The Australian Tourism Export Council (ATEC) will host a health and wellbeing conference in Cairns next month to look at ways of making Australia a medical tourism destination. Not on the agenda is a topic that will affect those countries attracting Australians for dental tourism, and those working out how to position Australia as a destination. The topic is wholesale reform of the Australian health system.
The Rudd Labor government has embarked on a massive transformation of the failing health system in Australia that will turn Medicare on its head and firmly embed the private health insurers as managers of a US-style health system. The reforms will effectively hand over the Medical Benefits Scheme (Medicare), the Pharmaceutical Benefits Scheme (PBS), a new dental scheme, and public and private hospital cover to the private health insurance industry.
The aim is to create a health industry where health care becomes a commodity and public and private providers compete for patients seen as customers in a market. The key elements of the government’s program are outlined in the final report of the National Health and Hospitals Reform Commission (NHHRC) entitled A Healthier Future for All Australians. The commission wants the federal government to fund and control all primary health care services and establish primary health care centres, taking control from individual states, with the new system up and running by 2015.
Every Australian will automatically belong to a government operated health and hospital plan under a voucher system. They can then select to move to a not-for-profit or private health insurance fund of their own choosing. The insurance fund would receive a risk-adjusted allocation of funds for each member the amount would vary depending on the age, medical history, and other possible risk factors of the individual. The payment is attached to the individual hence the term voucher. It is the government’s contribution towards payment of medical and hospital services. This voucher covers a very basic level of cover, referred to as universal service entitlement.
The new Medicare Select means that will be able to select what medical services their health insurance covers them for, their choice only limited by their ability to pay. Those who can afford it, may buy additional coverage for services not included in the universal service entitlement or to cover the gap between the rebate from the fund and what the medical practitioner charges.
The health funds will shop around on the health market and purchase services from competing public and private providers for their members. A fund may buy places in public or private hospitals for its members.
The belated recognition that dental care should be a universal entitlement is a huge step forward. Denticare would be established to provide access to basic dental services.
The government has embarked on a program of consultation with the key participants in the health sector to thrash out more detail and hopes to gain agreement for its health agenda from the states and territories at a meeting of health ministers in late 2009. If it fails to gain their cooperation Rudd has vowed to take it to a referendum at the next federal elections.

As part of efforts to develop medical tourism in Cross River, Nigeria, the state government and a consortium of US-based hospital development experts, led by OMMA Healthcare, have agreed to build a world class state-of-the-art hospital in Calabar.
Cross River State governor Liyel Imoke says that this is part of the state’s vision of providing an affordable health care delivery service to its citizens. The state intends to remodel its health facilities and services including full compliance with international standards. The Governor explained that the state took time to identify competent partners that share its vision based on its competence and capacity, stating that they intend to provide services that are now being provided outside Nigeria.
The aim is to stop Nigerians travelling outside the country for medical treatment .The hospital would be for Cross Riverians, other Nigerians, and people from other countries across the West African Sub region where healthcare availability is poor.
Colorado, USA, based OMMA Healthcare, will develop a modern, state of the art hospital in Calabar. The company has wide experience of developing healthcare projects in the Middle East, Africa, Mexico, Latin America, Central Europe, and Asia. Rees Associates has over 30 years experience in hospital design and is a regular partner of OMMA.The aim is to plan, programme and design a highly efficient and functional US standard hospital. Construction work will begin soon on a site near to Calabar Energy City, and will take three years
And in Ghana, Dr. Felix Anyaa of Holy Trinity Medical Centre (HTMC) in Accra wants the government to consider health tourism as Ghana has expertise in heart operations and spinal surgery. He says that while it costs$100,000 in the USA for cardio surgery, it cost just $10,000 in Ghana to have the same surgery. HTMC is a private 60-bed hospital, dental clinic and spa. Anyya argues that if medical business is well promoted as a tourism product, the country would benefit tremendously and earn much-needed foreign exchange.

Last year, despite being well-known for cosmetic surgery ,South Korea could not take advantage internationally due to the Medical Service Act that banned the introduction of patients to medical practitioners.
2009 shows a completely different story. Following the enactment of the revised Medical Service Act on May 1, hospitals can promote medical services to foreign patients. A medical tourist visa was introduced on May 11, and foreign patients who make reservations at Korean hospitals can now easily enter Korea. As a result of this changing environment, the number of foreign patients at six leading Korean hospitals jumped 41 percent year-on-year in May, higher than the 32-percent gain between January and April. Korean hospitals are radically changing what services they offer foreign medical tourists after the Korean government singled out medical tourism for growth.
South Korea’s Health Ministry hopes to attract 100,000 medical tourists by 2011.
The Seoul Metropolitan City recently held a familiarization tour for ten leading Japanese tour operators. Gyeonggi Province sent representatives from seven hospitals in the province to Kazakhstan’s largest city of Almaty to hold a medical services promotional session there. A call center will soon be launched in Tokyo to connect Korean hospitals and clinics with Japanese patients. A new website is providing foreigners with counselling on medical tourism in Korea via translators.
Indicative of the change is that the country’s first profit-making hospital backed by foreign corporate capital will be set up in Jeju. Previously, only doctors and non-profit corporations were allowed to open and operate medical institutions. Wooridul Hospital in Korea, and the Tasly Group, a large Chinese pharmaceutical company, have agreed investment for the project. Wooridul International Hospital will have 100 beds and aims to be open by 2011 in Seogwipo, Jeju.It will include a spinal clinic and cutting-edge medical examination facilities. The US$100 million project is the first large-scale joint investment of domestic and foreign capital in the medical industry.
With a revised law, hospitals can now hire agencies to help attract medical tourists. In the past, although advertisements targeting the general public were allowed, medical institutions could not hire agencies to seek patients for them or directly target marketing efforts at specific groups. South Korea continues to be a popular destination for Asian women seeking cosmetic surgery and the government now hopes to get patients from all over the world, including America and Europe.
Many rivals suffer from doctor shortages, but here over 3000 new doctors start practice every year, and they need overseas patients as the domestic market is at capacity. New jobs as medical coordinators and medical agents are also being created. A new educational company has been set up to teach South Koreans how to pursue a career in this industry. Hospitals and medical agencies that want to carry out marketing activities to attract foreign patients have to register with the government. The health ministry says that since May, 388 medical institutions and agencies have registered.

According to the Medical Tourism Report 2009 from UK based medical tourism information website YourSurgeryAbroad.com, four out of 10 Britons going abroad for surgery do so to avoid NHS waiting lists at home. This was the top reason for seeking treatment, including dentistry and eye laser surgery, while 30% went overseas because it was cheaper. Most people (28%) had dentistry work done while 10% opted for cosmetic operations like liposuction or breast surgery. Of this figure, 8% had had surgery abroad at least once, and men were almost twice as likely to have had surgery abroad. Older people were far more likely to go abroad for treatment, with 16% of those aged over 65 years seeking treatment abroad, and 12% doing so on more than one occasion. In comparison, 7% of those aged 18 to 24 and 8% of those aged 25 to 35 sought treatment abroad. The poll found that 34% of people went abroad because they were uninsured for particular treatments or surgery in the UK, while 32% wanted a treatment or surgery not available at home. More than one in four (27%) wanted to combine treatment with a holiday and 9% wanted to go abroad to get away from family or work while they recuperated. The most popular treatment was dentistry, 10% had cosmetic surgery, 7% had eye surgery and 6% had blood and dialysis treatment.
Thailand (7%), Malaysia (8%) and Singapore (7%) are the most visited destinations, with Spain (7%) and Italy (5%) revealed as Europe’s medical tourism destinations of choice for UK medical tourists. Adam Nethersole comments: "Our research shows that people are willing to travel to get the treatment they need, rather than endure a protracted waiting process with the NHS. 71% of Britons in our survey are using the internet to research their international medical treatment options.
The survey was carried out online by independent market research agencies, Global Market Insite in the USA and 72 Point (One Poll) in the UK. The sample size of 8003 had 7000 from the UK and 1003 from the USA.
Key findings:* Only 10% of most recent surgery abroad was cosmetic, contradicting a commonly held viewpoint that healthcare abroad is primarily for cosmetic and plastic surgery.* The US market predominately considers cost of treatment to be the most important motivations when deciding to go abroad for treatment. * The UK market generally goes abroad for procedures to beat NHS waiting times.* The most common fear with surgery abroad is the medical standards in destination countries, highlighting a need to publish more information about international accreditation and healthcare standards abroad.* The global financial crisis has increased the likelihood people will participate in medical tourism.
There are two separate reports available for purchase; The Medical Consumer Report: UK and The Medical Consumer Report: USA. You can order a copy of the individual reports for £160, or both the USA and UK reports for £300.

Taiwan is a relative newcomer to medical tourism, but while others in Asia look for American and European business that may or may not exist in sufficient quantities, Taiwan is concentrating efforts on visitors from Japan and China. These countries are the two main sources for tourists, as each year 2.2 million Japanese and Chinese tourists go to Taiwan.
While in American and Europe, economists argue about whether there is a deepening recession, slump, downtown, or slow recovery, the latest predictions from China are very encouraging. China’s economy is expected to expand 8.5 percent in 2009, and its growth will accelerate to 9.8 percent next year, as a strong growth in domestic demand has offset the drop in external demand. Japanese industrial output plunged last year, but analysts say the worst appears to be over, with production and spending recovering quickly.
Taiwan is also particularly well positioned to attract medical tourists from China, given the cultural proximity, common language and popularity of its tourist attractions. There is no universal free healthcare in China and few have insurance. China is going to be switching to a new Universal Health Care Insurance plan by the year 2110. It will be a great deal different from the Chinese health insurance plans that are currently available. For the average Chinese person the out-of-pocket expense for medical treatment is astronomical.
Shin Kong Hospital has signed an agreement with Shin Kong and HNA Life Insurance Co  a 50-50 joint venture between China’s Hainan Airlines Co and Taiwan’s Shin Kong Life Insurance Co, for Beijing-based MJ Health Screening and SweetMe Hotspring Resort to arrange for policyholders and members of these companies to visit for medical tourism. The business is still in its trial period, Beijing MJ Health Screening president Jack Tai reports that three more medical tourist groups from Beijing will travel to Taiwan in the next three months, In future, we hope there will be a group of more than 30 members visiting Taiwan each month.
A 32-member tour group from Beijing recently went to Taiwan for six days of health checks, spa treatments and sightseeing, making it the second Chinese group to visit Taiwan for medical tourism this year. Shin Kong Wu Ho-Su Memorial Hospital, which launched the special tourism packages, reports that in addition to the health checks offered last month, more services were on offer this time around.
In addition to PET and other health checks, Taiwan is offering micro cosmetic surgery, liver transplants, heart surgery and artificial joint replacements. Jen Chi Hospital has a dialysis centre that is attracting overseas patients. In the case of Japanese tourists, dental implant surgery or Chinese medicine packaged with hot-spring treatments for a reasonable price is proving attractive.
But not everything is rosy. Local hospitals are lagging behind in terms of international marketing and resources to develop the industry. Tight regulations limit the services they can offer. As the medical services sector is considered non-profit, government regulations bar hospitals from advertising their prices to attract foreign clients. Being unable to compare prices is a huge drawback for potential medical tourists. Taiwan also has a long and complex visa application process for medical tourists.

Cruise ship operators often point out the health benefits of a relaxing cruise, but an American company plans cruises with a difference. SurgiCruise, based in Los Altos, California, is a new business set up to put American patients on purpose-fitted healthcare cruise ships. Using doctors on ships, it seeks to offer a wide range of medical procedures at prices far lower than in US hospitals.
SurgiCruise seeks to wed medicine and travel by offering surgical procedures on cruise ships. Originally, the business planned to focus on cosmetic procedures such as liposuction, facial peels and breast augmentation, but the recession has driven down prices in the US. So it will now begin with orthopaedic treatment, as it is difficult for these patients to travel many hours in a plane and to stay in an unfamiliar country. The number of orthopaedic procedures increased in the US by nearly 25% between 1997 and 2005, with knee and hip surgeries topping the list. But with rising healthcare costs, many people are finding it difficult to afford the surgery they need. Most people needing this are retired, so have the time to recuperate with a cruise, while younger people wanting cosmetic surgery do not.
The doctors will be US-trained, with nurses and other staff from overseas. SurgiCruise will charge a fee for the procedures and post-surgical care, and the patient will pay for the normal cost of the cruise.
Co-founder Jeff Winner has an IT and engineering background, while partners Dr. Terry Knapp is a plastic surgeon, and Dr. Martin Polanco founded a specialized treatment centre focusing on treatment-resistant depression.
The company is self-funding and using angel investors, but still has to raise the rest of the $2 million it needs for a start-up. As it cannot afford to buy a ship, is in advanced negations with several cruise lines to introduce on-board surgery centres, to begin in 2010. The cruise ships will be specially retrofitted to provide a state-of-the-art facility to deliver medical care close to the United States, probably off the coast of San Diego. This could be in US waters, as the US doesn’t interfere with economic activity on cruise ships, or may take advantage of the lower regulatory costs of using ships in near-offshore waters, about 12-miles offshore.
The company’s mission is to deliver excellent medical treatment at a reasonable price.  It believes that as a service provider it should do everything possible to reduce the fear, pain, anxiety, and frustration of customers. By linking surgery and cruising, it aims to aid recovery by a totally relaxing environment.
Whether the business even begins is not yet certain, it may depend on funding. Cruise companies are wary of expensive refits of ships unless they are certain of being paid.

Singapore is quite successful at attracting medical tourists, but healthcare providers accept that potential is limited. It is a small island selling on quality rather than price.
Several businesses have thought that rather than getting people to come to them, why not take their offering to them. Local hospital groups are very efficient, understand marketing and are able to deliver high quality care at a reasonable price. By taking care overseas, they benefit from lower costs, while customers benefit from savings on airfare and accommodation. Having an overseas presence also raises the profile in local regional markets. Many Singapore-based companies have or plan hospitals or clinics in overseas countries. Parkway Holdings, Singapore’s largest healthcare provider, is one of the region’s leading healthcare service providers, with a network of 16 hospitals and medical centres with more than 3300 beds throughout Asia, including Singapore, Malaysia, Brunei, India and China. Last December, the company made its first foray into the Middle East when it won the bid to manage the Danat-Al-Emarat Women and Children’s Hospital in Abu Dhabi. Overseas operations now account for a third of revenue, with international revenue growing faster than domestic revenue. Future plans include five new Pantai hospitals in Malaysia over the next five years.
Raffles Medical Group is the largest private group practice in Singapore. It operates a network of 65 multi-disciplinary clinics across Singapore and three clinics in Hong Kong. The group also manages the airport clinics in Singapore’s Changi International Airport and Hong Kong’s Chek Lap Kok International Airport.
Currently the largest non-hospital based healthcare provider of specialist medical, dental and wellness services in Singapore, Pacific Healthcare has operations in China (Shanghai, Shenzhen), Hong Kong and India (Mumbai) as well as representative offices in Jakarta, Bangkok and Ho Chi Minh City. It has investments in cardiac centres in Goa and Bangalore, a cardiology and imaging facility in Shanghai and wellness facilities in Shenzhen. Later this year it is opening a medical centre in downtown Jakarta in a joint venture with PT Plaza Indonesia Realty.
Another Singapore-based healthcare company, Thomson Medical Centre, runs Hanh Phuc International Women and Children Hospital in Binh Duong Province. When other similar hospitals open elsewhere in Vietnam, it will run those too.
International Enterprise Singapore is a government agency promoting the overseas growth of Singapore-based enterprises. It sees great opportunity in building or operating hospitals and clinics, particularly in China, UAE, India, Vietnam, Russia, Ukraine and Indonesia. China and the Middle East are seen as offering the best long-term potential on health care.
Singapore is in a strong position to compete for a slice of the healthcare business in the emerging markets. It has a great reputation and track record for clinical excellence that cuts across the full spectrum of healthcare services. Singapore also has high healthcare management standards. It is in the forefront of medical science and technology and is a multi-faceted medical hub in the region.

A few months after the launch of two specialist travel insurances aimed at UK-based medical tourists, comes the launch of the first of two covers, ironically both using UK insurers based at Lloyds’ of London, primarily targeting US-based travellers.
Both are offered on a wholesale basis rather than being aimed directly at consumers. This week, we cover the offering from Seven Corners. Next week, we will be able to reveal details of Custom Assurance Placements and their link up with Companion Global Healthcare.
Seven Corners’ Medical Tourism Insurance includes:

Trip cancellation/ interruption
Medical treatment to remedy treatment complications
Emergency medical coverage for acute illness and injuries
Emergency evacuation due to acute illness and injuries
Emergency evacuation due to treatment complications
Repatriation of remains
Lost baggage/personal effects and baggage delay
Trip delay / missed connection
Global assistance 24/7

It does not guarantee the treatment or pay any of the bills of the treatment or travel or accommodation, or cover travel or treatment within the US.
Jim Krampen, co-Founder of Seven Corners, said: "It addresses the specific needs and concerns of the medical tourist. Distribution will only be through medical tourism agencies, hospitals and clinics that directly market their services to individuals and have been approved by us. They will be evaluated on how many years they have been providing medical travel and tourism services, the volume of patients, the hospitals and clinics they utilize, their E&O coverage for medical tourism. 
If they would like to receive a small commission for selling the plan they have to have an applicable and valid license in their jurisdiction and complete insurance agent contracting with us. We offer them customised branding of the online quote and purchase [internet] engine link we provide for the plan. We also provide a voluntary delivery of the plan for individual purchase via a customised quote and purchase link we can provide to medical tourism providers. 
The main target will be Americans travelling from the US. The medical tourism providers can be based anywhere in the world.  The hospital or clinic providing the treatment must be outside the US.
Krampfen added: Many of the medical tour providers I have spoken with are not insurance professionals and just want to offer the plan as link on their site as a service to their clients and assist them in providing more medical tours.  In which case, we are the licensed agents.  We will not pay commissions to anyone without a valid insurance license.  If they don’t have a valid license they will just have to offer the link as a service. We have launched our first live purchase engine link with an agency in the US at the beginning of this month.  We have 15 others, mostly in the US, in line, as we are reviewing their criteria to become approved.  We expect at least 20 providers with live links on their site by the end of the year.’
The company expects a take up rate of 50 percent primarily for the high-end treatments. 
The experience of those already offering cover is that this is incredibly optimistic and that they will be very lucky to achieve a tenth of that, particularly as there is an age limit of 64 on it, which rules out many older travellers. Depending on the country where the agency or hospital is based, if the insurance is offered on voluntary basis, the provider must comply with local insurance laws if they want a fee. Offering it as a package is more complex as the Lloyds’ rules are very strict, if the agency or hospital has customers from certain countries then they have tough rules on laws on offshore insurance, and some providers will have to be licensed to sell insurance in their own country.