Abstract
Medical tourism is a growing phenomenon with policy implications for health systems, particularly of destination countries. Private actors and governments in Southeast Asia are promoting the medical tourist industry, but the potential impact on health systems, particularly in terms of equity in access and availability for local consumers, is unclear. This article presents a conceptual framework that outlines the policy implications of medical tourism's growth for health systems, drawing on the cases of Thailand, Singapore and Malaysia, three regional hubs for medical tourism, via an extensive review of academic and grey literature. Variables for further analysis of the potential impact of medical tourism on health systems are also identified. The framework can provide a basis for empirical, in country studies weighing the benefits and disadvantages of medical tourism for health systems. The policy implications described are of particular relevance for policymakers and industry practitioners in other Southeast Asian countries with similar health systems where governments have expressed interest in facilitating the growth of the medical tourist industry. This article calls for a universal definition of medical tourism and medical tourists to be enunciated, as well as concerted data collection efforts, to be undertaken prior to any meaningful empirical analysis of medical tourism's impact on health systems.
Highlights
Growing demand for health services is a global phenomenon, linked to economic development that generates rising incomes and education
This paper presents a conceptual framework of medical tourism and policy implications for health systems in Southeast Asia, drawing on the cases of Thailand, Singapore and Malaysia, via an extensive review of the academic and grey literature, as well as insights from health consultancies in the public and private sectors across the region
We decided to undertake this fourth type of comparative analysis, in order to generate a conceptual framework that could be usefully employed by policymakers to understand the policy implications of medical tourism on health systems with similar structures
Summary
Growing demand for health services is a global phenomenon, linked to economic development that generates rising incomes and education. Waiting times and/or the increasing cost of health services at home, coupled with the availability of cheaper alternatives in developing countries, has lead new healthcare consumers, or medical tourists, to seek treatment overseas [1]. The correspondent growth in the global health service sector reflects this demand. The globalisation of healthcare is marked by increasing international trade in health products and services, strikingly via cross border patient flows. Some countries are establishing comparative advantages in service provision based on their health system’s organizational structure (table 1). Thailand has established a niche for cosmetic surgery and sex change operations, whilst Singapore is attracting patients at the high end of the market for advanced treatments like cardiovascular, neurological surgery and stem cell therapy [2]. In Singapore, Malaysia and Thailand alone, an estimated 2 million medical travellers visited in 2006 - 7, earning these countries over US$ 3 billion in treatment costs (table 2)
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