, most private healthcare providers hold modest ambitions about which foreign patients would come to India seeking treatment.
For instance, of the 5,200 hospital beds run by the Apollo hospital group, about 100 beds are usually occupied by foreign patients, mostly from the Middle East, Africa and countries of south Asia.
Indeed, demand for medical tourism is most likely to come from among the 20m-strong Indian diaspora, says Deep Kalra, chief executive officer of travel agency makemytrip.com.
Mr Kalra says wealthy first- and second-generation expatriate Indians are aware of the rise of India's high quality, low-cost hospitals.
He estimates there is a potential market of some 12m expatriate Indians who would combine regular visits to India and save time and money by undergoing non-emergency procedures such as eye operations, dental work, cosmetic surgery and knee surgery. Mr Kalra's agency plans to launch a medical tourism package later this year.
Still, some remain sceptical about medical tourism's potential. Sumanjit Chaudhry, an executive at India's Max Healthcare group, says: "I imagine if someone is sick and ill they won't want to have a holiday. You'll hardly see a guy who comes here for heart surgery leaping off and going to the beach."

Check it out:

2005-02-22T02:09:00.004-08:00

http://www.sunway.com.my/sunmed/medical_tourism/medical_tourism.asp

Check it out:

2005-02-22T02:09:00.003-08:00

http://www.sunway.com.my/sunmed/medical_tourism/medical_tourism.asp

Medical tourism expo

2005-02-22T02:09:00.002-08:00

Over 1 million of UK citizens are waiting for hospital treatment, yet in the rest of Europe waiting lists are non-existent. Why must we wait and wait so long? The maximum waiting time for an NHS operation is set to be six months by 2005. We consider this still to be an unacceptably long time to wait when in pain, worried and when life has been so disrupted by an illness.” ----The Patients Association, UKThe above quote signifies the importance of wellbeing of the citizens understanding which International Business Events propose to create a collaborative exhibition on trans-national healthcare in which the services of the Healthcare Industry of India can be experienced by the UK citizens. The exhibition will travel to UK with Indian Healthcare Industry & concerned authorities coming on board with a common interest of promoting universal healthcare. The interactive nature of the exhibit will encourage visitors to relate what they see to their own life, increase mutual understanding between our two nations, and spark a larger interest in and acceptance of diverse pre & post heath care options available in India.INDIA MEDICAL TOURISM EXPO is being organised from 2nd - 4th June 2005 at Alexandra Palace, Wood Green, London in association with Government of India, India Tourism - UK, High Commission of India - UK, Delhi Tourism & Federation of Indian Exports Organisations (FIEO). A number of glocal medical & allied association will be supporting the event.The India Medical Tourism Expo '05, London, would be instrumental in promoting Global Wellbeing by promoting the services of Indian Medicalcare & allied sector through this international affair. The concurrent Conference addressed by Medical Professionals of both the country, officials from Tourism & Health Ministry, India, Multi Specialty Hospitals etc., will aim at providing an ideal platform to understand the needs & required synergized efforts for trans-national healthcare. It will be an Exhibition & Conference targeted on bringing to a common platform the Indian Medical Industry & concerned authorities in UK This project is very important and relevant at this moment in time. There a clear need for greater mutual understanding between our two countries. Moreover, healthcare service problems are figuring more prominently into the lives of all UK citizens. The knowledge that this exhibit will convey will not only bring the citizens of the two countries closer together, but may also foster an trans-national healthcare awareness among the British citizens that may help to serve the needed better. The event will call the participation of all major players of Indian Medical Care Industry.For any further details please feel free to contact the undersigned.Thanks & Regards,Manish Joshi
International Business EventsC1/D, First FloorGreen Park Extension, New Delhi - 110016, India.Tel : +91-11-26536075 - 77, 26536084 Fax: +91-11-26536086 E-mail : manish.joshi@ibeworld.com
Posted by: Manish Joshi February 17, 2005

Medical Tourism

2005-02-22T02:09:00.001-08:00

Sridevi’s mother came to America for medical treatment; so did almost all of the Bollywood’s ailing. It was almost a fad some years back to profess that you have to fly to America for your treatment where in fact, chances of an Indian treating you in America are not too different from medical treatment in India. Recent developments have seen amazingly hi-tech hospitals being built and professionally run in almost all major Indian cities. But the trend is reversing, wealthy foreign patients are making their way toward India – for a $8000 bypass operation that would otherwise cost them a whopping $25,000 [via Washington Monthly].
A study by the Confederation of Indian Industry (CII), and McKinsey consultants estimated "medical tourism" could be worth 100bn rupees (£1.21bn) by 2012. Last year some 150,000 foreigners visited India for treatment, with the number rising by 15% a year, says Zakariah Ahmed, an analyst who helped compile the report.
....A number of private hospitals also offer packages designed to attract wealthy foreign patients, with airport-to-hospital bed car service, in-room internet access and private chefs. Another trend is to combine surgery in India with a yoga holiday or trip to the Taj Mahal [Source: The Guardian]
Now will Indian Tourism have a picture of Apollo Hospitals on their colorful brochures next to the large-moustached Rajasthani and the Taj Mahal? Heck, as Kevin suggests, America can solve its Medicare woes in one swift move by merely flying patients down to India (and also revive the airline industry while they are at it).

Health Tourism-an overview:::::

2005-02-22T02:09:00.000-08:00

Health Tourism: An Overview By Kim Ross (HSMAI Marketing Review)

Whether traveling to a spa for some serious rest and relaxation or flying somewhere to seek non-traditional medical therapies, cosmetic surgery or diagnostic testing, a multitude of people can be classified as health tourists. This is good news for the hospitality industry since an affluent population that is determined to stay well and stress free is an expanding and profitable market for those who meet their needs.
Health tourism is concept as ancient as prehistory and as up-to-date as tomorrow. While we don't know whether troglodyte innkeepers made any money on such travel, health tourism may be just what the doctor ordered for today's hospitality marketers.Definition
There is no single definition for health tourism, but a simple and succinct description comes from Mary Tabacchi, a registered dietician and Ph.D. who teaches courses in spa management, wellness and business, and healthy cuisine at Cornell University's School of Hotel Administration. According to Tabacchi, health tourism is "any kind of travel to make yourself or a member of your family healthier."
Most health tourism today focuses on two areas: pampering and wellness. Pampering involves offering people an experience that makes them feel good—services such as massages, herbal wraps and exfoliating scrubs. Wellness involves helping healthy people prevent problems so they stay well, both physically and mentally. Sometimes this means offering diagnostic testing to identify potential problems. More often, guests who have self-identified concerns are taught how to relieve stress, change eating habits, reduce the likelihood of sports injuries or improve their sex lives.
There are also enterprises, however, that go beyond Dr. Tabacchi's definition to include services designed for travelers who have special health needs. For example, 160,000 people in the United States need dialysis. Dialysis at Sea is a company that puts the machines on select cruise ships so people with kidney problems can enjoy cruising without compromising their health. Hotel de Health, a beachfront resort in Anguilla, offers island delights such as snorkeling, windsurfing, and fishing as well as eight dialysis stations "with a magnificent view of the Caribbean."Impetus for Growth
Several demographic, economic and lifestyle developments are fueling growth in health tourism. First and foremost is the aging of the Baby Boomers, 78 million of them in the United States alone. Seeing the grim reaper in their rear view mirrors has increased Boomers' interest in and need for travel opportunities that also meet their health needs. Already boomers represent 60 percent of the spa market.
Another factor is America's fascination with fitness and alternative therapies for health maintenance and healing. These statistics tell the story. In 1997, 42 percent of Americans spent $21 billion on non-traditional medical therapies and products. In the past three years nearly 25 million U.S. travelers fought the battle of bulge by using a fitness center or gym while on the road.
The third element spurring on health tourism is the fact that today's consumers are already well traveled. As a result they seek something new and different in a holiday experience. They often want something educational or experiential and various aspects of health tourism fulfill those requirements.
The fourth reason can be found in the health care system itself. In Canada and Britain, long waiting lists at home are causing some to go abroad to seek medical care. Cost can also be a factor. According to England's Daily Express newspaper, a cataract operation in Britain costs around $4,500, but only $2,250 in France. In India, the same cataract removal is only $345. A hip replacement in London costs as much as $12,000, but in Siberia a mere $1,500. If managed care continues to deny U.S. consumers access to certain medical services, Americans too may begin to look abroad for lower-cost options for out-of-pocket procedures.Background
The earliest form of health tourism—visiting mineral or hot springs—dates back to the Neolithic and Bronze ages in Europe. Legend says Bath, England was founded by Bladud, father of King Lear, in 863 BC.
By the Middle Ages belief in the curative powers of thermal springs was firmly established. In the 16th Century, Ponce de Leon brought the concept to the New World when he traveled to Florida in search of the fountain of youth. In the 1700s and 1800s, "taking the waters" at spa towns such as Baden-Baden was popular with the upper crust on both sides of the Atlantic. In the late 19th Century, the emerging urban middle class sought the healthful benefits of fresh sea or mountain air as an antidote to the overcrowding and pollution wrought by industrialization. The early 20th century saw the emergence of "health farms" or "fat farms" where the emphasis was on fitness and good diet. A new era of health tourism began in 1939 when Deborah and Edmond Szekely opened a $17.50-a-week bring-your-tent spa and healthy-living retreat, which became the renowned Rancho La Puerta fitness resort. In 1958 Deborah moved north to the San Diego area where she created the Golden Door, a luxurious destination spa known for its lavish individual service and successful mind-body programs. In the same vein, Mel and Enid Zuckerman opened Tucson's Canyon Ranch in 1979. Today it provides pampering, fitness and medically supervised wellness programs to their well-heeled clientele.
The notion of spas for the mass tourism market, however, didn't take off until the late 1980s. The International Spa Association was not formed until 1991. Since that time, the number of spas has grown geometrically. Most such spas give only a cursory nod to wellness, instead focusing primarily on feel-good services.
Recently, however, some organizations have gone a step further by making hospitals more like spas and spas more like hospitals. Such facilities integrate alternative medical therapies with conventional Western medicine. They perform operations and otherwise treat and rehabilitate people who are sick or injured, but they do so in a more congenial, resort-like atmosphere.
For example, the Bougainvillea Clinic in Tortola, British Virgin Islands, offers plastic, reconstructive and general surgery in a setting replete with gentle Caribbean breezes; tropical gardens; fountains, waterfalls, a swimming pool; and an antique Chinese bar. It also provides recuperating patients with a full range of pampering services such as aromatherapy, seaweed wraps, facials and massages.
Destination spas such as Canyon Ranch and La Quinta Resort and Club have added staffs of doctors, nurses and technicians who can perform and evaluate a variety of medical tests and provide behavioral counseling and physical therapy.
Cornell's Tabacchi noted, "From the consulting I've been doing and the phone calls I'm getting, hospital-spas are a natural match, a natural marriage. People know what spas are and they expect to be healed at spas. If hospitals can integrate this some way, I think it would be the hottest business you could have."U.S. Spas
Spas for healthy people currently represent the lion's share of the health tourism market.
In November 2000, the International Spa Association released the results of a survey by PricewaterhouseCoopers. The study found 5,689 spas in the U.S. The number of spas grew by 52 percent between 1997 and 1999 and spa visits rose 70 percent during
that period.
Nearly three-quarters of the spas in the survey were day spas, sometimes nothing more than glorified beauty salons, that serve a local clientele rather than travelers. In terms of health tourism in the U.S., the important types of spas are:
Resort/hotel spas, which are located within a resort or hotel and provide spa services, fitness and wellness components, and some spa cuisine menu choices.
Destination spas where the sole purpose is to provide guests with lifestyle improvement and health enhancement through spa services, physical fitness, a spa cuisine menu, educational programming, and on-site accommodations.
According to Travel & Tourism Analyst, the number of destination spas in the United States actually decreased between 1987 and 1997, while the number of hotel/resort spas increased dramatically.
Victor Lopez, division vice president of Hyatt Resorts, described his company's rationale for adding spas to its properties. "We've certainly found over the years that in the resort business, sun, sand and sea were not enough any more. People were looking not only for adventure and learning activities, but they really wanted to be able to exercise and be pampered.... Where before the beach or the pool or the golf course were fine, now people definitely want a spa. They want a full-service spa as a part of the amenities a place offers and many of them are making their vacation plans based on whether a property offers a full-service spa or not."
Results of a 1997 consumer survey conducted by Health Fitness Dynamics, Inc., a Florida spa consulting firm, confirms Hyatt's experience. It revealed 81 percent of consumers who went to resort-based spas said they expected a property to offer spa services. These consumers said they actively seek out resorts that offer those services. Hyatt's response to consumer demand mirrors that of the hospitality industry. Lopez said, "Most of our properties had health clubs. Most of them had a room with some bicycles, some Stairmasters, treadmills, etc. We started expanding on that. We built some big beautiful spas—anywhere from 15-25,000 square feet-and offer treatments of all kinds." He added, "And it's not just for the ladies any more. The men are getting not only massages, but facials and manicures and pedicures. It used to be that the ladies were at the spa and the men were on the golf course, but it's really changed. Now we're finding almost as many men using spas as the women."
Another HFD survey found that meeting consumer demand for spa services translates into direct and indirect benefits for hoteliers. According to general managers or directors of operations at 30 resort-based spas, spa facilities generate net operating profit of 15-25 percent. Among the GMs and DOOs surveyed, 97 percent said spas enhance or increase their marketing advantages, 83 percent said they boost revenue per occupied room and 73 percent said having a spa on site increased occupancy.
To maintain the competitive advantage spas give them, hotels and resorts are adding Asian, Native American or "alternative" therapies and approaches to the services they offer. Bernard Burt, publisher of SpaGoer.com and co-author of the book "100 Best Spas in the World", reported options often include:
Spiritual encounters such as the Javanese Lulur, a body cleansing based on Balinese wedding rituals;
Native American traditional healing adapted for exfoliations and wraps;
Massages with heated stones;
Grapeseed oil in French and American facials; and
Whipped cocoa baths (at, where else, but Hotel Hershey).
Some hotel/resort spas also offer physical and mental wellness activities such as yoga, meditation, reflexology and reiki and the water-based therapies popular in Europe and Asia.
The concept of the hospi-spa, the next logical step in the development of the spa business, "hasn't arrived yet" in the United States, "but many companies are considering it," said Cornell's Tabacchi. Who will finally break the barrier and open up the market? Tabacchi said, "My experience with established hospitality organizations and established hospitals are they are not flexible enough. They're too big, too unwieldy. It takes too much grinding to change their direction.... It would be my guess that it will take an entrepreneurial effort. It won't come from Ritz-Carlton. It won't come from Brigham & Women's."Destinations
Certain destinations have catered to health tourists for centuries. Bath and Baden-Baden were spa destinations since Roman times. The supposedly healing waters put Saratoga Springs, New York, and Hot Springs, Arkansas, on the map. In the late 19th and early 20th centuries, the warm dry climate of the Southwest attracted those with respiratory problems.
Today, once again, promoting the healthful and health-care benefits of a destination is gaining popularity because tourism marketers need ways to differentiate their products. A search of the Internet finds dozens of countries touting their health tourism products, including some most Americans would not associate with healthy conditions or excellent medical care, i.e. Ethiopia, Pakistan, Yemen, Bulgaria, Siberia and El Salvador. According to "Travel & Tourism Analyst," Germany, with its 330 spa towns, is the number one spa destination in Europe. Britain has 11 spa towns, including Bath where the primary "watering hole" was recently refurbished with $12 million from the national lottery, one of the country's Millennium projects.
While some of Canada's citizens are crossing the 49th parallel to seek medical care in the United States, the Canadian Tourism Commission is trying to lure American health tourists to its side of the border. The CTC gave Spa Canada, a national trade association, a grant to create a 40-page "Canadian Spa Escapes" brochure as a direct mail piece targeted at the U.S. market. Spa Canada is also working with the CTC on advertising and media relations efforts to increase the visibility of Canada as a destination for spa travel. Spas are not the only things that draw health tourists to a destination. Promotion of a country's low cost and/or high quality health care and medical innovations have proven very effective in attracting visitors. One percent of all international visitors to the United States come here for medical treatment, that's nearly 247,000 people. According to Costa Rica's Health Tourism Corporation, this tiny Central American nation attracts 150,000 health tourists annually. "U.S. News On Line" reported Cuba earned $25 million from health tourism in 1997.
Not all health tourism, however, is considered desirable. In Britain, the same government system causing Britons to go abroad for health care is attracting foreigners who want free medical services. Treatment is free in Britain to citizens of 60 countries, with which the U.K. has a reciprocal arrangement, who have been in the U.K. for 12 months or more, are emergency patients, and for people in several other limited categories. One member of Parliament decried this development saying Britain is becoming the "health supermarket for the rest of the world," and the situation is costing "taxpayers millions of pounds a year."Tour Operators and Cruise Ships
The appeal of health tourism has not been lost on tour operators or cruise lines. HealthyTravelNet.com listed a variety of "Aroma Tours," including a "Provence Aromatherapy Retreat," which includes meetings with aroma therapy experts and visits to essential oils distilleries. It also has yoga-for-golfers tours to the Yucatan and Hawaii.
Mindbodytravel.com offers "High Feminine Healing—A Sacred Women's Tour to Bali," which includes "yoga, meditation and connection," mask making, "a purification ritual at a spring in one of Bali's most sacred temples," and two spa treatments. HlidayBank.co.uk lists tour operators such as Thermalia Travel, which arranges "health and beauty vacations in spas around the world," and Palmland Tours, offering "Ayurvedic health holidays" at a lake resort in southwestern India. Travelers who want a little nip and tuck can book a cosmetic surgery package to Colombia through Surgeries Overseas.
Lacey Gude, owner of Amazon Adventurers and Gerosa Tours in Arlington, Virginia, develops special itineraries to the Brazilian Amazon for individuals and groups interested in the indigenous medicinal herbs and traditional healing practices. Cruise lines also have responded to consumer interest in health and fitness. Today virtually every large cruise ship has a spa, fitness center, and healthy-eating choices on their menus.
And since turnabout is fair play, destination spa Canyon Ranch recently announced plans to build two cruise ships of its own. Mel Zuckerman, Canyon Ranch's founder said, "We're very excited to offer an exotic travel experience consistent with our goal of providing a healthy, life enhancing vacation. Our ships will be like no other cruise ships afloat."
According to the press announcement, each ship will be equipped with amenities such as a 50,000-square-foot, state-of the-art gym; studios; a rock-climbing wall; a jogging track; 35 spa treatment rooms; and a beauty salon. In addition, they would have a health and healing center staffed by physicians, health educators, nutritionists, exercise physiologists, physical therapists and others.
Those plans, however, may be in permanent dry dock. In late January, Roxanne Housley, vice president of sales, said, "There is a delay in building right now." She also noted, "Obviously there will be components from behavioral and medical when and if we build ships, but at this point that decision has not been made."Conclusion
With the economy beginning to weaken, perhaps now is a good time for hospitality marketers to give their marketing plan a thorough checkup. Something as simple as targeting health tourists may be just the prescription for maintaining a healthy bottomline.CONTACT

Kerala has big plans for health, eco tourism:

2005-02-22T02:03:00.000-08:00

[Kerala, India]: Thiruvananthapuram, Feb 10 : Health, pilgrimage, farm and eco tourism are about to get a boost in lush green Kerala as the state pumps in more funds and encourages private participation in the sector. Minister of Tourism K.C. Venugopal Thursday told the state assembly that several new measures had been drawn up for the tourism industry."Above all, we propose to further open up this sector for private investment. This scheme is in its infancy and we feel there is no need to bring any sort of restriction, especially on foreign investment," he said."We propose to take into confidence local bodies to restrict, regulate and identify those units that are making money under health tourism projects without any control. "To make it more efficient and to weed out those who do not fall in tune with our culture, we are introducing new legislation."Promotion of farm tourism is a new area where the tourism department is taking a lot of interest. Several independent resorts run by family members have been started to accommodate visiting tourists.In another new project, tourism activities in the northern districts of Malappuram, Wayanad, Kannur and Kozhikode are being developed, the minister said. "The Nilambur area (in Malappuram district) has been identified as a rich eco-tourism segment and the centre has sanctioned close to Rs.40 million ($914,500) for this," minister said.However, tour operators in Kerala are not fully convinced."One instance that has really caused us some difficulty was the sudden change of tourism officials by the new government. They could have done that after March," said E.M. Najeeb, a leading tour and travel operator here."Moreover, even though there is a lot of talk of private-government partnership, this has not really happened after the new government took over."

The Health Travellers-2

2005-02-22T01:54:00.004-08:00

The Travellers You could divide the world's medical travellers into four distinct geographical groups who travel for distinctly different reasons. The first is made up of the Americans. Indeed, countries like Thailand, Malaysia and South Africa, which were the first to try and tap 'medical tourists', all geared their systems to attract the growing American clientele.Why would the Americans travel abroad when their own country boasts of the best medical facilities in the world? And especially as they don't have to wait in queue like the British? The two Es: ego and economy. The US healthcare system is predominantly insurance-driven. But health insurance covers critical care - not cosmetic care. And there are vast numbers of Americans today who are looking for cosmetic surgery - whether it involves a facelift, a liposuction or dental treatment for a brighter smile. According to the American Society of Aesthetic Plastic Surgery, in 2002, 6.6 million Americans went in for cosmetic surgery in the US itself. They were also the biggest chunk of foreign customers for cosmetic surgeons in Thailand, Malaysia and South Africa. These three countries, between them, pulled in over 100,000 Americans seeking cosmetic surgery.As the baby boomers - those 76 million Americans born between 1946 and 1964 - age, they are increasingly going in for facelifts, botox treatments, tummy tucks, et al. And since cosmetic surgery is mostly not covered by medical insurance, many Americans prefer to travel abroad. A full facelift costs $8,000-20,000 in the US and only $1,252 in South Africa. Thailand is slightly more expensive at $2,682. Best of all, going abroad means a vacation as well after the surgery is over.Vanity isn't the only reason why Americans seek treatment abroad though. Lack of insurance cover is another. Last year, 15.2% of the US population - some 43.6 million people - had no health insurance coverage. And a significant proportion of even the 84% with insurance were under-insured.Many of these people weren't poor - at least according to developing country standards. Some of them were people between jobs who didn't have insurance simply because they were earlier covered by their employers. Given the increasing cost of medical treatment in the US, it made sound economic sense to seek treatment abroad. If cosmetic surgery and costs were the factors driving the Americans to travel abroad, the second major group - the British - were being forced to seek medical treatment in other countries by the sheer waiting lists caused by the National Health Service (NHS). Unlike in the US, the British healthcare system ensures free treatment to all its citizens. The only problem is that the NHS, which was set up in 1948, is struggling to cope because of a shortage of both doctors and hospital beds. (Private medical facilities are available in the UK, but they are prohibitively expensive and also relatively fewer in number.) In 2001, more than 1 million British citizens were waiting for inpatient treatment and half-a-million for outpatient treatment according to a study by the Vienna University of Economics and Business Administration. At least 40% of the people requiring inpatient care needed to wait over three months for their turn to come. Hip replacement and eyecare had the longest waiting periods.The situation is so bad that in 2002, the NHS started a pilot scheme 'overseas treatment' to see if surgery services abroad could be bought to shorten the waiting lists. The project focussed mainly on facilities available in the European Union - in countries like Austria and Germany. Meanwhile, many thousands of British patients take the initiative to seek their own treatment abroad without waiting for the NHS to sort out its problems.
The third big group of medical travellers comes from the Middle East. These are citizens of the oil rich nations flying abroad to seek medical facilities that are either unavailable or in short supply in their own countries. An agency in Saudi Arabia estimated that every year, more than 500,000 people from the Middle East travel seeking medical treatment for everything from open heart surgery to infertility treatments. They travel everywhere - to Jordan, Saudi Arabia and Bahrain; to the US; to India, Thailand and Malaysia. By some estimates, India itself attracted 70,000-plus medical travellers from the Middle East last year.Finally, the last group of medical travellers form a motley lot. They are from the least developed countries and countries with generally poor medical infrastructure, who usually seek treatment facilities at some neighbouring country with better infrastructure. Last year, it was estimated that at least 50,000 people from Bangladesh and Nepal came for medical treatment to India. A significant majority of the 126,000 medical travellers to Jordan came from neighbours with poor medical infrastructure facilities.
Tapping The Big MarketA $40-billion-plus market growing at over 20% a year throws up huge opportunities for anyone smart enough to tap into it. The SSDS, Inc. study for the WHO pointed out that business opportunities covered a big spectrum - from retirement homes and spas, to cosmetic and dental surgery, to critical but non-emergency surgery needs like hip replacements, organ transplants, angioplasty and vision correction. Other studies show even alternative healthcare could be a significant niche opportunity.In the initial years, most countries that tapped into the medical destination opportunity essentially focussed either on spas or on the 'vanity' and the 'exotic' surgery requirements. In South Africa a number of outfits (travel agents with hospital connections) sprang up to tap into the market for facelifts, tummy tucks and cosmetic dental surgery. Thailand initially had a somewhat dubious reputation as an excellent country to go to for sex change operations. India's primary claim to fame was its ayurvedic treatment centres. "Beauty, youth and wellness is a huge area for growth and we need to promote it aggressively," says Apollo's Reddy.Over the past few years, though, many countries have realised that an equally big opportunity lies in promoting the more conventional treatments. Some of this, of course, was always happening in the background - like people from Mauritius, Bangladesh and the Gulf coming to India for conventional surgeries and people from Japan flying to Singapore, Malaysia or Thailand for similar reasons. Only now, the nations have started pitching themselves as world-class but inexpensive destinations for almost all health requirements.
They might be getting some unexpected help soon - from insurance giants. Healthcare insurers in the developed countries are not blind to the fact that the option of medical treatment in countries like Thailand and Malaysia could help them reduce premiums and offer options to people who are currently uninsured. Over the next few years, insurance firms are expected to provide a fillip to the medical travel business.Most insurance companies in the US and the UK have already accredited hospitals worldover where Western visitors can seek emergency medical treatment. Now a few hospitals in Thailand are going a step further - they are getting themselves accredited by the Joint Commission Accreditation of Healthcare Organizations (JCAHO). A full accreditation from this organisation allows a hospital to pitch for the insurance traffic too. Travelling has never been so healthy before.

The Health Travellers-1

2005-02-22T01:54:00.003-08:00

The market is $40 billion and counting. It is growing at 20% every year. But how does one tap the opportunity?
Cyril Parry waited for a very long time for his turn to come. The 59-year-old retiree from Birmingham, UK, was suffering from rheumatoid-arthritis. He needed a hip replacement operation urgently. He waited patiently though his pain was getting worse and his movements increasingly restricted. Unfortunately, Parry was stuck at the end of a very long queue. The overburdened National Health Service orthopaedic surgeons in the UK were booked solid - for several years. Finally, Parry was told that his turn would come four years and nine months down the line.
That was when Parry started surfing the Net to see if he could get his hip surgery done elsewhere in the world. After a full year of research, he shortlisted two destinations: a hospital in Thailand and Apollo Speciality Hospital, Chennai. In November this year, Parry opted for the latter because, at £4,000 (excluding airfare but inclusive of a 10-day stay, post-operative care and a full health check-up), it was almost £5,000 cheaper than the Thai option.It was ironic that Parry needed to travel abroad for his treatment. He was, after all, undergoing a procedure called the 'Birmingham Hip Resurfacing' - a new technique considered as a superior alternative to the full-hip replacement surgery, and named after the city it was pioneered in. It was perfected at the Royal Orthopedic Hospital in Birmingham as recently as 1998.
Cyril Parry needed to travel because of the healthcare system followed in the UK which is creating long waiting lists of patients in that country. More on that later. But long waiting lists are not the only reason that there's been a huge surge in medical travel globally in recent years. Patients from rich countries in the Middle East travel to the US when they need top notch medical care. Residents of poor developing nations such as Nigeria or Bangladesh travel to their more developed neighbours for medical treatment because there aren't enough good facilities available in their own countries. Thousands of Japanese citizens seeking medical treatment fly abroad because of the prohibitive costs of treatment in their home country. Americans seeking cosmetic surgery often fly to South Africa for face tucks and breast augmentation because their insurance coverage doesn't pay for those - and it is cheaper to get them done in South Africa than back home.Nobody has collated the complete worldwide statistics about how many people travel abroad for health- and medical care-related reasons every year or how much they spend. But a Saudi Arabian report pointed out that in 2000, medical travellers from the Gulf region alone spent over $27 billion seeking treatment in various nations around the world. If the medical travellers from around the world spent even half as much that year, the total business in 2000 alone would have been in excess of $40 billion. And even that could be an underestimate."The estimate is that the healthcare market in the Organisation of Economic Cooperation and Development countries alone is worth about $3 trillion, and expected to go up to $4 trillion in 2005," says Rupa Chanda, professor at the Indian Institute of Management-Bangalore, and who was part of a working group led by Isher Ahluwalia of ICRIER which prepared a report for the World Trade Organization on the potential for trade in health services. Chanda refuses to hazard a guess on how much of this is actually cross-border medical traffic, just saying that the opportunity is huge.More importantly, it 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 travellers and earned over $1 billion (in treatment costs alone). In each of these nations, medical travel spends are growing at 20%-plus year-on-year.
Elsewhere around the world, Hong Kong, Lithuania and South Africa are emerging as big medical/healthcare destinations. And a dozen other nations including Croatia and Greece plan to make themselves attractive healthcare destinations.By itself, travelling abroad for health is not a new phenomenon - even in ancient times, there were examples of people travelling abroad to spas or famous medical centres for health treatment. But in the past five years or so, the movement has accelerated sharply. It has developed a massive momentum for two critical reasons.The first is, of course, the demographics of the developed nations and also the problems that are cropping up in their healthcare systems. In the US, the UK, Japan and many European nations, the proportion of the elderly (60 years and above) vis-à-vis the total population is increasing rapidly. In the US, the baby boomers - the biggest chunk of the population - have either hit retirement age or are heading towards it. The number of people aged 65 years and above is expected to double in the next 15 years. In the UK, the people aged 60 years and above will form 25% of the population in the next 30 years - up from 16% now. Similar trends are being seen in almost all nations in Western Europe. Meanwhile, life expectancy here has risen steadily over the years. Add the two up and you get a big surge in demand for healthcare.
The big problem is that as their health needs increase exponentially, the healthcare systems in these countries are beginning to creak under the pressure. The number of doctors and nurses joining the workforce in both the UK and the US is not keeping pace with all the demands of the ageing population. This is creating the push factor.Meanwhile, there is a pull factor being created by a handful of developing countries like Thailand and Malaysia that have good doctors and excellent facilities, and which are positioning themselves as medical destinations in order to boost their economies. Both Thailand and Malaysia see this developing into a multi-billion dollars-a-year business. There is also the other factor - like people from the least developed countries who find affordable sophisticated medical care facilities in developing countries like India and Malaysia. "The competence and skills of Indian doctors is accepted internationally and people are coming from all over the world to our hospital to get treatment," says Prathap C. Reddy, chairman, Apollo hospitals group. Curt Schroeder, CEO of Thailand's Bumrungrad Hospital, echoes that sentiment about his country's healthcare facilities.Cross-border travel for healthcare reasons is still a highly disorganised movement, but nations are slowly waking up to its potential. In some places the governments have taken a lead. In others, like South Africa and Lithuania, travel agents specialising in medical tourism are driving the trend. In India, private hospitals like Apollo and Escorts Heart Institute and Research Centre are trying to attract patients on their own. Though the movement can still be considered to be in its infancy, medical travel has come under the radar of both the World Health Organization (WHO) and the World Trade Organization (WTO). As far back as the early 1990s, the WHO commissioned the Social Sector Development Strategies, Inc. (SSDS, Inc.), a Boston-based non-profit organisation specialising in global healthcare systems, to see whether the English-speaking Carribbean islands could become a significant healthcare destination for travellers from the US, the UK and Canada. The study took a hard look at both the advantages and the disadvantages of these nations before reluctantly coming to the conclusion that they would be uncompetitive in most of the areas. The WHO's interest is simple - it realises that medical travel can help boost the medical facilities (and the medical economy) in developing countries while also taking care of some of the problems of rich nations. The WTO sees medical travel as one of the four modes (See 'WTO: How The Medical Trade Will Grow') that will help boost trade in healthcare services worldwide. Both WHO and WTO understand that medical travel could ameliorate much of the demand-supply imbalance in global healthcare. Developed nations benefit as costs or waiting time - or both - come down for a significant chunk of their population. Developing countries benefit as it brings in revenues - and provides the right spur to improve their overall healthcare sector, apart from reducing brain drain in their medical fraternities. Least developed countries, too, benefit as they lack facilities for cutting-edge treatment.
The Travellers You could divide the world's medical travellers into four distinct geographical groups who travel for distinctly different reasons. The first is made up of the Americans. Indeed, countries like Thailand, Malaysia and South Africa, which were the first to try and tap 'medical tourists', all geared their systems to attract the growing American clientele.Why would the Americans travel abroad when their own country boasts of the best medical facilities in the world? And especially as they don't have to wait in queue like the British? The two Es: ego and economy. The US healthcare system is predominantly insurance-driven. But health insurance covers critical care - not cosmetic care. And there are vast numbers of Americans today who are looking for cosmetic surgery - whether it involves a facelift, a liposuction or dental treatment for a brighter smile. According to the American Society of Aesthetic Plastic Surgery, in 2002, 6.6 million Americans went in for cosmetic surgery in the US itself. They were also the biggest chunk of foreign customers for cosmetic surgeons in Thailand, Malaysia and South Africa. These three countries, between them, pulled in over 100,000 Americans seeking cosmetic surgery.As the baby boomers - those 76 million Americans born between 1946 and 1964 - age, they are increasingly going in for facelifts, botox treatments, tummy tucks, et al. And since cosmetic surgery is mostly not covered by medical insurance, many Americans prefer to travel abroad. A full facelift costs $8,000-20,000 in the US and only $1,252 in South Africa. Thailand is slightly more expensive at $2,682. Best of all, going abroad means a vacation as well after the surgery is over.Vanity isn't the only reason why Americans seek treatment abroad though. Lack of insurance cover is another. Last year, 15.2% of the US population - some 43.6 million people - had no health insurance coverage. And a significant proportion of even the 84% with insurance were under-insured.Many of these people weren't poor - at least according to developing country standards. Some of them were people between jobs who didn't have insurance simply because they were earlier covered by their employers. Given the increasing cost of medical treatment in the US, it made sound economic sense to seek treatment abroad. If cosmetic surgery and costs were the factors driving the Americans to travel abroad, the second major group - the British - were being forced to seek medical treatment in other countries by the sheer waiting lists caused by the National Health Service (NHS). Unlike in the US, the British healthcare system ensures free treatment to all its citizens. The only problem is that the NHS, which was set up in 1948, is struggling to cope because of a shortage of both doctors and hospital beds. (Private medical facilities are available in the UK, but they are prohibitively expensive and also relatively fewer in number.) In 2001, more than 1 million British citizens were waiting for inpatient treatment and half-a-million for outpatient treatment according to a study by the Vienna University of Economics and Business Administration. At least 40% of the people requiring inpatient care needed to wait over three months for their turn to come. Hip replacement and eyecare had the longest waiting periods.The situation is so bad that in 2002, the NHS started a pilot scheme 'overseas treatment' to see if surgery services abroad could be bought to shorten the waiting lists. The project focussed mainly on facilities available in the European Union - in countries like Austria and Germany. Meanwhile, many thousands of British patients take the initiative to seek their own treatment abroad without waiting for the NHS to sort out its problems.
The third big group of medical travellers comes from the Middle East. These are citizens of the oil rich nations flying abroad to seek medical facilities that are either unavailable or in short supply in their own countries. An agency in Saudi Arabia estimated that every year, more than 500,000 people from the Middle East travel seeking medical treatment for everything from open heart surgery to infertility treatments. They travel everywhere - to Jordan, Saudi Arabia and Bahrain; to the US; to India, Thailand and Malaysia. By some estimates, India itself attracted 70,000-plus medical travellers from the Middle East last year.Finally, the last group of medical travellers form a motley lot. They are from the least developed countries and countries with generally poor medical infrastructure, who usually seek treatment facilities at some neighbouring country with better infrastructure. Last year, it was estimated that at least 50,000 people from Bangladesh and Nepal came for medical treatment to India. A significant majority of the 126,000 medical travellers to Jordan came from neighbours with poor medical infrastructure facilities.
Tapping The Big MarketA $40-billion-plus market growing at over 20% a year throws up huge opportunities for anyone smart enough to tap into it. The SSDS, Inc. study for the WHO pointed out that business opportunities covered a big spectrum - from retirement homes and spas, to cosmetic and dental surgery, to critical but non-emergency surgery needs like hip replacements, organ transplants, angioplasty and vision correction. Other studies show even alternative healthcare could be a significant niche opportunity.In the initial years, most countries that tapped into the medical destination opportunity essentially focussed either on spas or on the 'vanity' and the 'exotic' surgery requirements. In South Africa a number of outfits (travel agents with hospital connections) sprang up to tap into the market for facelifts, tummy tucks and cosmetic dental surgery. Thailand initially had a somewhat dubious reputation as an excellent country to go to for sex change operations. India's primary claim to fame was its ayurvedic treatment centres. "Beauty, youth and wellness is a huge area for growth and we need to promote it aggressively," says Apollo's Reddy.Over the past few years, though, many countries have realised that an equally big opportunity lies in promoting the more conventional treatments. Some of this, of course, was always happening in the background - like people from Mauritius, Bangladesh and the Gulf coming to India for conventional surgeries and people from Japan flying to Singapore, Malaysia or Thailand for similar reasons. Only now, the nations have started pitching themselves as world-class but inexpensive destinations for almost all health requirements.
They might be getting some unexpected help soon - from insurance giants. Healthcare insurers in the developed countries are not blind to the fact that the option of medical treatment in countries like Thailand and Malaysia could help them reduce premiums and offer options to people who are currently uninsured. Over the next few years, insurance firms are expected to provide a fillip to the medical travel business.Most insurance companies in the US and the UK have already accredited hospitals worldover where Western visitors can seek emergency medical treatment. Now a few hospitals in Thailand are going a step further - they are getting themselves accredited by the Joint Commission Accreditation of Healthcare Organizations (JCAHO). A full accreditation from this organisation allows a hospital to pitch for the insurance traffic too. Travelling has never been so healthy before.

India : Gearing up for the opportunity

2005-02-22T01:54:00.002-08:00

There has been no concerted effort to market India as a healthcare destination though it has always attracted thousands of patients from abroad. Now a few private hospitals are trying to attract medical travellers on their own. Of them, the Chennai-headquartered Apollo Hospitals group is probably the most aggressive and organised.In the late 1980s and early 1990s, most medical travellers coming to India were from the Arab countries, Africa and South-east Asia. But today, there’s a significant number from the CIS nations too. “Afghanistan and the CIS countries have become very important for us,” says a senior doctor at Escorts Heart Institute and Research Centre, Delhi.To attract foreign patients, Indian hospitals are seeking international certification and accreditation. “We have taken comprehensive quality accreditation from the international quality certification body, TUV Rheinland,” says R. Basil, CEO, Manipal Hospital, Bangalore. Hospital groups like Fortis, Max Healthcare and Wockhardt may even go for the JHACO accreditation. Apollo has already applied for it. “We are going for... recognition for Apollo Delhi, Hyderabad and Chennai, and, ultimately, for all the hospitals,” says Prathap C. Reddy, chairman, Apollo Hospitals.
Cyril Parry with his doctor, Apollo Speciality’s Vijay Bose
India does have an edge if it wants to tap the medical traveller market. It churns out over 20,000 doctors a year and some of its healthcare facilities compare with the best in the world. It has earned a good reputation in a number of cutting-edge surgical treatments. And at least a couple of foreign companies think India is good enough to set up registries — centres where the first 500 surgeries are conducted after a medical device or surgical treatment has been approved by the US Food and Drug Administration. Baxter did it for its medicated stents; Bausch & Lomb set up a registry for zyoptic surgery. Eyecare, in fact, is one area where India has a distinct advantage — it has more Lasik centres than some of the dev- eloped countries. And Aravind Eye Hospital in Madurai conducts the largest number of cataract surgeries in the world. Travellers from South-east Asia also find that in some procedures, India offers significant cost advantages. Recently, a Malaysian patient suffering from Parkinson’s disease came for a deep brain surgery to Vimhans, Delhi. The cost, including travelling to India twice with an attendant, was a tenth of what it would have cost him in Singapore. India also has enough good private healthcare facilities. “We calculate that there are 6,000 beds in the private sector that are available for international patients,” says Roy Fernandez, vice-president (international marketing services), Apollo Hospitals group.The Apollo Hospitals group has treated 96,000 foreign patients till date. And is aiming for more. “The biggest opportunity is insurance and Apollo, for one, is looking for innovative ways to use it,” says Fernandez. As empanelment alone is not enough to get patients, Apollo is negotiating with oil multinational ARAMCO to offer special packages to its employees. Apollo has tied up with NIIT and Aptech so that attendants of patients who come for treatment for 2-3 months can take short-term IT courses. Meanwhile, a few travel agents are also trying to promote Indian systems of medicine. Kerala promotes its ayurvedic treatment centres to the tourist traffic.A few state governments are trying to pitch in. The Department of Tourism and the Department of Health in Karnataka took a mission to the International Health Tourism and Holidays exhibition in Bahrain. Last month, the government of Maharashtra and Ficci announced the setting up of the Medical Tourism Council of Maharashtra (MTCM). The Association of Private Hospitals of Maharashtra is joining the initiative. “The idea is to make an organised effort to get international patients to India,” says Joe Curien, CEO, Raheja Hospital, Mumbai. Some others are helping in a slightly different way. Metropolis chairman Sushil Shah says: “We are in the process of setting up labs in underdeveloped and developing countries. For developed countries like the US, we will do clinical testing here. The difference in costs is in the ratio of 1:10 or 1:8.” A recent study by McKinsey & Company estimated that India could earn revenues of $1 billion from medical travel. But for that to happen, the Indian government and private hospitals needed to be more systemic in their efforts. There is no paucity of ideas. Apollo’s Reddy suggests special flights targeted at international travellers. Improving the connectivity of Mumbai and Delhi (where most international flights land) with Hyderabad or Chennai, where there are many private hospitals, could help too. Building dedicated medical clusters outside, say, Mumbai, or Goa, and aggressively promoting them could be another major step. Finally, the opportunity needn’t be limited to conventional medical treatment. The study by SSDS, Inc. for WHO pointed out that retirement homes for the aged could be a big opportunity — especially if they were targeted at the clientele in the expensive, developed countries.

Malaysia :A new health destination

2005-02-22T01:54:00.001-08:00

With the global healthcare market up for grabs (see 'The Health Travellers, BW 22 December, 2003), countries are beginning to search for niches in which they can operate. And Malaysia, it seems, has found one for itself - to be the healthcare destination for the Muslim world. The Malaysian government is giving a new thrust to a programme that began in 1998 with the setting up of the Malaysian External Trade Development Corporation (MATRADE). It was part of the 8 Malaysia Plan (8MP) to combine tourism with healthcare. Now, however, the government has decided to focus on the Muslim world. According to the Malaysian minister of health, Dato' Chua Jui Meng, the middle eastern countries and the ASEAN nations will be the focus areas for Malaysian hospitals. Clearly, India, the traditional destination for patients from this region, had better watch out! A moderate and modern Muslim nation, Malaysia offers a culture that would certainly appeal to the sensibilities of the Islamic population. And, Meng is trying to differentiate Malaysia from neighbour Singapore, which is already a major healthcare destination, but is rather expensive. Malaysia, by contrast, offers a value-for-money proposition.Recently, MATRADE took a mission to Brunei. Health tourism brought in RM150 million worth of revenue in 2002 which is expected to reach RM400 million by 2005. The target is RM2.2 billion from this sector by 2010.

The medical tourism opportunity

2005-02-22T01:54:00.000-08:00

There was a sense of déjà vu when the setting up of L.H. Hiranandani Hospital was announced by the builders at Powai. 'Not another corporate hospital' was the common refrain. After all, healthcare seems to be the emerging opportunity and alternate investment for the builders. The Raheja's already have a multispecialty hospital in central Mumbai. And here was another one that was attempting to tap the same opportunity.Interestingly, even before the hospital was launched, it had received pre-approval from the UK-based National Health Services (NHS) for treatment of over seven disease categories. There is emphasis on ambulatory care and the 130-bedded multispecialty hospital, spread over 210,000 sq. ft, is headed by Sujit Chatterjee."Our infrastructure and services are amongst the best in the world, and we hope to tap into the medical tourism market." Says Niranjan Hiranandani, managing director, Hiranandani Constructions. Even the Maharashtra government has identified the opportunity in medical tourism, after it became the first state government in June 2003 to form a committee on these lines. The committee comprises members of the tourism ministry and the health ministry, along with major hospitals and pathology service providers.With corporate hospitals aggressively going for NHS-like accreditation and tie-ups, they are looking to tap the lucrative medical tourism market faster than older hospitals seeking similar tie ups.

Global Health Trade

2005-02-22T01:52:00.000-08:00

Even five years ago, Thailand's claim to fame in the medical travel world was as a cheap and reliable destination for sex change operations. Over the past few years, the Thai government and half a dozen private hospitals have gone into overdrive to change that image. They are now repositioning Thailand as Asia's premier healthcare hub for everything from cosmetic surgery to hip replacements.
The Thai Ministry of Public Health is working closely with the Thai Ministry of Tourism to promote medical tourism in Thailand. More interestingly, the Thai minister met his counterpart from Malaysia a few months ago to see if the two countries could mount some sort of joint-promotion to beat competition from other countries.But the government initiatives pale before the kind of action that the private hospitals are taking to attract medical travellers. Bangkok's Bumrungrad Hospital is by far the clear leader in the field. With 554 beds on offer, it treated 300,000-plus expatriates and foreigners last year. In fact, a full 25% of all the patients that the hospital treats today are foreigners. To make itself attractive to foreigners, Bumrungrad offers a host of facilities. It offers assistance in 13 languages and it has got itself accredited from the JCAHO, an international certification recog- nised by most of the big insurance companies. It's even got a McDonald's and a Starbucks coffee shop in its compound to cater to the tastes of its foreign patients and their companions. "To facilitate patients, we have opened offices in Myanmar, Vietnam, Nepal, Sri Lanka, Maldives, Cambodia, the Netherlands and the Middle East," says Carl Schroeder, CEO, Bumrungrad Hospital.The other private hospitals aren't sitting still either. The Phyathai hospital is hiring teachers from the British Council to train its staff, including the maids. It has also signed contracts with hospitals in the Netherlands and Bangladesh to bring in patients awaiting heart surgery there. Thailand provides specialised medical clinics, skilled nursing care, long-term care, nursing homes and rehabilitation clinics at costs that are a fraction of what it would cost in the US or Britain. "The cost of treatment in Thailand is less then half of what other neighbouring countries charge," says Surapong Ambhanwong, chief medical officer of Phyathai 1 hospital.The Japanese still form the biggest chunk of medical travellers coming to Thailand, though the Americans and the British are now coming in significant numbers. After 9/11, it also got a huge share of the Arab traffic.