• International Medical Travel Journal

    Courtesy Of IMTJ - International Medical Travel Journal

  • Courtesy Of IMTJ - International Medical Travel Journal

  • Courtesy Of IMTJ - International Medical Travel Journal

Industry Trends

PHILIPPINES: Eye clinic group targets medical travellers

Fri, 21 Aug 2009 16:07:09 GMT

A private eye clinic group in Cebu has its sights set on medical tourists as its next major market if the government will help medical tourism players promote the province as a healthcare destination. The Associated Cebu Eyes Specialists (ACES) eye referral clinics have treated some medical tourists but want to expand. ACES have two multi-subspecialty referral centres in Cebu City for complex and difficult eye cases - one at the Cebu (Velez) General Hospital and the other at the Perpetual Succour Hospital. A seven-member team of eye specialists runs these eye centres. ACES want to promote their services in Australia, Japan, and Korea but are cowed by the perceived amount of investment it would be involved. An ACES spokesperson reported said tapping foreign markets would be easier with government support. ACES doctors are willing to partner with travel and tourism agencies to accommodate more medical tourists. The group is one of the first to effectively challenge the politicians to stop talking about medical tourism, and give real support, financial and marketing, to make what so far has been mostly empty promises, a reality.

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UNITED KINGDOM: Scotland opened health tourism consultation

Fri, 21 Aug 2009 16:03:55 GMT

Scots travelling abroad for medical treatment must have "clarity and certainty" over what will be paid for by the NHS, health secretary Nicola Sturgeon said. Ms Sturgeon spoke at the Scottish Government launched a consultation on the issue of health tourism. The consultation is being carried out as the European Union seeks to clarify the rules surrounding the issue. As a devolved country within the UK, Scotland now rarely follows an identical path to that of England and Wales. New rights for Scottish patients to seek treatment abroad and claim the cost from the NHS are outlined in the consultation. The system, governed by a forthcoming probable European Directive, could mean patients who can access only a private dentist on their doorstep would save money by travelling to the Continent for dental work and then turning to the health service for reimbursement. Patients who face a particularly long wait for treatment in Scotland and people with second homes elsewhere in Europe are also likely to benefit from the proposals. The Scottish Government predicts an increase in the number of people interested in having their procedure abroad, and an increase in the number of foreigners wanting to use the Scottish NHS. A spokesman for the Scottish Government said: "We want to have as full as possible a Scottish consultation on this matter so that the interests of the Scottish NHS are taken into account when the new directive is drawn up." The current proposals state that patients could seek a refund only for treatment that is offered in their home country, so people would not obtain cancer drugs that are not available on the NHS by going abroad. In addition, the Scottish Government would not be expected to pay out any more than the procedure would have cost the NHS to perform. Although many Scottish health boards want to require patients to seek their permission before accessing treatment elsewhere in Europe, the method in the latest draft legislation - that is favoured by almost all EU countries - reduce delays and administrative red-tape by allowing patients to get treated first and get recompense afterwards. This method is in line with how healthcare already works in countries such as France. The British Medical Association is in favour of giving patients more power to access healthcare across the European Union but has warned other issues need to be addressed. Dr Terry John, chairman of the BMA’s international committee, said: "We would like to see much more work done on some of the practicalities - for example, who will interpret and translate medical notes? How will information be shared between doctors?"

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GENERAL: JCI's new quality and safety improvement framework

Fri, 21 Aug 2009 15:59:50 GMT

Joint Commission International (JCI), a healthcare accreditation body that has given its stamp of approval to more than 200 hospitals in 27 countries, recently launched a quality and safety improvement framework aimed at helping healthcare organisations, government agencies and ministries of health worldwide to achieve new levels in quality patient care. Called the JCI International Essentials of Health Care Quality and Patient Safety, the framework is designed to help organisations focus on five risk areas that have the greatest impact on improving healthcare quality and patient safety. The five risk areas are:     Leadership Process and Accountability     Competent and Capable Workforce     Safe Environment for Staff and Patients     Clinical Care of Patients     Improving Quality and Safety The JCI Essentials provide clear and achievable risk reduction expectations. Levels of effort are identified for each criterion to provide a means for evaluating progress in reducing risk and improving quality. Increasingly, JCI has been asked to provide assistance to organisations and countries that are focusing on the foundational elements of quality and safety, which may eventually serve as a step toward national or international accreditation, said JCI chief executive Karen H Timmons. She explained: The Essentials methodology for improving quality and safety is an accumulation of the knowledge necessary to achieve the level of healthcare safety and quality that meets the needs of all stakeholders. JCI recognises that healthcare organisations around the world are called upon to provide high quality, safe patient care despite limited financial and human resources. The Essentials framework aims to help organisations focus on the safety risk areas that will have the highest impact on patient safety. The mission of JCI is to improve the quality and safety of health care globally, and by offering the Essentials framework, we are now able to more efficiently assist healthcare organisations to higher quality care. JCI Essential received ISQua endorsement in early in 2008. ISQua, or the International Society for Quality in Health Care, is a non-profit, independent organisation with members in over 70 countries. ISQua works to provide services to guide health professionals, providers, researchers, agencies, policy makers and consumers, to achieve excellence in healthcare delivery to all people, and to continuously improve the quality and safety of care. While JCI is the numerical market leader in individual hospital accreditation, it has seen all four of its main rivals get involved with countries on country wide accreditations. Essentials is a tool to get more lucrative country based business. As part of the Essentials program launch, Mexico is the first country to demonstrate this product to other countries internationally.

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BAHRAIN: Local hospital gains ACHSI status

Fri, 21 Aug 2009 15:56:59 GMT

The KIMS Bahrain Medical Centre (KBMC) recently received accreditation by the Australian Council for Health Care Standards International (ACHSI). It is the first medical centre in the Gulf to achieve such recognition. The ACHSI accreditation comes at a right time as KBMC expects that iinternational accreditation will soon be made compulsory for all healthcare institutions in GCC countries. The UAE government has already announced that international accreditation mandatory for all its healthcare facilities by 2010. Bahrain has seen a growth of private health facilities with 13 hospitals, and a number of private industrial companies have their own in-house clinics providing primary care to their employees. One driver is the increasing expatriate population that is expected to reach 500,000 next year. KBMC opened in the Gulf kingdom in June 2004 as a multi-specialty medical centre offering outpatient and diagnostic services. Assessing the centre’s current growth, hospital management believes that there exists sufficient potential to start a 60-bed hospital in a strategic location in Manama in 2009. KBMS is a branch of the Kerala Institute of Medical Sciences (KIMS), a leading 450-bed private hospital located in Thiruvananthapuram, India. In 2006, KIMS became the first hospital in India to get the council’s accreditation. The KIMS group is in the process of opening new medical centres and hospitals in all the Gulf countries.

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INDIA: Treatment Abroad launched local portal

Fri, 21 Aug 2009 15:54:36 GMT

Treatment Abroad, the leading medical tourism portal in the UK, has launched a new website solely dedicated to medical tourism to India. Called Treatment in India, the portal will promote India’s growing reputation as a world-class provider of medical treatment. People mulling over a medical travel to the country will be able to research online the treatment and facility options in India. They can make informed decisions about the credentials of its medical facilities and doctors based on up-to-date information about surgeons, hospitals and medical tourism specialists in the country. With India’s high profile in medical tourism, there is too much scattered information on the web.  A simple Google search about medical travel in India produced 490,000 results from reputable agencies and hospitals to less reputable agencies promoting only one clinic with dubious qualifications. Treatment In India aims to cut through this confusion with a trusted existing brand. Philip Archbold of Treatment Abroad said: We know from the success of our other websites that country-focused sites are effective ways for medical providers to market themselves to medical tourists.  Additionally, medical tourists value the information provided on the sites as they know and trust that the Treatment Abroad brand will give them relevant and reliable information to help them make informed decisions when choosing to travel abroad for medical treatment. Intuition Communication, which publishes the main Treatment Abroad website, already runs a number of country-focused websites such as Treatment in Spain, Treatment in Cyprus and Treatment in Hungary. Treatment In India will constantly update information about local facilities, costs, medical information and health news, giving visitors answers to the questions that need to be taken into consideration when planning medical treatment abroad. The portal already links to the websites of medical travel agencies from the UK, the US and India. It also links to leading hospital group Fortis Healthcare among others.

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TAIWAN: Taiwan hopes for rise in mainland Chinese visitors

Fri, 21 Aug 2009 15:45:21 GMT

The daily number of inbound tourists from mainland China is now more than 600. Wu Chao-yen, chief secretary of the Tourism Bureau, said that simplifying visa-issuing procedures, works. Simplifying the procedures for mainland Chinese to visit Taiwan for medical tourism reasons is expected to be as successful. The first batch of medical tourism groups from mainland China arrived in Taiwan at the end of September. US medical-travel agency Companion Global Healthcare has added Min-Sheng General Hospital in Taiwan to its network of international hospitals that offer surgery and other care to American patients at affordable rates. Min-Sheng is a state-of-the-art, 600-bed hospital.

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ANALYSIS: Is there a crisis in Asia?

Fri, 21 Aug 2009 15:25:19 GMT

Some sections of the American press are predicting gloom and doom for the Asian medical tourism industry. But their main gripe seems to be that it is going to grow less slowly than earlier predictions suggested. With US insurers, banks, car makers and others having to go to their government for hand outs which are often bigger than the entire medical budget of a small country, and thousands of Americans worried about losing their jobs and homes, suggesting medical tourism is in crisis because it is only growing slowly is patently absurd. So what are they basing these figures on? A handful of random quotes from hospitals and agencies seem to be the main source. A few hospitals are admitting that they will have lower growth in 2009 then expected. The ones being worst affected are those relying very heavily on American business. Bumrungrad International in Bangkok expects lower growth in 2009, but how much of this is due to recession and the cost of travel from the US to Thailand, and how much of it is the result of political unrest in the country, is unclear. Asian countries such as Singapore, Thailand and India, which have attracted huge numbers of Americans, are now lowering their expectations. Just a few months ago, they had been anticipating rapid expansion, but the often-quoted prediction of 6 million Americans by 2010 is pure myth. India often claims to attract one or two million medical tourists a year. Although many hospitals and agencies have built business plans on this, there is no proof that even one million overseas patients have visited the country in one year. The Indian Healthcare Federation and the Confederation of Indian Industry estimate that the country has the potential to attract 1 million tourists per annum, but potential and actual are far different. Recently, one of the leading Indian hospital groups, that is heavily involved in the sector, made a responsible estimate that India would see 450,000 visitors in 2008. The next source of the gloom is from medical tourism agencies. In the last few years, hundreds of start-up companies in the US hoping to serve the needs of medical tourists have sprung up. The goal was to develop a niche for themselves by handling all the logistics for Americans travelling abroad for medical care. Many have no experience or even any medical background. Most have been wildly optimistic over the number of individuals and businesses that will pay for overseas treatment. The 300 US-based agencies are competing with over 500 overseas agencies targeting Americans. Quite simply, there is not enough business to keep all of them afloat, and many will perish. But the good professional ones will prosper. Those counting on large numbers of Americans are especially at risk. And the final source of the predictions of doom and gloom? None other than those institutions with the worst possible recent record of financial forecasting, stockbrokers and investment bankers!

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KOREA: Seoul beauty initiative

Fri, 21 Aug 2009 15:25:05 GMT

The Korean wave has put a growing number of beautiful Korean actresses in the global spotlight. Not only has this led to a surge in cinema box-office sales, but also a newfound foreign interest in Korea’s booming cosmetic surgery industry. According to a survey of 50 Chinese travel industry experts by the Seoul Tourism and Marketing Corporation, 65 percent recommended that Korea use plastic surgery or skincare treatments to lure more medical tourists. Tapping into the rising interest, the Seoul city government plans to market tours offering medical treatments. The packages, called "Seoul Beauty Tours," aim to boost tourism revenues by offering Korea’s finest cosmetic medical services.

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MALAYSIA: Healthcare developments

Fri, 21 Aug 2009 10:26:29 GMT

Sime Darby Bhd is gearing to grow its healthcare business with the launch of its new business unit Sime Darby Healthcare (SDH). The launch of SDH means that the group’s existing healthcare facilities Subang Jaya Medical Centre (SJMC) and Megah Medical Specialists Group are now formally integrated under the SDH brand. SDH chairman Tan Sri Wan Zahid Noordin describes the business strategy as twofold to focus on growing specialist treatment in Malaysia and leveraging Sime Darby’s international presence to grow internationally; We want to be known as a boutique treatment centre because we can do the high-end stuff. That requires a lot of expertise, which we have, and we also have the equipment. Those are the things that we can do and that’s our niche. SDH is keen to expand and will use Sime Darby’s presence in other countries to gain a foothold overseas: We are looking at emerging markets like China. Our strategy is not intended to be competitive in nature. It is more organic in the sense that we want to build a very strong foundation of quality. We want to develop the capability and the expertise of our doctors, nursing staff and management. We are also taking pains to get international accreditation because we do not want to only operate within the country but we want to go overseas. We are in the midst of securing international accreditation from JCI for both Malaysia hospitals should be in place very soon. Meanwhile, Penang International Dental College (PIDC) is keen on venturing into dental tourism in early 2009. Chief executive Dr S. Sharavanan said the college had necessary expertise in the field through its parent institution, the Vinayaka Mission’s University (VMU) in India. We have plans to start a separate private dental clinic facility to promote medical tourism. We will allocate space for this purpose and obtain necessary approval from the Health Ministry, Dr Sharavanan said. VMU has a dedicated hospital for medical tourism, drawing patients from all over the world. PIDC will initially target patients from Singapore, Thailand, Indonesia and Brunei.

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SUDAN: Sudan plans to invest in medical tourism

Fri, 21 Aug 2009 10:20:51 GMT

Sudan is the largest country in Africa but as yet has no involvement in medical tourism. While cost-comparative medical treatment is the high-profile end of the business, there is a view that alternative health and wellness tourism has a better long-term future. Sudan’s Ministry of Tourism and Wildlife intends to cash in on an indigenous knowledge that uses a pool of centuries-old sulphuric water to treat skin diseases, rheumatism and female ailments. The ministry has already prepared an investment plan for rooms, restaurants and sulphuric water baths. The fountains for the baths are at Okasha village, in the Northern State in Wade-Halfa locality.   This is just one of the expanded moves to tap into indigenous knowledge in the region. In Jordan, the first Arab country to enter medical travel, tourists from all world and other Arab countries visit the health resorts there including sulphuric waterfalls.

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SAUDI ARABIA: Saudi hospital wins JCI status

Fri, 21 Aug 2009 09:57:36 GMT

Sultan Bin Abdulaziz Humanitarian City, a 400-bed rehabilitation hospital and medical centre, has achieved JCI status. Located just north of Riyadh in the Banban area, it provides therapeutic, supportive and other services which are designed to assist in restoring health following acute illnesses. Opened in 2002, it is funded by the Sultan Bin Abdulaziz Foundation. The hospital offers specialised, comprehensive care to patients with physical, congenital and perceptual disabilities. This 200,000 sqm facility includes a 240-bed medical rehabilitation centre, a recovery centre focusing on mature adults and the elderly, an ambulatory services centre, and a child development centre focused on children up to the age of ten years old. A hospital that already has JCI status (awarded in 2006), The Dr. Soliman Fakeeh Hospital (DSFH) in Jeddah, has achieved international accreditation from The Australian Council of Healthcare Standards International (ACHSI). Dr Soliman Fakeeh Hospital is a leading referral hospital, established in 1978 by Dr Soliman Fakeeh. It is considered to be among the top ten in the world for in-vitro fertilisation procedures.

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COSTA RICA: Hospitals report medical tourism alive and well

Fri, 21 Aug 2009 09:55:38 GMT

Although the economic recession is slowing down the number of people buying cosmetic surgery, the reduction is much less than in the US where a 50 percent or more drop in business has been reported. The cost of cosmetic surgery and dental work in the country is about a third of what it would be in the United States and the quality is as good. Costa Rica has a positive image, strong healthcare infrastructure and proximity so potential patients and companies are taking an interest in Costa Rica, said Bill Cook, international patient coordinator at Hospital Clínica Bíblica in San José. Clínica Bíblica has been attracting medical tourists since the mid-1990s, but the number of foreign patients has tripled in the last year to about 30 per month. According to the Costa Rican Tourism Board, 95 percent of the estimated medical tourists who come to Costa Rica each year are from the US. The majority are uninsured or underinsured. Medical treatment is not only less expensive than in the US, but it is often less expensive than the deductible insured patients would pay for the same treatment at home. Labour costs are so different here. Healthcare prices are 30 to 40 percent lower than in the US, noted Carole Veloso, director of the Hospital CIMA in San Jose. Meanwhile, Hospital Católica, which is also located in San José, is putting the finishing touches on a new wing called Hospital Hotel La Católica to accommodate the growth in medical tourism. To develop and promote medical tourism, Costa Rican hospitals, doctors and government agencies have formed the Council of International Promotion of Costa Rica Medicine (PROMED), which is about to be launched. Its president, Dr Jorge Cortes, said PROMED will also organise and establish quality standards for the industry. In another development, 20 doctors have formed Costa Rican Medical Holding, the country’s first medical tourism consortium. The group will promote its services primarily in the US, where it also hopes to cultivate working relationships with insurance companies. This group of health professionals has been working together for over two years. By formalising links, these doctors seek to actively participate in health fairs, commercial missions and promotions initiated by Costa Rica’s Foreign Trade Corporation. All the doctors work in Costa Rica’s three major private hospitals; Hospital Hotel La Catolica, Cima San Jose and Hospital Clinica Biblica. The group seek to coordinate its promotion with local transportation and tour operator companies as well as with several specialised recovering homes. They will also contact specialised travel agents in the US to promote their services. Meanwhile, clients of South Carolina-based dental travel company Companion Global Dental now have a third option in San Jose, Costa Rica, for obtaining dental care at a fraction of the US cost. Companion has added Adult Dentistry of Costa Rica to its network of dental clinics. Led by Dr   Mario Garita, the clinic specialises in implant dentistry joins CGD-affiliated Prisma Dental Clinic and Meza Dental Care, both based in San Jose.

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UK: CHKS expands international hospital accreditation services

Fri, 28 Aug 2009 12:50:15 GMT

The international market for UK based accreditation agency CHKS continues to expand in some interesting directions. Having established a strong foothold in Europe over the past fifteen years, mostly in Portugal, Ireland and Denmark, it has worked as far afield as India and South Africa. Initially driven by statutory requirements for accreditation and independent certification, increasingly the reason is a need for hospitals and clinics to have something to enable potential medical tourists to choose on quality, rather than price alone.  CHKS has seen a surge of interest from Southern Europe, particularly from Cyprus, Greece and Turkey. Places with large numbers of British expatriates are seeking external recognition from organizations that the expat community will trust as independent. In Cyprus, it is working with the Cyprus Certification Company on certifying local hospitals. Having previously worked in Serbia to establish quality improvement and licensing, it is now part of a consortium introducing local accreditation systems to healthcare organizations, with validation and licensing of healthcare professionals. In Egypt, CHKS is developing healthcare services in Cairo that include acute hospitals, diagnostic centres and nursing homes- all at the commissioning phase. Once the facilities are built, CHKS will work with them on international accreditation. Meanwhile, in Egypt, discussions continue on the practicalities of rolling out accreditation to some local private clinics. The CHKS healthcare accreditation and quality unit (HAQU), incorporates the Health Quality Services (HQS), the longest established healthcare accreditation service in Europe, established as the King’s Fund organisational audit in 1989.CHKS is a corporate member of the International Society for Quality in healthcare (ISQua). The CHKS international accreditation programme has been designed to be adaptable to the local cultural, legislative and professional framework of the host country. It incorporates relevant features of quality programmes from other countries, as well as those from other sectors. The programme standards cover all aspects of healthcare provision, together with an organisational development and assessment process and accreditation award, with certification to ISO9001: 2000 if also required. Earlier this year CHKS launched Accreditation Online, for the ISO certification rather than the fuller international accreditation, and undertook the first paperless survey at the UK’s London Bridge Hospital. As the system worked it has been now offered to both UK and international customers .The first international launch was for the Bank of Cyprus Oncology Centre in Nicosia, Cyprus. Accreditation Online is now used by two hospitals in Cyprus, six in Ireland, and four in Portugal. The international standards manual is now available in Greek and Portuguese. Recent international HAQU accreditations include two more hospitals in Ireland; Shanakiel Hospital and St Francis Private Hospital. CHKS has now awarded international accreditation to 7 hospitals in Ireland. The HAQU Accreditation Programme focuses on patient safety, patient experience, clinical governance, leadership and staff experience. Brian Wright of Shanakiel Hospital explains why it chose CHKS, As CHKS works in the UK and across Europe, the standards are the best choice for Irish healthcare, especially where the standards reference compliance with EU directives or laws. We looked at other accreditation systems and decided that CHKS standards are easy to understand and the best for us.

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SOUTH AFRICA: Medical Tourism Association of South Africa reborn

Fri, 28 Aug 2009 12:47:45 GMT

Following the Health Tourism Congress held in Johannesburg in July 2009 where the medical tourism industry was endorsed by both the national departments of tourism and health, local agencies feel it is important that the industry organizes itself into an association to move forward as a collective with established guidelines and code of conduct in order to compete in the global competitive market. Lorraine Melvill of Surgeon and Safari and Dr Tshepo Maaka of Serokolo Health Tourism, both founders of the original organisation, have revived The Medical Tourism Association of South Africa, as a non-profit company. The original foundered on personal differences combined with hospital and government indifference. The pair believe it is time to combine their skills, expertise and streamline the industry thus enabling it to participate in the government’s economic growth policies of the future and enhance South Africa’s competitiveness as a destination. They believe that The National Department of Health and the National Department of Tourism will work with the association on the development of policy, strategy and funding of the local health tourism industry. The Medical Tourism Association of South Africa will liaise with government departments and other influential bodies in South Africa.Maaka and Melvill believe that the past and present success of the South African medical tourism industry has been built on the high standard of ethical practice employed by the country’s leading medical service providers. It is the objective of the association to ensure that the medical tourist enjoys a great experience throughout every facet of their stay, resulting in repeat visits and ongoing recommendations to other potential health and medical tourists. The work ethic, code of conduct, training and high standards together with transparency will form the cornerstone of the association. Membership is open to those involved in South African medical tourism. There is an annual membership fee and three membership categories- Primary;medical tourism agencies, medical evacuation companies, hospitals and clinics, doctors/dentists/specialists, medical associations and health insurers.  Secondary;accommodation, wellness centres, auxiliary medical services and individuals.Honorary; government departments. professional medical insurers, academic institutions. Objectives of the association To represent the collective interests of professional medical/ health service providers assisting patients seeking treatment in South Africa. Promote and develop medical tourism both locally and internationally as a medical/ health cluster. Function as a network forum between the various industries associated with medical tourism in South Africa. Assist new business opportunities and investments.Promote South Africa as the leading destination for the medical tourist seeking a quality product and service. Create dialogue with government departments.Work with the South African Medical Council and its associated professional bodies. All members are expected to Adhere to a code of conduct and respect the medical tourist rights as a patient / consumer Offer adequate accredited training of staff handling foreign patients/ clients. Maintain the highest standards of ethical business practice, accountability and objectivity.

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COSTA RICA: Seminar promotes Costa Rica as medical tourism destination

Fri, 28 Aug 2009 12:41:08 GMT

Although billed as a conference, an October seminar in Costa Rica in San Jose, Costa Rica on October 6 and 7, has the sole purpose of promoting the benefits of Costa Rica as a destination and drumming up more business. Tim Morales of HSA Clearing Corp says "People can read about medical tourism or attend seminars with medical tourism providers, but the only way to really learn is to experience it first hand. The propose of our seminar is for insurance company executives, employee benefit managers, health insurance agents, third-party administrators, and others, to view and meet the hospitals, physicians, dentists and other medical service providers that Costa Rican Medical Care works with. Once people see the quality of the health care Costa Rica has to offer, they will be comfortable working with us and recommending our services to their people. We feel it is important for us to provide these educational seminars at a price people can afford, so we are proud to be working with a five-star hotel to accomplish this, and we have priced this event at only $799.00all inclusive." The price may be discounted, but should people be asked to pay to go to an advertising event? Costa Rican Medical Care (CRMC), a division of HSA Clearing Corp, is a medical tourism agency, mostly targeting American customers with promises of savings of up to 70 % on US prices, that only offers destinations in Costa Rica. Opening speaker Roy Ramthun of HSA Clearing Corp will address reducing health care costs by going to Costa Rica. The morning session will include speakers from the three major private hospitals in Costa Rica, Hospital Clinica Biblica, Hospital Hotel La Católica, and CIMA Hospital. Carlos Ricardo Benavides.Minister of Tourism will present the many advantages of choosing Costa Rica as a medical and/or vacation destination. The first day afternoon session will have presentations from medical, cosmetic, and dental practices in the country. Day two is mostly a tour of three private hospitals Hospital Clinica Biblica, Hospital Hotel La Católica, and CIMA Hospital. These three San Jose hospitals are the only JCI accredited ones in the country. HSA Clearing Corp., a provider of health savings account educational services to financial institutions, employee benefit companies and health agents, set up Costa Rican Medical Care in March 2009.The core target market is the thousands of health agents, employee benefit firms and customers of the HSA bank and credit union network across the USA. Costa Rican medical care is good. Many doctors are US trained and the hospitals are generally well equipped. The new CIMA medical center and Hospital, outside of San Jose is comparable with US facilities. The organizers predict that the country will get a total of 100,000 visitors in the next five years, an average annual total of 20,000. Does the industry need to differentiate between conferences that discuss opportunities and problems and other wider issues, and events like this one that are blatant advertising for the delights of a single country?

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INDIA: India now wants dental tourists and Arab visitors

Wed, 26 Aug 2009 13:39:46 GMT

Indian dentists want a share of the medical tourism pie. Cities such as Chennai, popular with foreigners for its low-cost heart and eye surgery, now look to dental tourism. VV Dentistree is one of several promoting dental treatment at around a quarter of UK or US prices. Five-clinic Chennai dental service provider VV Dentistree plans to set up hospitals and clinics in Bangalore, Hyderabad and Kochi by early 2011. Within five years, Dentistree wants to have a national presence and also intends to spread overseas in Sri Lanka, the Maldives, Indonesia and Malaysia. VV Dentistree India Private Limited provides dental care services including root canal treatment, orthodontic treatment, implant, microscopic enhanced surgery, and laser assisted surgery. The company operates clinics in areas including Adyar, Mylapore, OMR, Anna Nagar, and Ashok Nagar in Chennai. August saw the launch of its first international dental hospital in Chennai, with the latest equipment, and built specifically to target dental tourists. Similar hospitals in Hyderabad, Bangalore and Cochin will open in the next 15 months, followed by hospitals in Mumbai, Pune and Kolkata. While cosmetic surgery or hip-replacement surgery in India may be economical for a foreigner even if air ticket and accommodation costs are included, the same may not be the case for dental care, which is much more about repeat treatment than a one-off surgery. That is why some leading healthcare providers in India who are heavily into medical tourism, rarely promote dental care. Smaller Indian dental clinics believe customers will find it viable to travel to or within India. The annual conference of the Travel Agents Association of India (TAAI), the country’s largest travel trade body, being held in Dubai this year, will showcase the key features of India’s medical tourism. One aim is to increase the number of tourists and medical tourists from the Middle East who visit India. 2000 delegates will take part in the conference from Sep 29 to Oct 2 in Dubai. India will promote medical tourism in states including Kerala, Andhra Pradesh and Karnataka. Seeking enhanced ties with the Arab world, India has said the countries in this region can benefit from its medical tourism sector under which traditional treatments like Ayurveda are offered at cheaper cost. The country’s medical roots go back to the centuries and much of the Western world is now utilizing the cheap but effective medical treatment in India," says Indian Ambassador to Qatar, Deepa Gopalan Wadhwa. Ayurveda and other traditional medical treatments are bringing many people to India. Indian tourism and medical tourism have been hard hit by global recession and the Mumbai terror attacks, but there are signs of a slow recovery. The government is focusing on niche tourism products including wellness tourism. This includes spas and ancient therapies ayurveda, unani, and siddha. Although it accepts the importance of medical tourism, the government admits it has no ideas of numbers as many come on tourist visas rather than specialist medical tourism visas. There are still no signs of the long-promised positive government help for this sector.

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USA: American healthcare and health insurance reform

Wed, 26 Aug 2009 13:37:48 GMT

The battle over US healthcare and health insurance reform is getting overheated. Ill-informed attacks on the UK’s NHS forced prime minister Gordon Brown, and leader of the opposition David Cameron to lead campaigns against a barrage of misinformation. In an effort to sway lawmakers and public opinion, a million dollars a day is being pumped into an advertising blitz for and against reform. Sifting through the conflicting and often bizarre allegations, such as those claiming that the country has no medical care crisis, is no small feat. AARP a nonprofit, nonpartisan membership organization with 40 million members aged over 50.It offers a sensible analysis of circulating myths. There are special interest groups trying to block progress on health care reform by using myths and scare tactics .The majority of working Americans will continue to receive their health care through their employer. Myth: Health care reform is socialized medicine. Fact: Health care reform will preserve the employer-based health care system where 200 million Americans will continue to get their coverage through their employers. Fact: For people buying coverage for themselves, there will be a range of private health plans to choose from. If it goes ahead, the public plan option will give American consumers another choice if they can’t find affordable, quality coverage in the private insurance market. Myth: Health care reform means rationed care. Fact: None of the health reform proposals being considered would stand between individuals and their doctors or prevent any American from choosing the best possible care. Myth: Health care reform will hurt Medicare. Fact: None of the health care reform proposals being considered by Congress would cut Medicare benefits or increase out-of-pocket costs for Medicare services. Fact: Rather than weaken Medicare, health care reform will strengthen the financial status of the Medicare program. Myth: Health care reform is too expensive America cannot afford it. Fact: The President and Congress have committed to producing legislation that will be paid for without debt. Fact: If we do nothing to fix health care, families with Medicare or employer-based health coverage will likely see their premiums nearly double again in the next seven years. Fact: When one in three Americans say someone in their family postponed or cut back on needed medical care due to the cost; when countless bankruptcies are related to medical expenses; when the number of uninsured approaches 50 million; and when employers struggle to pay for the costs of health care, we cannot afford not to fix health care. Myth: Health care reform means the government can make life-and-death decisions for you. Fact: Health care reform will NOT give the government or any insurer the power to make life-and-death decisions for anyone regardless of their age. Individuals, their doctor and their family will make those decisions. Exactly how reform will affect medical tourism is too early to say. Predictions that millions more will go abroad, or that almost nobody will, are both unlikely.

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JORDAN: Medical tourism developments in Jordan

Tue, 25 Aug 2009 10:31:13 GMT

The USAID Jordan Economic Development Program (SABEQ) has agreed to help five members of the Private Hospitals Association to increase Jordanian hospitals ranking in regional and global medical tourism. The project aims to create a pool of specialized customer service trainers in all participating hospitals, through building the capacity of selected staff members and providing them with the tools to become customer service trainers of other hospital staff. The training also aims to design guidelines on policies and procedures to achieve higher customer service performance in the medical sector. As the medical sector in Jordan has a distinguished reputation domestically and internationally, and in order to keep this reputation, local hospitals are working towards raising the medical service level through applying quality standards. The application of the national accreditation program is essential in creating a quality culture in all the divisions of the medical sector. The Health Care Accreditation Council (HCAC) is celebrating its one-year anniversary since its launch in August 2008.HCAC came to life as a joint initiative from the Ministry of Health and the USAID under the Jordan Health Accreditation Project (JHAP). JHAP had been working with all health care sectors for at least 2 years to develop hospital accreditation standards and to establish HCAC and develop its technical and financial capacity to become the leader and key propagator of continuous healthcare quality improvement in Jordan and region. HCAC was established in response to a need in having a national independent body that serves as a steward for health care accreditation. As an independent, not for profit organization, HCAC aims to foster the continuous improvement of health care services through its mission. Inherent to its purpose and mission, HCAC develops healthcare accreditation standards, and assists healthcare facilities to meet the standards and achieve accreditation through consultations, training, surveyor certification and surveys. HCAC recently accredited three additional hospitals from the public and private sectors, based on compliance to HCAC standards and bringing the number of HCAC accredited hospitals in Jordan to five. It has published the second edition of the HCAC hospitals standards, certificated two groups of hospital surveyors from Jordan and been elected to the accreditation council of The International Society for Quality in Health Care (ISQua. May Abuhamdia of the HCAC says, While we have only a handful of accredited hospitals so far, forty four hospitals from all sectors in Jordan have pledged to the implementation of the 2009 HCAC national quality and patient safety goals and we look forward to the upcoming months to survey these hospitals and grant two year certification to the hospitals that successfully meet the three goals announced for this year. Recently the HCAC has entered into a partnership with Brandeis University and Joint Commission International to study the cost value of accreditation in hospitals in Jordan.

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ACCREDITATION: International hospital accreditation skyrockets

Tue, 25 Aug 2009 10:30:01 GMT

One question that confounds every individual traveling overseas for treatment is that of choosing a hospital. While many patients are able to hone in on the choice of a doctor/hospital through agencies, referral doctors or their personal networks, a few are left without enough information on the hospital to choose. In the last five years, the number of JCI (Joint Commission International) accredited public and private hospitals around the world has increased by nearly 1000 %. Up from a mere 27 hospitals and health care organizations with that accreditation in 2004, currently over 250 such entities in 36 countries have now been accredited by the JCI. In 1999, JCI began surveying and accrediting hospitals and healthcare facilities outside of the USA. It is a private US based accreditation group that fulfils the requirements of an independent international body for healthcare standards accreditation. JCI is accredited by ISQua, an accreditor of accrediting bodies. It was in early 2008 that JCI was recognized by ISQua . Apart from JCI, other accreditation bodies are approved by ISQua.This international standardization body conveys the following message: Any hospital that is accredited by an ISQua approved accreditation body will be assured of the same patient safety and procedures of any hospital in developed world. Some associations and websites lead consumers to believe that  only JCI accredited hospitals are a credible destination.Consumers, businesses and insurance companies in America have been taught by constant repetition to recognize overseas hospitals accredited by JCI alone for in-patient treatment. This, in turn prompts hospitals already accredited by other ISQua affiliated bodies, to indulge in the expensive and laborious exercise of obtaining JCI accreditation. There is nothing wrong with JCI, but to lend some perspective to this issue of hospital accreditation in an international milieu, hospitals and agencies should not forget the other half-dozen international agencies based in the UK, France, Canada and Australia.These organizations perform a similar international role as the JCI, providing accreditation to international or regional health providers. * Accreditation Canada International focuses in improving patient safety. Recognizing that one standard approach does not work for everyone, it customizes its accreditation program to meet the client’s needs. * Trent Accreditation Scheme (TAS) A UK-based non-profit accreditation organization that performs surveying and accrediting healthcare providers in the UK and around the world. Trent was the first scheme to accredit a hospital in Asia, in Hong Kong in 2000.Apart from hospitals in the United Kingdom, Trent also surveys a large number of private sector hospitals in Hong Kong, and is also expanding into the Philippines and Malta. * The Australian Council on Healthcare Standards (ACHS) The leading accreditation organization in Australia. It features the Evaluation and Quality Improvement Program (EQuIP) and acts as a consultant for several countries. The different accreditation schemes vary in approach, quality, size, intent and the skill of their marketing. They also vary in terms of costs incurred by hospitals and healthcare institutions

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BAHRAIN: Local developer to grow "health islands"

Tue, 25 Aug 2009 10:28:02 GMT

Ithmaar Development Company (IDC), the development arm of the Bahrain-based Ithmaar banking group, plans to establish health island projects similar to the one it is building in Bahrain in three other countries. IDC intends to bring the Dilmunia Health Island concept to Tunisia, Morocco and Malaysia. The size of the investments will be similar, if not higher than the amount committed to the Bahrain project, where construction and reclamation alone are estimated to cost US$1.6 billion. The aim is to create a centre for health and wellness tourism. Dilmunia, which is currently being constructed on a manmade island off the country’s northeast coast, will include state-of-the-art diagnostic, nutrition and diabetes, cosmetic surgery, aesthetic medicine, alternative medicine and sports medicine centres. The complex includes a 358-bed hospital and a 216-bed women and children’s hospital. Located around the healthcare facilities will be residential and commercial areas, including hotels offering alternative therapies in their spas. The island, covering an area of 1.25 million square metres, will have three five-star hotels, a four-star hotel, 118 villas and 1,362 housing units complete with associated amenities. The project will also include deluxe spas and boutique hotels as well as residential clusters, beauty and wellness shops, and retail and leisure facilities. Construction of the first phase is slated for a 2012 completion, with the second phase by 2015. Reclamation work started in March and will take 15 months to complete. IDC is seeking a range of partners to run the hospitals and hotels. Dilmunia will be located very close to Bahrain International Airport, providing connectivity with the region and the rest of the world. Bahrain is also well connected to the Kingdom of Saudi Arabia, which is a potentially large market for Dilmunia. Additional road links will provide added connectivity between Bahrain and Qatar within the next few years. IDC has formed a dedicated healthcare entity, Ithmaar Health. This will establish a network of outpatient and diagnostic facilities across the GCC countries, which will be linked to the Dilmunia Health District and other regional referral centres. IDC is looking for partners to work with on the Dilmunia Health Island project. IDC is working for Dilmunia to become a global concept and work ranging from feasibility studies to master plan development, is already under way in North Africa and Southeast Asia. Feasibility studies in Morocco and Tunisia have been completed. The projects are at the master plan stage and construction will begin early next year. Feasibility studies in Malaysia will be completed within two months.

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KOREA: Aiming for higher medical travel figures

Fri, 21 Aug 2009 17:18:58 GMT

South Korea is increasingly becoming popular with residents of East Asia seeking medical treatment. The 20,000-patient target for 2008 has already been achieved, and the next figure the country aims for is 100,000 patients by 2012. The government funds the Council for Korea Medicine Overseas Promotion, which acts as a middleman between local hospitals and foreign patients and insurance companies. James Bae, a researcher with the Council, said Korea has better medical infrastructure than other nations. We really try to differentiate ourselves from other Asian countries for medical tourism with our high level of quality for healthcare services. So far this year, 20,000 foreign nationals have visited hospitals associated with the Council. Many came for plastic surgery, he said. South Korea, where an estimated 60 percent of women in their 20s have undergone some sort of cosmetic operation, has earned a reputation for producing surgically enhanced Asian beauties. Dr Lee Sang Jun, who runs several plastic surgery clinics in Seoul, said he had seen an increase in Japanese, Chinese and Southeast Asian customers in recent years. Europe and America also have a high grade of service but they are Caucasians, so it is better for Asian patients to come to Korea and have surgery done, he said. It could soon become a lot easier for Korea to attract more medical tourists. Legislation that would allow local hospitals to promote directly to overseas patients and avoid going through travel agencies is currently under review by the Congress. Currently, it is not legal to use the ad medium in building up clientele. The amendment, pushed by the Ministry of Heath, seeks to make an exception when it involves the international market, said Bae.

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CZECH REPUBLIC: Medical potential still growing

Fri, 21 Aug 2009 17:15:31 GMT

A growing favourite with patients from the US, Canada, the UK and Germany, the Czech Republic is considering branching out from services that have made it famous, such as cosmetic surgery and in vitro fertilisation. Eva Bendova, managing director of medical and spa tourism portal Czech Medical Spas, said: Most agencies concentrate on the expensive procedures and treatments to attract clients from abroad. We, on the other hand, believe that not all customers want and can afford to spend thousands of Euros on plastic surgeries, and not all women need in vitro fertilisation. That is basically where we see the weakest link of this business the services are too specific. We think it would be better to expand to those that appeal to everyone. Screening procedures might be what we are looking for. The company contacted some leading Czech clinics to join the effort, and succeeded. One of them even went so far as to promote itself on the internet. Coordination and conceptualisation of the partnership took time, followed by synchronising it with the requests and needs of patients. But the details eventually fell into place. The result is a set of high-quality screening programmes, supported by ancillary services such as prompt and comfortable transfers and good accommodation with all costs below the standard European and American rates. A two-day experience offers complete medical examination, including post-tests report with recommendations and notes for further treatment. The company is currently working on more programmes to do with gynaecology, EENT, orthopaedics and urology among others. It also provides information on spa destinations and over 200 spas around the Czech Republic.

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INDIA: Goa fears slump in medical travel arrivals

Fri, 21 Aug 2009 17:08:55 GMT

Hospitals in Goa, engaged in medical travel, expect a drastic decrease in foreign arrivals in the approaching tourist season. Industry players blame this on the global economic meltdown and an image problem. Victor Albuquerque of the Apollo Victor Hospital in Margao said: We expect a 50 percent decline among overseas tourists, who come for dental, cosmetic or bariatric treatment. Instead of the 200 overseas bookings, which materialised last year, only 20 now appear to be firm, he said. Dr Digambar Naik of Vrundavan Hospital & Research Centre in Mapusa said they had been anticipating a 25 to 50 percent rise in outside business, which doesn’t look likely to happen. We just hope there’s no decline in walk-in patients. Alarmed by developments, hospital administrators said they were planning new promotional schemes to stimulate activity. Goa, a former Portuguese colony in south India, has largely built its economy based on a four-month tourist season. Lately, however, adverse publicity of high-profile incidents involving foreigners, environmental pollution and spikes in airfare has affected the market’s perception of what has long been touted in all the guidebooks as paradise.

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MALAYSIA: Health travel means dollars

Fri, 21 Aug 2009 16:56:06 GMT

Malaysia is banking on medical travel as an economic driver due to its strategic location in the region and accessibility to the Middle East, according to the country’s human resources minister Datuk Dr Subramaniam. He attributed the industry’s progress to factors such as affordable professional treatments and the abundance of world-leading medical facilities. The government’s Health Tourism Programme, he noted, clearly supported the push to attract overseas patients.  Penang, already a well-known tourist destination in the peninsula, is fast building a reputation as a mecca for improvement, buoyed by the presence of quality healthcare institutions and attractions of beach and unique cuisine. In 2011, the Farrali International Specialist Hospital and Wellness Resort will heighten its appeal, offering both western and eastern therapies. Set to open in Batu Kawan, site of the second Penang Bridge, connecting the mainland to Batu Maung on Penang Island, it is minutes from the Penang International Airport in Bayan Lepas. The Farrali Mutiara Medical Group (KPFM) is behind the project. The 60,703-square-metre hospital intends to lead in the areas of diabetes and cancer care while providing complementary healing methods, including acupuncture and Ayurveda. Close to the hospital will be a 200-room, five-star resort, 30 water chalets and serviced apartments catering to the needs of patients and their families. Other facilities including a spa, restaurants, recreational facilities, retail outlets, herbal farm and an institute run by an established international nursing college.

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UNITED KINGDOM: The Health Tourism Show set to open

Fri, 21 Aug 2009 16:35:30 GMT

The Health Tourism Show, a brand new medical travel event, will open at London’s Olympia Two exhibition hall from October 25 to 26. Up to 120 exhibitors will showcase their cosmetic, elective, dental, IVF and sports treatments. The show will include three seminar theatres which will feature talks on medical and health tourism options worldwide. Around 5,000 visitors are expected over the course of the show. The show will give visitors the opportunity to meet  in person potential providers of medical and health procedure, and will allow visitors to compare hospital and clinics in one place. Medical and health service providers from around the world will be at the show, representing Western and Eastern Europe, Scandinavia, the Middle East, China and South-East Asia, Australia, New Zealand, South America and Canada. The Health Tourism Show is organised by PRo Global Media.

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YEMEN: Poor patients get medical travel grants

Fri, 21 Aug 2009 16:32:56 GMT

Every year, Yemen’s Ministry of Health, donor countries and other multinational organisations give more than 300 medical travel grants to Yemenis with urgent need for specialised medical treatment abroad. The Ministry of Health gives about USD500 and return tickets to Yemeni citizens with incurable diseases to seek treatment outside the country. Certain factors increase a patient’s chance to receive these grants: if the illness cannot be cured in Yemen, if the diagnosed illness is very rare, or if the disease is critical such as some kinds of cancer. Dilated cardiomyopathy (DCM), marrow surgery, some type of cancers, diabetes, chronic renal failure, hepatitis and innate deformation in children are some of the illnesses that push citizens to seek treatment abroad. A local doctor Rasheed Al-Awadhireports said that DCM in children is difficult to treat in Yemen because it requires the child’s heart to be replaced, which cannot be done in Yemeni hospitals. He added that innate deformation in children is another problem that cannot be solved in the country. Abdulkarim Abo Zaid of the Ministry of Health listed nine countries that provide medical grants to poor patients from Yemen.  These are Egypt, Jordan, Syria, Turkey, Russia, Algeria, Germany, America, and Saudi Arabia.

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THAILAND: Private sector sharpens competitive edge

Fri, 21 Aug 2009 16:26:58 GMT

Healthcare service providers in Bangkok are sharpening their competitive edge with partnerships and new services to ensure their facilities’ place as a top medical travel destination. Pacific Healthcare of Singapore is optimistic about the growth prospects of Bangkok Medical Complex, its joint venture in Thailand,), due to open late this year. William Chong, chief executive of Pacific Healthcare, said: "We have been looking at Thailand for some time. The investment offers great potential." Pacific Healthcare offers a comprehensive range of healthcare services, including five major integrated medical centres in the prime Orchard Road area in Singapore. In recent months it has stepped up its expansion abroad to India, China, Vietnam and Thailand. The company paid about THB500 million for debt and equity of Bangkok Mediplex. The THB1-billion Bangkok Mediplex offers 10 medical centres specialising in different services, including a multi-disciplinary specialist centre and holistic medicine, traditional Chinese medicine and acupuncture, a plastic surgery and reconstruction clinic, gastroenterology and intestinal treatment, skin and body rejuvenation, and chiropractic fitness. The medical complex signed an agreement with 10 major healthcare and medical tenants. The four storeys of medilifestyle, wellness and health offerings will occupy over 10,000 square metres. There will be a total of 39 outlets available almost around the clock to serve both local and international residents as well as tourists. Each of the mall’s floors is divided into four categories; medilifestyle shops and restaurants, general medical care, health and beauty, holistic and traditional medicine. Meanwhile, Bumrungrad International Hospital has launched an online service that gives prospective patients the estimated cost of their treatment. Called REALCOST, the service shows the price list for over 40 medical procedures at the hospital. Bumrungrad’s chief executive Mack Banner commented: "You cannot make a good estimate until the doctor sees the patient and knows what treatment will be required. But patients want to get at least an approximate idea in advance, to help them select a hospital and plan for the costs. We wanted to be transparent in this regard and we think the way to do that is simply to show what our patients actually paid." Created by an in-house team of developers and now up on the hospital’s website, REALCOST lists 45 procedures from surgeries such as appendectomy, heart bypass, hysterectomy and knee replacement to diagnostic procedures such as capsule endoscopy and colonoscopy. For each procedure, REALCOST shows information about the total bill patients paid upon leaving the hospital, including doctor fees, medication and supplies, and room costs for inpatient procedures. Inquiry results show three figures: a "low cost" which means only one in four patients paid less; a "median," which means half paid more and the other half paid less; and, a "high cost" which was exceeded by only 1 in 4 patients who had the procedure. For example, REALCOST will give the following prices for a hip replacement: a low cost of US$10,940, a median cost of US$12,545 and a high cost of US$13,565. Price estimates can be displayed in 45 different currencies. REALCOST is currently based on full year 2007 data. Bumrungrad plans to update its database to keep the system current and to add more medical procedure on its list.

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TUNISIA: Government to draft medical tourism action plan

Fri, 21 Aug 2009 16:19:30 GMT

In an aggressive push to put Tunisia on the medical tourism map, President Zine el Abidine Ben Ali has directed his government to draft an action plan focused on encouraging foreign patients to visit the country for medical treatment. The draft action plan is expected to include the creation of a special government body to promote the country’s healthcare sector. It will also include recommendations for the development of a medical resort and the development of designated medical tourism zones around the country. In a cabinet meeting held last month to discuss the action plan, it was also agreed that special measures will be included to encourage convalescent homes and retirement communities to open their doors to foreign patients. Tunisia has seen a steady growth in the arrival number of medical travellers seeking inexpensive but high quality healthcare. Last year, foreign patients visiting the country reached 102,000 nearly double the 2005 figure that was recorded at 55,000. Based on present trends, patients from Africa and the Middle East go for heart surgery, eye treatment, neurological and orthopaedic cure; while medical travellers from Europe visit for liposuction, breast implants and dental surgery. Tunisia is now the leading medical destination in Africa, overtaking South African where health tourism has been burdened by its surgery and safari. The country is the second most popular destination for spa and thalassotherapy (application of sea products primarily seaweed for beauty and health purposes).  Last year, Tunisian thalassotherapy centres welcomed some 150,000 visitors, mostly from Europe.

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SOUTH KOREA: Medical travel leaders convene at IMTC 2008

Fri, 21 Aug 2009 16:15:35 GMT

Leading healthcare providers, travel trade and medical travel facilitators will gather in Seoul from November 19 to 21 for the 3rd Annual International Medical Travel Conference (IMTC 2008). Thought leader speakers representing the healthcare, travel and medical travel facilitators from Asia, Europe, the Middle East and the United States will convene at IMTC 2008 to discuss and exchange ideas and knowledge on a range of topics covering the entire value chain of medical travel. Hosted by Korea Tourism Organization (KTO) and Korea Health Industry Development Institute (KHIDI), IMTC 2008 is part of Korea’s effort to strengthen the country’s position as the next medical travel hub. IMTC 2008 will demonstrate Korea’s capabilities as the medical travel destination. Our delegates will get to see Korea’s healthcare infrastructure and facilities through hospital site visits, experience Korea’s wide array of Oriental and alternative medicines, and explore Korea’s dynamic culture, said Mr Dedric Lam, CEO of Avail Corporation, organiser of IMTC 2008. IMTC 2008 will allow delegates to experience Korea’s healthcare hospitality through site visits to Korea’s world-class international patient medical centers. The pre-conference workshops focusing on medical travel entry assessments and enhancing healthcare hospitality as well as the dedicated conference tracks for healthcare and non-healthcare will provide delegates with an educational platform while the exclusive networking sessions will enable them to establish ties and clinch business deals. Exclusive this year at IMTC 2008 will be the Medical Travel Consumer Fair that is set for Novemberf 21. This Fair will enable consumers both foreign and local to know more about the availability and choices of healthcare options both locally and overseas. The Fair provides great opportunities for healthcare organisations to reach out to out to the consumers and educate them on medical travel. We are honored to have had the generous support from the hosts KTO and KHIDI in bringing IMTC into Korea. This clearly showed their enthusiasm in promoting Korea as one of Asia’s medical travel hub, added Mr Lam. Designed as a platform that integrates key players and sectors internationally, IMTC will provide an educational platform not only to existing players in the medical travel industry but also to those who are going to embark on this lucrative industry. It offers great opportunities for all parties involved to establish ties and clinch business deals through the exclusive networking sessions, one-on-one meetings and exhibitions

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UNITED STATES: The IMTA Americas Conference set for December 7

Fri, 21 Aug 2009 16:12:12 GMT

The IMTA (International Medical Travel Association) Americas Conference will be held on December 7 from 9 am to 3 pm. The conference will run concurrently with the Health Care Globalization Summit (HCGS) that is set from December 7 to December 10 in Arlington, Virginia. IMTA president Dr Steven Tucker said that The Americas Conference is geared towards IMTA members and other international stakeholders who are interested in developing the US market for medical travel. The conference will also feature joint workshops with leading US benefits executives and several executives from the IMTA’s hospital members on December 8 as part of the HCGS. The HCGS, chaired by Ruben Toral, is designed and organised to facilitate networking between international providers and US stakeholders, including employers, health plans, hospitals and others who are interested in learning about medical travel options. Toral said: December and January will be productive months for international providers to reach both business-to-business and consumer prospects. At HCGS in December, we are focused on connecting providers with their best business prospects, and in January, the IMTA-sponsored Medical Travel Roadshow for 2009 will open in Washington DC at the annual WRC NBC4 Health & Fitness Expo, which drew a huge audience of 85,000 consumers in 2008. The 2009 Roadshow will reach more than a half million consumers in a dozen major U.S. markets. The IMTA Americas Conference and Full HCGS program schedule is as follows: Sunday, December 7:     The US Marketplace Opportunities Speakers: David Boucher of Companion Global Healthcare and Wendy Borow Johnson of Boomj.com     Marketing to the US Market Creating Patient Opportunities with Consumers Panelists: US self-insured employers     The Importance of Establishing a Trusted Brand Panelists: US physician groups, global travel agencies and consumer health and lifestyle tradeshows Monday, December 8     Joint Workshop with IMTA and Center for Health Value Innovation     Employers & Providers Bridging Local & Global Innovative Healthcare Solutions Panelists: Employers like Kellogg, State of Colorado, Whirlpool and Hannaford Brothers as well as providers such as Partners Health Care System, Cleveland Clinic, ParkwayHealth, International Hospital Group and Bunmrungrad Hospitals. Tuesday, December 9     What Do Consumers Want For Their Healthcare Speaker: James Clifton, CEO, Gallop     Investment Opportunities in Global Care Market Presenters: Apax Partners, Apollo Hospital and MD Anderson Cancer Center     Engaging US Payers, Providers & Employers in Global Healthcare Presenters: CIGNA, Hannaford Brothers and Mercer American College of Preventative Medicine     Assuring Quality & Safety for Medical Tourists Speakers: Joseph M Heyman, MD, Board Chair, American Medical Association and Steven Tucker, MD, president of IMTA Wednesday, October 10 Theme: Solutions Driving a Global Healthcare Model     Promoting Continuity of Care Speakers: Dr Marcy Zwelling of Choice Care and Society for Innovative Medical Practice Design and Dr Sanku Rao of the American Association of Indian Physicians     Promoting Standards Speaker: Dr Steven Tucker, IMTA president     Promoting Liability Coverage for Medical Travellers Speaker: Dave Arvola of Lockton Companies, LLC     Promoting Platforms for Connectivity Speaker: Dr Mark Blatt of Intel     Marketing Global Healthcare Option National Initiatives Speaker: Dr Jason Yap of Singapore Medicine     New Insurance Products Moderator: Rick Johnson of HealthLeaders MediaPanelists: Dvid Boucher, MPH, Companion Global Healthcare; and, Charles S Green, JD, BasicPlus Insurance Services, LLC     US & International Medical Centers of Excellence Driving Global Innovation & Quality Patient Care Moderator: Dr Robert Crone, managing director of Huron Consulting GroupPanelists: Emme Leven Deland, senior vice president for strategy and regulatory planning, New York Presbyterian Hospital; Dr Fred Yang, CEO, Missioncare Hospital, Taiwan; and, Dr Liu Xiao Cheng, president, TEDA International Cardiovascular Hospital

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MEXICO: Mexicali Healthcare partners with Health Travel Technologies to manage medical travel operations

Tue, 08 Sep 2009 13:29:06 GMT

Health Travel Technologies, a technology and services platform for medical travel management, has signed an agreement with Mexicali Health Care to provide the technology infrastructure for managing its international patient operations. Mexicali Health Care was formed in response to the long-term trend of US patients particularly from California and Arizona crossing the border for dental and surgical care at significant savings over US prices. A recent study by the UCLA Center for Health Policy Research estimated that a million people from California alone seek medical, dental or prescription services in Mexico each year. Mexicali Health Care’s partnership with health Travel Technologies is designed to keep pace with that demand. Carlo Bonfante at Mexicali Health Care comments. Mexicali is very serious about becoming a major international healthcare provider. As a new business starting at ground zero, we need to work with a company that can guide us in building procedures for establishing a professional system for processing and managing patients. Working with Health Travel Technologies has helped us to get up and running with minimal up-front investment. Now we have the capability to grow our business and focus on health care delivery instead of the details of handling medical tourism. Herb Stephens at Health Travel Technologies says, Our core business is providing behind the scenes operational support for international health care providers. Our technology platform has been architected specifically to take the headache out of providing medical tourism services for large international hospitals, and our experience on the consumer end enables us to help newer entries into the medical travel field develop a brand and quickly begin generating requests for surgery quotes and patient flow. Health Travel Technologies supports the marketing, operations and brand objectives of medical tourism providers; our business model means our success is always aligned with our clients. Health Travel Technologies is a subsidiary of Health Travel Guides. A technology and services company, HTT operates and licenses a platform specifically developed to handle the many demands of health travel. Founded in 2006, and based in San Francisco and San Diego, California, it is a private company. The company’s systems currently process more than 1 million international travellers representing more than $500 million in financial transactions per year. Health Travel Technologies provides a centralized, automated system for managing medical tourism - not just booking procedures and travel, but also strategic marketing, web page hosting, quote management from multiple sources, as well as accounting, billing, collections, loan servicing and insurance offerings. Mexicali Health Care is a network of northern Mexico’s top physicians and two major hospitals, Hospital de la Mujer and Hospital Hispano Americano. Mexicali Health Care was formed specifically to provide Americans with quality, comprehensive medical and surgical care options at prices far below those in the US. Although Mexicali Health Care’s medical tourism programme is newly developed, their hospitals already treat 8000 medical travellers a year who cross the border on foot and by car from nearby US towns. Herb Stephens concludes, We are well beyond the point of asking, is this a safe, quality option? The superb level of health care in Mexico is indisputable. The question now is how can the growing volume of international patients be most effectively managed?

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MALAYSIA: Tracking Malaysian medical tourism statistics

Tue, 08 Sep 2009 13:28:49 GMT

The Malaysia Tourism Promotion Board (MTPB, Tourism Malaysia) is embarking on a three-year project to collect market data on health tourism, as the country seeks to increase the number of people visiting the country for medical treatment. According to analysts Frost & Sullivan, healthcare expenditure in Malaysia is driven by increased privatization within the healthcare service provision. The market for healthcare services has also received a positive impetus from health tourism. According to Frost & Sullivan’s Dr. Pawel Suwinski, "Malaysia healthcare tourism grew at a rate of 25.3 percent a year since 1998, while revenues posted a growth of 37.9 percent during the same period. Revenue per patient has also grown 2.5 fold from $92 in 1998 to $241 in 2008. By 2010, medical tourism revenue per patient is estimated to reach $590. This signifies the growth of foreign confidence in more advanced medical care services in Malaysia. Most international patients come from neighboring countries with less developed medical infrastructure (mainly Indonesia), and other developed countries from the West. Malaysia is also a preferred destination for these international patients due to the higher foreign exchange rate in Singapore and unstable political scene in Thailand." In 2006, the bulk of foreign patients came from Indonesia (65-70 percent), followed by Japan (5-6 percent), Europe (5 percent) and India (3 percent). There are an increasing number of patients from Middle Eastern countries (particularly U.A.E., Qatar and Saudi Arabia). The Malaysian government has set up several referral gateways to assist medical tourists. One of them is the health tourism website www.malaysiahealthcare.com, that assists medical tourists globally. Private hospital groups and major private hospital providers have set up departments to deal with international patients. Gleneagles Intan Medical Centre and Pantai Hospitals are among those that have set up international customer departments specifically for the admission and support of international patients. KPJ Medical Group, Mahkota Hospital and Subang Jaya Medical Center have established tie-ups with several travel agencies and hotels to provide comprehensive tourism packages in conjunction with healthcare services, as well as setting up representative or referral offices. Healthcare in Malaysia is mainly dominated by private hospitals. 62 percent of the total hospitals in Malaysia are privately owned. The number of private hospitals increased dramatically from 50 in 1980 to an estimated of 223 private hospital last year. The government has built 10 public hospitals in the past 4 years to increase the number to 140. The Malaysian government is promoting medical tourism. It has extended the visa period for health tourists from one month to six months. Major hospitals in Malaysia are targeting new markets such as Vietnam and Cambodia. Africans are now coming to Malaysia because it is cheaper to do so rather than go to Europe where they used to go previously. Malaysian prime minister Najib Razak recently said. Medical tourism is a high priority to position Malaysia as a world-class healthcare services provider. The government will invest in education and technology. The key is to make sure Malaysia’s regulatory environment is ready to support investment.

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USA: Medical travel survey shows hospital pricing can vary up to $40,000 for the same services

Tue, 08 Sep 2009 13:28:21 GMT

HighRoads, a consultancy advising US companies on controlling their health care costs, recently undertook a medical travel survey to compare procedural ethics, quality and costs around the world. Initial results show that flat pricing, surgeon compensation and use of electronic medical records vary dramatically from hospital to hospital. The survey looked at 66 leading hospitals including 50 US hospitals and 11 outside the U.S. Healthcare organizations including BridgeHealth, Healthplace America, HIMA Health, Intermountain Healthcare and Scott & White, responded to requests for information based on their desire to introduce procedural cost and quality transparency and reduce health care costs. The survey was designed to provide Fortune 500 employers comparable ethical, quality and flat fee data to make the best choice for superior medical procedures for employees at the lowest possible cost. The HighRoads Medical Travel RFI included questions such as: * When patients come to your hospital/clinic for a surgical procedure, are such patients screened by impartial physicians, other than the physician who will perform the surgery?* If your hospital/clinic provides a flat price for eight major procedures including aortic valve replacement, total hip replacement, cholecystectomy, please provide your prices in US dollars, the average number of cases per month, mortality rates and infection rates. Some of the initial survey findings include: * Flat pricing varied up to $40,000 for the same services. Example flat prices for coronary artery bypass surgery ranged from $19,000 to $59,279, and for total hip replacement from $9,900 to $29,005.* 48% of responses indicated patient or plan sponsors would have to pay fees to third parties who have negotiated their flat fees.* 57% of respondents indicated they use electronic medical records. Tom Emerick, of Emerick Consulting, comments, I have been leveraging medical travel for the past 14 years to improve the quality of medical care, reduce the practice of unnecessary procedures in order to improve the health of US employees, while reducing health care costs. HighRoads’ application of its technology to provide a transparent database of worldwide ethics, quality and flat prices for medical procedures will accelerate the adoption of medical travel and can dramatically reduce health care costs for patients, insurers and employers. Michael Byers at HighRoads says, Employers need an efficient mechanism to compare the ethics, quality and cost of medical procedures at top healthcare centres. It is too complex and time consuming to attempt alone. This is why HighRoads has developed a technology platform that will automate this data collection and comparison so employers have increased choices when it comes to the safest and healthiest options for their employees. What the survey clearly illustrates that simplistic comparisons of US and overseas prices, are an out of date approach. While individual medical travellers may be persuaded by price comparisons, businesses look at a lot of other factors too; they will not just take an agency or hospital’s word; they want detailed price, service, quality, disease, and satisfaction comparisons.

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SRI LANKA: End of 30-year war allows Sri Lanka to target health tourism and investment

Tue, 08 Sep 2009 13:27:21 GMT

Aitken Spence Hotels, one of Sri Lanka’s top hotel firms, has resumed talks with Six Senses Spas, an international spa chain, on building an up-market resort on the south-west coast. The firm, part of the Aitken Spence group, owns or manages nine hotels in Sri Lanka, five resorts in the Maldive Islands, five hotels in India and five hotels in Oman. Aitken Spence Hotels managing director Malin Hapugoda says the project is near Ahungalla, in Beruwala, a prime beach resort where it has two properties, Heritance and Neptune, Six Senses are keen to re-look at it and now we’re having talks to restart the project," The project had been mooted several years ago but shelved because of the island’s ethnic conflict. But the 30-year war ended in May when government forces defeated the Tamil Tigers and there has been an immediate revival in tourist arrivals, with economic growth also expected to pick up. Aitken Spence already has a tie-up with Six Senses that operates spas in the firm’s Heritance Kandalama hotel in the north-central region and at the Tea Factory, a hill-country hotel. The new project with Six Senses, originally billed as Evason Hideaway, Ahungalla, is for a combination of beach villas and several villas on stilts on a private island in the nearby backwaters of the Madhu Ganga river. Sixth Senses is an international spa manager and developer. Aitken Spence Hotels, one of the island’s top hotel firms, is aiming at exploiting opportunities thrown up by the fast growth of the market of health/wellness, where rates are higher. Neptune Hotel, a 500-roomed resort on the popular Beruwela beach on the south-west coast that is the oldest in the group’s chain, is being turned into a health resort. The hotel has been closed and will be re-opened in November 2010 after a complete refurbishment and conversion. Malin Hapugoda comments, Health tourism is one of the fastest growing segments in the tourist trade. We decided to make Neptune Hotel exclusively a yoga, meditation and ayurveda hotel. We are drawing up plans at the moment for its conversion. We already have our ayurveda section in the present property that is operational. We’ve made a good name for authentic ayurveda. We want to expand to yoga and meditation which is a growing market, especially in Europe." Rates at Neptune, when re-opened, will be "much, much higher" than what it would be able to derive if it remained in its present state, Hapugoda adds. This contrasts with recent price cuts across the country, as hotels struggle to regain visitors lost by the war and the recession. In Sri Lanka, the health tourism sector is growing in popularity, especially with Western tourists, who look to treatments, such as the ancient Ayurveda methods of herbal medicines and massage, as a way to recover from their fast paced life back home. To put the potential into perspective, Sri Lanka currently receives only 440,000 tourists a year, and a small proportion are health tourists. President Mahinda Rajapaksa wants more hotels and increased room capacity in order to attract 2.5 million tourists annually by the year 2016, with a focus on China. Most tourism investment is from overseas companies, with the Japanese, having already invested in two hospitals, sending a large investment delegation in November to assess potential.

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IRELAND: University of Pittsburgh Medical Center acquires Dublin private hospital

Tue, 08 Sep 2009 13:25:01 GMT

The University of Pittsburgh Medical Center (UPMC) has acquired majority ownership of Dublin’s independent Beacon Hospital, a hospital in the network of at least one US medical tourism agency. It has taken a 66 per cent stake in return for a €68 million investment. This is €25 million for the original investors, €25 million capital expenditure on the facility and €18 million to provide it with working capital to run its operations. The hospital’s original backers were led by businessmen Michael Cullen, Paddy Shovlin, John Delaney and consultant Mark Redmond. They will remain as owners of 33 per cent of the hospital itself. The renamed UPMC Beacon Hospital is part of UPMC’s 20-hospital network. UPMC Beacon Hospital’s Joel Yuhas says, Our plans are for significant expansion of UPMC Beacon Hospital. A full-service hospital opened in 2006, it has seen rapid growth in patient admissions and surgical procedures since UPMC began managing the hospital more than a year ago. Its initial future investment plans include opening a cardiac/ chest pain unit, which is in the final stages of commissioning. It is also planning to add another 31 beds. UPMC Beacon Cancer Centre, one of more than 40 cancer centres operated by UPMC worldwide, offers patients advanced treatment options, including surgical intervention, chemotherapy and radiation oncology. UPMC became the operator of the cancer centre in 2007, followed by its management of the entire hospital in February 2008.  UPMC has acquired majority ownership of the hospital management company and the entity that owns the hospital property from Beacon Medical Group. UPMC Beacon Hospital and Cancer Centre are part of UPMC’s international division that includes the UPMC Whitfield Cancer Centre in Waterford and one of Europe’s leading transplant centers, ISMETT, in Palermo, Sicily, that attracts patients from all around the Mediterranean. UPMC recently announced an agreement to manage a planned health center in Cyprus and a partnership with GE Healthcare to develop cancer centres throughout Europe and the Middle East. UPMC has reached an agreement with officials in Guam to manage a hospital there, with plans for a 2012 opening. Currently, more than 300 residents of Guam leave the island every month for medical care because of a lack of health facilities there. Located in south Dublin, UPMC Beacon Hospital provides world-class acute care services, including heart surgery, neurosurgery, comprehensive cancer care, and emergency medicine services. The hospital, opened in October 2006, has 183 acute care beds, eight operating theatres, two endoscopy suites and 14 dedicated critical care beds. Many world-renowned healthcare providers, including UPMC, are seeking to invest many hundreds of millions of euro in the provision of more world-class healthcare facilities in Ireland. The demand for private healthcare is growing faster than new hospitals and clinics can be built.

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THAILAND: Health Travel Industry Research Society Thailand

Tue, 08 Sep 2009 13:22:27 GMT

The Health Travel Industry Research Society of Thailand (HTRIS), a non-profit, private sector initiative, has been established focusing on Thailand’s international health travel industry, with new Secretary-General Chatree Niramitvijit. HTRIS will help Thailand’s medical tourism industry; hold its lead in the regional market against challenging Asian nations including Singapore, Malaysia, India, Korea and the Philippines. It will compile reports with data from media, the market, international industry consultants, national industry leaders and government advisers. The new organisation will work with Thailand’s Ministry of Foreign Affairs, the Office of the Prime Minister, various government bodies, non-government organizations and representatives of the international medical travel industry. Chatree Niramitvijit says, The society’s role as industry watchdog and its goals of industry improvement and trade promotion meet an urgent need. The purpose is not only to analyze how the world market views the international service industries such as healthcare, travel, security, hospitality, wellness and tourism in Thailand, but also to ensure that the increasingly aggressive promotion from competing nations in the region do not overshadow Thailand’s primacy in the region as a favourite medical travel destination. Thailand is more popular among Western European medical tourists for cosmetic surgery. Singapore and India specialize in complex procedures with India having a cost advantage and Singapore a technology advantage. The Thai tourist industry earns US$ 15.4 million each year, 6 % of Thailand’s gross domestic product and employing 7 % of its workforce. Recent statistics released by the Tourism Authority of Thailand show that visitor arrivals went down 19% in Jan-March this year, by 3.2 million, compared to the same period last year. Thailand’s Prime Minister Abhisit Vejjajiva is highlighting medical tourism to revive Thailand’s tourism industry during his personal visits and road shows around the world. He highlights measures taken by his government including the waiving of all visa fees, the reduction of take-off and landing charges for airplanes, the lowering of entrance fees to national parks and the provision of travel insurance to foreign visitors. He is also promoting spas and health checks. HTRIS has launched a monthly publication to promote Thailand’s medical travel industry. Medica Tourism Magazine highlights the very best of Thailand’s medical, hospitality, tourism, travel and wellness industries,The full-colour, 120-page glossy magazine is distributed to more than 60 countries every month through embassies and consulates, chambers of commerce, trade promotion offices and tourism information centres throughout the world. In its Thailand Investment Review February-March 2009, the Board of Investment of Thailand (BOI) announced new government policies that directly and immediately assist the tourism industry including advertising campaigns as well as measures to reduce tourism-related fees and service costs. Medium-term plans include expansion of the tourism and service sectors by increasing the diversity of service businesses, adding value, enhancing competitiveness, and improving skilled labour in quality and language skills. The BOI adds, The country has tremendous potential to serve as a centre for medical tourism and the government is exploring how to maximize that potential. The government also plans to review all tourism-related laws to ensure that they are up to date and complementary.

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INDIA: Indian hospital groups restructure and expand

Fri, 28 Aug 2009 12:58:16 GMT

The three leading Indian hospital groups have or plan deals that affect their medical tourism business in India and elsewhere. Fortis Healthcare is buying 10 hospitals including 2 under construction, from Wockhardt Hospitals for $187 million. The hospitals; 2 in Mumbai, 5 in Bangalore, and 3 in Kolkata, have a capacity of 1902 beds. The acquisition will give Fortis a stronger foothold in the health-care market. The purchase will help Wockhardt Hospitals to reduce their debt and expand. Wockhardt Hospitals won’t be able to operate hospitals in the three cities for three years, according to the sale agreement. The hospitals will transfer to Fortis in December. Wockhardt Hospitals plans to build hospitals in Madhya Pradesh and Uttar Pradesh after building in south Mumbai and Juhu in the same city. The two Mumbai hospitals are excluded from the no-competition agreement. Wockhardt Hospitals retains seven of its super specialty hospitals in the southern Indian city of Hyderabad and some other smaller cities in western India. Fortis has a network of 28 hospitals with a capacity of 3300 beds. That compares with Apollo’s 43 hospitals in India and overseas, with 7800 beds in India and over 2000 elsewhere, including a multi-speciality hospital in Bangladesh, and a just opened 220-bed multi-speciality hospital in Mauritius. Earlier this year, rival Fortis Healthcare bought a 120-hospital in Mauritius, which it will revamp into a 400-bed multi-speciality one. With the acquisition, when all open, Fortis will own or operate 38 hospitals with 5200 beds across India.Fortis aims to have 6000 beds across 40 hospitals by 2012. India’s largest hospital chain Apollo Hospitals plans to run about 15 hospitals in West Asia and North Africa and a heart hospital in Europe. It is in talks with a Dubai-based business conglomerate for setting up hospitals in West Asian and North African countries on a franchise basis and has offered to run a heart hospital in Europe on contract. We shall establish presence in select countries in west Asia and north Africa where Apollo, as the technical partner, shall be responsible for establishing and managing the hospitals, says Raghava Rao, vice-president for international projects. Each hospital will have 250 super-speciality and 100-150 secondary-care beds. Typically, corporate hospitals such as Apollo charge about 5% of the gross revenue of the franchisee hospital as commission for technical expertise and use of brand. In a separate deal, Apollo is in discussions for establishing a heart hospital in Europe where its role would be to assist in planning, establishing systems, protocols and management, exchange programmes and training of senior doctors. Last year, Apollo was engaged in unsuccessful talks to buy a hospital chain in the UK. Apollo also had a hospital in Sri Lanka but sold its stake in 2006. All three groups are positioning not only to serve the growing global medical tourism market, but also a growing Indian middle class that can afford to pay for quality healthcare, and a significant number of Indians who go outside their local area for medical treatment within India.

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IRELAND: Why Irish patients are looking overseas for dental treatment

Fri, 28 Aug 2009 12:56:05 GMT

The Consumers’ Association of Ireland has published research about the difference in the cost of services between North and South. They claim many services carried out in Northern Ireland are between 25% and 45% cheaper than the same services in the Republic. The study was published in the Consumers’ Association of Ireland’s magazine Consumer Choice. Irish consumers in the Republic of Ireland are paying a third more for routine services than those in the UK’s Northern Ireland for dental treatment, doctors’ services, and chiropractic treatment. Worse still, prices are continuing to rise so the gap is widening. And for those living in Dublin, the gap is wider as the cost of services there is more than elsewhere in the country. A routine dental exam and polish costs €96 on average in Dublin but it can go as high as €140. In Belfast the cost is just €68. The Irish Dental Association (IDA) said the survey highlighted the high cost of doing business in the Republic. Dentists are not immune from the wider economy and the bottom line is that Ireland is a high-cost economy. That impacts on the prices dentists charge their patients," said IDA chief executive Fintan Hourihan. Other excuses regularly used by the IDA, as this is one of several surveys in recent years criticizing the high prices charged by Irish dentists, are that dentists in Northern Ireland or further afield use inferior materials, that treatment overseas is often bodged, and that overseas dentists work too quickly. However, Dermott Jewell of the Consumers Association of Ireland, says he has received no complaints. He adds that dentists have been saying the same thing about price for years. "In the background technicians have been saying that the price for the materials they produce has no resemblance to the end cost for consumers. Jewell accepts that expensive equipment has to be purchased, but maintains that the gap in price is huge, ’The reality is that a significant amount of money can be saved if you are willing to travel for treatment". According to a reader poll by health website Irish Health, after the Consumer Association survey was published, one-fifth of Irish people have gone abroad to get cheaper dental treatment, and a further 58% say they would consider going outside of Ireland to get cheaper dental care. 14% said they were unsure while 8% said they would definitely not go abroad for dental care. A total of 541 adults took part in the poll. Poland is one of the more popular destinations for Irish people considering dental treatment abroad, particularly dental implants, along with Hungary and the Czech Republic. Dental treatment in Poland costs up to 70% less there when compared to Ireland. Dental implants in Poland cost between €1,070 and €1,615. In Ireland, they cost between €2,690 and €3,365. That represents a saving of up to 60%. Although these figures refer to the procedures only, even after adding in flights, accommodation and any follow-up appointments, savings are considerable. Ireland is well served with cheap flights to many European cities.

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SOUTH KOREA: Medical tourism income rising

Fri, 28 Aug 2009 12:53:55 GMT

South Korea has seen a growing number of foreigners visiting the country for medical treatment in the first half of 2009 due to the weak Korean won and eased regulations. Local hospitals have raised medical services fees for foreign patients, as they had to spend more on marketing and translation services. According to the Bank of Korea (BOK), foreigners’ payment for medical services were $40.5 million in the first half, up 31.1 percent from $30.9 million recorded during the same period last year. The first-half payment by medical tourists stood at $23.9 million in 2006 and $31.5 million in 2007. By month, the figures came to $7.2 million in January, $6.9 million in February, $7.4 million in March, $7.3 million in April, $6.2 million in May and $5.5 million in June. According to the Ministry for Health, Welfare and Family Affairs, the number of foreign patients receiving treatment at 21 major hospitals and medical institutes reached 9075 between January and April, up 32.1 percent from the same period last year. By region, the number of patients from the Middle East posted the highest growth rate of 167.9 percent, followed by Russia with 96 percent and Japan with 82.6 percent. In an absolute number, the US was the highest at 3043.By subject; obstetrics and gynaecology attracted 559 foreign tourists. Medical tourism is also outbound as Koreans’ spending on medical services abroad reached $43.3 million for the first six months, down 39.9 percent from the same period last year. The drop was due to rising overseas treatment costs caused by the weak won and falling income. The government has begun piloting information centres on skincare, beauty treatment and health check-up packages, to provide a one-stop service for medical tourists coming into Incheon International Airport. There are plans to build an air city at Seoul’s Incheon International Airport. The complex will include a clinic designed for medical tourists. It will provide commonly sought treatments and services that don’t require long hospitalization, such as lasik operations, Asian herbal medicine and eyelid surgery. The facilities and the airport terminal will be connected by a new magnetic levitation train system. The air city project is scheduled for completion in 2020.Incheon International, one of the world’s largest airports, has a huge amount of spare land, about the size of Manhattan. Korea is now looking beyond Asia and into untapped markets such as Europe. Korea Tourism Organization (KTO) recently hosted a seminar in London to introduce a package, together with Hanatour, Hanyang University Hospital, Wooridul Hospital and Hanshin Medipia. The package offers a seven-day program to experience the medical service through receiving health checkups to be followed by a tour around the metropolitan and Jeju regions. The KTO has prepared 14 other such packages targeting Japan, China, USA and Russia. A manual has been produced by KTO with help from medical consulting firm Medi Members and Cheongshim International Medical Center to provide basic guidelines for medical-related businesses seeking to offer medical tourism. KTO has established an English service on their website and plans to add the additional languages of Japanese, Chinese and Russian.

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PAKISTAN: Pakistan government keen on medical tourism

Tue, 22 Sep 2009 17:04:43 GMT

A sudden government interest in health tourism to prop up a national tourism industry with problems is an increasingly familiar refrain. The latest in this growing list of countries with little existing inbound medical tourism is Pakistan. More than 2,000 people have been killed in Taliban-linked attacks across Pakistan in the last two years, scaring away all but the most intrepid foreign tourists. Pakistan earned $200 million from 800,000 visitors in 2007. Fewer than 400,000 visitors came in 2008, and the numbers are expected to be even lower this year. Terrorism has really affected us a great deal, admits Tourism Minister Ataur Rehman.The Pakistan government hopes that medical tourists can help revive the country’s troubled tourism industry in a big way, which is why the main focus of their new tourism policy will be on health tourism. Rehman says that his ministry is in consultation with the provincial tourism departments, travel agencies, airlines, businessmen, and other stakeholders on the new policy of providing foreigners with quality healthcare at a price far less than what they pay in Western countries, The introduction of health tourism will not only bring in foreign tourists but will also help develop health infrastructure on modern lines, create job opportunities, generate greater revenues and most importantly, cast off the country’s negative image of being an unsafe destination. He argues that the country has internationally acclaimed doctors and world-class medical facilities, with Pakistani hospitals and doctors being at par with their Western counterparts in specialising in the fields of heart surgery, eye care, cancer therapy, dentistry and diagnostics, at a fifteenth of the cost overseas. Rehman says a new plan to revive the tourism industry is essential as there has not been a fully new one for two decades. The aim is engage the private sector in developing the tourism infrastructure to attract locals and foreigners. The minister criticises international newspapers and TV channels, for inflicting considerable damage on the country’s tourism industry and substantially reducing numbers, by generalising a bad law and order situation At present, most Pakistan medical tourism is outbound to countries including India, Thailand and the UK.Hospitals in Pakistan have problems with international credibility, as only one has JCI status and no others have any other international accreditation. While the Pakistan Tourism Development Corporation seems to promote dentistry, cosmetic surgery and open-heart surgery, the only medical tourism page on its website that works is one promoting a small clinic offering hair transplants. Only a small handful of medical tourism agencies outside Pakistan will offer treatment in the country, mostly cosmetic surgery and dental. The main market is still Pakistani expatriates based in the US and UK, but others are trying out what is on offer. A few medical tourism agencies specializing in treatment in Pakistan, some based in Pakistan, some not, are beginning to appear. Medipassion Healing is a new Canadian agency with an office in Pakistan. Medical Travel Pakistan is a new agency based in Karachi that will soon offer heart surgery, dentistry, knee and hip replacements and cosmetic surgery.

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WORLDWIDE: News from the medical tourism and travel associations

Tue, 22 Sep 2009 17:02:10 GMT

The Asian Medical Tourism Association (AAMT) is offering potential members involved in medical tourism in the Asia-Pacific region free membership for the first year. Details of the organization and a venue for an initial meeting are still being worked on. Medical Tourism Facilitators Association is a new international non profit group created by a medical tourism agency for medical travel agencies, with the common goal of increasing awareness towards liability risks, practicing standards, guidelines and help towards pricing, investments. Founder Raj Joseph Raj of US agency Medvoy has recruited members in the USA and Argentina. The European Health and Medical Travel Association was a Lithuanian based trade organization that began in late 2007.The aim was to unite agencies and hospitals in Europe. After three years of never having more than two members, both agencies owned by the founder of the organization, it has ceased to exist. UK based International Medical Facilitators Association was founded in 2007 by Jagdish K. Jethwa, owner of UK agency Taj Medical.TIHFA aimed to initiate regulation and standards for a growing industry. But with standards agreed when the sole member was the agency owned by the founder, and the requirement for agencies to be bonded, nobody joined and it too has now closed. Another well-intentioned body that has closed after failing to get much if any interest is The Society for International Healthcare Accreditation (SOFIHA). It was set up in 2008 in the UK as an international organization devoted towards the development and promulgation of high-quality accreditation of hospitals and healthcare facilities across international borders. Few organizations or people joined up and it has now ceased to exist. The International Association of Medical Tourism has changed its name to International Wellness and Healthcare Travel Association (IWHTA) to avoid any confusion with others with similar initials. The new name is accompanied by a re-branding initiative to present a unified approach to the wellness and healthcare travel Industry. The association’s name change is a result of its desire to broaden its services, further distinguish itself in the industry and to avoid any confusion with other organizations and their activities. The name change reflects the organization’s long-term strategy to advance its international presence, and more closely aligns and strengthens the identity of its core programs: helping hospitals to achieve accreditation and higher standards of safety and quality, involve more resources for its ’donate a surgery’ programme and truly assist people to have access to better, more affordable care and get better value for their health care dollars. It offers membership to doctors, hospitals, clinics, insurers, travel and medical tourism agencies, manufacturers and individuals. There are no details yet of any organizations that have signed up. Healthcare Tourism International/HTI launched the world’s first accreditation system for health tourism agencies in October 2007;HTI compliance. After a sluggish take up, there are now eight signed up agencies. The latest three to join the HTI programme are MedTravel Costa Rica of Costa Rica, Universal Air Travel Tours of India, and MT Bulgaria of Bulgaria.

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USA: Oklahoma attracts Canadian and American medical tourists

Thu, 17 Sep 2009 14:01:53 GMT

The Surgery Center of Oklahoma is a state-of-the-art multispecialty hospital in Oklahoma City, owned and operated by 40 top surgeons and anesthesiologists in central Oklahoma. Being doctor owned, it can offer lower prices than others. A recent decision to list prices upfront on the website is already attracting medical tourists from across the US and resulted in a five-fold increase in people coming from over the border in Canada. The message to Americans is that if they are considering going overseas for surgery, get quotes from this American hospital first. The hospital says, It is no secret to anyone that the pricing of surgical services is at the top of the list of problems in our dysfunctional healthcare system. Bureaucracy at the insurance and hospital levels, cost shifting and the absence of free market principles are among the culprits for what has caused surgical care in the United States to be cost prohibitive. As more and more patients find themselves paying more and more out of pocket, it is clear that something must change. We believe that a very different approach is necessary, one involving transparent and direct pricing. Transparent, direct, package pricing means the patient knows exactly what the cost of the service will be upfront. Fees for the surgeon, anesthesiologist and facility are all included in one low price. There are no hidden costs, charges or surprises. The pricing outlined on this website is not a teaser, it is the actual price you will pay. We can offer these prices because we are completely physician-owned and managed. We control every aspect of the facility from real estate costs, to the most efficient use of staff, to the elimination of wasteful operating room practices that non-profit hospitals have no incentive to curb. This powerful message that prices are comparable with costs in countries competing for medical tourists and are a fraction of what large US hospitals charge, is not limited to individuals; insurers and businesses are being targeted too. In an ambitious move, the hospital is soliciting business from large, self-insured companies; brochures have been sent to all the Fortune 500 companies in the US. The hospital says it can do deals with self-insured companies that are better then they can make through a third-party administrator. India based international medical tourism web network Kosansh now has more than 20 US hospitals signed up, many seeking domestic US tourists rather than international patients. Patients can search on price and other factors. Roshan Shah comments on the Oklahoma initiative, This is exactly what is needed. Clear transparent pricing is what patients love. According to a story in a major American insurance trade magazine, Best’s Review, some health plans are now countering the appeal of international medical tourism by offering discounts for medical care performed at US facilities.

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TUNISIA: Tunisia targets new medical tourism areas

Thu, 17 Sep 2009 13:56:57 GMT

Until recently, legal restrictions on investment by overseas companies, taxation on medical tourists and limited facilities, meant that Tunisia was limited to a few, mostly local visitors, seeking cosmetic and dental surgery at small clinics. That is about to change. All the restrictions have now been swept away, and the long-planned private hospital targeting medical tourists, will start being built in 2010. Tunisia aims at becoming a destination for medical tourism and spa procedures. A new large international airport is expected to completed and operational by the end of 2009.  Tunisia is soon to boast its first private hospital, built by the Japanese group Tokushukai Medical Corporation, in order to improve the local offer in the field of medical tourism to attract European and Arab patients. The hospital will have an initial capacity of 400 beds. Target countries will include those across Africa, particularly from Chad, Nigeria and Mali. The Japanese TMC group, with 260 private hospitals, is the third biggest hospital group in the world, and the largest in Japan. In December 2006, Tokushukai ’s first overseas hospital, Tokushukai Sofia Hospital (1,016 beds) opened in the Bulgarian capital Sofia. For Bulgaria, this was the first new general hospital that has been built in 30 years. The group hopes that the new one in Tunisia has the same appeal and impact as the one in Bulgaria has had. According to the Tunisian Health Ministry, some 72,000 foreign patients were registered in 2006 mainly from the Maghreb region and Europe. Trade estimates for 2009 vary, but are around 75000.Higher figures you may have seen quoted, include spa visits and other wellness tourism. Most Europeans come for cosmetic surgery or dental treatment, while Africans come for surgery. Tunisia has 80 private clinics with an accommodation capacity of 2500 beds, and most of these clinics are well developed and with the latest technologies. Tunisia attracts more and more Brits, Germans, Italians, French, Belgians, Swiss, Portuguese, and Spaniards. The number of foreign patients having been treated in private Tunisian clinics has grown rapidly in the last five years. Medical tourism in Tunisia has become the countries second highest foreign currency earner, and the second largest employer. Most of the 8000 doctors were trained in Europe or America, so they meet Western standards. Prices are 40% to 60% less expensive than those in Western Europe, even allowing for a stay of one week. Its proximity to Europe makes Tunisia an attractive alternative to India and Thailand, for those who want to avoid long-haul flights. Another new investment, again believed to be with overseas money, is a planned health tourism complex that will soon be built in the El Khabayat region near Gabes; a coastal town located some 400 kilometres south of the capital. Covering an area of 140 hectares, the complex will comprise several health cure centres using essentially thermal waters for which the area is known. The complex will include hotels, leisure facilities, including a golf course as well as a congress centre.

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PHILIPPINES: Philippines puts more efforts behind medical tourism

Thu, 17 Sep 2009 12:11:40 GMT

Medical tourism is one of the few bright spots in the gloomy Philippine economic landscape. Government officials are hoping the medical tourism sector will help alleviate the poor investment climate, fall in tourism revenue and the depressed overseas employment market that has traditionally provided jobs to millions of Filipinos who send money home. Since 2006, the Department of Tourism (DOT), in conjunction with the Department of Health (DOH), has been heavily promoting the country as Asia’s premier medical and wellness hub. The attraction is that officials say each medical and wellness tourist that comes to the Philippines spends $3500 during his or her stay. The DOT will hold the biggest medical tourism and wellness summit in the Southeast Asian region at the end of October. Joyce Alumno, Philippine Health and Wellness Tourism Summit project director, says We hope to showcase the Philippines as a provider of world-class, globalized health care, with excellent quality, patient safety and the uniquely Filipino culture of caring, kindness and compassion. Philippine medical tourism has some problems to solve. The Department of Health recently suspended kidney transplantations on foreign patients in the country after human rights groups expressed alarm over the increasing number of medical tourists who came to buy kidneys from poor Filipinos. In launching the summit, Alumno said one aim is to address the misconception that the Philippines has third world health care, This conjures up images of decrepit medical facilities, insufficiently trained doctors, nurses and medical professionals and an overall backward state of affairs, such a picture is false. Dr. Anthony Calibo, Medical Tourism Program manager of the DOH, notes that the Philippines established some of the earliest specialty hospitals in Asia; the Philippine Heart Center, the National Kidney Transplant Institute, the Lung Center of the Philippines and the Philippine Children’s Medical Center.Calibo believes the Philippines, should concentrate on medical; hospital- surgical clinic services, and wellness; spa facilities, corporate wellness programs, and alternative lifestyles. DOT Undersecretary Cynthia Carrion is in charge of wellness tourism and Wellness.She argues that the main attraction for foreigners to come to the Philippines is affordability of quality medical care in the country, at only a fraction of what they would pay in their home countries, The price comparison is really big. Cheap is not the word. It’s just that we do good value for the money. For example a rhinoplasty that would cost $8000 in the US would only be $1200 in the Philippines. Carrion stresses that medical tourism is not only for foreigners. She is appealing to the millions of Filipinos living and working abroad to come home for their healthcare needs. A dental clinic in Cebu wants to attract more tourists as the province tries to position itself as a preferred medical and wellness tourism destination. Bright Smiles Oral Care Center (BSOCC) has just begun offering dental packages to tourists, plans to partner with travel agencies, and intends to open another clinic in Cebu.The Cebu Health and Wellness Council (CHWC) is working on a marketing blueprint for growth of the health and wellness sector in Cebu in the next few years.

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TURKEY: Turkey wants more income from health tourists

Thu, 17 Sep 2009 11:48:05 GMT

Why are countries so keen on medical tourists? The answer, according to the health subcommittee of the Turkish Industrialists and Businessmans Association (TUSIAD), is that a health tourist spends 12 times what a normal tourist does. The same organization reports that 30,000 to 40,000 health tourists go to Turkey each year for treatment, spending $ 150 million, and that by 2020 that figure could increase to a million people. The cost of medical care in Turkey is competitive with the rates of South America and Southeast Asia, and is a fraction of the cost of similar treatment in the US. Turkey is a candidate for membership to the European Union. This has prompted private clinics and government hospitals to shore up their standards in order to meet and surpass rigorous international requirements, ultimately boosting the country’s image. As a result, much of the healthcare available in Turkey is sophisticated and modern. It has one of the largest number of JCI accredited hospitals and clinics in Europe. Turkey has always been popular with Europeans, as a closer low-price high-quality alternative to Asian countries. Slowly it is gaining popularity with Americans. According to Health Tourism Turkey, the arriving patient profile has changed with the number of American patients increasing faster than the number of Europeans, although there are no records of either total numbers or numbers from individual countries. Most of the Americans are self-paying with no health insurance. Selin Yıldırım, deputy-managing director of the World Eye Centers, although accepting American numbers will probably increase, is not convinced that the American invasion is as great as claimed, as the  majority of patients coming to Turkey for eye treatment are still EU citizens. Many of Turkey’s leading health care organizations participated in the U.S.-Turkey Medical Health Tourism Conference held by the Health Tourism Council in Chicago in May 2009, and although there is some increase in individuals traveling, the optimistic expectations of people being sent by insurers and businesses, seems to have produced no results so far. Turkey has advantages in terms of prices, but it is also much ahead of Europe with its investments in technology. Its technology is used in some advanced hospitals in Germany and the US. It claims to be ahead of Scandinavia, the Balkans and Central Europe. Medical standards are monitored through independent accountability watchdogs built into the system. The ministry of health lays out regulations with which every hospital and clinic must comply. There’s also an independent Turkish Medical Association and several other societies that promote high standards and learning among the medical community. As well as Europe, an increasing number of Middle Eastern patients are coming to Turkey for dental treatment, particularly from Iran and Kazakhstan.

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AUSTRALIA: Australia set to make a push into health tourism market

Thu, 17 Sep 2009 11:30:36 GMT

Over 60 delegates from tourism, health, medical and government sectors, at the first Health and Wellbeing Conference in Cairns heard international experts discuss the opportunities available in health and wellness tourism to Australia. At the end of the conference delegates issued the Cairns Declaration; a document outlining Australia’s planned entry into the growing medical tourism sector. Australia’s traditional tourism sector is suffering, so looks to health and wellness tourists who often stay for long periods, bring family members, and are a higher spend traveller. According to conference organiser and fervent advocate of Australia as a new destination, Australian Tourism Export Council (ATEC) managing director Matt Hingerty The Cairns Declaration is a landmark document for the Australian inbound tourism industry. For the first time we have a formal statement from tourism and health professionals agreeing to work together to build a viable new tourism sector for Australia. Countries such as Singapore and Dubai are already investing billions in building new hospitals and other facilities to cater for the forecasted boom in medical travel in the decades to come. It’s time Australia did the same. A collection of medical tourism entrepreneurs told the conference that Australian healthcare’s strong reputation would attract South-East Asians and Americans. Wei Siang Yu of medical tourism agency Fly Free for Health, argues that Australia could become the largest second opinion destination for medical tourists, as doctor shopping, where people seek up to six medical opinions ahead of treatment from diseases like cancer and pediatric services, is a standard practice in South-East Asian countries. Matthew Hingerty says medical tourism would provide a big boost to the tourism sector and would not impact on health services in Australia, "This is not about the public health system at all. There’s spare capacity in our private health system. There is also some promise down the track that if the industry does develop there will be further investment into our private system, so this is about building capacity and not taking away from it." Not everyone has bought into the fervour of the conference. The Australian Medical Association (AMA) argues that a health tourism push could raise prices for Australians. AMA’s Steve Hambleton says," Everyone is entitled to a second opinion, but multiple doctor shopping is not appropriate for the individual or the health system." Others have voiced concerns about agencies promoting Australia and New Zealand as English-speaking and more culturally close to America than Asian countries, with worries that this could be interpreted as racism; a touchy topic in the country after the recent comments from the United Nations special rapporteur on indigenous rights that there is entrenched racism in Australia. The current value of inbound Australian health tourism is unknown, but believed to be much smaller than outbound Australian medical tourism, which is mainly cosmetic and dental, but surgery too. A colonoscopy, for example, might cost $1,600 in Australia, but only $440 in Thailand. According to the Australian-based medical tourism agency My Medical Choices, the most common destinations are India, Thailand, Malaysia and Singapore.

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MIDDLE EAST: Medical tourism conferences and roadshows planned

Thu, 17 Sep 2009 11:06:13 GMT

India’s Ministry of Tourism (MoT) will organise medical tourism road shows in the Middle East this October, in a bid to increase medical tourism traffic from countries in the region to India. The road shows will be held in UAE (Dubai), Saudi Arabia (Riyadh), Kuwait (Kuwait city), and Qatar (Doha) from October 2 - 10, 2009. MoT is expecting a total of 15-20 medical service suppliers from India, primarily hospitals to participate in the road shows to spread awareness about the high-class services available in India. The focus will be on medical tourism rather than health/wellness tourism. Pradeep Thukral of the Indian Medical Tourism Association (IMTA) comments, The medical tourism industry in India is growing at the rate of 30 to 40 per cent year-on-year. Conducting road shows will definitely help the destination to promote the services aggressively. IMTA has 55 members as of now and there are a few members who have shown keen interest in being a part of the road shows. Middle East outbound healthcare travel is experiencing growth despite large number of new hospitals being built in the region. The Healthcare Travel Exhibition & Congress is taking place from 15 to 17 November 2009 in Dubai. High on the agenda are discussions on how to attract medical tourists. Dr Prem Jagyasi, chairman of the conference, who runs healthcare management consultancy ExHealth in Dubai HealthCare City, comments, The Middle East has a unique dual position in the medical tourism Industry. On the one hand, the region’s well-developed hospitals are preparing to capture the international market for elective procedures while on the other, international healthcare organizations are tapping into GCC’s affluent society in search of highly sophisticated and advanced healthcare services unavailable within the GCC. A leading sponsor of the conference is the Association of Private Hospitals Malaysia (APHM), as Malaysia feels it can compete with local hospitals on service and better them on price. Dr Jacob Thomas of APHM adds, This conference is an excellent platform to inform healthcare buyers about what we have to offer in Malaysia. The United Arab Emirates currently has an outbound annual medical travel bill of US$2 billion. The UAE in general, and Dubai Healthcare City in particular, are attempting to turn the tide by reducing outbound medical tourism and increase inbound, but with little success so far. Dubai Healthcare City once had a flood of new projects planned, but the only major one now is the new 400-bed University Hospital that will not open before 2011. All of the Middle East will have to fight to attract medical tourists from within the region, and from other countries. This is as well as seeking to reduce the outbound flow, when several Asian countries that see this region as a prime target for high-paying medical tourists, are becoming increasingly sophisticated at marketing their offerings.

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CUBA: Is Cuba ready for American medical tourists?

Wed, 30 Sep 2009 14:11:04 GMT

The island of Cuba, just 90 miles from Florida’s coast, has had a fifty year dispute with the USA.The cash-strapped state has suffered from an embargo that prevents trade with the US. But with a new president, a new day may be dawning. US entrepreneurs are planning for the day when the embargo is lifted. Tourism firms have the promise of new regulations promising greater access. Although Cuban-Americans have been able to go there since April, the big unknown is if or when other Americans can travel there freely. More foreign visitors would provide access to the quick cash that it needs to jump-start the economy. The island received 2.3 million visitors in 2008, according to the Caribbean Tourism Organization. If the U.S. government dropped its travel restrictions entirely, the island could expect more than one million additional visitors a year. The island has about 50,000 hotel rooms, and while it is making improvements, its phone system, electricity and water supply infrastructure are struggling. Cuba needs the infrastructure to attract investors, but it can’t pay for the infrastructure until it gets the investors. Cuba’s mild weather, proximity to the United States and surplus of trained doctors and nurses could make it ideal for Cuban-American retirees and those requiring long-term medical care. The Cuban economy has benefited from the promotion of health tourism. This is despite the fact that Americans, but not Canadians, could be punished by fines and imprisonment for travelling to Cuba without a special licence that was harder and harder to get during the Bush era. The official position is unchanged but in practice special licences are easily obtainable now and penalties are not imposed. Cubanacan Turismo y Salud (Cubanacan Tourism and Health), the   state owned travel and tourism agency oversees more than 25 of Cuba’s hotels, luxury resorts, restaurants, and other tourism properties used by health tourists. Sol Melia manages a quarter of the hotel stock but all hotels are government-owned. Although the citizens of Cuba are often ill-afforded a decent standard of healthcare, health tourists are offered top level care at prices that are often far below those in North America. All overseas medical tourism agencies have to go via Cubanacan Tourism and Health. The company varies in how many overseas patients it says it deals with, as the answer can depend on which country you are from. Figures vary from 3500 to 9000 patients, from 40 countries. Cuba says it can handle the surge of American travellers expected if restrictions to the island are lifted. The number of American visitors would increase slowly if the ban were lifted because it would take time for airlines to develop routes and for operators and agents to put together Cuba packages, Cuba plans to build 30 new hotels with 10,000 rooms by 2014, regardless of whether or not the travel ban is lifted. Cuba has a network of specialist medical and health centres that deal with foreign clients, but bed capacity is limited.

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INDIA: India looks to Commonwealth countries for medical and health tourism

Wed, 30 Sep 2009 14:08:52 GMT

It is easy to forget that India is more than just a country offering cut-price surgery. The size and breadth of the medical and health tourism market is staggering. Spa and traditional medicine are at least as important as modern medicine. The popularity of the Indian spa industry is increasing every year, making the country one of the most popular spa destinations across the world. The Indian spa industry, with over 2300 spas, generates revenues around US$ 400 Million annually. India has 20-25 major spa centres, mostly in the Southern states such as Kerala and Karnataka. Hotel chains are undertaking major renovations to update their spas in order to meet the needs of Western tourists. These include vichy showers, lockers, hydrotherapy tubs and steam, sauna and multipurpose rooms for massage and facials. In India, there are 380,000 registered medical practitioners of the ayurvedic system as compared to about 700,000 modern medical systems. Ayurvedic and medical tourism industries will be beneficiaries of the 2010 Commonwealth Games, according to The Associated Chambers of Commerce and Industry of India (ASSOCHAM). Major hospital chains and ayurvedic/spa centres are gearing up to attract large number of visitors. A paper by ASSOCHAM on the opportunity for ayurvedic and medical tourism during the Commonwealth Games, predicts opportunities from tourists from UK, Canada, Australia, Malaysia, South Africa, Singapore, Sri Lanka and elsewhere. 200 ayurveda, spa and herbal centres will provide services to tourists and athletes during the games. In September, ICRI-Health of Delhi held a workshop on medical tourism in India .The aim was to understand the healthcare set up in India from the perspective of international patients. Also covered was the role of medical tourism agencies and how to evolve a link between them and hospitals. ICRI Health is offering a two-year full time MBA in healthcare management with the option of specialization in medical tourism in the final year. India: Medical Tourism Destination 2009, the first ever trade show in Canada by leading Indian hospitals, wellness and medical tourism players, is to be held in Toronto, from November 20th to 22nd 2009 at the Metro Toronto Convention Centre. The conference is supported by The Indian Medical Travel Association (IMTA), the Embassy of India in Canada, Ministry of Tourism and medical tourism agency Surgical Tourism Canada. Canada is seen as a good market for promoting medical tourism to India as the healthcare delivery system is under strain and waiting lists are growing. There is also a large population of Indian origin in Canada

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TAIWAN: Taiwan promoting medical tourism in China and the US

Wed, 30 Sep 2009 14:07:20 GMT

The Beauty and Healthcare Tourism Promotion Association of Kaohsiung City will visit Beijing to attend a cross-Taiwan Strait medical tourism alliance conference in late October to promote its health care services. The association consists of representatives from local medical institutions, clinics, hotels, the catering industry and restaurants, and travel agencies. The Association’s president, Tsao Shi-bin, says the association will use the occasion to promote southern Taiwan’s health care and tourism sectors to Chinese government officials and representatives of civic organizations. The main purpose of their planned trip to Beijing is to introduce the quality medical tourism services offered by the many mid- and small-scale clinics in the southern port city and spark interest among Chinese tourists seeking micro cosmetic surgery and health checks in Taiwan. The conference in Beijing came after the association signed an agreement on medical tourism cooperation with a private health care group in China in July. Under the pact, Chinese tourists will enter and leave from southern Taiwan when they visit the island for medical tourism. To help increase the market share of Taiwan medical travel programs in Taiwanese-American and Chinese-American communities in the USA, Dr. Wu Mingyan of Taiwan Task Force for Medical Travel (TTFMT) has signed cooperation deals with medical tourism agencies in Los Angeles. TTFMT, established by joint cooperation of Taiwan Nongovernmental Hospitals & Clinics Association, Taiwan External Trade Development Council and Chung-Hua Institution for Economic Research to promote medical travel programs, has been supported by the Overseas Chinese Affairs Committee of Taiwan. The committee is in charge of connections between overseas Taiwanese and Chinese and their descendents and the government of Taiwan. The committee chairman believes that tens of millions of Taiwanese and Chinese and their descendents who live abroad would benefit from Taiwan’s affordable high quality of medical services. He supports and promotes Taiwan medical travel, as the success will help bring the relationship between the emigrants and Taiwan even closer and help Taiwan develop its medical business. The committee will promote Taiwan medical tourism through all of its overseas branch offices. The issue will also be addressed in all of the committee’s services, activities and programmes. The focus is on the affordability of health check-ups and specialised surgical treatment. Specialist treatment includes living donor liver transplantation, cardiovascular treatments, craniofacial reconstruction surgery, joint replacement surgery and artificial reproductive techniques. Surgery in Taiwan’s costs about one fifth of the price in the United States, and one sixth of the price in the UK. Tonsil removal surgery costs $500 to $600 USD in Taiwan but the same procedure would cost ten times higher in the United States. Similar differences exist for endoscopies, colon fiber mirror, cancer tomography and other examinations; PET costs half the price of the US fee.

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UK, USA: Medical tourists need specialist travel insurance

Wed, 30 Sep 2009 14:04:54 GMT

However many thousands or millions there are traveling overseas for medical treatment, the majority will either have no travel insurance or have travel insurance that if claimed on, is likely to refuse to pay out on finding that they are medical tourists. Across the world many travel agencies and medical tourism agencies are arranging insurance for medical tourists, unaware that standard travel insurance schemes do not provide cover for medical tourists. Part of the problem is misinformation, even from insurance trade bodies. If your car was on fire, and you rang an insurance company, you would be surprised if they would insure it and pay for the fire damage. As the most expensive area that travel insurance covers is medical treatment, why do people expect insurers to cover medical tourists just as they would holidaymakers? The UK pioneered specialist medical travel insurance, with Health Traveller from Marcus Hearn, followed later by specialist company Angelis Insurance. Two or three US based products followed, including Seven Corners with a product that also targeted UK based medical tourists. Now a major UK travel insurance provider is taking existing players on with its own cover, for UK residents and expatriates, underwritten by major travel insurer AXA. P J Hayman has launched Free Spirit-travel for treatment, travel insurance for UK nationals, resident in the UK or elsewhere in the EEA or the Channel Islands, travelling abroad for surgical, dental or cosmetic treatment. Special features include an upper age limit of 74, and cover for complications occurring after 48 hours and up to 31 days whilst abroad. Prior to the launch, PJ Hayman organized a survey of 1300 British adults. This suggests that despite common elective, cosmetic and dental surgery costing up to 89% less overseas, the majority of UK consumers are too worried about something going wrong to travel abroad for treatment. The biggest fears for most people when considering treatment abroad are the potential side effects after surgery (20%) followed by risks involved during surgery (18%)post surgery complication costs (16%), whether the organizer or provider is reputable (13%) and costs (10%). Worry about complications (31%) is the most commonly cited reason for why 74% of the UK population is unwilling to go abroad for surgery. Concerns about standards (28%), distrust of foreign medical practices (21%) and not wanting to be so far from home (15%) are also seen as major barriers to foreign treatment. Of those who would consider travelling abroad for treatment, both men and women rated dental surgery as the most popular potential procedure.   Laser eye surgery and breast surgery are popular options, followed by hip replacement, liposuction, and facelifts. Peter Hayman says, With the cost of treatment abroad an average of £1256 lower than in the UK and with many reputable companies operating overseas, the option of foreign surgery should not be ignored. To put any fears to rest, it is important that those considering surgery abroad should undertake thorough research before making their decision and also ensure they take out appropriate travel insurance to cover them in the unlikely event that anything goes wrong.

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SWITZERLAND: Medical tourists welcome, but not Americans

Wed, 30 Sep 2009 14:02:56 GMT

Zurich University Hospital has stopped treating North American medical tourists from the USA and Canada, fearing million-dollar claims from litigious patients if operations go wrong. Other Swiss hospitals are cautious as to what they treat Americans for, but have no outright bans. The ban applies to patients from the US and Canada who come to Zurich for elective treatments. The hospital is not prepared to put itself at risk of legal actions or incur a significant increase in its own medical indemnity premiums. The concern is not that these patients are self-financing, but the propensity to sue within different healthcare systems; litigation for medical negligence is far more common in the USA than in Switzerland. The ban does not apply to North Americans living in Switzerland, nor to emergency treatment. Of the 170,000 patients Zurich University hospital treats annually, 3,000 come from abroad. Only 30 are North Americans; and these are mainly emergencies. Most medical tourists come from Europe, the Middle East or Russia. In some hospitals in the Valais region, medical tourists have to sign a specific consent form that states that the limits of responsibility are fixed in Swiss civil law, and legal action can only be taken in Switzerland. This is not uncommon, even for patients based in Switzerland, as it stops patients from shopping across Europe. Switzerland is not part of the EU so is unaffected by rules allowing patients freedom of legal action and medical treatment across the EU. Switzerland was one of the first health tourism destinations, as early as the 19th century when wealthy travellers came to spas. For years before medical tourism became an industry, local hospitals and clinics have treated wealthy people seeking specialist and discreet attention. Switzerland has a reputation for healthcare excellence. Zurich-based think tank Gottlieb Duttweiler Institute carried out a study on Switzerland’s potential and concludes that the country could do more to attract wealthy foreigners looking for specialist treatment. Up to 30,000 foreigners a year are treated in Swiss hospitals, but this includes business and holiday travellers, plus expatriates living there. So the actual number of medical tourists is lower but unknown. However, there are another 150,000 travelling every year for health spa holidays. There are 321 hospitals in Switzerland. 68% are public, 38% are private. Private Swiss clinics advertise surgery in in-flight magazines while agencies specialising in organising medical treatment for foreigners offer a deluxe service covering everything from interpreters to visas. People travel to Switzerland for a broad range of treatments and procedures, cosmetic surgery included. Agency Swixmed is a local medical tourism agency that offers treatment in local hospitals. For the last decade Swiss Leading Hospitals (SLH), a federation of 18 hospitals in Switzerland, have been offering a combination of top-class medical treatment and five-star hotel accommodation. Switzerland competes on quality of care and has little interest in attracting medical tourism business with low prices.

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USA: Medical Tourism Association takes legal action against International Medical Travel Association

Wed, 30 Sep 2009 14:00:32 GMT

The International Medical Travel Association (IMTA), a non-profit association registered in Singapore, has been notified that the Medical Tourism Association (MTA), a non-profit association incorporated in Florida, has filed a legal complaint against the IMTA for unfair competition and trade name infringement.   The complaint was filed on September 10, 2009 in US District Court for the Southern District of Florida. In a statement released to its members, Ruben Toral, IMTA President, says, This makes no sense.  The IMTA was clearly the first organization of its kind to serve the medical travel industry; there are over a half dozen associations with medical tourism in their name; and the organization is not engaged in any commercial activity whatsoever. "  Mr. Toral cites the Indian Medical Travel Association and the Asian Medical Tourism Association as examples of two recently formed organizations that would qualify for trade name infringement using MTA standards. Based on registration documents filed in Singapore and the US, the International Medical Travel Association was registered in Singapore in October 2006 and the Medical Tourism Association was incorporated in May 2007 IMTA’s official statement says, It is unclear why the MTA singled out the IMTA, whose officers and board members perform their duties on an unpaid, voluntary basis.  Several attempts were made to settle this issue amicably, but were unsuccessful and the continuous threat of litigation made it difficult for the organization to carry out meaningful initiatives around quality, liability and continuity of care.   IMTA adds The IMTA views the action taken by the MTA as a potentially dangerous precedent for the medical tourism industry, and creates a framework that moves dispute resolution from the boardroom to the courtroom.  The IMTA is in communication with its membership on how best to address this issue, but views litigation as both unnecessary and unwarranted. Footnote Readers should note that IMTJ has no relationship with and is not a member of either the MTA or the IMTA and is independent of both associations.  IMTJ also reminds any readers that wish to comment on this legal action to bear in mind that this is now a live legal action that could come to court soon.

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THAILAND: What's happening at Bumrungrad International Hospital?

Thu, 24 Sep 2009 17:23:42 GMT

Bangkok’s Bumrungrad is often held up as one of the first hospitals in the world to focus on medical tourism. Thailand’s Bumrungrad International Hospital has been attracting patients from America, Europe, Australasia, and Asia and across the Middle East with a combination of lower-cost, state-of-the-art medical care and five-star hotel service. It claims more than one million patients, including 40% from 200 countries visit every year for outpatient or in-patient treatment. However, some have expressed doubts about the validity of these medical tourist figures due to the way in which patient numbers are counted at Bumrungrad; it is suggested that multiple visits to the hospital by a single patient are reported multiple times, thus inflating the patient numbers.SouthEast Asia’s largest private hospital plans to increase inpatient admission numbers by 30% over the next few years and double capacity for outpatients.The private hospital was opened in January 1997. 2001 saw the United States put visa restrictions on people from the Middle East; so many Middle Eastern patients sought alternatives. The hospital saw about 12,000 Middle Eastern patients in 2001 and by 2008 this had increased to more than 100,000. The hospital sees 3000 outpatients including 1200 who are non-Thai. The international patients are medical tourists, business and other travelers, and expatriates living in Thailand. International patients make up 42% of patient volume, but 55% of revenue. The hospital has developed services for international patients. The International Medical Coordination Office [IMCO] has 25 doctors and nurses. Annually, 600,000 patients are Thai. A large number of patients are either expats in Thailand or the region or come from surrounding countries including Vietnam, Cambodia, Burma and Bangladesh, who come for advanced treatment. Then there are 30,000 patients a year from North America, under 30,000 patients from Europe and under 30,000 from East Asia, which includes Japan and China. Over 100,000 patients a year come from the Middle East and those are mainly the Gulf countries, principally the United Arab Emirates, Qatar and Oman. There are growing numbers from Africa and Australia. In Southeast Asia, the Middle East, Africa, and emerging markets like Mongolia and Ethiopia, patients go for advanced care that they cannot find at the hospitals in their country. Medical tourists from the US mostly go due to the cost being from 50% to 80% less expensive than for comparable procedures in the US. Bumrungrad was the first hospital in Asia to be JCI accredited in 2002 and has been reaccredited three times. This year, the hospital has signed up for the International Quality Indicator Project (IQIP), being the first hospital in Thailand and one of the first hospitals in Asia to sign up. The International Quality Indicator Project (IQIP) assists healthcare organizations in identifying opportunities for improvement in patient care. Nearly 180 healthcare organizations in 12 countries use the IQIP tools to collect, analyze, and compare clinical and administrative health care data.The hospital owns 31.5 % of Bumrungrad International Limited (BIL), with other investment partners in Dubai and Singapore, and private investors in Bangkok. BIL is an investment and operational arm outside Thailand. BIL is majority owner a hospital in Manila, Asia Hospital International. It has a five-year management contract with the government of the United Arab Emirates to manage the Al Mafraq Hospital in Abu Dhabi that includes planning a 600-bed hospital to replace the existing hospital.

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KOREA : Good and bad news for Korean cosmetic surgery tourism

Tue, 22 Sep 2009 17:14:41 GMT

An increasing number of Chinese and Japanese women head to Korea for beauty treatments and cosmetic surgery, encouraged by a vogue for Korean actresses among Asia’s young people and a Korean pop culture boom in the region. Many Korean clinics have websites in Chinese and Japanese, as well as English and Korean. A dermatology clinic in southern Seoul sees 10 Chinese women a month for cosmetic treatment. More than 90 percent of the patients are professionals or family of executives of large Chinese corporations or high-ranking government officials. They range in age from their 20s to 50s. Korean doctors say most Chinese patients seek dermatological treatment and cosmetic surgery together. Some Chinese women travel twice a year to get their Botox injections renewed. Chinese patients will make the trip from Shanghai to Seoul several times if their surgery has to be done in stages. The Korean cosmetic surgery boom is expanding its reach to Japan. More Japanese are traveling after Japan’s Nihon TV made a programme on a clinic in Seoul. How long the boom will go on for is debatable as more Chinese doctors and clinics offer Korean style makeovers. Another problem is that cosmetic surgeons in Korea are furious that the Ministry of Strategy and Finance plans to impose VAT on all cosmetic surgery not covered by national health insurance. Under the current law, medical procedures are exempt from VAT. But as of next July, procedures like eyelid surgery, breast augmentation, nose jobs, wrinkle-removing surgery and liposuction will be subject to VAT. Surgeons say VAT is unreasonable as it is a medical practice that treats physical complex of patients. For example, breast augmentation surgery may be equivalent to depression treatment for a woman with small breasts, and liposuction may be done not only out of desire to be more beautiful but also to treat obesity. The government is not convinced by these arguments. Surgeons fear VAT will depress the booming price sensitive market as it is likely to raise the cost of surgery by 10 percent. Hwang Young-joong, president of the Korean Association of Plastic Surgeons, says, "The government action is contradictory as it encourages surgeons to attract more foreign patients while putting a dampener on the market with the introduction of new tax." Cosmetic surgeons claim the issue is fairness. If the rule is to charge VAT on procedures undergone with the goal of looking more beautiful, then hair transplants, eyesight-corrective LASIK surgery, straightening of teeth, and anti-wrinkle Botox treatment should also be subject to VAT. Clinics offering these services are less than thrilled as the government has taken the suggestion on board as it sees more ways to increase tax revenue by adding VAT to these procedures. Lee Sang-yul, in charge of VAT at the Ministry of Strategy and Finance, says, "All European countries that have VAT impose it on cosmetic surgery. We have not set the range of procedures yet, but we will now expand the range gradually."

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MEXICO: Hopes for Medicare coverage in Mexico

Tue, 22 Sep 2009 17:12:35 GMT

Medicare is a key area within US health reform. Medicare does not pay for treatment overseas. Medicare has very strict guidelines on what hospitals it uses and how it pays them, so any country hoping for a Medicare paid medical tourism boom is going to be disappointed. Of the 800,000 American citizens living in Mexico, 200,000 are over 60 years old and at or near eligibility for Medicare benefits. Last year, Paul Crist founded Americans for Medicare for Mexico (AMMAC), a non-profit organization dedicated to bringing Medicare coverage to seniors living in Mexico. Crist has lobbied 85 members of the U.S. Congress and prepared a 34-page proposal in which he outlines the pros of extending Medicare to Mexico, Medicare is now spending $6700 per year per beneficiary in the United States. For the same care in Mexico, my estimate is that it will spend only $3400 dollars, which translates to a very substantial saving. His argument is that if Medicare is extended to Mexico, the programme would only work with hospitals approved by JCI.This is one reason why there are now 10 JCI hospitals in Mexico, over 20 in the pipeline, and most new ones are built to JCI standards. Crist argues that if Medicare is accepted in Mexico, the 64 percent of American retirees currently flying back to the United States for expensive care would opt for treatment nearer their homes, cutting Medicare overall costs by a minimum of 22 percent. Although the health sector is regulated and certified by the Mexican General Health Commission, the task of getting JCI certification for private hospitals is of prime importance. One of the main reasons for pushing for certification is that the North American Free Trade Agreement obligates the Mexican medical system to be on a par with the United States and Canada, allowing for the free flow of patients from border to border and for fair trade. The logic is that as long as hospitals are prepared to accept the delays and detail of the Medicare system, it makes sense for Medicare to accept JCI hospitals in Mexico. Crist argues that Mexican hospital standards are similar so Medicare should accept all hospitals. That argument falls on the basis that if the standards are similar, why are Mexican hospitals keen to spend substantial sums of money in getting JCI accreditation? Whether Mexican heath care meets Medicare’s quality standards and payment system is debatable. The US government is concerned that creating a Mexican medical exemption might be too complicated and costly to implement and would open the door for Americans in other countries. The approval of Medicare would greatly benefit hospitals such as Christus Muguerza, a Texas chain that now has seven hospitals under construction across Mexico. Even without a Medicare deal, most Americans seeking overseas treatment seem much happier travelling the short distance to Mexico than hopping on a plane to Asia .It is easy to forget that in the US, Hispanics are now the largest racial group.

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GERMANY: Hospital certification organisation, TEMOS, in international expansion

Tue, 22 Sep 2009 17:06:38 GMT

Earlier this month, health tourism was the main topic of programme on a major German television channel. The presenter followed health tourists from Germany and USA searching for treatment in Bangkok, Thailand. The documentary dealt with questions about legal aspects of health tourism, quality of care and patient safety. The camera crew followed a TEMOS assessors’ team during its certification visit at the Bangkok Hospital Medical Center. Telemedicine for the Mobile Society (TEMOS), the network based in Germany that certifies hospitals for quality, is a subsidiary company of German Aerospace Centre (owned by the German Government). It has already certified 31 facilities in South-east Asia, Eastern and South Europe. The TEMOS certification system and the respective standards were established in 2006 as the result of problems insurance companies worldwide were facing with respect to the management of international patient cases. TEMOS has no interest in the USA or Canada, but is focusing expansion plans on countries with a high number of medical tourists from Europe in general and Germany in particular. Mainly this will be South/East Europe and Asian countries, especially India, Indonesia, China, and Korea. The company is going to release a new product ’ TEMOS Health Tourism’ for TEMOS -certified hospitals in the third quarter of 2009. Certified hospitals will get free access to tele-lectures, e-courses and relevant partners from research, insurance and assistance institutions from Germany and other European countries. TEMOS will also offer consultancy for implementing second opinion treatments in hospitals. TEMOS is working with German doctors, travel agencies and medical tourism agencies to encourage them to direct health tourists to TEMOS certified hospitals. The TEMOS Quality System is different from other certification   or accreditation systems on the market. Applicants for certification have to prove that they are able to treat international patients on a high quality level. Most of the hospitals applying already have a national or an international accreditation. Even before the process begins they must have a quality system in place, be interested in medical and non-medical aspects of patient care and international patients or intend to do so in the near future. The evaluation begins with a detailed self-evaluation form, which collects data about staff, infrastructure, communication, medical disciplines, quality management and more. This is followed by on-site evaluation visit lasting two to three days; depending on the size and complexity of the respective facility All TEMOS assessors are medical doctors with international experience in medicine and quality in medical care worldwide. Within eight weeks after the audit, the applying facility gets a comprehensive individual report with recommendations on how to optimize its services. Once any outstanding items are resolved, the hospital is presented with the certificate. The first re-certification is due 3 years after certification has been granted. It will again include an on-site evaluation visit and a detailed report afterwards. TEMOS has developed special quality criteria, which partner hospitals and clinics in the TEMOS network have to fulfill. These criteria are based on the needs of tourists in foreign countries and have been developed in cooperation with leading assistance companies and experts in travel medicine.

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USA, COSTA RICA: Costa Rica clinics receive accreditation from AAAASF

Thu, 15 Oct 2009 12:36:13 GMT

The news that three Costa Rican clinics have just received accreditation from the AAAASF may lead you to ask, who? The American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) was established in 1980 to develop an accreditation program to standardize and improve the quality of medical and surgical care in US ambulatory surgery facilities while assuring the public of high standards for patient care and safety in an accredited facility. Today more than 1,100 outpatient surgery facilities are accredited by AAAASF, the largest not-for-profit accrediting organization in the United States. Many more facilities are in process for accreditation. These numbers have increased dramatically over the last two years. The vast majority of ambulatory surgery facilities in the world are unaccredited by AAAASF or anyone else, operating independent of any peer review and inspection process. In 1996, California became the US state to mandate accreditation for all outpatient facilities that administer sedation or general anesthesia. AAAASF was instrumental in the development of the California legislation as well as subsequent laws and regulations in Florida, Georgia, New Jersey, Pennsylvania, Texas and many other states. AAAASF conducts an accreditation program that certifies that an accredited facility meets nationally recognized standards. Physicians, podiatrists and oral and maxillofacial surgeons conduct the accreditation program. The AAAASF strives for the highest standards of excellence for its facilities by regularly revising and updating its requirements for patient safety and quality of care. AAAASF has designed an accrediting program to help provide patients with the assurance of safety and quality in all aspects of their outpatient surgery experience. To achieve this goal, every AAAASF-accredited ambulatory surgery facility must meet stringent national standards for equipment, operating room safety, personnel and surgeon credentials. AAAASF’s Harlan Pollock says; The business of AAAASF is accreditation. It is the high quality of our standards that have made AAAASF the ambulatory facility accreditation choice of governmental agencies, professional organizations and individual facilities. AAAASF core principles and philosophy concerning patient safety is a constant that is unwavering regardless of political or economic pressures that impact on healthcare, and therefore on the accreditation agencies.  Our standards are continually upgraded in order to eliminate any ambiguity, as well as, to meet constantly changing practices and technology. This flexibility allows us to address the needs of our facilities, while still providing for patient safety. The agency was founded by a group of plastic surgeons who had high professional standards related to surgery, sterile technique, anesthesia and a strong opinion that office surgery needed oversight. Through the years, the leadership has been expanded to include physicians in other surgical and medical specialties. Recent expansion of AAAASF accreditation to include procedural and other medical facilities has been both challenging and rewarding.  Applying our surgical philosophy and high standards on non-surgical specialties has contributed greatly to patient safety. Until recently, the organisation limited itself to the USA.It is now expanding into countries where the majority of medical tourists are Americans requiring outpatient treatment. This may be very attractive to small hospitals and clinics for which international accreditation by JCI or others is not cost-effective compared to the volume of Americans treated.

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UAE: Can Dubai Healthcare City become a health tourism destination?

Thu, 15 Oct 2009 12:33:16 GMT

Dubai has been promoting Dubai Health Care City (DHCC) as a world centre for medical tourism. Tourism officials have attempted to talk up the potential by quoting numbers of inbound medical tourists in the millions. But there are no official figures on current inbound and outbound medical tourists. Phase I of DHCC is going to be completed in 2010, but there still seems no cohesive marketing strategy to promote the location. Listing how many new hospitals and clinics you have, what connections you have to prestigious US and European hospitals, what new equipment you have bought is not a marketing strategy. Medical tourism is an increasingly competitive marketplace, with over 300 countries targeting international patients. The myths of millions of high-spending American medical tourists, and thousands of Britons seeking ways of jumping NHS queues, have both been shattered. There is a huge international move away from long-trip to short-trip air travel, or travel by road and sea rather than by air. No longer is Dubai just competing with Asia. It is competing with domestic US medical tourism, South and Central America, Africa, Europe and lots of places previously uninterested in medical tourism. Several competitors are in the Middle East region itself with both Jordan and Lebanon both very active, and Abu Dhabi close behind Dubai in developing its healthcare offerings. On quality of care, DHCC can promise new buildings, comfort and the latest equipment. The quality of doctors may depend on the number of home and overseas patients a hospital attracts. Leading specialists only remain leading specialists if they can regularly operate, so if they can only rarely use their expertise, they will neither go to nor stay in Dubai. Patient care is about much more than clinical excellence, and on the softer elements of customer care, Dubai has a steep learning curve to climb. A key attraction for medical tourists is financial savings. Compared to top Asian hospitals, Dubai has a serious cost disadvantage. Dubai has partnered with Harvard Medical International (HMI) to provide a trusted name as its strategic collaborator. But, HMI operates in more than 30 countries including many medical tourism locations, so there is no longer any uniqueness of the partnership in Dubai. Many other governments are working with health and tourism bodies to promote their country as a medical tourism destination. Some are now expert in marketing and advertising to target countries and individuals. As yet, the Dubai government strategy seems to be limited to a very broad We have lots of new hospitals, come to us.  Thousands of UAE citizens traditionally went to the US for medical treatment. Now fewer patients from the Middle East and Gulf states seek treatment in the US. This does not mean they stay at home. 200,000 UAE citizens a year go to Asian countries including 90,000 to Thailand. Targeting and capturing the UAE citizens who now go overseas should be the first priority for DHCC. Only when it can convince its own citizens to get treated there can DHCC be regarded seriously as a destination for overseas medical tourists. DHCC includes scores of international health businesses, but 2009 has not yet seen a single press release from DHCC, and there is no sign of any marketing strategy.

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SPAIN: Spanish politician attacks health tourism

Thu, 15 Oct 2009 12:25:01 GMT

The Socialist ex President of Extremadura, Juan Carlos Rodríguez Ibarra, has attacked medical tourism in a radio interview, and written an article published in El País on gatecrash health tourism, where thousands of Europeans take advantage of the Spanish Health Service for their operations. He is not attacking medical tourism where people pay to go to Spain for treatment in a private clinic, but cross border healthcare where some holidaymakers, and foreign part or full-time expatriates are accessing free treatment in Spain. Ibarra’s argument is that health tourism is increasingly common with thousands of Europeans taking advantage of the free Spanish system for procedures which are free there but charged for in the countries of origin, describing replacement hips and knees, and heart and cataract operations the most in demand. He claims the practice has reached such dimensions that some travel agents have added the health service to the list of attractions. Ironically, the nation most blamed is the British, the irony being that only weeks ago British politicians were blaming foreigners going to Britain just for free treatment as a reason the NHS is not delivering as well as they would like. It would be easy to dismiss Ibarra as yet another politician ranting at foreigners, but he gives some data to back up his argument. He may be using old data, but anyone who has ever tried to get Spanish figures on anything will know that they are usually several years old before they reach daylight. He quotes the Malaga division of the Andalucian Health Service as saying in June 2004 that some 400,000 EU residents live in the province and get health cover and the ensuing financial black hole is enough to pay for the Malaga Metro or build 25 hospitals. He says that every EU citizen not on the census but receiving health care is costing Spain 686 euros a year. Key points from his article; Surgery tourism is becoming an increasingly common practice among visitors to the Costa del Sol on holiday or long stays in their second homes. Thousands of Europeans exploit the benefits of the Spanish public health to undergo surgery and get free hip and knee, cataract and coronary operations that they would either have to pay for or wait a long time for in their home country. In 2004 Spain received 44.7 million tourists. This included 183,000 paying health tourists in all of Spain. But for Malaga province alone 400,000 EU citizens had free health care, only 5 % being registered as resident expatriates. Of the registered foreign residents in the various municipalities of Spain, only 114,000 had done the paperwork that allows Spain to get 2000 euros per person per year from the countries from where these people come. The remaining resident expatriates are neither registered nor legally resident in Spain. Each foreign EU citizen not registered in Spain and receiving health care, costs the Spanish health system 686 euros a year. 45 million tourists go to Spain annually, far exceeding the number of Spanish going on holiday to other EU countries.  23% of patients treated in emergency Costa del Sol Hospital in Marbella were foreigners, mostly from the European Union. It is increasingly common for foreign citizens, who have a home in the Costa del Sol and in their home countries decide to go to a Spanish public hospital for surgery or benefit from treatments they need, primarily hip and oncology.

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INDIA: India promotes natural tourism and ayurvedic treatment

Thu, 15 Oct 2009 12:10:49 GMT

Ancient remedies and treatments are often referred to as alternative medicine. But as they predate modern medicine by many centuries, many would argue that modern medicine is the alternative to centuries old natural treatment that is frequently more holistic and long lasting than modern medicine. Traditional medical, dental and cosmetic medical tourism in India relies heavily on being able to offer prices much lower than in other countries. But as scores of other countries go down the; come to us as we are cheaper road, some agencies and tourist bodies are concerned that selling on price advantage alone could be short-lived. Traditional remedies have survived the test of time, but people realise that they now have to be marketed with good accommodation, transport and food; the number of health tourists prepared to be treated in wooden huts and travel by yak is limited. Following in the footsteps of the Kerala tourism industry, Himachal Pradesh is integrating tourism with ayurvedic treatment by setting up a hub of health tourism in north India. The state has introduced ayurvedic treatment packages at three of its premium hotels- Holiday Home Shimla, Tea Bud Palampur and Chail Palace, that offer rejuvenating panchkarma therapy massage to tourists, besides treatment for aliments such as chronic conjunctivitis, corneal ulcer, dry eye syndrome, osteo and rheumatoid arthritis and mental disorders. The panchkarma therapies for these ailments will be provided under expert guidance of doctors and trained staff of special ayurveda centres being set up in the hotels. Hotel Tea Bud at Palampur has been equipped to provide treatment for more serious aliments through therapies like abhyangam for improving concentration and mind power and netra-tarpan for eye and mental disorders. Special techniques developed and mastered by ayurveda experts of Kerala, pizhichil and the ancient classical therapy kayadhara have also been introduced for curing rheumatic diseases like arthritis, paralysis, hemiplegia and nervous disorders. Sarvakaya abhyangam, shiro dhara and skin treatments such as triposha, nalikerodakm and kartatika kepam are being offered at Shimla and Chail hotels. Alternative medicine is based on completely natural methods; there is no usage of any chemicals, and there is no danger of any interference with the organic system. It uses a holistic approach as opposed to looking at a set of symptoms and just treating them. Alternative medicine holds out immense potential in attracting medical tourists to India where medical tourism in alternative medicine has its ancestry in South India and North-Eastern India. Internationally famed for its natural remedies and therapies, Kerala’s schools of medicine have embraced siddha, naturopathy and ayurveda in treating their patients. These traditional medical practices are expected to attract high-spending medical tourists from Europe, Australasia and the Middle East, particularly in the summer months. These tourists stay longer than those jetting in for a cheap surgical operation, and more importantly are likely to be regular returners, while conventional medical tourists stop coming one they have been cured. Ayurveda, the Indian wisdom of medical knowledge, has boosted medical tourism in Kerala and helped draw a large number of tourists to the state, says the state’s health minister.

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USA: California medical tourism association formed to promote Baja

Thu, 15 Oct 2009 12:03:45 GMT

Baja California Medical Tourism Association (BCMTA) is a State of California non-profit mutual benefit association. It is the only association outside the Republic of Mexico totally dedicated to advocating and promoting medical services for the entire state of Baja California. BCMTA will represent all of Baja California not just one location or cluster BCMTA aims to help provide medical service seekers access to Baja California’s highest quality, affordable and compassionate medical services. It has offices in Tijuana, Mexico and San Diego, USA.From the Mexico border north through the Greater Los Angeles Region there are 24 million residents. The huge number of Americans travelling to Mexico has seen many agencies; hospitals and clinics open to medical tourists, or set up specifically for them. While many offer excellent care at reasonable prices, some are taking advantage of the modern equivalent of the California gold rush. Choosing a clinic or hospital is a lottery, and incompetent or dishonest surgeons and agencies cheat a few unlucky medical tourists. BCMTA wants to offer a Seal of Approval to people seeking medical services, information and referrals in the Western United States, with emphasis in California’s vast Hispanic and non-Hispanic population. BCMTA wants to make available a network of highly accredited health care providers dedicated to the practice of providing treatment with healing in mind and dedicated to wellness programmes. The organization believes that the practice of medicine requires of its practitioners an advanced level of competence and above reproach moral values. BCMTA considers for membership only those who meet this code of values. The chairman is Judith Wilson, managing partner of the Tijuana law office of Bryan, Gonzalez Vargas & Gonzalez Baz. The secretary is another lawyer, R. Anthony Moya, a partner in the San Diego office of Lewis, Brisbois, Bisgaard & Smith. The other board members are: Mauricio Monroy, who runs investment advisors Mauricio Monroy Contadores in Tijuana; Carlos Rosette and Carolina Rosette, owners of Hi-Tek Mexico web designers; Hank Morton and Geoff Hill of Baja Bound, a major seller of Mexico auto insurance on the internet; Patrick Osio and Hector Molina, of media and marketing agency TransBorder Communications; Melissa McKeith, of attorneys Lewis Brisbois Bisgaard & Smith; Alfonso Hernandez of travel and medical tourism agency Five Star Tours based in San Diego; and Al Delino, who runs his own graphic design firm. BCMTA will go direct to the California consumer with attendance at health expos, television and radio spot advertisements, news releases, commentary articles, networking with other organizations, and as guests on television and radio programmes, as well as reviving The Baja Connection radio program over the Internet. And an important element is the organizing of medical tours, several of which are already in the works. BCMTA is actively inviting for membership medical institutions and practitioners who have a proven track record, and are accredited. By having only those with full accreditation the California non-profit will sustain a high degree of credibility with the U.S. public. It will work with other organizations in promoting and lobbying for Medicare payment approval for services in Mexico; and with local authorities to expedite border crossings.

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ACCREDITATION: News from international hospital accreditation bodies

Mon, 12 Oct 2009 09:55:42 GMT

ACHS has been awarded a contract by the Hong Kong Hospital Authority (HKHA) to assist with the development and implementation of a pilot scheme of hospital accreditation.     The project will run over the next three years. Initially, five public hospitals will participate in a pilot project to be prepared for accreditation. These hospitals will first undergo a mock survey by early 2010, followed by formal assessments for accreditation within two years. The assessments will look at patient safety, services outcomes, patient records, handling of medical incidents and training, using the EQuIP 4 standards. Following the assessment of the project’s outcomes, it is intended that a common accreditation programme will be developed that is applicable to all hospitals, public and private, in Hong Kong. The Hospital Authority is a statutory body that manages 41 public hospitals, 48 specialist outpatient clinics and 74 general outpatient clinics. JCI is continuing to add to the number of hospitals it has accredited, with new ones being added every month. It has recently accredited its first hospital in Japan, first in Colombia and second in Egypt.Kameda Medical Center in Kamogawa City, Chiba became the first hospital in Japan to be accredited by Joint Commission International.Kameda Medical Center includes Kameda General Hospital and Kameda Clinic. In addition to treating patients from Japan, Kameda Medical Center frequently sees patients from all corners of the globe. Fundación Cardiovascular de Colombia inSantander is the first JCI hospital in Colombia. Despite recent claims by the Colombian president to have 11 medical clinics with international accreditation, the other international agencies have no Colombian hospitals or clinics listed. Magrabi Eye Hospital in Cairo is only the second Egyptian hospital with JCI status, the first being originally accredited back in 2005. JCI is holding two seminars on quality improvement and accreditation, in Seoul in November and in Amman in December. The interactive seminars are for healthcare professionals who are preparing for JCI accreditation or are interested in improving quality and safety in their organization. Participants will learn from global experts, share experiences, and observe a simulated accreditation survey at a local health care organization. The World Health Organization recently redesignated the Joint Commission and Joint Commission International as the world’s first WHO Collaborating Centre for Patient Safety Solutions, dedicated solely to patient safety. The Collaborating Centre focuses worldwide attention on patient safety and best practices that can reduce safety risks to patients. The Collaborating Centre coordinates efforts to spread these solutions as broadly as possible internationally through its work with ministries of health, patient safety experts, national agencies on patient safety, health care professional associations, and consumer organizations. Hospitals across the US are switching to new accreditor DNV Healthcare for accreditation. A new video illustrates some experiences of hospitals using DNV.

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UK: Health and Medical Tourism Show London

Mon, 12 Oct 2009 09:39:36 GMT

A new show aimed at people looking to travel abroad for medical treatment is set to take place next spring in London. Supported by The Independent newspaper and online media partner Treatment Abroad, Destination Health will take place on the 17th & 18th April 2010 at the Olympia Exhibition & Conference Centre. The show is expected to attract up to 5,000 people from all walks of life who are actively planning to travel abroad for treatment. In addition, visitors will also include health and medical professionals who are looking to establish business partnerships with healthcare providers from around the world. Destination Health is the ultimate event for people who are planning to travel abroad for health and medical treatments. With just one visit they will have an opportunity to meet and discuss their medical requirements with a host of hospitals, clinics and consultants representing the world’s leading medical tourism destinations right on their door step said Event Director Nav Mann.Exhibitors will be promoting a wide range of health and medical services including dental treatments, cosmetic surgery, breast augmentation, IVF and other medical procedures. Exhibitors will also include medical spas, health resorts, insurance companies, travel agencies, intermediaries and medical tour operators.Visitors to the show will be offered free seminars, presentations and all the help and information they need to make their decision to travel abroad for treatment.Entry to the show is free if visitors register in advance. The price at the door is £12.To register for free tickets visit www.destinationhealth.co.uk For further information on the event contact:Nav MannEvent DirectorDestination HealthTel: +44 (0)20 8230 0066Fax: +44(0)20 8230 0067 This email address is being protected from spambots. You need JavaScript enabled to view it. www.destinationhealth.co.uk

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NETHERLANDS GERMANY: Dutch insurance companies sending customers to German hospitals

Fri, 09 Oct 2009 16:06:16 GMT

In the Netherlands there is a system of obligatory health insurance, for everyone including expatriates, with private health insurance companies. These insurance companies are obliged to provide a package with a defined set of insured treatments. Five large mutuals control the market. Insurance companies must offer a core universal insurance package for the universal primary curative care. They must do this at a fixed price for all. The same premium is paid whether young or old, healthy or sick. People are free to purchase optional packages from the insurance companies to cover additional treatments such as dental procedures and physiotherapy. Healthcare in the Netherlands is generally very good, but is more expensive even than countries previously thought to charge more for equivalent care. When taking into account cost, quality and easy access, the only country that qualifies is Germany. The two biggest Dutch insurers have agreed to send a small number of patients to private hospitals and clinics in Germany. Agis, a subsidiary of Achmea, the largest Dutch insurer with 5.3 million policyholders, is sending a few patients to Germany for procedures that are cheaper. Medical tourism agency Holland InterCare arranges the treatment and travel for its parent Agis. For the last decade the company has arranged medical treatment in the Netherlands for patients from Surinam, the Dutch Antilles and Aruba. It also has service centers in Turkey, Morocco and Surinam, as many policyholders of Agis have their roots in these countries. The service centers help Agis clients visit these countries for the purpose of planned and organized treatment. The agency recently began arranging healthcare overseas for Dutch nationals on a self-pay basis, and has extended this to insurer paid patients. The agency is negotiating to extend the operation from just Agis policyholders to the other Achmea group insurers; Zilveren Kruis, Avero Achmea, Centraal Beheer Achmea, FBTO and Interpolis. Large insurance group UVIT is using two German healthcare groups, MEDIAN and Helios; the former for hip and knee replacements with a five-week stay in a rehabilitation unit with intensive physiotherapy and coaching. This is for those, mostly older retired patients, who prefer aftercare in a home, compared to the Dutch practice where the patient goes home and then gets outpatient treatment. Numbers are expected to be small, 100 patients a year. Helios covers all types of operation, and there is no set numbers. Helios Healthcare International arranges treatment for international patients in hospitals within the Helios group. In Germany, Helios owns 57 hospitals with 17,300 beds, including five maximum care hospitals in Erfurt, Berlin-Buch, Wuppertal, Schwerin and Krefeld. MEDIAN operates 27 rehabilitation and acute care clinics. In August, the company was sold to Advent International, the US private equity firm, and Marcol, London based real estate private equity investor. The Health Insurance College of the Netherlands suggests, with no supporting numbers, that 1% of medical care for Dutch people takes place abroad. Much of this is dental tourism, as dental care is not within the compulsory health package, and private dental treatment in the country is expensive. Another group is expatriates who go home for treatment. Very few go overseas for major medical treatment.

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GLOBAL: Medical tourists may donate to world healthcare every time they travel

Fri, 09 Oct 2009 11:05:39 GMT

A criticism of medical tourism to less-developed countries is that it takes doctors and nurses away from caring for the citizens of that country, particularly the poor. A new United Nations initiative will enable medical tourists to donate every time they travel. This will only work if medical and other tourism agencies, organisations, and hospitals/ clinics dealing direct with overseas patients, grasp this opportunity to show the medical tourism business as more than about profit. The United Nations and the World Travel & Tourism Council have launched an ambitious global health initiative, MassiveGood. The project was created by the Millennium Foundation for Innovative Finance for Health and will allow travellers to give a voluntary contribution every time they purchase travel services. The innovative travel related fundraising initiative will help finance healthcare for the world’s poor. The money will go towards fighting life-threatening contagious diseases including HIV/AIDS, malaria and tuberculosis, in developing countries. Managed by The Millennium Foundation for Innovative Finance for Health, it will allow travellers to give a small donation ($2/€2/£2) every time they purchase travel services. Funds will be distributed by UNITAID, hosted by the World Health Organization.The Millennium Foundation is an independent, non-profit foundation, established in November 2008 under the auspices of the United Nations. MassiveGood is in testing phase. The technology solution was developed by Amadeus and can be integrated into all global distribution systems and embedded in the regular booking system for tickets and other travel reservations. As a result, it will make it easy for everyone who travels to make their micro-contributions through a simple click each time they book their reservation, whether online or through an agent. It is on track for launch in early 2010 in USA, UK, Spain, Germany and Austria, followed by Australia and New Zealand. It has the potential to raise up to $1 billion in additional funding for global health during its first four years of operation. Major global distributions systems including Amadeus, Sabre and Travelport have signed on, as have online travel agent Opodo, American Express Business Travel, Carlson Wagonlit Travel, Voyageurs du Monde and Mondial Assistance. No organizations connected with medical tourism are known to have signed up yet. Dr. Philippe Douste-Blazy of the Millennium Foundation says, "The biggest crisis the world is facing is the glaring inequalities in access to health care between the rich and the poor.Unitaid was launched 3 years ago as an innovative mechanism for scaling up access to treatment for HIV/AIDS, tuberculosis and malaria. Founded by Brazil, Chile, France, Norway and the UK, it now has the support of 29 countries and supports partner programmes in 93 countries worldwide, addressing HIV/AIDS in 49 countries; malaria in 29; and tuberculosis in 72 countries. Malaria kills 1 child every 30 seconds - $2 can treat 2 children against malaria. Tuberculosis kills 1 person every 15 seconds - $24 can cure 1 adult of TB. HIV/AIDS kills 1 person every 13 seconds - 40€ can treat 1 child for a year. Every 3 seconds, a child under the age of 5 dies in low-income countries. Every minute, a woman dies in pregnancy or childbirth. Any medical tourism organisations interested in helping this excellent project should contact the Millennium Foundation.

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ICELAND: Iceland health tourism takes step closer at Asbru

Fri, 09 Oct 2009 10:47:51 GMT

Iceland’s business centre Asbru is nearer to developing a medical tourism destination targeting Scandinavian and British medical and dental tourists. Asbru, on a former NATO airbase next to Iceland’s Keflavik International Airport, will become home to a new international health services centre. A contract has been signed by the Keflavik Airport Development Corporation (Kadeco) and Iceland Health. Kadeco aims to develop a health village concept where businesses working in health related industries are clustering together to exploit synergies. It is Iceland Health’s goal to increase specialised health services and begin substantial medical tourism in Iceland. Iceland Health’s initial product offering will include joint surgery and obesity surgery, including important post-surgery rehabilitation. Obesity services will include a range of behavioural treatments against obesity. Iceland Health’s Asbru health centre has a professional advisory council. The council has confirmed members including: Otto Nordhus, chest wall surgeon; Bjarni Sem, heart surgeon and Leif Ryd, orthopaedic surgeon. The council will also include obesity and rehabilitation experts. The Iceland Health project will catapult Asbru to the position of the premier medical tourism facility in Iceland. Asbru is already home to several innovative companies in the health and wellness sector. The majority of tourists who go to Iceland travel through Keflavik Airport. Icelanders enjoy the longest life expectancy and highest healthy life expectancy in Europe. The facilities at Ásbrú will include a health and fitness village with an international centre for health and relaxation. A Reykjanes Health Association has been founded to promote Reykjanes in the as a destination for health and relaxation. The goals are to market Iceland as the land of strength, fortitude, beauty and health. In May 2009, Icelandic entrepreneur Jonina Benediktsdottir opened a 50 room detox health center in Asbru.She is now getting large numbers of Norwegian customers, and has been profiled on Norwegian television. Jónína’s connection with Norway began when Norwegians began going to the detox treatments she offers in Poland. Norwegians prefer going to Iceland rather than Poland. Also booked in are health tourists from Sweden, Finland, the Czech Republic and Canada. After Nato evacuation in 2006, the base was re-invented as a community of entrepreneurs, students and business. Ásbrú has the largest university campus in Iceland, one of the largest business incubators in Iceland, as well as other projects including a green energy research centre.

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CANADA: The future of Canadian medical tourism could be decided in court

Fri, 09 Oct 2009 10:43:30 GMT

While media attention may be on US healthcare reform, over the border in Canada, an equally bitter fight is taking place on the future of state and private healthcare. The outcome will affect medical tourism into, out of and within Canada. Although this is a highly political fight, it is not being fought by politicians, but in the courts. In British Columbia, private clinics and surgery centres are catering for patients who would normally look to pay privately for faster treatment across the border in the USA. The courts will consider their legality within weeks. Healthcare in Canada is a government-funded health system where all Canadians get free care. It is not national, but controlled by each province. It was only in 2005 that a Quebec court ruled that private health insurance was legal, and only in that state. This ruling paved the way for private care. Facing long waits and substandard care, private clinics are proving that Canadians are willing to pay for treatment. Private for-profit clinics are permitted in some provinces but not allowed in others. Under the Canada Health Act, privately run facilities cannot charge citizens for services covered by government insurance. A network of technically illegal private clinics and surgery centres has opened in British Columbia, copying what happened in Quebec. In October, the courts will be asked to decide whether these clinics are legal, illegal, or can operate in a restricted way. More than 70 private health providers in British Columbia schedule simple surgeries and tests with waits as short as a week, compared with the months it takes under the public system. Brian Day runs a private surgical centre in Vancouver, "You cannot force a citizen in a free and democratic society to simply wait for healthcare, and outlaw their ability to extricate themselves from a wait list." Opponents say that allowing private care will drive the best medical staff and well-off patients into the private sector; leaving the public sector to slowly crumble. The lawsuit is to determine whether the Canadian Constitution guarantees citizens the right to choose their own care. Separately, an investment group backed by Arizona businessman Melvin J. Howard has filed a legal challenge under the North American Free Trade Agreement, demanding that US healthcare companies gain access into Canada. The consortium hopes to build Canada’s largest private health centre in Vancouver, offering orthopedics, cosmetic surgery, general surgery and other services. Private health insurance is allowed in Canada, but the provincial governments allow it only for services that the public health plans do not cover; for example, semi-private or private rooms in hospitals and prescription drug plans. Several provinces have legislation that financially discourages but does not forbid private health insurance in areas covered by the public plans. Canadians are free to use private insurance for elective medical services such as laser vision correction surgery, cosmetic surgery, and other non-basic medical procedures. The Canadian government has invested a large amount of money nationwide in a successful effort to reduce wait times, especially for life-threatening conditions such as cardiac disease and tumours, and for procedures such as knee replacements and cataract surgery. Under Canada’s system, most doctors run private practices but are paid uniform rates by a government-funded network. Many Canadians have private or employer-paid insurance that covers things such as dental and eye care, which are not part of the larger plan. The outcome of the legal case will probably determine the future of private healthcare in Canada. While a few Canadians travel to South America, Cuba and China, most go to the USA. If private treatment is allowed in Canada, then the rationale for most Canadians becoming medical tourists may vanish.

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EUROPE: Annual EU healthcare index puts The Netherlands ahead

Fri, 09 Oct 2009 10:40:46 GMT

The Netherlands has come top in the 2009 Euro Health Consumer Index (EHCI), for the second year in a row. Denmark keeps its runner-up position from last year. Besides the Dutch and Danish system there is a small group of strong performers: Iceland, Austria and Switzerland. There are general improvement trends among most of the measured healthcare systems, with examples of reform making impact not only in Netherlands but in Ireland and the Czech Republic as well. There is continuous decline in the Spanish, Portuguese and Greek healthcare systems and improvement in the Netherlands, Denmark and Iceland. Large parts of Eastern and Central Europe are affected by the financial crisis. Research director, Dr. Arne Bjornberg, comments "The Netherlands is the best performing country by combining competition for funding and provision within a regulated framework. There are information tools to support active choice among consumers. The EHCI is a measurement standard for European healthcare. It ranks 33 national European health care systems across 38 indicators, covering six areas that are key to the health consumer: patients’ rights and information, e-Health, waiting times for treatment, treatment outcomes, range and reach of services provided and access to medication. The Index is compiled from a combination of public statistics, patient polls and independent research conducted by Brussels-based think tank Health Consumer Powerhouse Johan Hjertqvist of Health Consumer Powerhouse, comments, "With patient mobility growing around Europe there is a strong need for transparency exposing the pros and cons of the national healthcare systems. The EU intends to introduce a cross border care scheme that requires significantly better information to patients. " The individual category leaders:* Patient rights and information: Denmark* Waiting time for treatment: Albania, Belgium, Germany, and Switzerland* Outcomes: Sweden* Range and reach of services: Belgium, Luxembourg, and Sweden While dental and cosmetic surgery tourism are driven by other factors, outbound medical tourism from European countries is driven by cost, waiting times and how good a national healthcare system is. This shows to any agency or hospital targeting Europeans that the likelihood of people travelling and what may make them become a medical tourist differs hugely between countries.  Germany probably has the most restriction-free and consumer oriented healthcare system in Europe, with patients allowed to seek almost any type of care they wish whenever they want it. The report debunks the myth that German healthcare is excellent but expensive, German healthcare costs are in the middle of the Western European countries. The report includes all 27 European Union member states, plus Norway and Switzerland, the EU candidate countries of Croatia and Macedonia, plus Albania and Iceland. The Netherlands has a consumer-friendly healthcare system. In Denmark, a determined political effort to improve delivery and transparency of healthcare is paying off.  Germany is improving, as are Ireland, Hungary, the Czech Republic and Lithuania. Long waiting times are a reason for surgical tourism. In the 31 countries, the worst two are Portugal and the UK. The NHS in the UK recently spent millions on reducing waiting and introduced a target maximum of 18 weeks to definitive treatment after diagnosis. The patient survey shows it has got worse since 2008. The UK in 2009 has showed surprisingly negative feedback from patient organizations on the waiting time situation, particularly after government spending on the NHS has been increasing heavily, states Dr. Arne Bjornberg After the spring 2009 EU directive on cross-border care, the indicator on cross-border mobility was reintroduced. The only three countries scoring well are Denmark, Luxembourg and the Netherlands. Denmark had its 2007 law on free mobility in the EU temporarily suspended between November 2008 and June 2009, but that has now come back into effect. Luxembourg does not have a healthcare services, it lets citizens seek care in neighbouring countries. There are only three countries Germany, Denmark and the UK where the public can go online and compare outcomes at hospitals. Patients may soon be able to travel across European borders for treatment, in line with a new directive on patient mobility. This option, suggests Bjornberg, will only be used by between 3% and 5% of patients, but It is important to have access to data showing which hospitals are best for particular operations. Once Croatia joins the EU it could become a destination for health tourism because it is relatively inexpensive and has a record of good results. There are no reasons for restrictions on cross-border care. Patient mobility seems to scare healthcare administrators but that’s because they are control freaks.

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CHINA, ISRAEL, USA: Developments in air ambulance services

Fri, 09 Oct 2009 10:38:09 GMT

AirMed Asia, a subsidiary of leading U.S. air ambulance company AirMed International, has entered into a joint venture agreement with China-based Asia Air Medical (AAM) in which the two companies will cooperate in the Greater China region (China, Hong Kong, Macau and Taiwan) to expand air medical transport operations. The joint operation will feature Beechjet air ambulances, with initial operations in Beijing and Shanghai. The aircraft will be Chinese registered, providing access to most domestic airports in China. AirMed Asia will staff the aircraft with medical teams and use its 24/7 dispatch and medical coordination system to guarantee the highest quality of patient care and transportation. Wilson Kao of Asia Air Medical says, Our plan is to establish a new Chinese communication center as well as more bases in the western region of China. Asia Air Medical (AAM) is the first dedicated air ambulance service in China.  AAM will take on the role of air medical transportation service provider in partnership with AirMed to expand operations into domestic airports within China. AirMed Asia is the first and only USA air ambulance company with a base in Asia. It operates a state-of-the-art Hawker 800 medical jet from Hong Kong. In April, AirMed Asia was awarded full accreditation from the Commission on Accreditation of Medical Transport Systems (CAMTS), the highest standard possible for an air medical transport service. AirMed Asia, the only accredited program in Asia, is one of only four international programs to achieve this status. US based AirMed International is the parent company of AirMed Asia and operates a fleet of medical aircraft from multiple worldwide bases. AirMed has flown more than 15,000 global transport missions. Shemer Medical Centre, a leading medical tourism hospital in Israel, is promoting its International Flying Doctor service. This offers emergency evacuation by air transfer to Israel from any location in the world; non-emergency medical flights to Israel from anywhere in the world; hospitalization in Israel; urgently flying-in a leading senior specialist physician from Israel to provide consultation and treatment at the patient’s bedside in his/her country; and bedside to bedside medical escorts that accompany patients on commercial flights. US based Foundation for Air-Medical Research and Education (FARE) has become MedEvac Foundation International; a name change to reflect its growing international focus. The Foundation was established in 2000 by the Association of Air Medical Services (AAMS) to support research and education for the air-medical and critical-care medical-transport community. MedEvac’s Kevin Hutton says The MedEvac Foundation International is the first organization of its kind to engage, mobilize, and empower people and organizations to make a difference in medical transport across the globe. The vision of is to ensure that every patient in need has access to safe, quality air-medical and critical-care ground transport. We hope to achieve these goals for medical transport patients everywhere. It is funding a soon-to-be-available online database containing an annotated bibliography of critical-care-transport safety literature, as well as a monthly On the Fly newsletter featuring issues specific to aviation and patient safety.

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EUROPE: European Medical Travel Conference 2010 announced

Fri, 06 Nov 2009 09:45:25 GMT

A major European medical travel conference will remind the world that every year, millions of medical tourists and health travelers go to, from or within Europe. The European Medical Travel Conference 2010 in Venice will focus on a sector of the medical tourism industry that is long established and highly significant in revenue terms. Topics covered will include areas which many international medical tourism conferences have failed to address such as the implications of the European Union Directive on Patient Mobility, and the growth of spa and wellness tourism. Representatives of the twenty plus medical travel industry associations around the world have also been invited to attend and discuss the need for creation of an umbrella trade organisation for the medical tourism industry. The agenda is evolving to respond to the issues and challenges that medical tourism needs to address for patients and providers. The conference accepts that the industry contains people with often conflicting views, so will seek to stimulate genuine discussion and be much more than just a shop window for products, services and destinations. Around 350 participants with a genuine involvement or interest in the business are expected, quality of participant being more important than just boosting numbers by any means. The venue for EMTC 2010 is the Villa Fiorita Park Hotel, a 4 star hotel in Venice. The dates, 5th to 7th May 2010.There will be visits out to local spas and hospitals in the Venice region. The conference has an advisory board with members who are assisting in the development of the conference and selection of speakers. Speakers are selected according to the quality and value of their contribution and expertise. The advisory board includes;* Sabiha Al Aidroos, Ministry of Health, UAE* Professor  Ferruccio Bonino, University Pisa, Italy* Dr. Luigi Bertinato, Department of Health and Social Services, Venice * Dr. Constantin Constantinides, Symmetria, Greece* Dr. Maurizio D`Aquino, CdC San Giovanni XXIII* Professor Heinrich Fürst, MM Clinic, Munich* Dr. Prem Jagyasi, exHealth, Dubai* Keith Pollard, Treatment Abroad* Dr. Carlo Ramponi, EU office of the JCI* Dr. Abdulaziz Nasser, King Faisal Hospital, Riyadh How conferences treat speakers has recently been a topic of quite heated debate in IMTJ and the medical tourism world. This conference feels that speakers are very important and the organizers follow a code of conduct for speakers, which fully respects and protects their intellectual property. Speakers may: Use their contribution and knowledge for presentations on   other events before or after the congress. Publication of materials is undertaken only with the speaker’s consent and is free of charge. The organizers will not make use of the presentations for commercial purposes unless there is a specific agreement on shared profits, which regulates the business. Dr. Uwe Klein, chairman and organizer is CEO of Health Care Strategy in Munich, chairman of the previous European Congresses in Germany and Hungary. Earlier this year, Dr.Klein resigned from the advisory board of the Medical Tourism Association.

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USA: Deloitte's report reduction in US medical tourism due to the recession

Fri, 06 Nov 2009 09:43:03 GMT

Optimistic predictions of 23 million outbound US medical tourists by 2017 are unrealistic says a new report from the Deloitte Center for Health Solutions. ’Medical Tourism: Update and Implications’, says that outbound medical travel fell by nearly 14% between 2007 and 2009 largely because of the recession. The number of Americans traveling overseas for more cost-effective surgery and other medical care fell from an estimated 750,000 in 2007 to 540,000 in 2008. That number is projected to rebound a bit in 2009 with a projected 648,000 Americans seeking care abroad. Paul Keckley of the Deloitte Center for Health Solutions comments, The prolonged US recession has had a significant impact on patients ability to afford medical care, and by extension their use of medical tourism. The study suggests that outbound medical travel is likely to pick up in 2010, growing an estimated 35% a year in coming years. If it grows by 35% a year, by 2017, the number could exceed 5 million. After dramatic backtracking on growth estimates made in 2007 and 2008, Keckley is understandably wary of long-term predictions. He estimates that at the very best, there could be 1.6 million outbound Americans by 2012, but then comes a long list of caveats, Barring any tempering factors, such as supply constraints, resistance from health plans, increased domestic competition or government policies. The report says that medical tourism has transitioned from a cottage industry to an acceptable alternative for elective care that is safe and cost effective if coordinated by reputable health plans and providers. The emergent technologies of distance medicine combined with insurance coverage for certain low-risk procedures provide a backdrop for healthy growth in this sector. Paul Keckley comments, In 2010, as quality is better defined, new business models emerge, insurers, legislators and employers explore pilots and programs, health care providers become increasingly involved in coordinating care and consumers continue to test it out to explore savings. Pent-up consumer demand for elective procedures, especially outpatient dental and cosmetic procedures, will help fuel increased demand for medical tourism again.  Health reform efforts in the near term will also likely contribute to medical tourism’s growth, though in the long run it is difficult to assess given uncertainty about the public option, employer and individual mandates." Among the additional key findings highlighted in the report:* Inbound US medical tourism will see relatively slow growth to up to 561,000 travellers by 2017;although lack of reliable data means it does not attempt to put figures on intervening years* Although several health insurers have launched medical tourism pilots as part of health benefit plans, it is yet to be determined         if these pilots will be adopted on a broad scale and whether employers or patients will receive the benefits of cost savings via reduced premiums, co-payments or deductibles.* West Virginia and Colorado both failed to pass legislation that would either require or incentivize insurers to incorporate medical tourism within their health benefits plans.

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GLOBAL: TUV Rheinland expands services for the spa and wellness industry

Fri, 06 Nov 2009 09:41:14 GMT

TUV Rheinland has expanded its service portfolio for the hospitality and tourism industry to include new services for spa and wellness organizations, as recent international incidents have changed the attitude and expectations of those who travel and therefore the way the tourism sector operates. These new services help tourism operators and hotels distinguish their services from the competition and highlight excellence. TUV Rheinland is an independent international certification body based in Cologne, Germany. Marius Stepien of TUV’s Asian office says, "Each of our services can be conducted independently, but can also be integrated and combined, eliminating the duplication of work, saving time and money. The audits are conducted by mystery guests combined with formal on-site assessments including back office document checks and employee interviews. The evaluation system is multidimensional with mandatory questions as well as supplementary bonus questions. With more than 1000 certifications for hotels and tourism operators in 21 countries, TUV Rheinland offers a wide variety of services in the areas of tourism and health, ranging from training and staff qualification to the certification of quality management systems for wellness resorts, health spas, hotels, tourist offices, cruise ships and fitness studios. Personalized care and comfort is expected to be worth a trillion US Dollars by 2010. Disappointed guests can endanger market image.  An assessment can show how much organisations care for guests by independently assessing service performance with a wellness quality evaluation program. Quality standards vary widely in the international wellness industry, ranging from businesses offering genuine quality and a great experience for the guest, to companies, who just jumped the bandwagon and offer sub-par service and sometimes even life-threatening dangers. As there is no specific system existing to evaluate the quality of the wellness and spa business, the situation makes it increasingly difficult for the customer to make an informed decision. Therefore, TÜV Rheinland has developed a program for quality evaluations of spa hotels, resorts, and day spas, offering a guarantee of genuine quality with third-party certification, helping operators to demonstrate the quality of their service. Over 300 criteria are examined, ranging from the environment through the equipment in the spa area to the qualification of the staff, their attentiveness, and the level of service provided; Assessment of actual hardware and software Standardization and checking of treatments Qualification of employees Improvement of earnings Assured quality for the guest Competitive advantage Objective observation and analysis of quality Independent auditors The wellness and spa programme can be combined with one or more of the other new offerings; eco-hotel, safety and security, and service quality. Eco-hotel allows businesses to demonstrate a commitment towards sustainability and ecological preservation with an independent verification and advice on saving costs by optimizing energy and resource management. Safety and security risk analysis includes physical security, and food safety. Service quality is where customers talk about their experiences - positive or negative. Openly assessed throughout the organization or discreetly checked by mystery guests.

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ARGENTINA: Argentina launches Medicina Argentina medical tourism promotion

Thu, 29 Oct 2009 13:28:55 GMT

After several years when the only promotion of medical tourism to the country was by small agencies and clinics, the Argentine government has launched a medical tourism initiative. The government’s sudden interest in medical tourism is driven by a dramatic fall in tourism to the country because of the effects of the global recession and the swine flu epidemic. In August, the latest month where figures are available, the number of foreign visitors dropped by 31.8 percent compared with 2008, according to a recent government report. With income of $3.36 billion in 2008, tourism was the country’s third-largest source of foreign currency. Trying to make-up the lost $ billion with medical tourism is hugely optimistic, as most medical visits to the country are short-stay cosmetic surgery.  The Argentine government plan to promote medical tourism hopes to attract visitors who divide their stays between getting medical treatment or operations and sightseeing. To get the initiative under way, the National Institute for the Tourist Promotion of Argentina, INPROTUR, has agreed to promote selected medical facilities that will offer lodging and tourist visits to patients from abroad. Tourism Secretary Enrique Meyer says, We are also taking to the different fairs around the world a programme with prestigious medical professionals, latest-generation technology available in the country, personalized attention and comfort, added to unique tourist attractions. This work, that seeks to promote Argentine medicine abroad, will be adopted as a state policy that should remain in place over time, obtaining good income for our country. The government is following on from local clinics who have began offering plans combining treatment with trips to the country’s main tourist locations, including Iguazu Falls and the gigantic Perito Moreno Glacier. These have attracted an unknown number of customers over the past few years who have taken advantage of the low prices in the South American country compared with the costs of European or US medical treatment, particularly following the devaluation of the peso in 2002.Most medical tourists come to Argentina to undergo cosmetic surgery, although there are also people who come for surgical operations, while many childless couples come seeking fertility treatments. INPROTUR is public-private agency responsible for the promotion of Argentina as a tourist destination abroad. Medicina Argentina was organized as a result of the initiative sponsored by INPROTUR and Fundacion Exportar with the purposes of offering healthcare in Argentina: highly-specialized skills of physicians, scientists and technical staff and at the same time making Argentina a medical tourism destination. The Medicine Argentina program includes stays in luxury hotels, as well as a variety of tourist and cultural attractions. At launch it promotes six hospitals, four specialist clinics and four local medical tourism agencies. The website is in English and Spanish, and plans to add more services soon.

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UAE: New website promotes Dubai as a medical tourism destination

Thu, 29 Oct 2009 13:27:27 GMT

With little official marketing or promotion of Dubai, a new private website seeks to fill the gap by showcasing Dubai’s healthcare resources online via a free online service Doctor-Dubai.com. The Ministry of Health (MOH) UAE licensed portal is displaying detailed profiles of 1500 healthcare professionals from more than 280 medical facilities in Dubai to the world, attracting thousands of views every day. The portal lets doctors and companies create their profiles free of cost and display them to hundreds of thousands of visitors from across the globe, highlighting Dubai’s efforts in building excellence of service and value. It charges organisations for advertising. Doctor-Dubai.com is a next-generation website dedicated to helping the people of Dubai find local medical professionals who accept their health insurance and ideally match their requirements. With nearly one and half thousand local providers listed, it has a profile for nearly every individual licensed to practice medicine in Dubai. The site combines detailed provider data with an easy to use search interface to enable users to take the guesswork out of finding the right doctor online. It is an easy mistake to assume that the growing number of health facilities in Dubai are just after medical tourists. Demand for healthcare services in Dubai has increased quickly over a relatively short period of time thanks to rapid population growth and an increasingly unhealthy populace that, analysts believe, will make the demand for hospital beds double by 2025. In the face of this, the UAE government has overhauled the public health infrastructure at primary, secondary and tertiary levels and there are nine major hospital projects underway at a value of $596m. Dubai has invested heavily in specialist care units for the treatment of cardiovascular diseases and cancer over the past few years as its population starts to develop the healthcare woes associated with an affluent society. At Dubai Healthcare City (DHCC), a $1.8bn public-private partnership with the Tatweer group, houses a collection of medical teaching institutions, private hospitals and clinics, pharmaceuticals offices, research facilities, spas and rehabilitation centres. In the future, the private sector is expected to play an increasingly crucial role, with healthcare providers from around the globe eyeing the Dubai market as a potentially lucrative option, and entering into partnerships with local companies. Layla Moufid co-founder of Doctor-Dubai.com is extremely optimistic on the potential, Dubai is expected to be the favourite destination for most of the expected 11 million medical tourists to the UAE by 2010 and we are playing our part in establishing Dubai as the city that cares for your wellness.

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BULGARIA: Can spa and wellness solve Bulgaria's tourism woes?

Thu, 29 Oct 2009 13:25:23 GMT

Having experienced a poor summer season, with earnings and bookings down, Bulgaria’s tourism industry is using the winter months to review the situation and find a solution. While official sources try to play down the problem, private operators say the 2009 situation is bad and likely to get worse. Figures issued by state agencies and the industry initially suggested problems, with official sources saying arrival numbers down by between 4 and 8%, compared to the 20% down that private organisations were reporting. The reality is worse, as Bulgarian tourism this year is expected to record a decrease in revenue of between 20 and 25 per cent, according to Rumen Draganov of the Institute for Analysis and Evaluation of Tourism. Some Black Sea resort regions reported occupancy rates below 25% in the peak month of August, despite having slashed prices by as much as 50%. The poor season has prompted many in the industry to sell up, with 700 of Bulgaria’s 3000 hotels put up for sale on the market, according to figures from the Institute for Analysis and Evaluation of Tourism. The institute says the problem is a mixture of economic crisis, poor standards and increased competition from rivals Greece, Turkey, Italy, Spain, Portugal, and the Northern coast of Africa. To counter the recent downturn and the longer-term malaise predicted by some for the industry, tourism operators and officials are being advised to diversify their product and develop niche appeal rather than continue to promote Bulgaria’s mass-market sun-and-sea image. The EU is Bulgaria’s main source of tourism revenues, with around 75% of visitors coming from Europe. The tourism industry in Bulgaria is largely dependent on the country’s summer seaside resorts and mountain ski resorts. One idea is to increase the profile and the quality of Bulgaria’s spa and wellness tourism segment. Spa and wellness tourism is expected to play an increasing role in the future, and it has been made a part of the state’s national strategy for sustainable development of the sector. Bulgaria has splendid opportunities for the development of a spa and wellness industry, said Anelya Krushkova of the State Agency for Tourism, She suggested that the 8000 mineral springs in Bulgaria are fresh stimulus for the development of that kind of tourism. Shortly after her statement at a Bulgarian conference on spa and wellness, the government abolished the organization, on the basis that the ex-communist state still works on the principle that if something goes wrong it must find someone to blame, and that the government has to find some money after the agency spent 140% of its 2009 budget. A new Ministry of Economy, Energy and Tourism, will now be in charge of the tourism sector. How or even if, it will promote the local spa and wellness industry is too early to say.

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LEBANON: Ministry of Health appoints Accreditation Canada International to improve healthcare

Thu, 29 Oct 2009 13:19:30 GMT

Accreditation Canada International has been selected by the Ministry of Public Health in Lebanon to identify opportunities for improvement in the Lebanese health care system and ensure optimal use of Ministry resources. The six-month project, started in October, involves the review of current Lebanese primary health care standards and the pilot testing of the revised standards with three local health organizations. This project is a key step in accomplishing the Ministry’s goal to upgrade health facilities including hospitals, primary health care centres, laboratories and other health institutions in Lebanon. The further development and enhancement of these standards will help ensure that the people of Lebanon have access to quality, safe and comprehensive health care services and will help to keep Lebanon’s population healthier. Dr. Walid Ammar of the Ministry of Public Health in Lebanon says,Accreditation Canada International will help us in improving the quality of care and overall performance in primary health centres in Lebanon." Wendy Nicklin of Accreditation Canada adds, Accreditation Canada International is proud to be a part of this project and is eager to share its expertise in health care excellence through accreditation with Lebanon’s Ministry of Public Health. This initiative clearly demonstrates the Ministry’s commitment to improve the health and well-being of the Lebanese people by providing them with the best quality health care services possible." This project further establishes Accreditation Canada International’s ongoing contribution to health care in Lebanon. Accreditation Canada International first became involved in the region in May 2009 when it was selected to provide technical support in the auditing of Lebanese acute care facilities. Regional partners in the Lebanon project include United Management Bureau, based in Beirut, Lebanon, and Al-Mashura Health Group, based in Riyadh, Saudi Arabia. Accreditation Canada International specializes in exporting health accreditation expertise worldwide.  It is a not-for-profit, independent organization that provides national and international health and social service organizations with an external peer review to assess the quality of their services based on standards of excellence. Programmes and guidance have been helping thousands of organizations strive for excellence since 1958. Although Accreditation Canada International has not yet accredited any hospitals in Lebanon, it has accredited individual hospitals in Bahrain, Kuwait, Saudi Arabia and the UAE.It is or has been involved in healthcare projects with the governments of Kuwait, Bahrain, Saudi Arabia and the UAE. Very few Lebanese hospitals have any international accreditation, the exceptions being American University of Beirut Medical Center and Clemenceau Medical Center (CMC), both in Beirut and both with JCI status.

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CAYMAN ISLANDS: Are the Caymans an important medical tourism market?

Thu, 29 Oct 2009 13:17:39 GMT

Government ministers of the Cayman Islands and others are promoting medical tourism. Not to the island, as healthcare provision there is poor, but as opportunities in developing inbound medical tourism to the US and elsewhere. Patients from the Cayman Islands who need specialized medical treatment travel to the United States and within Latin America to receive high quality medical care. Health insurance is handled by private insurers and a government-run company (CINICO). There is no universal health coverage. All employers are required under law to provide health insurance for their employees (although the employee may be required to contribute 50% of the premium). The island is a British overseas territory and one of the world’s top tax havens. The territory comprises the islands of Grand Cayman, Cayman Brac, and Little Cayman, located south of Cuba and northwest of Jamaica. A new constitution giving the Cayman Islands greater autonomy from Britain takes effect this November The change will give the Caribbean territory its first premier: McKeeva Bush, one of the ministers promoting outbound medical tourism. The Cayman Islands is the world’s most important hedge fund location and the world’s fifth-biggest banking centre. But it has suffered dramatically because of the financial crisis as its bank licence income slid. Public spending also got out of control, with blame particularly attached to an expensive school building programme. The Cayman Islands is desperate not to levy taxes on residents and financial institutions, fearing they will decamp to other tax havens. The Cayman Islands have endured a difficult year after being singled out specifically by Barack Obama in his presidential campaign last year for allowing aggressive tax avoidance. The Cayman Islands has a limited health care system. There are two hospitals in George Town, the government run George Town Hospital and the smaller private Chrissie Tomlinson Memorial Hospital. Additionally, Faith Hospital is an eighteen-bed facility on Cayman Brac.All are limited in the treatment and surgery they can offer. The government is very close to being broke. It has been negotiating with the UK’s Foreign Office a complex $279 million loan package that has conditions including higher taxes and significant cuts to its public expenditure programme. The deal is close to resolution, but not completed,  and should avert the embarrassment of the island authorities being unable to pay their staff; it is already unable to pay government suppliers. But local political resistance to raising taxes and a change in the UK minister that has to sign the deal off, means the deal is not a foregone conclusion. Although the potential is being talked up, it is worth mentioning that the entire population, including children and pensioners, is at a mere 49,000, a quarter of the size of a London borough.

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INDIA: Medical tourism gets a reality check

Thu, 22 Oct 2009 13:30:48 GMT

Numerous conferences have talked up the potential of medical tourism to India. Many hospitals were led to believe by organisations with a vested interest in painting a rosy picture, that Europeans and Americans would flock to India - Americans because of a non working health system and high prices, and Europeans wanting to escape long waiting lists. The problem is that the rush of medical tourists from those areas is always tomorrow’.  Although Indian hospitals report signing deals with American and European medical tourism agencies, and ongoing discussions with US insurers, deals that actually produce mass business are nowhere to be seen. European health insurers and health authorities are slowly sending a few people abroad for surgery, but not to India or other Asian countries as they feel the long-haul flight is a medical risk for people needing surgery. Indian medical tourism has often talked of 1 million or 2 million medical tourists. These figures sound good but have little relation to reality. Hospital groups now suggest that the figure at best is 300,000 a year, and could even be as low as 150,000. At the Association of Indian Chambers of Commerce’s medical tourism conference in January 2009, a presentation from India’s Institute for Clinical Research said India had treated 300,000 medical tourists back in 2006, but it had no newer figures. India’s medical tourism industry is actually doing quite well and increasing the number of medical tourists. But Indian hospital groups accept that existing numbers and growth will be lower and slower than though in the heady days of 2007 and 2008. They are looking for deals and business, but will be more careful in dealing with entrepreneurs offering the next big deal, and wary of organisations and businesses predicting armies of American and European medical tourists.  The Asian Heart Institute treats 400 international patients each year. Many are government ministers and senior businessmen from Africa and the Middle East .It has been accredited by JCI for three years, and is a modern building with state-of-the-art equipment. The top international surgeon who runs it can offer surgery at a fraction of US or EU prices, but Dr Panda reports that he sees only two or three American or European inpatients each month.  Fortis Healthcare, India’s second-largest hospital chain is also still waiting for the long promised rush of American and European patients. The group hospitals are getting African and Middle East patients who used to go to London or the US. But patients from Canada, Australia, US and Europe are few.  Another top Indian hospital group that welcomes medical tourists, Wockhardt, only treated 3,500 foreign patients in 2008,of which about half came from the US and Europe. Wockhardt expects the number of foreign patients to rise by 38 per cent this year. Apollo Hospitals and Wockhardt Hospitals have spent a lot of time and money seeking international business, and both believe that the effort is beginning to show positive results, but that growth will be slow and steady.

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USA: American hospitals fight back against overseas medical tourism

Thu, 22 Oct 2009 13:29:25 GMT

To compete with lower international pricing for lap-band weight loss surgery the Metabolic Surgery Center at Baptist Hospital has created a lap-band wellness stimulus package. The cost has been reduced by 25 percent, from $16,100 to $12,000, only for self-pay patients who schedule lap-band weight loss before the end of January 2010. The package includes the surgical procedure with no overnight stay or complications, as well as three months of lap-band adjustments and consultations with the hospital’s dieticians and exercise physiologists. Bernie Sherry of Baptist Hospital says, "The package is competitive with medical tourism travel rates. Medical tourism is gaining popularity as patients cross the border to Mexico where costs of surgery are lower. By receiving treatment at Baptist Hospital, self-pay patients receive both financial value and high quality care from an accredited centre of excellence." Dr. Charles Morton, medical director of the Metabolic SurgeryCenter, says thousands of patients travel to Mexico each year for lap-band surgery, "In some places, medical qualification standards for physicians and health care facilities are very different than they are in the United States and there is no follow up care once the patient is back home." The hospital expects the new package to draw patients from across the country and to help this has developed travel packages with special rates on hotel and air travel. The Metabolic Surgery Center at Baptist Hospital offers one of the most comprehensive weight loss surgery programmes in the country. It is designated as a bariatric surgery centre of excellence by the American Society for Metabolic and Bariatric Surgery (ASMBS). Apart from in the USA, the only two international centres of excellence of bariatric surgery are both in London. In Flint, Michigan, McLaren Health Care’s new proton therapy centre will open in 2012. The revolutionary treatment facility will encourage patients to come to the Flint area for cancer treatment at the Great Lakes Cancer Institute. The facility will be Michigan’s first proton beam therapy centre. McLaren predicts an influx of medical tourists from neighbouring US states and Canada. The hospital is considering how best to serve patients and their families who would be staying in the Flint area for six to eight weeks at a time for a standard course of treatment. McLaren is open to considering options from contracts with existing hotels to partnering with someone to build a new extended-stay facility. Cancer patients will be able to receive one of the most advanced forms of treatment available due to a partnership formed between McLaren Health Care and ProTom International, a Texas-based medical device company focused on proton therapy for cancer patients. ProTom’s proton therapy system, the Radiance 330, uses smaller machines so proton beam centres can be built for about one-third the cost and on a much smaller area than conventionally built centres that span the size of a football field. McLaren Health Care’s Philip A. Incarnati says, Proton beam therapy represents an innovation in cancer treatment, and we will bringing such an important advancement to patients across the Midwest."

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SINGAPORE: Why National Heart Centre Singapore sought JCI accreditation

Thu, 22 Oct 2009 13:27:39 GMT

National Heart Centre Singapore (NHC) is a tertiary referral centre within Singapore Health Services. This 185-bed facility is the national and regional referral centre for cardiovascular disease and cardiothoracic surgery, and a public hospital in Singapore. In 2005, NHC became the first heart hospital in Asia to be accredited by JCI and was re-accredited in 2008. NHC’s mission is to provide excellence in health care and initially sought JCI accreditation to improve its patient care processes and outcomes. Dr Teing-Ee Tan, senior consultant surgeon, says NHC wanted to reinforce our commitment to quality care for patients as well as ensure a safe environment and continually work to reduce risks to patients and staff. NHC decided to obtain accreditation from JCI because the JCI accreditation process is designed to accommodate specific legal, religious, and cultural factors within each country, an important consideration for a multicultural society like Singapore. Post-accreditation, NHC has experienced numerous positive impacts: increased levels in patient comfort and satisfaction, a safer environment for patients and staff, and improved staff performance. More emphasis is placed on the quality of care for patients. And patients’ and families’ rights are given higher priority and respect. A systematic approach has been established for individually assessing the clinical quality of medical specialists. Professional policies and guidelines have also been established to standardize care and improve clinical outcomes. The risk of medication errors has been reduced with improved storage and labeling of medications. Also, the risk of harm to patients, including the threat of patient falls, has been reduced, due to the implementation of new protocols. Better patient identification processes have helped ensure that patients receive the proper procedures and medications. Communication and patient education have also been enhanced and made more effective, helping to increase patient satisfaction. Joanna Chia, NHGP’s quality manager, says her organization has a philosophy of continuous improvement, and sought JCI accreditation to gain a holistic review of the many facets of care delivery. Greater focus on analyzing data and tracking improvements was a direct result of the JCI accreditation process. Through this process, managers are more willing to look at data and to discuss problems and effective improvements based on data. Increased staff compliance with hand hygiene guidelines is another area in which NHGP sustained improvements.  The preparation process helped NHGP to define the service it is delivering and the equipment necessary to deliver the care. It uncovered many areas for improvement, addressed them systematically, created policies and procedures and worked to embed these improvements in work processes. Since accreditation NHC has experienced a gradual influx in foreign patients. National Heart Centre Singapore’s International Medical Services (IMS) team provides a wide spectrum of services to patients from overseas and their families. A multi-disciplinary team from the NHC’s Heart and Lung Transplant Unit and SGH’s Liver Transplant Service successfully performed the first-ever combined heart and liver transplant in Asia in early April 2009. NHC is currently the only centre in Singapore that performs robot-assisted mitral valve repairs.

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EUROPE: The EU Health Commissioner on healthcare budget restraints and patient safety

Thu, 22 Oct 2009 13:25:29 GMT

EU Health Commissioner Androulla Vassiliou has directed a serious warning to her fellow policymakers at the 12th European Health Forum Gastein (EHFG), There is now a risk that decision-makers are being tempted to think short term and to make cuts in the health budget. The crisis is causing increased psychosocial stress and in many cases an increase in hazardous behaviour such as alcohol abuse, smoking and unhealthy nutrition. For this reason the demand for health services will significantly rise as a result of the crisis. The Commissioner’s warning that now is totally the wrong time for governments to cut health spending is against a background where several EU governments are using sleight of hand in their budgets. Even if what they spend is static or increased slightly, the demand for and cost of services is growing faster than even increased budgets can cope with. The UK is one of the first to reluctantly admit that over the next decade, the government will not be able to spend as much on the NHS as is really needed. On cancer, patient safety and electronic records, the EU is making great strides. The Commission proposal on the issue of patient safety has made quality assurance a highly regarded healthcare issue throughout the EU. The European Partnership against Cancer initiated by the Commission facilitates coordinated cross-border measures The European Network for Patient Safety (EUNetPaS) was officially launched in Utrecht, Netherlands in 2008. The project aims to establish an umbrella network of all EU member states to encourage and enhance collaboration in the field of patient safety. Patient safety is a global issue affecting countries at all levels of development. Understanding the magnitude of the problem and the main contributing factors is essential in order to devise appropriate solutions. An international expert working group set up by WHO Patient Safety produced a list of global research priorities that indicate areas with substantial knowledge gaps and where it is expected that further knowledge will significantly contribute to improving patient safety and reducing harm. The WHO study ranks the priorities for patient safety in developing countries, transitional countries and developed nations and identifies the differences and similarities for each. One of the significant outcomes was that issues of effectiveness and cost effectiveness were most important for developing nations while issues of communication and safety culture were ranked most highly for developed nations. Patient safety is a fundamental principle of health care. Every point in the process of care giving contains a certain degree of inherent unsafety. Patient safety is a serious global public health issue. Estimates show that in developed countries as many as one in 10 patients is harmed while receiving hospital care. In developing countries, the probability of patients being harmed in hospitals is higher. The risk of health care-associated infection in some developing countries is as much as 20 times higher than in developed countries. Patient safety is an area that many agencies and hospitals targeting medical tourists have not yet taken seriously enough.

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SOUTH KOREA: Medical tourism debate in Seoul

Thu, 22 Oct 2009 13:24:00 GMT

The Seoul International Medical Tourism Congress (SIMTC) in September gave local hospitals the chance to reflect on medical tourism’s expansion in Korea, discuss better business practices, and create connections with hospitals across the globe, including India, China, the USA, and Russia. Korea’s international medical tourism is seeing a 30 percent increase in overseas patients despite the ongoing global recession and the H1N1 influenza outbreak. Serious help from government and other national bodies has made all the difference, and is a lesson to countries that think that inbound medical tourism can increase without such help. Kuwait’s Ministry of Health is considering sending patients to South Korean hospitals for treatment. Speaking after a tour of South Korean medical facilities, ministry official Qais Al-Dowairy said that hospitals in the country were advanced and included state-of-the-art equipment, as well as highly skilled staff. South Korea is aiming to become the number one destination for patients from oil-rich Arabian Gulf states.  277 South Korean hospitals and clinics have expressed interest in treating Kuwaiti patients in Korea. The number of foreign patients receiving treatment in South Korea is expected to reach nearly 50,000 by the end of 2009, compared to 40,000 in 2008, earning US$48 million. The South Korean government has declared medical tourism as a next-generation growth engine. Local governments plan to build health care clusters for medical tourism to attract foreign patients. Daegu has launched Medi Citi as its own brand, arranging for 40 hospitals to prepare English, Japanese and Chinese brochures, opening websites in foreign languages and participating in international conferences and exhibitions. Osong and Daegu are both building medical complexes. Busan is a popular medical tourism destination among the Japanese for weekend cosmetic surgery. The local government runs a call center for translation services for foreign patients. Gangwon-do seeks to develop medical tourism in Gangwon province, targeting 10,000 foreign patients. The Jeju Healthcare Town is a joint project of the South Korean Government and the private sector. Jeju hopes to attract medical travellers to Jeju Island’s clean and beautiful natural environment with cutting-edge health care. Jeju Healthcare Town will hold a groundbreaking ceremony around the year’s end and plans to open in early 2011. Projects in The Wellness Park, a medical relaxation complex for beauty, prevention, health and relaxation will open in 2011 and 2012.Those in The Medical Park, a high-tech medical complex for various high-quality specialized treatments; will open in 2013 and 2014. International companies wanting to invest will get local tax exemption, housing, special employment benefits for newly hired employees, corporate tax incentives, registration tax incentives, and property tax incentives for customs duties.

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ARGENTINA: Study examines ethical dilemmas of medical tourism

Thu, 22 Oct 2009 13:21:42 GMT

Medical tourism in Latin America needs to be regulated to protect consumers, according to Université de Montréal researchers. A new study published in the journal Developing World Bioethics argues that Argentinean fertility clinics are increasingly marketing themselves to international health care consumers: these clinics offer all-inclusive packages with fixed prices that feature airfare, accommodations, transfers, language interpreters and fertility treatment. The appeal of such packages is obvious: healthcare consumers need not worry about any of the practical details of their trip budgeting, travel arrangements or language barriers and can instead focus on obtaining quality medical services combined with a vacation. Non-accredited clinics in Argentina offer much more competitive prices for services in comparison with clinics in North America or Europe. For example, in vitro fertilization in the United States runs upwards of $10,000 U.S. per cycle of treatment, says Bryn Williams-Jones, a bioethics professor in the Université de Montréal’s Department of Social and Preventive Medicine, who coauthored the paper with graduate students Elise Smith, Carolina Martin and Jason Behrmann. An increasing number of private fertility clinics have opened in developing countries such as Argentina over the last decade and are attracting consumers through lower pricing. There are two subcategories of medical tourism clinics: accredited centres that are part of the broader healthcare industry and non-accredited clinics focused on medical tourism. India and Poland are actively involved in the fertility sector, so too now are Latin American countries such as Brazil, Chile, Mexico and Argentina. Reproductive tourism clinics are targeting wealthy North American or European couples through the Internet. The main interest for these individuals to become medical tourists is the high cost, long waiting lists, or even the absence of access assisted reproductive technologies services at home. Developed and developing nations have encouraged the practice of medical tourism, the authors argue, because of the economic spin-off. Legislation and professional guidelines both local and international are needed to regulate the conduct of private fertility clinics in order to ensure that services are safe and effective. It is in the best interests of consumers, health professionals and policy makers that the reproductive tourism industry adopts safe and responsible medical practices, says Dr. Williams-Jones.This study was supported by the Social Sciences and Humanities Research Council of Canada, the Fonds de la recherche en santé du Québec, COPSÉ and the Université de Montréal’s Faculty of Medicine. The paper, Reproductive Tourism in Argentina: Accreditation and its Implications for Consumers and Policy Makers, published in Developing World Bioethics, was authored by Elise Smith, Carolina Martin, Jason Behrmann and Bryn Williams-Jones of the Université de Montréal.

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SOUTH KOREA: Medical tourism debate in Seoul

Fri, 16 Oct 2009 11:23:56 GMT

The Seoul International Medical Tourism Congress (SIMTC) in September gave local hospitals the chance to reflect on medical tourism’s expansion in Korea, discuss better business practices, and create connections with hospitals across the globe, including India, China, the USA, and Russia. Korea’s international medical tourism is seeing a 30 percent increase in overseas patients despite the ongoing global recession and the H1N1 influenza. Serious help from government and other national bodies has made all the difference, and is a lesson to countries that think that inbound medical tourism can increase without such help. Kuwait’s Ministry of Health is considering sending patients to South Korean hospitals for treatment. Speaking after a tour of South Korean medical facilities, ministry official Qais Al-Dowairy said that hospitals in the country were advanced and included state-of-the-art equipment, as well as highly skilled staff. South Korea is aiming to become the number one destination for patients from oil-rich Arabian Gulf states.  277 South Korean hospitals and clinics have expressed interest in treating Kuwaiti patients in Korea. The number of foreign patients receiving treatment in South Korea is expected to reach nearly 50,000 by the end of 2009, compared to 40,000 in 2008, earning US$48 million. The South Korean government has declared medical tourism as a next-generation growth engine. Local governments plan to build health care clusters for medical tourism to attract foreign patients. Daegu has launched Medi Citi as its own brand, arranging for 40 hospitals to prepare English, Japanese and Chinese brochures, opening websites in foreign languages and participating in international conferences and exhibitions. Osong and Daegu are both building medical complexes. Busan is a popular medical tourism destination among the Japanese for weekend cosmetic surgery. The local government runs a call center for translation services for foreign patients. Gangwon-do seeks to develop medical tourism in Gangwon province, targeting of 10,000 foreign patients. The Jeju Healthcare Town is a joint project of the South Korean Government and the private sector. Jeju hopes to attract medical travellers to Jeju Island’s clean and beautiful natural environment with cutting-edge health care. Jeju Healthcare Town will hold a groundbreaking ceremony around the year’s end and plans to open in early 2011. Projects in The Wellness Park, a medical relaxation complex for beauty, prevention, health and relaxation will open in 2011 and 2012.Those in The Medical Park, a high-tech medical complex for various high-quality specialized treatments; will open in 2013 and 2014.International companies wanting to invest will get local tax exemption, housing, special employment benefits for newly hired employees, corporate tax incentives, registration tax incentives, and property tax incentives for customs duties.

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EUROPE: Countries must tackle fraud and corruption in health tourism

Thu, 15 Oct 2009 12:38:03 GMT

100 delegates from 16 countries representing ministries of health, sickness funds, healthcare providers and other parties committed at the European Healthcare Fraud and Corruption Network (EHFCN)’s Annual Conference to strengthen co-operation in their fight against healthcare fraud and corruption. Centered on the theme of Cross-Border Healthcare in Europe, the conference discussed possible consequences of the draft EU directive 2005/36/EC-giving patients and practitioners the right to free movement throughout member states. Paul Vincke, president of EHFCN said, Although EHFCN supports patients and healthcare providers mobility, we also warn decision makers of the risks of increased fraud and corruption in this sector. We call on them that provision is made to reduce losses to a minimum. We also look forward to implementing solutions that were advanced at the conference. An estimated 80 billion euro is lost to fraud and corruption in the healthcare sector every year. Let us eliminate fraud for the benefit of healthcare systems in Europe and the ultimate benefit of every patient". Cooperation between member states and between healthcare parties is perceived a key to successfully tackling cross-border fraud and corruption. Sharing information is vital and can be started on a small scale between neighbour countries. An example is the bilateral cooperation agreement between the French health insurance fund for salaried employees (CNAMTS) and the Belgian National institute of disability and health insurance (INAMI/RIZIV). The purpose of this agreement is to facilitate the quick exchange of files and information in order to improve research and investigation. The agreement will take effect in 2010. An important tool to assess risk and outline issues and contributing factors affecting fraud was presented by members of the EHFCN Cross-Border Fraud Working Group. The matrix is designed to identify the most important obstacles that member states are likely to encounter in their work of prevention, detection and sanctioning of fraud. It is particularly intended to be used in a cross-border context, taking into account that member states have different healthcare and legal systems. The matrix helps to analyse the types of fraud that can derive from specific risk factors such as legal loopholes or lack of access to information or treatment, for every party involved (governments, practitioners, patients, insurers). Representatives shared their experience and best practices in tackling fraud and corruption. EHFCN also conferred its first Excellence Award on Ewa Kopacz, Minister of Health for Poland, where tangible progress has been made towards an anti-fraud and anti-corruption culture within the Polish healthcare system, thanks to her continued efforts and determination. The European Healthcare Fraud and Corruption Network (EHFCN) was established in 2005. EHFCN is the only European organisation dedicated to combating healthcare fraud and corruption across Europe in order to bring back money to healthcare services for the benefit of every patient. EHFCN provides information, tools, training and assistance in fighting fraud and corruption to its member associations. It also offers a platform for members to exchange information and ideas. The matrix proposed by the Cross-Border Fraud Working Group is based on the Enterprise Risk Management-Integrated Framework (COSO ERM Framework). The framework provides a solid foundation that can be used by companies to enhance corporate governance and deliver greater stakeholder value.

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PHILIPPINES: Plans to develop medical tourism

Thu, 12 May 2011 15:49:13 GMT

Cebu Doctors’ University Hospital (CDUH) has obtained international accreditation, a development to boost medical tourism. CDUH is the first hospital in the Philippines to receive full-accreditation for two years by QHA Trent, a health care company owned and managed by a group of doctors and experts in the UK. QHA Trent is looking into accrediting more local hospitals. The accreditation assures patients that the hospital has all safeguards, policies and procedures in place to ensure high-quality health care. Tim O’Carroll of QHA Trent says,” With the Philippines looking increasingly to promote medical tourism, the need for local hospitals to obtain international accreditation is increasingly important. QHA Trent’s doctors and experts are actively working within Britain’s NHS, the world’s largest publicly funded health system.” CDUH and two other big private hospitals, Chong Hua Hospital and the Perpetual Succour Hospital, are spearheading efforts to make Cebu a destination for medical tourism. The three hospitals will work with the Department of Tourism (DOT), Department of Trade and Industry (DTI) and the Board of Investments (BOI) to make the plan a reality. Macau is the first place in Asia to have a branch of The Malo Clinic medical spa that offers implant and cosmetic dentistry as well as cosmetic surgery. Currently the clinic can also be found in Brazil’s Sao Paulo, New Jersey in the United States and Lisbon in Portugal. Malo has three clinics under construction in Angola’s Luanda, Tokyo and Casablanca, which are all expected to be opened within the year. Four more clinics are under negotiation, two in Asia, one in the United States and another in Europe The Malo Clinic sees Macau as a stepping-stone for eventual expansion of the business to continental China. Paulo Malo comments,” We decided to come to Asia for a simple reason. In Asia health care is not of a standard as what we have in Europe and the United States, especially dental health care that is very low quality. Quality of life starts with prevention rather than solving problems later. For Macau’s future as a possible medical tourism destination, there is no point of being the best in the world if people don’t know that you are here, so visibility is very important. If we had a cluster of brand clinics with different specialties then Macau would become visible in Asia.” The Macau clinic receives patients mostly from Mainland China, Hong Kong and South Korea. Medical tourism promises to be a boon for the Philippines: the National Economic Development Authority expects the industry to be worth $3 billion, with an influx of about 200,000 foreign patients each year, by 2015.

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CHINA, TAIWAN: China and Taiwan seek to make most of medical tourism

Thu, 12 May 2011 15:43:13 GMT

Shanghai is expected to attract 50,000 to 100,000 foreign patients in the next three years, each spending an average of $10,000 to $15,000 per trip, says Dr Yang Jian, of China Medical Tourism Company, "We aim to turn Shanghai into Asia’s leading medical destination for advanced patient care." Shanghai will promote medical tourism this year by increasing overseas marketing. It also has a medical tourism products and promotion agency, Shanghai Medical Tourism Products & Promotion Platform (SHMTPPP) which is jointly supported by five municipal bureaus to offer a link between patients and Shanghai hospitals. Fierce competition in the market means Shanghai will focus on its specialties, namely gamma knife therapy, traditional Chinese medicine and stem cell technology. Every year, more than 300 Argentineans come to Shanghai for gamma knife surgery, which is banned in some countries. For some local companies, selling medical travel packages to growing numbers of Chinese customers wishing to receive treatment abroad is already big business. Now, Chinese firms want to promote their own facilities at home to growing numbers of foreign medical tourists. Medical tourism promoters Ciming Health Check Group and its partner, the China Medical Tourism Company, can no longer afford to ignore China as a medical tourism destination. China’s major urban centers of Beijing, Shanghai and Guangzhou have already attracted growing numbers of medical tourists due to advanced technology, high quality of service, and affordable prices. Despite the ever-increasing quality of China’s medical facilities, lack of awareness as well as language and cultural barriers remain a challenge to attracting more patients. Taiwan’s medical resources are on par with those found in Europe and the U.S., but it lags behind leading regional medical tourism destinations. 85,000 medical tourists visited the country last year for treatment. Taiwan has been seeking to expand its presence in this industry since 2004, but lack of funding meant that large-scale overseas promotion of the nation’s medical tourism facilities did not begin until 2007. The launch of direct cross-strait flights, along with the opening of Taiwan to more mainland Chinese tourists, has seen more visitors keen on cheap travel costs and a similar language and culture. Although only 15,000 mainland Chinese will travel to Taiwan as medical tourists in 2012, the government believes this number is set to eventually hit 75,000, or 5 % of total visitor numbers. Taiwan attracts the new middle-class of Mainland Chinese looking for treatment overseas. The Taiwan government plans to develop special international medical zones. It is currently seeking some private investment for the planned project at Taiwan Taoyuan International Airport that has a target of 40,000 medical tourists. Taiwan has at least three other such zones in the pipeline. But for these to go head to head with international competitors, the government must amend or at least liberalize the Medical Care Act under which hospitals and healthcare centers are banned from advertising for patients. It also needs to review laws covering the employment of foreign doctors.

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USA: Obama wants to curb medical tourism to Mexico and India

Thu, 12 May 2011 15:42:07 GMT

In response to a question about why US health insurance won’t cover medical expenses incurred abroad, US president Barack Obama answered that his aim is to change the US healthcare system to discourage Americans from seeking medical treatment in India and Mexico. ”My preference would be that you do not have to travel to Mexico or India for cheap healthcare. I would like you to be able to get high quality treatment right here in the United States of America. Before we go down the path of you can go somewhere else to get your healthcare, let us work to see if we can reduce the costs of healthcare here in the United States of America. That is going to make a big difference. Prices of prescription drugs must be brought down so that you don’t feel like you are getting cheated because you are paying 30% more or 20% more than prescription drugs in Canada or Mexico." The Indian press in particular has picked up on the comments. Watch the YouTube video - Obama targets India again. While previously having stayed neutral on medical tourism, in the run up to the elections last November, Obama repeatedly brought up off-shoring to India and indicated how he intended to change rules to keep US jobs from going to India to save money. There has been a strong suggestion that Obama wants to reduce the US spending on overseas goods and services, partly to protect US jobs and partly to help solve economic problems; but the speech at a community college in Virginia is the first time that he has openly attacked medical tourism. Although almost always promoting medical tourism to Americans as offering vastly cheaper treatment in India than in the USA, Indian politicians and doctors have taken offense at Obama suggesting that Indian healthcare is cheap. Health minister Ghulam Nabi Azad says, "Affordable healthcare does not mean our medicine is inferior to any superpower." Dr Naresh Trehan of Global Health adds, “People from advanced countries like the US come to India because the quality of medical treatment here is at par, at times even superior, and more affordable.” Dr H. Sudarshan Ballal of Manipal Health Enterprises, agrees, "Cheap means sub-standard. It is definitely not the truth about healthcare in India. The medical care here is on par with, if not better than, in the US." Dr Vinay Agarwal of the Indian Medical Association is unconcerned; " It only tells us that the US feels threatened by India as we are competing with them in providing quality healthcare at a cheaper cost. People in the US are conscious about quality but are still choosing India because all health technologies are available here while the cost is 10 to 15 times less." In the college speech Obama said his plan is to ask the wealthy to pay more, which would save Medicare and Medicaid by making them more efficient, and would increase spending on education, energy research and roads. He described Medicare as one of the most important pillars of US social safety net. Medicare is a government run social insurance programme providing health insurance coverage to people aged 65 and over and Medicaid is a health programme for people with low incomes and resources. A Republican budget plan passed by the House of Representatives would gut Medicare and Medicaid to finance more tax cuts for the wealthy, Obama said. Obama’s comments have to be taken in the context that he faces stiff opposition from Republicans on health reform and decreasing the budget deficit –while attempting a tight rope act of reducing government spending at the same time as increasing government spending on healthcare.

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EUROPE: Tissue authority to set European organ transplant standards

Fri, 06 May 2011 11:27:21 GMT

The Human Tissue Authority (HTA) has been selected as the body that will set standards for the quality and safety of transplant organs across the EU.The HTA has also been named as the organisation for England, Wales, Scotland and Northern Ireland, for the EU Organ Directive and will take the lead on developing a regulatory framework and implementation into legislation by August 2012. It is the first time a formal regulatory framework has been developed for the donation and transplant of organs. The aim is to standardise the systems and processes used by member states. It will also assist in a more effective exchange of organs between member states on the small number of occasions where this is necessary. The ultimate goal is to ensure common high quality and safe standards for the donation, procurement, transportation, traceability and follow up of donated organs for transplant across the EU. The intent is to:• Create an overall framework that will ensure the all organisations involved in organ donation and transplantation comply with the directive.• Develop a system to license procurement and transplantation.• Confirm arrangements for reporting serious adverse events and reactions.• Issue guidance to healthcare providers involved in all stages of the transplant chain.• Supervise organ exchange between member states. The EU Organ Donation Directive will improve the quality and safety of organs to be transplanted into patients across Europe. EU member states must be compliant with the EU Directive 2010/53 EU by August 2012 The number of organ donations and transplantations has grown steadily across the EU and thousands of lives are saved every year through this medical procedure. Organ transplantation is now the most cost-effective treatment for end-stage renal failure. Currently, there are wide variations in quality and safety requirements between member states. A directive is needed to ensure a high level of health protection throughout the EU by establishing common standards of quality and safety of human organs intended for transplantation and for those exchanged between EU countries each year. The HTA aims to maintain confidence by ensuring that human tissue is used safely and ethically, and with proper consent. The HTA regulates organisations that remove, store and use tissue for research, medical treatment, post-mortem examination, teaching and display in public. It also gives approval for organ and bone marrow donations from living people. The EU Organ Donor Directive (ODD) is a European requirement that aims to bring all EU countries up to the same high quality and safety standards. With better organs available in the EU, more citizens may benefit from the availability of suitable organs transferred from across Europe. The ODD will affect governance and clinical practice in organ donation and transplantation. A full copy of the EU Directive can be found here.

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EUROPE: ESHRE sets standards for cross border reproductive care

Fri, 06 May 2011 11:25:53 GMT

The European Society of Human Reproduction and Embryology (ESHRE) is setting the first ever standards in cross border reproductive care .The safety of patients, donors, surrogates and future children take centre stage in ESHRE’s Good Practice Guide for Cross Border Reproductive Care. The guide aims to ensure high-quality assisted reproduction treatment as defined by the European Union criteria for good quality medical treatment and the ESHRE position paper on good clinical treatment in assisted reproduction. Although in principle foreign and local patients should be treated the same and with the best possible treatment, there is evidence that this is not always the case. The guide is based on the core principles in health care: equity, safety, efficiency, patient centeredness, timeliness’ and effectiveness. The principle of equity means that any difference between local and foreign patients should be justified, for instance the extra cost for a translator. Foreign donors should receive similar care to patients and local donors. No distinctions are to be made based on their origin and/or motivation. ESHRE recommends that national and foreign donors receive comparable compensation and that the recruitment criteria are the same. According to the ESHRE task force, the ideal is fair access to fertility treatment at home for all patients. However, often faced with no realistic alternatives due to legal restrictions, long waiting lists, lack of donors or unavailable or expensive treatments, patients travel across borders and may not receive adequate treatment in the country of their choice. Dr. Françoise Shenfield of ESHRE says.” Doctors should consider the principles of beneficence and non-maleficence together and aim at producing minimal risks with a maximum chance of pregnancy. Treatments should abide by good practice rules, such as a restrictive embryo transfer policy to eliminate high order multiple gestations. To prevent abuse of donors coming from abroad, intermediate agencies should be avoided, since this may lead to violations of the rules of good clinical practice and, in the worst case, to trafficking. Our recent study showed that an estimated 14,000 cycles of treatment are performed annually for infertile patients crossing borders in six European countries alone. The total number in Europe is therefore much higher. Together with collaborators such as egg donors or surrogates that also cross borders to provide reproductive treatment outside their home country, cross border care is a wide spread phenomenon.” Patients should receive clear information about necessary tests, their costs and realistic waiting times; donors should receive a stimulation cycle that minimizes their health risk. In order to obtain information on repeated donations and to be able to verify legal restrictions on donations, ESHRE recommends the establishment of national registers of donors and for centres to participate in data registries. Legal advice about local rules should be given to patients at home and abroad. Potential legal problems in their home country should be outlined to patients. Clinics should follow up on children conceived after treatment at home and abroad. Collaboration between the home practitioner and the receiving clinic offers the best chance of optimal care for the patient. The principle of patient centeredness includes adapting practical management to foreign patients. Counselling and psychological support should be available in a language understood by the patient. If this cannot be guaranteed, ESHRE recommends not treating the patient. This is important since the patients have to give proper consent. Clinics should provide patients with the details of their ombudsman or complaints department in order to give them the possibility to redress their grievances. The ESHRE task force aims to enroll as many signatures as possible to the good practice guide from regulatory bodies, fertility societies and clinics. The International Federation of Fertility Societies (IFFS) has already agreed to it in principle. Richard Kennedy of IFFS says,” ESHRE produces important European guidance. The movement of patients across international boundaries has emerged as an increasingly important global phenomenon providing significant challenges to safeguarding patient safety. In practical terms, this means that often patients will travel to countries where standards of care may be very different to that available in their home country, or where there is variability of care from clinic to clinic. It is inevitable in such a rapidly growing and internationalised field, that there will be wide variation in practice and development of services. We need to ensure the global infertility industry commits to common goals in standards of care to achieve the goal of maximum patient safety."

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INDIA: Report proposes incentives for hospitals to promote health and wellness tourism

Fri, 06 May 2011 11:17:01 GMT

The Indian government should provide tax incentives to hospitals to promote India as a health and wellness tourism destination, says a report by Federation of Indian Chambers of Commerce and Industry (FICCI) and Yes Bank. The report, ’Health and Wellness Tourism – Advantage’, offers a 10-point agenda for boosting health and wellness tourism in India. It recommends encouraging medical tourism by offering tax-breaks and export incentives to participating hospitals. It says that the focus should be to market the country’s health and wellness product in a way that would attract the maximum number of tourists, especially from America and Europe. It suggests that the marketing of alternative forms of wellness packages (ayurveda, yoga, naturopathy, unani), as follow up practices to surgery will lengthen the stay of the tourist in the country. Another key recommendation is that there must be mandatory quality accreditations for Indian hospitals. It highlights the need to provide good quality accommodation, hospitals and post treatment recuperative centres. The study also suggests setting up a national organisation to provide information to foreign patients on Indian hospitals, and act as a marketing and sales agency. It also recommends setting up health care medi-cities on the lines of the Chettinad Health City in Tamil Nadu to further boost the sector. Thomas Cook (India) Limited has a strategic partnership with the Indian Institute of Tourism and Travel Management (IITTM). Together they have designed a postgraduate diploma in management in international business, focusing on tourism. It will be a two-year full-time residential course offered at the IITTM campus in Gwalior (Madhya Pradesh). The course module will include business travel, medical tourism, tourism service quality, intercultural management and research. The teaching methods will be case based learning. The first course will begin in June.

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ICELAND: Geothermal water is white gold in health tourism

Fri, 06 May 2011 11:14:18 GMT

“Geothermal water is Iceland’s white gold,” said health tourism consultant Csilla Mezösi at the annual meeting of the Iceland Association for Health Tourism. Iceland’s most famous commercial spa is the Blue Lagoon, which is visited by more than 400,000 people annually. Myvatn Nature Baths is a newer smaller version. Fontana Steam Bath capitalizes on a natural steam vent next to Laugarvatn Lake and is scheduled to open this summer. Csilla Mezösi believes Iceland’s abundant supply of geothermal energy provides the opportunity for the development of health tourism, which is still in its infancy in Iceland, “Iceland has barely started tapping into this genre of tourism, although there is a lack of information on the number of tourists who actually visit Iceland with the purpose of improving their health. Reykjavik’s public geothermal swimming pools are of a high quality and clean so offer opportunities to build hotels next to the pools for greater convenience for foreign visitors. The country could organize dance parties in the thermal pools in winter to attract young tourists in the low season. It should get the Olympic handball team medalists to promote health tourism in Iceland. Health tourism incorporates both spa tourism, as well as medical tourism. However, a typical spa tourist focuses on different things than a medical tourist. Spa tourism involves a holiday whereas medical tourism involves cost-effective operations but more importantly a guarantee of a follow-up service after the treatment.” Iceland offers many ways to relax and recover from life’s tensions through physical activity. The warm water that is found so abundantly in the Icelandic soil provides opportunities for relaxation and recreation. Every village or town has a swimming pool. In some places you can swim in natural bluish water, rich in minerals and soothingly warm. The country has very low levels of pollution and a high life expectancy. The Blue Lagoon’s ecosystem is unique. Spa treatments and massages use the energy of geothermal seawater and its active ingredients: minerals, silica and algae. The treatments take place both inside and in the lagoon itself, in the open air. Floating in the mineral-rich water, in close proximity to the Blue Lagoon’s extraordinary environment, surrounded by the natural elements and pure Icelandic air, is a unique experience for body and mind. The geothermal seawater is led directly to the Blue Lagoon from wells as deep as 2000 m. and the water stays warm and inviting at 36-39° C/100-110°F throughout the whole year. An indoor Blue Lagoon and geothermal sauna are also on the site. The white silica mud gently cleanses and exfoliates the skin and has a revitalizing effect while the blue green algae nourish and soften the skin. The mineral salts balance and relaxes body and soul.

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IRELAND: New dental patient information for Irish customers

Fri, 06 May 2011 11:06:21 GMT

The Dental Council of Ireland has launched guidance documents for dental patients. A guide to assist members of the public in choosing a dentist at home or abroad has been issued. This is the first time that the council has issued guidance that has been aimed primarily at patients and members of the public. All dental practices throughout Ireland will be obliged to display private fees from June 1. The Dental Council issued a Code of Practice making it mandatory for dentists to display private fees in a place where patients can view them before consultation. A single fee must apply for some procedures while the fees for others may be shown as a range, with a minimum and maximum clearly stated. Where a range of fees applies, it is not permitted to set a minimum price only. Dr Eamon Croke of The Dental Council of Ireland explains, "Patients will be able to check fees in advance for a range of treatments including examinations, x-rays, routine and surgical extractions, root canal treatment and crowns. A single fee must apply for some procedures while the fees for others may be shown as a range, with a minimum and maximum clearly stated. Where a range of fees applies, it is not permitted to set a minimum price only.” The fees notice must be at least A4 size and be legible, accurate and up-to-date. The fees must be prominently displayed in the practice and must be situated in a place where the patient could reasonably be expected to see it before the consultation “Choosing a Dentist at Home or Abroad” is a guide to assist members of the public in choosing a dentist. The guidance also includes information for patients who may consider travelling abroad for treatment highlighting certain matters that should be considered in advance. It goes into great detail on what to look for, questions to ask, and things to consider. The document agrees that high quality dental care is available overseas. The areas of investigation it suggests include- · What qualifications and experience does the dentist have? · What is he/she a specialist in? · Can we understand each other? · What aftercare is provided? · Who pays for remedial work and related costs? · What are my legal rights? · Can remedial work be done at home? · Who can I contact for advice? · Can I have my records and what language are they in?

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JAMAICA, BARBADOS, TRINIDAD AND TOBAGO, GUYANA, ST KITTS AND NEVIS : Caribbean islands investigating potential of medical tourism

Wed, 20 Apr 2011 15:47:47 GMT

Jamaica tourism minister Edmund Bartlett says efforts are underway to use medical tourism to diversify Jamaica’s tourism product, and bring in much needed foreign investment with the construction of state-of-art medical facilities,” The growth of this form of tourism would lead to the development of new resorts that are conducive to recuperation and rejuvenation, present new possibilities for the employment of highly skilled and specialized health professionals locally, and recapture those health professionals who have migrated. The move to position the island to benefit from the lucrative medical tourism market is part of a thrust to diversify our growing tourism sector, as well as boost visitor arrivals and earnings.” A task force has been established through Jamaica Trade and Invest to examine Jamaica’s potential as a medical tourism destination. The task force, chaired by the tourism ministry, will also guide the development of an appropriate policy and regulatory framework. The task force will see if Jamaica has a potential as a major medical tourism destination given its close proximity to the United States, which is a major source of travellers seeking outbound medical care, and which has a well established air transportation network that is conducive to quick and easy travel. In Barbados, the Barbados Fertility Centre is advertising IVF holiday packages that bundle airfare and accommodation with airport and clinic transfers. IVF costs are not included in the package prices. Guyana’s President Bharrat Jagdeo had secured an $18 million line of credit from India to build a new specialist surgical hospital. The new hospital will offer specialised procedures such as organ transplants and cosmetic surgery to medical tourists. Construction will start this year and end in early 2014. An Indian company will build the hospital and Indian medical specialists will operate it. In Trinidad and Tobago, Umesh Rampersad of the Private Hospitals Association of Trinidad & Tobago (PHATT) is keen on developing the US medical tourism market. But local hospitals only have 325 hospital beds available. In Trinidad, private hospitals attract patients from neighbouring Caribbean territories. But to take it to the next level, the ministry of health and ministry of tourism need to develop a strategic marketing plan that would quantify and qualify the opportunity as well as describe the best way forward. St Kitts has started constructing an 18-bed surgical hospital, which will offer the latest CT, MRI and cardiac equipment. The St Kitts American University Hospital is a joint venture between the American Hospital Management Company (AHMC) and the Royal St Kitts Beach Resort Limited (RSKBRL) and is to be opened in 2013. The St Kitts and Nevis prime minister, Dr Denzil L Douglas says, "This new venture will attract patients seeking a quality medical tourism destination such as St Kitts while also finding an effective way of increasing access to state of the art diagnostic equipment for the local population." Randall D. Arlett of AHMC says, "The St Kitts American University Hospital is being developed as part of the overall continuing development of the Marriott St. Kitts Beach Resort complex. This project is the result of an in-depth study on medical tourism.”

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INDIA: Controversy over Delhi superbug returns to haunt medical tourism in India

Wed, 20 Apr 2011 15:47:20 GMT

Controversy over a superbug has returned to haunt medical tourism in India following the latest claims made by British medical journal, The Lancet. A new article has claimed that a superbug is present in the water of New Delhi and that the Indian government suppressed the truth last year by threatening its own scientists. The study claims that the controversial New Delhi metallo-beta-lactamase gene has been found in water pools, overflowing sewage and drinking water samples in New Delhi. Initial Indian reaction was to deny the claims. The Indian Medical Association said that water from US and European sewage should be checked for the presence of superbugs as the cass of drug resistance for high-end antibiotics is much less in India compared to the United State and Europe. The Delhi Water Board has also ridiculed the claims by saying that they are constantly checking water samples and there is no trace of the superbug. The Health Ministry of India questioned the credibility of the research and claimed that it is illegal for the researchers to remove Indian water to the UK for study. Some organizations in India have done themselves few favours by alleging that it is all part of a planned and concerted attack on India as a medical tourism destination. According to a study published in the Lancet Infectious Diseases Journal, the New Delhi superbug has been found in water samples in the Indian capital. British researchers found the NDM-1 superbug in two of 50 tap-water samples and 51 of 171 samples of water from puddles in Delhi. Part of the argument is over whether or not people are at risk of infection from bacteria carrying this drug-resistant gene? No water anywhere is totally pure. While the superbug may be in the drinking water, for it to cause infections, the concentration has to be very high. As long you drink boiled water, most bacteria present in the water can be killed. But all hospitals need water for other purposes, and whether boiling can kill superbugs is a moot point. The Lancet study found the NDM1-Superbug in eleven different types of bacteria, including those that cause dysentery and cholera. Last year, a Lancet study found only one type of bacteria with the NDM1 gene, now it has other even nastier types of bacteria. An article, 7 April 2011, “Dissemination of NDM-1 positive bacteria in the New Delhi environment and its implications for human health: an environmental point prevalence study” is by Timothy R Walsh, Janis Weeks, David M Livermore, Mark A Toleman. It argues that the presence of NDM-1 ?-lactamase-producing bacteria in environmental samples in New Delhi has important implications for people living in the city who are reliant on public water and sanitation facilities. International surveillance of resistance, incorporating environmental sampling as well as examination of clinical isolates, needs to be established as a priority. According to the country profile of The World Health Organisation (WHO), India has environmental health risk hazards related to lack of safe water, inadequate sanitation and waste disposal, indoor air pollution and vector borne diseases. It says that the Indian government has identified six priority programme areas, including urban low cost sanitation, urban waste water management, and urban solid waste management; while the level of enforcement has been extremely poor and there is no comprehensive legislation on environment and health. A Cardiff University-led team of scientists discovered new strains of antibiotic-resistant bacteria in India. It is the first time the bacteria, found in the drinking water supply of Delhi, have been located in the wider environment outside a hospital. The full findings of the Cardiff University study are published in The Lancet Infectious Diseases. Cardiff scientists were the first to identify the NDM-1 gene that makes bacteria resistant to a large range of antibiotics. Their UK research was extended when it was discovered that while most patients with the bacteria had recently spent time in hospital in India, some cases had occurred without recent hospital treatment. This then prompted the team to test the wider environment in Delhi. They collected 171 swabs of seepage water and 50 public tap water samples from sites within a 12km radius of central Delhi between September and October 2010.The NDM-1 gene was found in two of the 50 drinking-water samples and 51 of 171 seepage samples. Researchers then identified 11 new species of bacteria carrying the NDM-1 gene, including strains, which cause cholera and dysentery. Professor Tim Walsh comments,” We found resistant bacteria in public water used for drinking, washing and food preparation and also in pools and rivulets in heavily populated areas where children play. The spread of resistance to cholera and to a potential-untreatable strain of dysentery is also a cause for extreme concern. This is an urgent matter of public health. We need similar environmental studies in cities throughout India, Pakistan and Bangladesh to establish how widespread resistant bacteria are." The Indian Health Ministry argues that the study was unsupported by clinical and epidemiological evidence and patients were responding well to medical and post-surgical antibiotic treatment,” The environmental presence of NDM-1 gene carrying bacteria is not a significant finding. Bacteria exist naturally everywhere and there is no evidence that anyone had been made ill.” A recent United Nations report showed 650 million Indian citizens do not have access to a flush toilet and even more probably have no clean water. The Delhi sewage system is also reported to be unable to cater for the city’s population. The research team said it believes that temperatures and monsoon flooding make Delhi ideal for the spread of NDM-1. To its credit, the Indian government accepts that simple denials and attacking well-regarded doctors and scientists only reflects badly on India as medical tourists will retain nagging doubts over who is telling the truth. So it has formed a scientific committee to look into the findings of the New Delhi superbug study.

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CAYMAN ISLANDS, BAHAMAS: Offshore financial centres as medical tourism destinations

Wed, 20 Apr 2011 15:46:51 GMT

Offshore finance has been the subject of increased attention from US and European governments. Most offshore centres are losing out to major financial centres. Their other main income is tourism, which has also suffered recently. So medical tourism looks appealing. Many offshore financial centres are current or former British colonies or overseas territories that have lower levels of regulation than the UK. The twice-yearly Global Financial Centres Index published by think tank, Z/Yen is a ranking of the competitiveness of financial centres .In the latest report, all offshore centres with the exception of the British Virgin Islands fell further in the rankings, continuing a trend since the financial crises began. The Cayman Islands and the Bahamas were the biggest fallers. The report explains that offshore centres are still regarded as tax havens and there has been significant pressure applied to these centres by many national regulators as well as international bodies such as the OECD and IMF. Tax specialist F. Ron Jenkins of the Meridian 361 International Law Group in a recent presentation at the 9th Annual Off-shore Alert Conference in Miami Beach, Florida painted a picture of an embattled offshore financial industry, "Many of these offshore centers are going through a crisis and not all will survive, especially if they don’t learn to diversify their business models. For offshore jurisdictions with good tourism infrastructure already in place, medical tourism will allow for the transfer of technology, skills and know-how to create real economic development. This has economic substance and there are wealthy, motivated economic participants who will incorporate and launch businesses in these jurisdictions and achieve legitimate tax planning advantages," Jenkins has advised two clients on how to establish their medical tourism businesses In May 2009, US President Barack Obama declared his intentions to curb the use of financial centres by multinational corporations and he singled out the Cayman Islands as a tax shelter. So while it remains an offshore centre, it is under increasing pressure to “clean up its act’ with tougher rules on tax. So it is surprising that Jenkins says jurisdictions need to relax many laws to be more appealing to medical practitioners, "They need to cap, restrict or make off-limits punitive damages and include provisions for no-punitive or pain and suffering damages, or capping damages to $250,000.00.Jurisdictions may need to relax their immigration rules to allow in the number and quality of professionals that successful medical tourism businesses need, relax land ownership rules, and generally codify a package of commercial incentives for such businesses.” The Cayman Islands government has approved an extension of the agreement with Dr. Devi Shetty to build a huge medical tourism-hospital in Cayman. Local partner in the project, Gene Thompson, says both government and private partners agreed to amend the agreement to give both parties time to satisfy their obligations. These include granting of building permits, planning approvals and various duty concessions. The healthcare city will cost about $2 billion and include a hospital, medical university and assisted-living facility; and target American patients and insurance providers seeking deep cost reductions. Shetty believes it will draw 50% of its patients from the United States. The Caymans recently passed legislation that caps medical negligence claims at $600,000. Tourism is Bermuda’s second largest industry, with the island attracting over one-half million visitors annually, of whom more than 80% are from the United States. Other significant sources of visitors are from Canada and the United Kingdom. Bermuda has often talked of becoming a medical tourism destination but has no national strategy on it.

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TAIWAN: Private partnerships seen as key in promoting medical tourism to Taiwan

Wed, 20 Apr 2011 15:46:26 GMT

Taiwan’s private sector is trying to involve more industries in its effort to promote medical tourism, with the latest trial drawing interest from a local airline, according to a local travel agency. Sammy Yen, of Lion Travel’s medical tourism unit, says the company has partnered with Taiwan’s second largest carrier, EVA Airways in an experimental campaign that began April 1 to provide medical package tours for travellers from Hong Kong and Macau. He believes that only through similar cooperative strategies among different sectors will medical tourism in Taiwan thrive,” By working with airline companies or hospitals, we can establish a network instead of relying on random points of business." Yen also hopes that independent medical tourists from China will soon be allowed to visit Taiwan, as they would also provide a boost to the sector, "Individual trips offer visitors more flexibility and privacy in their tours, which will help contribute to medical tourism." Chinese travelers are currently only allowed to visit Taiwan as members of tour groups rather than on their own. Alex Hung of Shin Kong Wu Ho-Su Memorial Hospital, a proponent of medical tourism, who works with Lion Travel, believes the government has to do more to expand Taiwan’s medical tourism, "We need to promote medical tourism more actively to international travelers and tell them what Taiwan’s strengths are." Taiwan president Ma Ying-jeou expects the arrival of individual Chinese tourists for self-guided tours in Taiwan by the middle of the year, but will not give any dates. Tourism industry representatives from Taiwan and China have held a new round of talks in Hong Kong to remove obstacles for the plan. Taiwan now has to compete with Japan, Korea, Singapore, Thailand, India, and Mainland China for medical tourism. The self-guided trips by Mainland Chinese to Taiwan will generate business for the hospitals and hotels. President Ma Ying-jeou says Taiwan must quickly work to relax rules to remain competitive in medical tourism. He believes that while Mainland China is unable to attract Taiwanese hospitals to set up base there, it is possible to woo Taiwanese doctors. Now the government has plans to set up an international medical service area in Taoyuan County, northern Taiwan. A government official said that it would take at least six months to revise related rules for the area. He said that it would be at least two and a half years before the area would yield results. A record number of people visited Taiwan in the first two months of this year, while the number of Taiwanese travelers to Hong Kong and Macau has fallen, according to the latest government statistics. Tourist arrivals reached 850,000 between January and February, representing a daily average of 14,476, both of which were new records for this period. China provided, by far, the largest source of tourists, with Chinese citizens making 220,000 visits, accounting for a quarter of all total visitors. Japan followed; contributing 200,000 visitors, while Hong Kong and Macau came in third, at 110,000 visits.

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AUSTRALIA, INDONESIA; Reasons for outbound medical tourism

Wed, 20 Apr 2011 15:46:03 GMT

West Australians are increasingly seeking cut-price treatment in Asia. Restored Beauty Getaways, a Perth-based medical tourism agency takes up to 50 people a month to Thailand for a range of cosmetic surgery procedures, the most popular being breast augmentation, breast lifts, tummy tucks, facelifts and liposuction. Dental work, lasik eye surgery, Botox, and teeth bleaching are also popular. Favourable exchange rates, lower labour costs and lower running costs mean that these medical procedures can be offered at prices well below those available in Australia. Travel agency Travel.com.au sends Australians seeking medical procedures to Thailand, India, Malaysia, the Philippines and South Africa. While cost drives Australian outbound medical tourism, Indonesians are driven overseas by the poor quality and unavailability of local healthcare. Many Indonesians travel to Malaysia or Singapore as they feel that hospitals in those two countries offer a higher quality of care, better standard of service and better prices than the best hospitals in Indonesia. Seeking medical treatment abroad has become a common practice for Indonesians who live in Sumatra; treatment in Penang or Malaka is a convenient option. Richer patients from Jakarta can travel to Singapore for treatment. Indonesians spend about US$11.5 billion a year for healthcare abroad, according to the Health Ministry. Malaysia and Singapore are quite close, while competitive hospital fees in Malaysia have attracted more and more Indonesians. According to a report by Frost and Sullivan, Malaysian hospitals treated 288,000 Indonesian patients in 2008 and Singaporean hospitals treated 226,200 Indonesians in 2007. Major private hospitals in Malaysia and Singapore have special referral systems and international customer departments that specifically cater to the needs of international patients. Indonesia plans to improve local healthcare. Health Minister Endang Rahayu Sedyaningsih claims that Indonesia will soon have world-class public health care services as the government is now preparing three public hospitals to pursue full accredited status from Joint Commission International (JCI), a global accrediting agency, “They are ready to attain world-class status to enter the international competition arena.” Three Indonesian private hospitals have JCI accreditation. The government plans to increase its accreditation assistance for 66 public hospitals in the eastern part of Indonesia.

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UK: Survey states that 30% of women never see their cosmetic surgeon during treatment

Fri, 15 Apr 2011 11:20:07 GMT

A new survey for UK based cosmetic surgeon group Liberate, who operate from 60 locations in the UK, claims that women need to be better informed about what can go wrong with cosmetic surgery and the importance of knowing the qualifications and experience of their surgeon, to help them make an informed decision. Liberate surveyed 3,000 women between the ages of 18-34 and found that 30% had undergone cosmetic surgery with breast augmentation being the most popular procedure (28%) followed by nose (17%) eyes (11%) and liposuction/tummy tuck (15%). However, the survey suggests that many women do not receive the service they deserve from their cosmetic surgery provider. Even though 74% felt it was important to know and see their surgeon throughout the course of treatment, the reality was that 30% of women who had surgery never saw their surgeon. The group fails to explain how you can actually have surgery without seeing the surgeon! The Liberate survey also highlights the need for women to be better informed of the dangers of cosmetic surgery abroad and in the UK. 40% said that they would consider having surgery abroad if it was cheaper. 50% would have cosmetic surgery if cost were no object with 17% prepared to take out a loan to cover this. James Murphy of Liberate says, "Although people claim safety is the most important decision when considering cosmetic surgery, many will still be influenced by price regardless of the physical cost. Cosmetic surgery is a medical surgical procedure and it should be treated as such. Without the tools needed to make responsible choices cosmetic surgery can end up costing people financially, physically and psychologically, Liberate aims to give people the power to choose, providing them with a new and safer approach to cosmetic surgery.” Liberate is not a trade body, but a promotional body for UK based cosmetic surgeons, who naturally are opposed to their customers going overseas for cheaper treatment; so their default position in their own words in a recent press release is “having surgery abroad is the last thing you should do, no matter how cheap it is.” The two cases they use to highlight their position are of a British woman whose surgery in a US hotel would have been illegal anywhere, and an Argentinean woman who had surgery in her own country.

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QATAR: Qataris spent £85 million on treatment abroad

Fri, 15 Apr 2011 10:50:05 GMT

Qataris spent £85 million on healthcare treatment abroad for 950 patients in 2009, the National Health Strategy document reveals. This works out at £90,000 on average with the top expenditure being £102,000. This shows that travelling abroad is not just driven by low price. According to the research for the government, 70% of costs are for non-medical items such as flights and accommodation. When Europeans and Americans travel for treatment they go alone or with another person and tend to keep the trip short. When Qataris and people from other Arab countries travel abroad such as to the UK or USA, they take a large extended family for a long trip that usually includes some tourism and shopping. The National Health Strategy research says that because certain specialty services are unavailable in Qatar, some citizens pay for or are sent by government or companies abroad for treatment and every year, increasing sums are being spent on such treatment and associated costs. Particularly where the state pays the bills, the research suggests that there is room for improvement through cost efficiency and management, which can be done without limiting access to care and that there is potential for enhancing quality through the standardisation of processes. It accepts that treatment abroad is a key element of the scope of care in Qatar now and for the foreseeable future as an increasing number of patients are being referred outside the country with a majority of cases being elective as most patients are travelling abroad for elective treatments than urgent cases. The figures:• 2002 - 398 patients travelled abroad for elective medical care while 80 patients went for emergency care.• 2003 - 107 elective and 422 emergency patients• 2004 - 321 elective and 78 emergency• 2005 - 414 elective and 106 emergency• 2006 - 463 elective and 163 emergency• 2007 - 575 elective and 148 emergency • 2008 - 730 elective and 227 emergency The research adds that no prior agreement is made with the provider of care regarding likely treatment costs and many cases are supported by multiple alternative funding sources, resulting in limited control of treatment and a likely increase in expense .The NHS recommends an establishment of a database containing selected preferred providers in order to ensure inclusion of the highest-quality centres; providing follow-up care in Qatar; negotiating volume contracts to control costs; making travel arrangements through a single source to realise better price points on airfares and hotels; and defining the eligibility to treatment abroad and for a transparent application and approval process. The National Health Strategy is intended to propel Qatar toward the health goals and objectives contained in the Qatar National Vision 2030, with goals that will achieve:• A comprehensive world-class healthcare system whose services are accessible to the whole population.• An integrated system of healthcare offering high-quality services.• Preventive healthcare, taking into account the differing needs of men, women, and children. • *A skilled national workforce capable of providing high-quality health services. • A national health policy that sets and monitors standards.• Effective and affordable services in accordance with the principle of partnership in bearing the costs of healthcare.• High-calibre research directed at improving the effectiveness and quality of healthcare. The National Health Strategy 2011-2016 is one of 14 sector strategies under the Qatar National Vision 2030’s new National Development Strategy. Qatar’s exceptionally rapid economic growth has stimulated numerous large-scale medical infrastructure and expansion projects. But medical treatment in Qatar is very expensive and the number of modern hospitals inadequate, so outbound medical tourism is likely for several years yet.

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USA: Americans divided on healthcare law

Fri, 15 Apr 2011 10:02:38 GMT

One year after President Obama signed the Patient Protection and Affordable Care Act into law, Americans are still divided on it, with 46% saying it was a good thing and 44% saying it was a bad thing. Many Americans are sceptical that the law will improve medical care in the U.S. or their own personal medical care. A year ago, Congress passed a law that restructures the nation’s healthcare system. The current level of support for the bill, based on a Gallup poll this March, generally mirrors what Gallup found in polling conducted a year ago, just before President Obama signed the bill into law. At that point 49% said the law was a good thing, while 40% said it was a bad thing. Other updates asked over the last year show a similar divide. Less than half of Americans believe the law will make medical care better either for the United States as a whole, or for them personally. In both regards, more believe the law will make things worse rather than better. Opinions on the impact of the healthcare law on medical care in the U.S. are divided in similar fashion to Americans’ overall reactions to the bill: 39% say it will improve medical care in the United States, while 44% say it will make it worse. Americans are less positive about the impact of the healthcare reform law on their own medical care. 25% say the law will improve their medical care, 39% say it will worsen it, and 31% say it will not make any difference. These results are also similar to those found in July 2009. Democrats and Republicans have totally different views of the healthcare law, as has consistently been the case since Gallup began measuring attitudes toward it. The law was proposed by a Democratic president, and passed by a Democratic-controlled House and Senate over the vehement objections of most Republicans in Congress. Republicans have also continued to criticize the bill since its passage, and Republican leaders in Congress are now pursuing efforts to prevent many of the bill’s provisions from taking effect. 8 in 10 Democrats say the law’s passage was a good thing, while 7 in 10 Republicans say its passage was a bad thing. Independents tilt toward saying passage was a bad thing. Reactions to the impact of the law on medical care in the U.S. are similarly divided. Democrats are a little more muted in their views of the law’s impact on their own medical care, with about half saying it will improve their medical care, while most of the rest say it will not change it. 6 in 10 Republicans say the law will worsen their medical care, while nearly half of independents agree. The American public’s reactions to the landmark healthcare law passed a year ago continue to echo the partisan nature of congressional debate. Democrats applaud the law and say it will improve medical care in the U.S., while Republicans strongly believe that its passage was a bad thing and that it will make medical care worse. Independents tend to be more negative than positive about the law. These reactions reflect a lot of politics and perhaps less reality, given that a full assessment of the real-world effects of the law is not possible at this time, because most of its provisions have not yet taken effect. President Obama and Democratic leaders who supported the bill currently face a public that is less than overwhelmingly positive about the bill and its promised ability to fix healthcare problems in the U.S. The importance for medical tourism is simple. Despite numerous speeches and articles for or against reform, and strong opinions whether it will encourage or discourage Americans from being medical tourists; the reality is that it may be another five years before we know the effect.

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ROMANIA: Medical Insight launches website for health travel outside Romania

Fri, 15 Apr 2011 09:51:50 GMT

Medical services consulting company, Medical Insight, has launched healthtravel.ro, the first Romanian site containing information about foreign hospitals. The website targets those who want to travel from Romania for medical services and capitalizes on a developing trend on the Romanian market. Many Romanian patients – including Romanian president Traian Basescu – have chosen hospitals outside the country for major health interventions. Medical Insight, founded in 2010, is a company that offers consultancy to those who are looking for medical services in foreign countries. Adriana Sarbu of Medical Insight says, “If in the past people used to go to Austria or Germany for treatment, now, according to our research, a lot of Romanians prefer Turkey for medical controls and interventions. This is a growing thing, considering that the quality of service is very high and that the prices are comparable to the ones in Romania and lower than those from the Western European countries.” The site contains information about treatments, medical specialties and the country providing treatment, along with detailed presentations of hospitals based on the held certifications, reports of independent institutions and former patients reviews. The site also helps people who want information about health insurance or funding opportunities for treatments. Romanian hospitals might be classified into five categories of competence from May this year, if the Romanian Health Ministry’s project is approved. The project contains the methodology for classifying hospitals, depending on jurisdiction and minimum mandatory criteria for hospitals classification in new categories. This should ensure efficiency by avoiding overlap and duplication between hospital units, ensuring equitable access to health services for citizens and lower treatment costs. Moreover, the classification based on this methodology will be used to establish protocols for transferring uncritical cases between hospitals. It will also play a key role in developing proposals for additional funding to hospitals and good planning, as well as procurement of medical equipment. Private healthcare services operator Centrul Medical Unirea (CMU), the second largest clinic group in Romania, bought Euroclinc with a hospital and three clinics. CMU runs four hospitals in Bucharest, a hospital in Brasov and 20 clinics. It also owns half of the stem cell bank Stem – Health Unirea in Bucharest. The company took over Euroclinic hospital and clinics from Eureko in September 2010. CMU is majority owned by investment fund Advent, and the rest of the shares are owned by founder Wargha Enayati.Despite such investment, the provision of health services in the country is still poor, which is why many people seek treatment elsewhere.

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TAIWAN: Slow growth of Taiwan and Hong Kong medical tourism

Fri, 15 Apr 2011 09:48:01 GMT

12 Taiwanese companies from the tourism and medical industry recently held a presentation in Beijing to attract Chinese citizens to Taiwan for medical procedures. The companies promoted the advantages of Taiwan’s health care, cosmetic surgery, and dental implant industries. Danis Chen of the Taipei-based Chinese Tourism Industrial Development Association, said Taiwan’s medical services are advanced without being overpriced, making it an ideal place for those who want to get health checkups or cosmetic surgery. But he called on the Taiwanese government to allow independent travellers from China into the country, arguing that this will appeal to many Chinese travellers and it would contribute significantly to Taiwan’s tourism industry. Chao Mei-chen of Show Chwan International Medical Center added that she knows Chinese retirees want to come to Taiwan for health checks, and plan on bringing their family and friends along for some leisure travel as well, but are not prepared to go on a membership club group tour. Cheng Huishan at the Beijing-based Taiwan Travel Service Information Center said tourism prospects for Taiwan look good and that many Chinese would love to visit Taiwan,” I hope independent travel would be allowed soon." Despite claiming to promote medical tourism and promising to help, Taiwan’s government currently prohibits mainland travelers from visiting Taiwan on their own, and has so far not delivered on promises to allow Chinese tourists to go on an independent basis. The Taiwan medical tourism industry is frustrated that this artificial handicap holds them back. That the various government departments of Taiwan are not working together is further illustrated by the health department’s plans for a proposed special medical tourism zone. The health department needs a new law before a special medical tourism zone, but plans to take a large slice of income for its own uses. Health minister Chiu Wen-ta says, "Development of an international special medical tourism zone would be limited, as it would require special authorization. First, national health insurance would not be accepted and all medical costs would be out of pocket. And 20 % of the profit from medical tourism would be injected into our health insurance reserve.” The Taiwan External Trade Development Council (TAITRA) continues to promote medical tourism among Chinese visitors, with business limited to five groups of 30 to 50 Chinese visitors for medical tours each month, for health checks and medical services. So until individual /family trips are allowed, the potential is only producing some 2500 Chinese medical tourists a year. Meanwhile, Hong Kong hopes that international hospital accreditation will help its lacklustre medical tourism business. The Hospital Authority (HA) of Hong Kong says that that four public hospitals have been awarded full accreditation for four years by the Australian Council on Healthcare Standards (ACHS) subsidiary ACHS International. The hospital accreditation is a process of continuous quality improvement. ACHS conducted surveys in Queen Elizabeth Hospital (QEH), Caritas Medical Centre, Pamela Youde Nethersole Eastern Hospital, Tuen Mun Hospital and Queen Mary Hospital. The five hospitals were all in the pilot scheme of hospital accreditation launched in 2009.

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EUROPE: The future of healthcare in Europe

Thu, 07 Apr 2011 11:16:34 GMT

A new report ’The future of healthcare in Europe’ from the Economist Intelligence Unit and sponsored by pharmaceutical group Janssen, argues that across Europe, healthcare is barely managing to cover its costs. Not only are the methods for raising funds to cover its costs inadequate, but also, of even greater concern, the costs themselves are set to soar. According to World Bank figures, public expenditure on healthcare in the EU could jump from 8% of GDP in 2000 to 14% in 2030 and continue to grow beyond that date. The overriding concern of Europe’s healthcare sector is to find ways to balance budgets and restrain spending. Unless that is done, the funds to pay for healthcare will soon fall short of demand. The financial meltdown is being caused by two interconnected trends: the ageing of the population and the parallel rise in chronic disease. Those financial burdens are being exacerbated by the rising cost base of medical technologies. On the positive side, the prospects for vanquishing many diseases are improving rapidly with the mapping of the genetic make-up of people who develop cancer, diabetes and heart disease. This prospect makes it all the more imperative to agree on a survival strategy for Europe’s healthcare systems. The basic problem is the spiralling cost of healthcare, which is expected to continue. European governments and other payers are trying to slow that upward spiral, but they are far from agreeing how best to do so. A key question is how healthcare systems can be redesigned without damaging the foundations upon which they were originally built. Europe’s healthcare system is paid for by the population at large, with the risks of medical expenditure essentially pooled. Most European citizens agree with this shared-risk principle and would resist any efforts to change it and thereby remove the promise of universal healthcare coverage. However, the financial contributions required for healthcare have risen steadily, to the point where governments realise that further increases are no longer possible or politically acceptable. Yet the rise in the cost of healthcare systems continues to outstrip economic growth and shows no sign of slowing down. The Economist Intelligence Unit interviewed 28 leading healthcare experts between December 2010 and March 2011. Each expert was asked to give his or her hopes, fears and predictions for Europe’s healthcare in the year 2030. This report is based largely on their comments, detailing the factors driving the fiscal crisis in healthcare and the major forecast trends for the next two decades. The analysis of past trends is, in turn, the basis for five scenarios for healthcare in 2030. Healthcare costs are rising faster than levels of available funding. The rising cost of healthcare cannot be met with current levels of public funding, raised via taxation and insurance. The main drivers of rising healthcare costs in Europe are:• Ageing populations and the related rise in chronic disease.• Costly technological advances.• Patient demand driven by increased knowledge of options and by less healthy lifestyles.• Legacy priorities and financing structures that are ill suited to today’s requirements. The future of healthcare will be shaped by seven separate, but interconnected, trends-• Healthcare spending will continue to rise, not only because of inflationary drivers, but also because of growing recognition by policymakers that improved health is linked with greater national wealth.• Keeping the universal healthcare model will require rationing of services and consolidation of healthcare facilities, as public resources fall short of demand.• General physicians will become more important as gatekeepers to the system and as co-coordinators of treatment for patients with multiple health issues.• More effective preventive measures and fundamental lifestyle changes will be promoted to encourage healthy behaviour.• European governments will need to find a way to improve collection and transparency of health data in order to prioritise investment decisions.• Patients will need to take more responsibility for their own health, treatment and care. The report identifies five extreme scenarios for European healthcare in 2030:• Technology triumphs and cures chronic disease, while e-health takes a prominent role in the management of healthcare.• European nations join forces to create a single pan-European healthcare system.• Preventive medicine takes precedence over treating the sick.• European healthcare systems focus on vulnerable members of society.• European nations privatise all of healthcare, including its funding. The five scenarios make clear that, although there may be great debate across Europe on the details of healthcare reform, what is needed most is adaptability. The current debate is driven in large measure by self-interested factions, such as insurers, doctors and government bureaucracies. Over time, citizens may succeed in shifting the discussion so that it focuses where it should: on the best ways to maximise the health and wellbeing of Europe’s population.

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TURKEY: Turkey achieves success in medical tourism

Thu, 07 Apr 2011 11:09:06 GMT

Turkey is attracting over 100,000 medical tourists a year, thanks to an increase in the number of private hospitals, and even larger numbers of wellness tourists. The Health Tourism department of the Health Ministry and Gazi University faculty of commercial and tourism education have taken an inventory of health tourism in Turkey. According to the study, the number of health tourists coming to Turkey for medical treatment has been increasing regularly for the past three years. While 74,093 patients came to Turkey in 2008, there were 91,952 in 2009 and 109,678 last year. The total number of patients who came to Turkey in the past three years is 275,723. Among those patients, 94 percent received treatment in private hospitals while 6 percent went to public hospitals. According to the study, foreign patients choose to receive treatment in Turkey because of its reasonable prices, high quality of service, pleasant climate, abundance of vacation opportunities and short waiting time. The infrastructure, competent doctors and reputation of hospitals are listed among the other reasons. The eye, brain surgery, orthopedic and cardiology departments attract the largest number of patients. Turkey attracts the largest number of medical tourists from Germany, the Netherlands and France, where the population of people with Turkish roots is high. Patients from Balkan countries and Turkic republics are also among the largest groups. The study further shows that Istanbul, Kayseri, Adana and Gaziantep are the provinces that attract the largest number of foreign patients. In addition there are many wellness tourists in the 34 thermal spa centres of Turkey that are marketed as a choice destination with various treatment options such as balneotherapy and thalassotherapy. Anatolia is located on a major geothermal belt and has several thermal baths and spas. These thermal spas are promoted as cures for various illnesses due to the high density of minerals in their waters. The thermal spa treatments in Turkey attract travellers every year, especially from the adjoining countries of Greece, Bulgaria, Russia, Georgia, Azerbaijan, and Iran, which accounted for about 25 % of all wellness-related visitors to Turkey in 2009. Apart from the thermal spas, medical procedures such as IVF, eye, dental and cosmetic surgery are also gaining popularity. The geographical location, US dollar exchange rates and added tourist attractions make Turkey a medical tourism destination with potential. The number of medical tourists is expected to increase by 15 % in 2011

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INDIA: Indian government agrees not to add new service tax on healthcarefor now

Thu, 07 Apr 2011 11:06:27 GMT

To the immense relief of the local medical tourism industry, the Indian state government has agreed not to impose the 5% service tax on healthcare services that was introduced in this year’s Union Budget after strong protests from several quarters that estimated that it would have increased local medical tourism prices by between 7 and 12%. Finance Minister Pranab Mukherjee had proposed a 5% service tax on air-conditioned hospitals with more than 25 beds and on diagnostic services, but he has announced a complete u-turn, "The purpose of the new levy was not merely to mobilise revenue, but to pave the way for introduction of the general service tax However, I have decided to exempt the new levy in its entirety both in respect of services provided by hospitals as well as by way of diagnostic tests until general service comes into force.” So the early rejoicing at the decision may be a trifle early, as the government still plans to include healthcare within a wider general service tax while extra taxes on restaurants, air travel and hotels will make India a more expensive travel destination. At a time when other countries are waiving fees to encourage tourism, India is the one of the few countries that has raised taxes. Dubai-based DM Healthcare plans to invest nearly $335m in the next five years in India as its looks to expand operations. The company is setting up MedCity in Kochi, a medical college and hospital at Wayanad in Kerala and it also plans to open specialised eye care centres. The company will spend two-thirds of the money over the next three years, including funding for the first two phases of MedCity. The healthcare company runs hospitals, polyclinics, pharmacies and diagnostic centres under the brands Aster and Medcare in the UAE, Qatar, Oman and Saudi Arabia. Azad Moopen of DM Healthcare says, “We plan to invest $335m in the next five years to set up MedCity at Kochi. Work has already started for the 500-bed hospital. The first phase will be completed by 2013, and MedCity will include a large hospital, six centres of excellence, a resort hotel, a convention centre, a medical college and other facilities. Hopefully in the next two years, we will be able to admit the first patient.” The company will also invest in 4-5-specialist eye care centres in the Delhi region. It has also acquired a 65 % stake in a 100-bed hospital at Kolhapur and is planning to add another 200 beds to it. The group is also planning to acquire hospitals across India has finalised a deal in Pune, while a new hospital is being planned for Nagpur. DM Healthcare is also exploring options in Delhi and its adjoining townships to expand its operations. It has already launched Aster-Eye Care eye care centre in Faridabad (Haryana), and plans to open four new similar centres in Delhi and another 20 across India by 2015.

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USA: Economy means more Americans are uninsured

Thu, 07 Apr 2011 10:03:29 GMT

Nearly 3 in 10 adults living in Texas do not have health insurance, making it the state with the highest uninsured rate in the country in 2010. Mississippi and Louisiana also have high rates of uninsured residents, with about one in four lacking coverage. By a significant margin, Massachusetts -- where state law requires all adult residents to have health insurance -- continues to have the lowest percentage of uninsured residents, at 4.7%. Connecticut, Minnesota, and Hawaii also have relatively low uninsured rates, with about 1 in 10 adults not carrying health insurance in each. These state-level data are based on daily surveys conducted as part of the Gallup-Healthways Well-Being Index from January through December 2010, encompassing more than 350,000 interviews with American adults. Gallup and Healthways began daily tracking of American adults’ health insurance coverage in January 2008. At the national level, 16.4% of adults were uninsured in 2010, statistically unchanged from 16.2% in 2009, but up from 14.8% in 2008. Southern and Western states have a disproportionately large percentage of uninsured residents, as they did in 2009 and 2008. This geographic pattern is likely tied at least in part to these states’ larger Hispanic populations. Gallup finds Hispanic Americans are the demographic group most likely to be uninsured in the United States, at 38.9% in 2010. Seven out of the 10 states with the fewest uninsured residents are in the Northeast, similar to past years. Most states saw a rise or no change in the percentage of uninsured residents in 2010 compared with 2009. Wyoming was the lone state where the uninsured rate decreased to a significant degree in 2010. More Americans in almost all states, however, were uninsured in 2010 than in 2008. For example, the percentage of adults without healthcare coverage in Texas rose from 25% in 2008 to 27.8% in 2010. The uninsured rate is up the most since 2008 in Kentucky, Utah, Florida, and Louisiana. Nationwide, Gallup has measured a decrease in employer-based based healthcare and an increase in government health insurance, which includes Medicaid, Medicare, and military/veterans’ coverage, since 2008. As long as unemployment remains high, the percentage of Americans who get health insurance from an employer is unlikely to increase. The increase in government healthcare, which Gallup finds across all age groups, is causing financial problems for states when they are already grappling with reduced revenues. Many states are now looking to cut back on government-funded health services with an eye on Medicaid programs in particular, which serve some low-income Americans, a group that is among the most likely to be uninsured. Depending on the extent of states’ cuts to Medicaid and the overall economic situation in the United States, the uninsured population could grow in 2011. The new healthcare law, which seeks to expand coverage, may fill the voids in care that state budget troubles and unemployment are creating. However, the government will not fully implement all pieces of the legislation until 2014, and many of the new programmes could take time to ramp up. The Commonwealth Fund 2010 Biennial Health Insurance Survey estimates that 9 million adults lost their health insurance in the last two years. In the USA the loss of a job also often comes with the loss of health insurance. Without their jobs, the unemployed have had great difficulty finding affordable coverage. An estimated 29 million people have used up all of their savings to pay medical bills, while 22 million were unable to pay for basic necessities like food and 4 million declared bankruptcy. The survey’s authors note that the Affordable Care Act provisions that are already in effect are bringing some relief in the form of pre-existing condition insurance plans, allowing young adults up to age 26 on their parents’ plans, small business tax credits, elimination of lifetime limits on benefits, and required coverage of preventive care without cost-sharing. Once the law is fully implemented in 2014, nearly all of the 52 million currently uninsured American adults, including those who became uninsured during the recession, will have access to comprehensive health insurance coverage through expanded Medicaid, private health plans with consumer protections, and tax credits for those with low and moderate incomes to purchase insurance. In addition, health benefits will have to conform to an essential benefit standard, and no one will be denied coverage or charged more because of a pre-existing health condition.

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GLOBAL: New online medical tourism courses launched

Thu, 07 Apr 2011 09:56:12 GMT

US company, Medical Tourism Training, has launched five new online courses to provide fundamental information and skills vital to success, for industry professionals and consumers who want to learn about international health travel and medical tourism. Developed by a team of experts including medical tourism experts with backgrounds in healthcare, business, education and law, the affordable and convenient course materials are based on international best business practices as well as experience in the sector. The five courses-• Introduction to medical tourismFocuses on five areas fundamental areas forming the basic understanding of medical tourism: its definition and history, factors driving the growth in the sector, major countries involved in international health travel and the services they offer; and current issues.• Basic medical terminologyCovers more than 225 words related to medicine and medical tourism. Throughout this class, words are spoken while each slide contains the written word, a phonetic guide to pronunciation, a definition, and images or photographs to maximize understanding and retention.• Telephone skills for the medical tourism professionalThis is filled with practical advice as well as audio and video clips demonstrating the “Do’s” and “Don’ts” of telephone etiquette. It offers opportunities for you to practice and improve your telephone skills. Learn how to manage telephone interactions professionally so that you can consistently create positive impressions about you and your business.• Email etiquette – netiquetteProper business skills for communicating via email are vital to building and maintaining a global business. This course contains no-nonsense advice as well as audio clips demonstrating the “Do’s” and “Don’ts” of email etiquette. Sharpen your email communication skills to deliver improved customer service.• Essential skills for working with upset customersThis business skills development course provides essential tools to avoid or defuse negative situations as well as restoring business relationships following a harmful experience with upset customers. Through the use of narrative, audio and video clips, you will learn skills for better interactions with your clients, staff and management, and other professionals. All are available individually or in any combination and reflect the company’s emphasis on the importance of excellent customer service. Ruth Rietveld-Kirwan explains, "Online courses provide flexibility for busy people who want to learn in the convenience of their own home or office, at their own pace, when they have the time. It is an easy way for a global audience to access the information, training, and skills needed to succeed in medical tourism. These introductory courses are for individuals interested in learning more about international medical travel.” The courses are designed for a wide audience including medical travel agents; international care coordinators; medical professionals; support staff in hospitals, clinics, private medical and dental offices, spas; travel agents; hospitality professionals; as well as prospective or current medical tourism clients and anyone who is curious about the medical tourism industry. Elizabeth Ziemba of Medical Tourism Training says,” Our objective is to design content-rich, visually appealing courses that are affordable to just about anyone, anywhere. Through the use of audio and video clips as well as a variety of quizzes, individuals can learn essential information and practice skills, bringing a higher level of professionalism and excellent customer service to the international health travel sector. While we are busy developing additional courses that will be at an intermediate level, our team has created courses that are an excellent introduction to medical tourism".

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MALAYSIA: Cost effective treatment boosting the growth of Malaysia medical tourism

Thu, 07 Apr 2011 09:55:23 GMT

Due to government support and world class infrastructure, the number of medical tourists in Malaysia will increase 17% a year until 2012, says a new report by analysts RNCOS, “Malaysia Medical Tourism Outlook 2012”. Malaysia has become one of the top health tourism destinations in the world for medical tourists seeking cost effective treatment. The total number of medical tourist arrivals in the country reached 425,500 in 2009, due to a good healthcare infrastructure, government support through promotional programmes, and skilled medical professionals. It is estimated that, the total medical tourist arrivals in the country will reach 689,000 by 2012. The report says that competitiveness in cost of medical treatment is a driving factor for the Malaysian medical tourism sector. The country offers complex medical treatments and services at considerable low prices compared to the developed world. For instance, the cost of knee replacement in Malaysia is US$8000 compared toUS$ 40,000 in the US for the same treatment. Tropicana Medical Centre (TMC) in Kota Damansara, Petalaying Jaya, the flagship hospital of TMC Life Sciences, plans to increase its foreign patients to 30 % over the next three years. At present, foreign patients account for 5% of its total number and TMC aims to increase that to 10 % this year. Francis Lim of TMC explains, "If you look at successful hospitals in health tourism locally, they get 25 % to 30 % patients from overseas and we want to do that as well." TMC is increasing the number of partnership deals it has with organizations in Indonesia, and planning strategic affiliations with corporate partners from Bangladesh and Indo China this year to expand its services to a wider market and boost its visibility locally and regionally. TMC gets 20 Indonesian patients a month and hopes to increase that to 200 a month. Deputy Minister of Health, Rosnah Abdul Rashid Shirlin, says India and Thailand are role models for making Malaysia an attractive destination for medical and healthcare tourism as it can generate a huge income for the country. The government intends to expand the healthcare sector through the 10th Malaysia Plan because there is a high demand at international level,” We should view India and Thailand as role models because they are the most popular in the world as a pioneer of healthcare industry where they give quality services and competitive price. We must continue to work hard to place Malaysia strategically as a medical tourism destination of choice. Malaysia can compete in the sector because the country’s health industry is on par when compared with others in the world.” The government will reform the healthcare system with focus on four key areas, transforming healthcare delivery, increasing capacity and coverage and improving quality of the healthcare structure, shifting towards wellness and disease prevention rather than treatment, and increasing the capacity and capabilities of human resources for health.

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MIDDLE EAST, GULF, NORTH AFRICA: News from the Middle East and Gulf regions

Mon, 04 Apr 2011 09:45:56 GMT

All private hospitals in Qatar must be accredited by an internationally recognised body within the next four years, says the Supreme Council of Health (SCH). It will be compulsory for the private sector to obtain an international accreditation until the National Accreditation Standards (NAS) are available. Dr Kamal Khanji of SCH says it will approve the accreditation of all private hospitals in the country, “We will request all private hospitals to achieve accreditation within the next four years because developing our own standard will be easier when they are all already accredited by recognised bodies internationally. The programme will help all hospitals in the country to further raise their standards. Of course it will require a lot of effort but it will improve the healthcare sector significantly and change the face of health services in the country. We are going to help the private sector by providing them with some publications to guide them to a list of well-known international accreditors. We will guide them step-by-step towards achieving the accreditation, which will position them as an attractive destination for visitors from around the world thus helping Qatar achieve the planned status as the health tourism destination in the region.” SCH has announced that a broad national health insurance system with universal access for citizens, expatriates and visitors will be set up within the next 3 to 4 years. The Kuwait government is working on a strategy to bolster health care facilities with an additional 3500 beds. The private sector will be instrumental in the execution of this strategy and the development of the sector. Kuwait has long offered its citizens an expansive cradle-to-grave welfare system that has involved the dispersal of the nation’s oil wealth through a number of free services. The government has been moving towards implementing a comprehensive health insurance scheme, despite criticism from some opposition circles. In 2010, the government drafted two bills for comprehensive health insurance for Kuwaiti nationals and the establishment of an independent health authority to regulate the system. Under the proposals, the government would pay health insurance fees for citizens, while additional optional services must be met through out-of-pocket expenses. This free insurance would also partially cover overseas treatment for Kuwaiti citizens. The government hopes that such proposals, which are yet to be put before parliament, will dramatically improve the level of care and reduce the outsized bill for overseas treatment. They will also lead to significant private investment opportunities in the country. While wars and protests in the area hit the headlines, the impact on inbound medical tourism is as yet unknown. Libya, Bahrain, Oman. Iran, Lebanon, Syria, Yemen, Saudi Arabia and Iraq have very few inbound medical tourists. The leading local inbound destination is Jordan, where protests so far are limited. Egypt, Tunisia and Morocco do attract medical tourists, mostly for cosmetic surgery and dentistry, and mainly from Europe; the unknown is whether or not recent unrest has or will deter medical tourists. The great unknown is the effect on outbound medical tourism. The ministry of health said that over 1 million Libyans went abroad in the last few years for healthcare-this is not for one year but an unspecified period. That is nearly 20% of the population. They went mostly to Jordan or Tunisia. That has now stopped. A Frost and Sullivan report suggested that one in five global outbound medical tourists come from the Middle East/Gulf region, but many in the business have serious doubts over this figure. What is agreed is that while much medical tourism traffic in the area is between countries, there is outbound traffic to Asia, Europe and the US, mostly from Saudi Arabia and the UAE.

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USA: Americans should shop around locally to compare with medical tourism quotes

Fri, 01 Apr 2011 11:45:15 GMT

Medical tourism is encouraging Americans to look at overseas options to reduce high medical costs. Until recently, most Americans opting for medical care abroad went for dentistry, cosmetic surgery and other procedures not typically covered by insurance. With the poor economy and insurance cutbacks, more individuals are considering travelling for medically necessary surgery, such as hip or knee replacements or reconstruction, and even heart procedures. Nationally, more patients are looking at options in Southeast Asia, Mexico and even Cuba. Some are seeking care abroad because certain technologies, such as stem cell therapies and alternative cancer therapies, are not readily available to them in the U.S. Yet patients who are considering surgery options in other countries need education far beyond potential cost-savings, according to Dr. Nicholas Abidi of US hospital Santa Cruz Orthopaedic Institute, “ Hospitals overseas market their facilities as top-flight and promote the expertise of their clinical staff, many of whom have been educated in the U.S. Yet the marketing can obscure the reality of conditions and risks associated with overseas surgery options. If they encounter unexpected findings during surgery or post-op problems like blood clots, can the doctor and the hospital respond in a timely fashion that is up to U.S. standards? There is also always the chance of infection post-surgery, and many doctors here are reticent to take on such patients. Many overseas hospitals do not have access to the type of equipment that we use to monitor patients during surgery or install the implants. Artificial joints can also fail or be recalled, which will quickly eat up cost savings patients realize from opting for surgery abroad. Many foreign locations do not match U.S. standards for infection control and quality assurance. Accreditation standards are not on par with the U.S. Licensing standards, training of medical staff and accepted levels of staffing also vary among global locations. Should problems arise, there are not the same safeguards built into the U.S. medical system for patient recourse.” Aptos resident Sandy Dini seriously considered having her recent hip replacement surgery done in India. Her primary care doctor felt there were excellent options overseas for certain procedures, such as joint replacement and shoulder surgery. She and husband Mark found, "The hip replacement surgery would have been $8000 in India, which included our airfare, a four-star hotel, follow-up appointments and a full-time nurse for a three-week stay. Total costs for the surgery here was close to $80,000 before the contracted insurance discount---that’s a huge difference. But, as we have insurance the costs were about the same after the insurance kicked in, so it made sense to have hip replacement surgery locally." Medical travel was the focus of a webinar ’Should You Be in the Medical Travel Business?’ presented by American Society of Travel Agents (ASTA) for travel agents interested in the medical travel market. Chris Russo of ASTA explains, “They need to understand a variety of significant issues involved with providing medical travel services to patients. Understanding the issues and how to deal with them will allow travel agents to explore a new and highly profitable niche. There are legal and liability issues surrounding medical travel.”

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UK: Tougher rules for overseas visitors, but good news for expatriates

Fri, 01 Apr 2011 11:18:01 GMT

Action to establish a more balanced charging regime for overseas visitors, including tackling health tourism has been promised by the UK government ’s Department of Health and Home, following a 2009 review that set out to examine the rules on charging overseas visitors for access to NHS services. The Home Office measures for the UK to be included in new immigration laws include:• Anyone owing the NHS £1,000 or more will not be allowed to come to or stay in the UK until the debt is paid off. It is hoped the £1,000 threshold, which will be implemented later this year will capture 94 per cent of outstanding charges owed to the NHS.• To enforce this action, the NHS will provide information to the UK Border Agency to enable it to identify the debtors when they make their application to return or stay in the UK. NHS measures for England include extending the time UK residents can spend abroad without losing their automatic entitlement to free hospital treatment from three months to six months. People living in the UK for part of the year, while also spending significant periods of time abroad risk being judged as not ordinarily resident and so not entitled to free NHS treatment, although some exemptions do protect this group. The current regulations allow residents a regular absence from the UK of up to three months per year before they risk being chargeable for hospital treatment. With people having increasingly mobile lifestyles, the time is right to review this regulation. While the NHS remains committed to providing immediate or necessary care, as it is important that a balance of fairness and affordability is also struck, a full review of the rules and practice will be undertaken and will consider:• Qualifying residency criteria for free treatment.• The full range of other current criteria that exempt particular services or visitors from charges for their treatment.• Whether visitors should be charged for GP services and other NHS services outside of hospitals.• Establishing more effective and efficient processes across the NHS to screen for eligibility and to make and recover charges.• Whether to introduce a requirement for health insurance tied to visas. Health minister Anne Milton says, “The NHS has a duty to anyone whose life or long-term health is at immediate risk, but we cannot afford to become an international health service, providing free treatment for all. These changes will begin the process of developing a clearer, robust and fairer system of access to free NHS services which our review of the charging system will complete." Damian Green, immigration minister adds,”The NHS is a national health service not an international one. If someone does not pay for their treatment we will not let them back into the country.” The NHS started charging those who are not ordinarily resident for treatment in 1982, although the UK has reciprocal arrangements with many countries allowing their residents to receive healthcare on the same terms as Britons. Emergency treatment will continue to be provided irrespective of status or ability to pay. The new review is expected to complete in late autumn and the proposals will then be consulted upon. The UK has an international obligation to provide free NHS treatment to those seeking asylum under the UN Convention on human rights. It will continue to fulfil this obligation. Access for European Union residents is determined by separate EU regulations. The review will not consider changes to these regulations. Many medical tourism sites confidently quote ’long NHS waiting lists’ .It may pay them to look at the real figures that are regularly produced. Bearing in mind that the figures exclude accidents and emergencies and refer to treatments that are not urgent, need planning around work schedules and often need a curse of treatment over several weeks, the NHS waiting times are short and compare well against how long it would take to arrange and complete private treatment at home or overseas. The average (median) time waited for patients in January 2011 was 9.1 weeks for admitted patients and 4.8 weeks for non-admitted patients. At national level, 90.7% of admitted patients and 97.3% of non-admitted patients completed their treatment within a maximum of 18 weeks.

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CYPRUS: Cyprus developing as a centre for medical tourism

Fri, 01 Apr 2011 11:05:14 GMT

Joanna Matsentides of Cyprus and Lebanon based medical tourism agency Sonomar Medical, has provided an update on the development of Cyprus as a medical tourism destination-• Many of the medical services available in Cyprus are of a high standard and the island is becoming increasingly popular as a destination for medical tourism.• As there are no medical schools in Cyprus, all doctors and surgeons study abroad and gain their experience at international institutions worldwide. As a result a wide range of information, knowledge and various techniques has been brought back. • One of the most sought after procedures is assisted reproduction or IVF. Numerous couples seek treatment abroad as the waiting list in their home country is either too long or the cost too high. There are a number of fertility clinics on the island and the majority have experience with overseas patients. It is important to have a clear understanding of the treatment suggested, the costs involved as well as the success rate. Also find out how long it is necessary to stay in Cyprus for each visit. • Cosmetic surgery is in high demand and Cyprus has a number of cosmetic surgeons. Check the surgeon’s credentials and ask how many procedures they have carried out. Photographs of their previous work will allow you to have an idea of what to expect. It is imperative the surgeon understands what is wanted and listens to your requirements.• Liposuction is not an ideal procedure for everyone, and is suggested for patients with localised fat who will benefit more and see better results. In some cases, it is better if you lose weight before considering various cosmetic surgery options.• Cyprus has a number of surgeons who carry out procedures by laparoscopic intervention. Recovery is very quick - normally one night (or at most, two) in the private hospital - and patients are generally fit to return to routine or fly back to their home country within the week.• Weight loss surgery is in high demand with an increasing number of people suffering from obesity and the consequences of being overweight, such as high blood pressure, diabetes, high cholesterol and heart malfunctions. • *Cyprus is very popular for dental procedures. The costs are far lower than in several other EU Member countries and there are a number of highly specialised dental professionals on the island. The most frequently performed dental procedures are veneers or smile makeover and dental implants. More complex procedures such as maxillofacial treatments are also offered.• Cyprus is gaining a reputation for offering specialised procedures such as minimally invasive spinal surgery, cancer surgery and facial reconstruction. The low costs, highly experienced medical professionals and desirable Cyprus environment contribute to its increasing popularity.• Most of the larger private medical facilities either have international accreditation or are in the process of gaining it.

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USA: US event organizer proposes five myths of medical tourism

Fri, 01 Apr 2011 10:30:26 GMT

Daniel Ordonez of Special Events USA, organizers of the Medical Tourism World Fair for consumers that will be held in New York in May, has put forward five medical tourism myths: 1. It is medical tourismWell, that is what it is often called but just like we say business travel and not business tourism, it is more about the provision of healthcare services across international boundaries than about sprinkling healthcare on vacations. So, medical tourism is really only a small part of medical travel. Incidentally, after that cosmetic surgery, your surgeon will tell you "no sun, no sea, no sand" so don’t believe the brochures. 2. It is new and boomingIt is a growing business but not quite so new. Medical tourism had thousands of healthcare visitors in 2010, and stories of patients (even heads of states) travelling for medical care go back decades. As to the boom, guesstimates vary and credible statistics on medical travel are few. Hospitals routinely report hundreds of thousands of patients because they are not counting individual patients but separate episodes of care (once today, once tomorrow or even once to the consult, once to the lab, once to the pharmacy!). Many figures include the local expatriates and holiday/business travelers who fall sick, who are not medical tourists. 3. Patients are going to cheap low quality healthcareCheap it may be relative to some Western countries, but comparing healthcare quality is hard. Healthcare systems are so different and low costs in themselves do not mean low quality. The USA spends less than 4% of GDP on healthcare (Editor: This figure is substantially incorrect. The USA spends over 16% of GDP on healthcare) but has more JCI-accredited facilities than any other country (Editor: JCI does not accredit facilities in the USA. The Joint Commission accredits health care organizations in the United states and its territories.) While the best healthcare in the world is undoubtedly in the USA, the average beats out the average in any other country. In any case, the world is now so flat that US facilities like Johns-Hopkins operate outside the USA as well. 4. Asian healthcare destinations threaten the facilities of the WestSounds logical, but consider the relative sizes of the economies. The USA alone has a two trillion dollar economy, while the entire annual foreign medical revenue from deliberate medical travellers to USA, Malaysia, Thailand and India barely exceeds one billion. How much can be siphoned away when supply is limited? The true danger in medical travel is not to the sending medical economies but to the receiving medical ecologies, as doctors are enticed away from public hospitals, prices escalate, foreign patients get preferential treatment and public healthcare systems become strained. Countries must pay attention to the public health implications of the medical travel industry, or risk hurting their own population and eventually their medical visitors as well. Globalization will happen. The risk for the overburdened payers in countries with expensive healthcare is that the early movers find the better quality healthcare for their insured/employees, and late adopters have nothing left. 5. There are many excellent healthcare destinations in the worldActually, there is not that many. Some countries have announced national programmes and many have marketed themselves as great destinations, but few really deliver. Too many patients had successful surgeries but bad experiences because of poor service, unsafe city streets, or heart-rending street urchin beggars. Beyond excellent, safe and trustworthy clinical services, affordable costs and good customer service, patients need a warm and non-threatening environment, cultural acceptance, ease of travel, safety for themselves and their families, and even opportunities for recreation and shopping for their travel companions. Few places in the world truly provide their patients the peace of mind when health really matters.

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MEXICO: Mexican dentists target American patients

Mon, 28 Mar 2011 12:47:59 GMT

Located in the heart of the Mexican Caribbean is a dental clinic focused on and designed for American and Canadian patients. Cancun Cosmetic Dentistry is celebrating 10 years of providing quality dental care for thousands of North Americans. The popularity and growth rates of dental tourism are a relatively new concept and the practice of traveling to have dental treatments is not only about saving money and time but not wanting to sacrifice quality and high standards. The costs of dentistry in Mexico can be as much as 70% less than at home in the United States and Canada. The high costs of dentistry in the United States (which thousands of Americans are not able to afford, and taking in consideration that millions are uninsured) drives people to look somewhere else for their dental needs. This is when they start looking for a dentist abroad, and Cancun is one of the top destinations for Mexican dental vacations. Cancun Cosmetic Dentistry has an English speaking team of 14 dental specialists that have been helping American people with all type of dental treatments, from a simple resin filling to a complete smile makeover. The clinic gets between thirty to forty American and Canadian citizens every month seeking affordable dental work in Mexico. Dental Implants Center in Tijuana has arranged new special dental patient rates for two of Tijuana’s top hotels, the Grand Hotel Tijuana and the Lucerna Hotel. Every year thousands of dental patients go to Tijuana from throughout the US and Canada to get high quality dental care at an affordable price. The special rates are at the Grand Hotel Tijuana, ($68 per night - regularly $140), and at the Lucerna Hotel ($65 per night - regularly $140). For those who prefer to stay in the US, the Western Americana Inn San Ysidro, with 2-way shuttle directly to and from the clinic, is only $79 per night including the shuttle service). Tijuana is easily accessible by air and train, or only a short 15- minute drive across the border to get to the clinic. By using new Medical Fastrack Border Pass patients can cross back across the border in 20 minutes or less as the Mexican government has established a special lane that is reserved for just dental and medical patients.

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PHILIPPINES: Medical tourism needs more government help

Fri, 25 Mar 2011 15:58:16 GMT

Dr. Eduardo A. Santos of Beverly Hills 6750, a beauty and wellness clinic in Makati, is seeking regulation of the medical tourism industry and calling for the creation of a Cabinet-level council to oversee it. He argues that the Philippines has a fighting chance of getting a bigger share of the global medical tourism business only if it is able to surmount the negative perception over security and peace and order. Bernabe R. Marinduque of Beverly Hills 6750 also says the industry should be policed to prevent the proliferation of fly-by-night clinics that may negatively affect the credibility of the country in providing medical tourism services. He argues that although the industry is regulated to some extent by the Department of Health, which accredits surgical facilities, and by the Department of Tourism (DOT), the Philippines has no single agency or a harmonized and unified standard by which procedures and facilities can be measured. Even marketing efforts by the DOT are sporadic, he argues, with various competing bodies all working independently. Dr. Eduardo A. Santos says “ Government has to play a more active role in creating success in medical tourism because the Philippines is negatively perceived compared to Thailand, India and Malaysia .He is referring to such issues as infrastructure like airports and security of tourists, where various overseas governments such as the UK, have warnings to their citizens that parts of the Philippines should be avoided due to high risks of terrorism and crime. Santos argues that efforts should be sustained with the private sector players and the government working through one overall body rather than the current confusing collection. Set up in 2006, BH 6750 has been posting a 20% annual growth, and opened a second branch in Quezon City in March.BH 6750 claims services at the multi-specialty clinic are 10 to 20 % cheaper than those offered by much bigger and older competitors. About a third of its customers are balikbayan (Filipinos who live overseas) who come home not only to visit relatives but also get healthcare. Santos says that compared to the United States, where most live, dental procedures are cheaper by 60 % while cosmetic surgery is half the price. Although he has not yet succeeded in finding a hospital that he can partner with in Cebu, business tycoon Manuel Pangilinan will continue to search for other hospitals and clinics to add to the Metro Pacific Investments Corporation (MPIC) portfolio. It already owns four - Riverside Medical Center, Makati Medical Center, Cardinal Santos Medical Center and Davao Doctors Hospital. MPIC subsidiary Medical Doctors, Inc. (MDI) owns and operates the Makati Medical Center (MMC), a 420-bed hospital in Makati City, Cardinal Santos Medical Center, a 235-bed hospital in San Juan City; and Davao Doctors Hospital, a 250-bed hospital in Davoa City. It has invested in improving all three and plans further improvements. It recently signed a 20-year management agreement to run Our Lady of Lourdes Hospital in Metro Manila. MPIC sees medical tourism as vital to financial success but Pangilinan admits that complex issues surround medical tourism, saying hospitals and the infrastructure have to be world-class before non Filipinos decide to get their medical services in the country in any real numbers. To attract foreign patients, he believes all need to get accreditation from international standard organizations. He is also concerned that foreign companies do not recognize local facilities, and unless they can get insurance company business paid direct by US insurers, medical tourism will not fully take off in the country. He sees Cebu as an ideal place to locate medical tourism and back in 2008, visited the Cebu City Medical Center and initially expressed interest in a major investment for a hospital in Cebu.

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TURKEY: South West Asia expanding share of medical tourism market

Fri, 25 Mar 2011 12:45:48 GMT

Turkey’s medical tourism sector is aiming to expand its share in the global market over the next two years. The Turkish Health Tourism Organisation (TUHETO) has been and will be promoting health tourism to Turkey at a number of events in Ukraine, Dubai, Switzerland, Azerbaijan and Kazakhstan during April, May and June. Scenes shot at private hospitals for Turkish soap operas broadcast in Arab countries have also notably contributed to the growth of health tourism to Turkey. Private hospitals are attracting more health tourism from Arab countries. At a recent workshop in Kazakhstan, ?brahim Artukarslan of TUHETO said, “People from Kazakstan have been traveling overseas for health treatments and operations for many years now, with top destinations including Israel, India, Spain, the United States and Hungary. When we asked representatives of the local health sector representatives why Turkey is not among these countries, the response was that they are very keen about health tourism to Turkey but have not had the chance to meet with representatives of the Turkish health sector. We need to consider very carefully the legal and insurance aspects of package tours to Turkey, which include, for example, in vitro-fertilization treatments or eye surgery. One mistake in one operation could ruin our reputation.” In an attempt to help Turkish healthcare establishments increase their presence in the market, Turkish Airlines is promoting a support package for healthcare institutions that invest in medical tourism. The package offers special discounts and incentives for patients travelling to Turkey for medical treatment. Gokalp Yazir of Turkish Airlines says, "Turkey had 80,000 patients in 2009, mostly travelling from Europe and the Middle East. Turkish healthcare establishments have set new goals in the field of medical tourism to increase the number of incoming patients from 80,000 to 1 million by 2015.Substantial investment has been made in improving the quality of medical facilities in Turkey, training current and new staff, building new medical centres and promoting Turkey as a prime medical tourism destination. Turkish Airlines, with its large network and quality service, intends to support medical facilities that promote Turkey as a global healthcare destination. Turkey’s central location between East and West, as well as quality and cost-effective medical care make it easier for many people from not very wealthy countries to receive the care they need. Turkey offers the same quality of services as Americans are used to through its network of 32 JCI-accredited hospitals at a price level which is of one tenth of the US domestic cost." The support package that Turkish Airlines offers is a 25 % discount for patients travelling from the US and a 20 % discount for patients travelling from other countries. In addition to the discounts, excess luggage allowances, waived re-booking penalty and discounts for two companions are also offered. Turkish Airlines, together with nine accredited hospitals in Turkey, has sponsored a market research study on the contribution to the US economy of Turkey’s healthcare partnership, which is being prepared by Kellogg School of Management, Northwestern University.

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IRELAND: Radical reform of Ireland's health and health insurance systems

Fri, 25 Mar 2011 11:10:29 GMT

Health and health insurance in Ireland will change dramatically in future years after the Fianna Fail ruling party was trounced in the elections. The new government is a coalition between Fine Gael and Labour. Fianna Fail oversaw Ireland’s greatest economic boom during its 13 years in office. That same government also witnessed the Irish economy’s demise as its swollen bank debts and credit driven economy ran the country into the ground. The EU bailout means that government spending on everything, including health, faces drastic cuts. Fine Gael says it will cut €1.1 billion from health service spending over the next four years. There are many problems in the Irish health system where patients cannot access services quickly due to cost. During the election, Fine Gael was highly critical of recent actions of the state owned health insurer VHI, on high insurance price rises at a time individuals and companies are seeing falling income and rising outgoings, lack of progress on privatization, and embedded position to any changes such as those suggested by an independent report. Ireland has an unusual health insurance system. It is not compulsory to buy insurance. The country operates a risk equalization scheme where companies with larger numbers of older subscribers receive financial payments, via the industry regulator, from rivals with a younger membership profile. So VHI gets payments from Quinn Health (whose parent company is in administration) and Aviva.The government has argued that a risk equalization scheme is essential to underpin the concept of community rating in the private health insurance market where everyone pays the same for identical products regardless of age. The Supreme Court has ruled that the correct interpretation of the term “community rating across the market for health insurance” means that each insured person within a policy must be charged the same premium, irrespective of their risk profile. The government has always argued that risk equalization is a fundamental prerequisite for the effective operation of community rating as it would guarantee all insurers proportionately share the costs. In 2009 the government changed the system with an interim scheme involving the introduction of age-related tax credits and a community-rating levy on companies in the health insurance sector. The new government has instructed the Department of Health that from 2012 new transitional arrangements will be put in place that are planned to closely approximate the effect of a full risk equalization scheme. Legislation providing for the introduction of a new risk equalization scheme in the health insurance market is scheduled to come into effect in 2013. The coalition means that both Fine Gael and Labour election promises are being modified into a new agreed plan on radical health reforms with a new equal-access universal health insurance (UHI) system based on the Dutch system, and including free GP care for all, with insurance for universal hospital cover introduced by 2016.The plan provides for a public insurer option, as well as private insurers, VHI will now be kept in public ownership to retain a public option in the universal health insurance system. A hospital insurance fund will subsidise or pay premia for those who qualify for subsidies. The universal insurance system will not discriminate between patients on the grounds of income or insurance status and the two-tier access system will end. The system of universal health insurance (UHI) will be introduced in 2016. Insurance with a public or private insurer will be compulsory, with payments related to ability to pay. The State will pay insurance premia for those on low incomes and subsidise those on middle incomes. This scheme will provide guaranteed access for care in all public and private hospitals from 2016 on the same basis as privately insured people now have. Exchequer funding for hospital care will go into a hospital insurance fund that will subsidise or pay insurance premia for those who qualify for state subsidies. Under UHI, insurers will be obliged to offer the same health cover package to all and will not be allowed give faster access to procedures covered under UHI.Under UHI, hospitals will no longer be managed by the state but will be independent, not-for-profit trusts. Insurers will not be allowed to run hospitals. The programme pledges to abolish tax incentives for private hospital developments. A new Patient Safety Authority will deliver a national licensing system for hospitals. It is not clear if dental treatment will be in the new system, but even if it is Irish people will still travel abroad for fertility treatment, cosmetic surgery and dentistry.

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GLOBAL: Free widgets for medical tourism and medical travel news

Thu, 24 Mar 2011 17:35:54 GMT

Interested in using IMTJ content on your own website? IMTJ can now provide free widgets for medical tourism and medical travel news. International Medical Travel Journal manages the most up to date and informed medical tourism news service for the medical travel industry. Each week, our e-newsletter goes out to over 10,000 people involved in healthcare around the world. Now you can share our medical travel news service, our articles and our blog with visitors to your site. All you have to do is add some code to your web site and your site will be automatically updated with IMTJ content. You can choose whether you want to include news items, articles or blog posts or perhaps all three. If you have a specific interest in medical travel news from a particular part of the world, or are interested in an RSS feed (as opposed to a widget), let us know and we will see what can set up for you. Personalisation of widgets and RSS feeds to meet your specific needs is free to clients of Intuition (owners of IMTJ, Treatment Abroad and DoctorInternet) How it works You can add our news, articles or blog posts to your own site with ease using IMTJ Widgets. 1: Choose the widget you want to use on your site 2: Copy the Javascript code 3: Paste the code onto your site

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BERMUDA: Bermuda explores medical tourism

Tue, 22 Mar 2011 12:07:33 GMT

The Bermuda Hospitals Board (BHB) is actively exploring medical tourism with one venture already generating 1,000 bed nights for local hotels. BHB says that new prostate cancer treatment unavailable in the USA has brought 200 medical tourists as well as their families and doctors to the Island since being introduced at King Edward VII Memorial Hospital (KEMH) nine months ago. Bermuda only has two hospitals, both run by BHB, a government owned body and the second largest employer on the island. KEMH in Hamilton is Bermuda’s largest hospital. In February, BHB cut short by 18-months a five year deal where US medical consultants Kurron Medical had been tasked with developing a health strategy for the island, including medical tourism. BHB believes that high intensity focused ultrasound could be one of a number of niche procedures to attract medical tourists. But Shadow Health Minister Louise Jackson warns adopting practices not accepted in the US could shatter Bermuda’s international reputation. HIFU, a non-invasive alternative to chemotherapy has not been approved by America’s Food and Drug Administration (FDA) BHB replied, “The treatment enables prostate cancer patients to travel to Bermuda to have a leading edge treatment. This treatment is proven and available in many countries, including Canada and Europe, and is currently in the final stages of clinical trials in the US. Until it goes through final approval in the US by the FDA, Bermuda’s proximity to the US and the fact we can offer recovery in a beautiful island setting make it a compelling destination for US patients. This is a benefit to the hospital and Bermuda.” Louise Jackson retorted, “We have got to ensure that the medical facilities here operate in accordance with recognised standards in care. This prostate cancer treatment has been brought to Bermuda, not FDA approved, and, we have our reputation in danger. At stake here is the protection of patients and Bermuda’s reputation. It is medical tourism of the worst kind.” The Bermuda Democratic Alliance is calling for BHB to ensure waiting times for locals don’t go up as a result of medical tourism. Candidate Michael Branco said the BDA is keeping an open mind on the topic, “ Bermudians could suffer as a result of bed space being handed over to American residents, and that care on offer is of an internationally accepted standard. The BDA is opposed to the provision of services in Bermuda that do not represent internationally recognised good practice. Is there capacity within our system to absorb medical tourists? Bermuda has a duty to provide safe and effective health care for our residents, and if an influx of medical tourists will take up hospital beds and drain resources available to locals, this would obviously be undesirable. How does BHB plan to balance these issues, particularly in relation to allocation of operating room time.”? BHB recently signed a deal with Paget Health Services, a consortium of local and international businesses, to design and build within 3 years, a new hospital to replace KEMH’s ageing structures.

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EUROPE: Directive on European cross-border healthcare formally adopted

Fri, 18 Mar 2011 12:42:09 GMT

The Council of the European Union has formally approved the European Parliament’s amendments on a draft directive aimed at facilitating access to safe and high-quality cross-border healthcare and promoting cooperation on healthcare between member states (6/11 + 6590/11 ADD 1 REV 2). The European Parliament’s amendments reflect a second reading compromise reached between the Belgian presidency and representatives of the European Parliament in an informal trilogue on 15 December 2010. In line with article 294 of the Lisbon Treaty the cross-border healthcare directive has now been adopted. Member states will have 30 months to transpose the directive’s provision into national legislation. The new directive provides clarity about the rights of patients who seek healthcare in another member state and supplements the rights that patients already have at EU level through the legislation on the coordination of social security schemes (regulation 883/04). It meets the Council’s wish to fully respect the case law of the European Court of Justice on patients’ rights in cross-border healthcare while preserving member states’ rights to organise their own healthcare systems. More specifically, the new directive contains the following provisions:• As a general rule, patients will be allowed to receive healthcare in another member state and be reimbursed up to the level of cost that would have been assumed by the member state, if this healthcare had been provided on its territory.• Instead of reimbursing the patient, member states may also decide to pay the healthcare provider direct.• For overriding reasons of general interest (such as planning requirements for ensuring permanent access to a balanced range of high-quality treatment or the wish to control costs and to avoid any waste of resources) a member state may limit the application of the rules on reimbursement for cross-border healthcare.• Member states may introduce a system of prior authorisation to manage the possible outflow of patients. This is limited to healthcare that is subject to planning requirements, such as hospital care (defined as care involving overnight hospital accommodation) and healthcare that involves highly specialised and cost-intensive medical infrastructure or equipment, healthcare that involves treatments presenting a particular risk for the patient or the population, or healthcare which would be provided by a healthcare provider which could raise serious concerns with regard to the quality or safety of the care.• A member state may refuse to grant prior authorisation if the patient seeking cross-border healthcare will be exposed to an unacceptable safety risk, if the general public will be exposed to a substantial safety hazard, if the healthcare is to be provided by a healthcare provider that raises serious concerns relating to compliance with standards and guidelines on quality and safety, or if the healthcare can be provided in the home country within a medically justifiable time-limit.• In order to manage incoming flows of patients and to ensure sufficient and permanent access to healthcare within its territory, a member state may adopt measures concerning access to treatment where this is justified by overriding reasons of general interest (such as planning requirements for ensuring permanent access to a balanced range of high-quality treatment or the wish to control costs and to avoid any waste of resources).• Member states will have to establish national contact points that must provide patients with information about their rights and entitlements and practical aspects of receiving cross border healthcare, e.g. information about healthcare providers, quality and safety, accessibility of hospitals for persons with disabilities, to enable patients to make an informed choice.• Cooperation between member states in the field of healthcare has been strengthened, for example, in the field of e-health and through the development of a European network which will bring together, on a voluntary basis, the national authorities responsible for e-health; another example is rare diseases, where the Commission will have to support member states in cooperating in the field of diagnosis and treatment capacity.• Long-term care services provided in residential homes and the access and allocation of organs for the purpose of transplantation fall outside the scope of the directive. The decision was taken, without debate, at a session of the Transport, Telecommunications and Energy Council in Brussels. The Austrian, Polish, Portuguese and Romanian delegations voted against and the Slovak delegation abstained. The cross-border directive will apply to all EU member states; Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and UK. It will also apply to any members joining the EU, including active candidates Croatia, Turkey, Macedonia and Iceland; and potential candidates Albania, Bosnia and Herzegovina, Kosovo, Montenegro and Serbia. It is highly probable that other countries that follow the EU on many services directives and also are part of the current European Health Insurance Card system for travellers, will accept the principles of the directive; Norway, Iceland, Liechtenstein and Switzerland.

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IRELAND: Tiny Irish village gets its teeth into dental tourism

Fri, 18 Mar 2011 12:40:40 GMT

The small rural community of Ballylanders, County Limerick is taking a bite out of the dental tourism market and is to build a factory to produce crowns, dentures and veneers. The clinic was born out of a meeting between Monika Raffael of the Hungarian Cultural and Business Association, and John Gallaghue, a former mayor of Co Limerick, in Hungary two years ago. Gallaghue, who lives in Ballylanders, was amazed at the amount of Irish people visiting Hungary to combine cheap dental work with a holiday and saw an opening. His local development company supplied a premises and equipment for a Hungarian-operated clinic in the village and is preparing to build a dental factory which will employ 15 people. Other villages in Co Limerick are making inquiries about setting up similar clinics, which the dental factory could supply after next May. John Gallaghue says, "We already have people coming from all over Ireland. When we expand after opening the factory we could look at marketing our own dental tourism in Britain." Hungarians are operating the clinic in conjunction with Ballylanders Development Association, will not charge religious people for cleaning and other minor work, and will give them a discount on major work. Dr Dilyan Bachvarov is very busy in the dental surgery with cleaning and scaling for as little as €40, an extraction €55, root canal treatment €195, and crowns from €300.These are way below normal Irish prices. Irish dental health is an increasing problem as state support for dental care is now severely curtailed. From January 2010, the government curtailed all support for treatments that used to be covered by the PRSI dental scheme, other than an annual examination. Subsidies for routine treatments such as fillings and extractions are no longer available. The average private price for a dental check-up is more than €80. While some Irish health insurance policies either cover dental work or offer discounts, all the three major insurers have recently raised prices, sometimes as much as 45%, and sometimes for the second time in a year. One health insurer is part of an insurance company in administration, while the state owned VHI is technically insolvent. An increasing number of Irish customers are taking advantage of the significant savings to be had in Northern Ireland. The promise of Northern Ireland prices south of the border is being offered by Smiles, which has 13 clinics throughout the country. Last year, the Smiles chain took the drastic step of dropping its prices by 30 per cent to match prices on offer in the North – and it has paid off with a 50 per cent increase in customer numbers. A clinic in Dublin’s Ranelagh called Access Smile is operated by dentists from Hungary who organised treatments for Irish patients in Budapest for a fraction of the price in Ireland. Pellevé is the latest entry into the non-invasive or non-surgical face lift market, and was launched in Ireland by Kambiz Golchin from About Face Clinic. Pellevé uses radio frequencies to modify the collagen bundles deep beneath the skin giving an immediate tightening effect. Over the next six months the collagen begins to re-knit, continuously tightening which should give ongoing results. The application of radio frequencies causes a warming sensation leading to the nickname “face ironing”. About Face Clinic is offering the treatment at €650 per session, a significant discount on UK prices, where it can cost as much as £1,200 per session. Kambiz Golchin is a consultant surgeon at Beacon Hospital in Dublin. About Face Clinic is next to Beacon Hospital.

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THAILAND: Hospital deals in Thailand

Fri, 18 Mar 2011 11:20:15 GMT

Bangkok Dusit Medical Services (BGH) has acquired shares which will give the hospital group an 11 % stake in rival private hospital operator Bumrungrad Hospital as the private health operator continues to strengthen the group’s position in the Thailand healthcare market. The move by BGH to invest in the highly regarded Bumrungrad Hospital is part of the group’s strategy to achieve synergies between medical operations in a bid to lower costs and strengthen its position in the expanding private healthcare market in Southeast Asia. The new partnership is expected to benefit both parties, as combined operations will help with the control of medical costs, resource management and general overheads at a time when healthcare costs are under pressure from inflationary increases. In 2010 BGH merged with private hospital chain the Health Network Group (HNG) in Thailand. The deal includes Phyathai Hospital, Paolo Memorial Hospital and six other private hospitals in HNG’s ownership. BGH is now the second largest hospital group in the Asia-Pacific region outside Japan with 27 hospitals. Patients Beyond Borders has released a stand-alone focus on Bumrungrad International Hospital, profiling the destination. Bumrungrad was the first hospital in Asia to receive Joint Commission International (JCI) accreditation in 2002. BNH Hospital in Bangkok is the latest to attain JCI accreditation.

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THAILAND: Australian parents travel to Thailand to choose baby's sex

Fri, 18 Mar 2011 10:38:50 GMT

Australian IVF clinic, Sydney IVF, is helping clients choose the sex of their baby by sending them to a Thai clinic it co-owns, avoiding Australian rules which allow the practice only for medical reasons. Sydney IVF has several clinics in NSW, Canberra, Perth and Tasmania. It is also part owner of Superior ART, a Thai clinic that provides IVF for family balancing, when families with children of one gender are seeking another child of the opposite sex. It costs $11,000 including flights and accommodation, Australian fertility clinics are prohibited from offering sex selection for non-medical reasons by national ethical guidelines by which they must abide to be accredited. The National Health and Medical Research Council’s health ethics committee developed the guidelines as argues that Australians generally believe parents should not be allowed to choose their child’s gender to balance out their family. Sydney IVF maintains it is not in breach of the guidelines, as it would breach people’s rights to ban them from travelling overseas to have the procedure. It also argues, with support from the Fertility Society of Australia, that sex selection overseas is within the rules of Thailand and Australia has no right to interfere in the laws of another country. One in six Australian couples suffer from infertility problems.

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USA: WorldMed Assist sets own benchmark for hospital quality evaluation in medical travel

Fri, 18 Mar 2011 10:32:20 GMT

Concerned that while national/international accreditation is essential for the hospitals and clinics it sends customers to, US agency WorldMed Assist has set up its own hospital quality evaluation programme to evaluate the quality of hospitals and health care facilities, purely on areas of importance to medical travellers. The company is only evaluating those hospitals it uses. It is neither a commercial venture nor an attempt to join the increasingly crowded international accreditation market. The programme was developed by Dr. Sharon Kleefield of Harvard Medical School. WorldMed Assist has helped hundreds of consumer medical travellers since 2006. The quality evaluation programme is to stay ahead of the additional demands of self-funded employers as they have started to sign up for WorldMed Assist’s corporate medical travel services on a wider scale. The programme is claimed to be consistent with the best of US and international standards, but focuses on the additional requirements for those that accept medical travellers. Wouter Hoeberechts of WorldMed Assist comments, “The objective is to be able to offer a high quality network that is safe for the patients. What we have found so far is that hospitals are very appreciative of our reviews since we provide them with input that allows them to become a better provider for international patients. It does not cost hospitals a single dollar. This is not a revenue generating programme, but only for the safety of the patient. Although we mainly use JCI hospitals we have a few in our network that are not JCI accredited, so we started with these. JCI is good, but our approach includes components of other bodies as well, allowing for a more rounded approach. It also includes our experience of having helped upwards of 600 international patients get treatment abroad. JCI only focuses on foundational and process metrics. We also include outcome metrics. We want to have our own, independent approach. It is impossible to keep up with what each accreditation organization provides and determine its merits/shortcomings. We also don’t want to rely on what other organizations do and see things with our own eyes.” Hoeberechts continues, “Our focus is an internal one. Our approach is not trying to copy or outdo JCI. We cannot review hospital processes with a level of detail that takes several JCI accreditors hundreds of person hours. We simply don’t have the financial strength to do that, as much as we would like to. However, our approach focuses on reviewing the critical areas that, when passed, allow us to comfortably send patients to the reviewed hospital. The focus on outcome data is something that JCI does not have. We visit every hospital before sending any patients, and every 3 years after that. This is something that we have done from the outset. We have had our own review process in place from the outset as well. The new programme is a more rigorous, thorough and standardized approach. We are only looking at the nine hospitals in our network and those that we are considering adding to our network. We made a strategic decision very early on to keep our network small so that we are a relatively large player for each of our providers, get to know doctors, management, logistics very well, all of which leads to a better relationship, ultimately leading to a better and safer patient experience.”

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POLAND, ESTONIA, LITHUANIA: Signs of recovery of medical tourism to Central Europe

Fri, 18 Mar 2011 10:20:59 GMT

The Polish market for medical tourism had a very weak 2010, as the global downturn hurt demand among foreigners for medical treatment in Poland, but is expected to begin a solid recovery this year, according to the Polish Association of Medical Tourism (PTSM).The number of foreign patients who received medical treatment in Poland plunged by almost a quarter last year, to 250,000 from more than 330,000 in 2009, dropping well below the figure registered in 2008 (280,000). For 2011, PTSM is forecasting robust growth of a 10-15% rise in patient numbers. In particular, it is anticipating a strong rebound in demand for dental care and cosmetic surgery services from Germans, Dutch and British medical tourists-the categories which saw the steepest decline during 2010.Other growth-supporting factors are expected to be substantial investments in the country’s sanatorium medicine infrastructure, as the sector is being transferred to private hands; and the availability of government grants for medical tourism projects, after the Ministry of Economy placed the sector on the list of 15 key export industries and earmarked €77m for export promotion projects over the next five years. PTSM will launch promotional and marketing efforts in promising foreign markets, especially in the United States and the Middle East. But PTSM predictions may not come true as on January 1, a 23 % VAT rate was imposed on cosmetic surgeries. As a result, their prices have gone up almost a quarter. The owners of clinics are afraid that this could lead to a collapse of the market. Monika Chomiuk from Artplastica clinic says,” Our foreign customers now have to pay more, which reduces our competitiveness in the global market. Right now, our prices make us marginally more competitive than Belgium. However, we are not even trying to catch up with the Czechs because it is simply impossible. More and more Poles have their cosmetic surgery performed in the Czech Republic or in one of the Eastern countries.” Commenting on the passing of the EU cross-border healthcare directive, Minister Hanno Pevkur said, "Estonia has always supported the free movement of patients, as we are a small country and the occurrence of a number of diseases is relatively small. Estonia could also be supplier of healthcare and not just a consumer. Estonian doctors are very professional and highly valued. Patients from abroad can bring supplementary revenue to our health care system." Your Health First has added gastric banding and gastric bypass services to the long list of medical tourism, health and spa services it offers from hospitals, clinics and spas in in Lithuania. Primary destination cities are Vilnius, Kaunas, Trakai, seaside resort Palanga, plus spa cities Druskininkai and Birštonas.

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BRAZIL, GUYANA: Innovative cosmetic procedures propel global medical tourism

Fri, 11 Mar 2011 11:50:38 GMT

According to a new report from Frost & Sullivan “Technology Trends in Cosmetic Procedures”, Brazil is a destination for global cosmetical companies and therapeutic equipment manufacturers to promote their products, as cosmetic procedures are poised to grow exponentially. Frost & Sullivan research estimates there is a demand for cosmetic surgery in a country that has created a reputation for procedures such as liposuction, breast augmentation, and buttock augmentation. The Brazilian Government offers lower tax rates and tax deductions for cosmetic surgery as a means of facing the global recession. Medical tourism is set to grow globally because of innovative cosmetic procedures. The demand for non-invasive cosmetic procedures such as radio frequency and laser-based methods are increasing. However, with malpractice insurance driving up costs and health insurance not paying for cosmetic procedures, customers in western countries such as the USA and Europe are looking for economical alternatives in South America. With regard to technology, more hybrid lasing techniques such as Triactive+, VelaShape, MedSculpt and MedContour are poised to dominate the cosmetic procedures market. High-intensity pulsed light is gaining more popularity and is accepted widely as a non-ablative alternative to microdermabrasion, chemical peel and laser resurfacing. Epidermal leveling is a relatively new procedure that offers benefits when combined with chemical peels and lasers. Among the existing dermal fillers, commercial fillers that mix hyaluronic acid and lidocaine reduce pain before and after the procedure with adoption increasing globally. Other fillers such as polymethlymethacrylate (PMMA) have proven to be long-lasting injectable microimplants for subdermal augmentation. Guyana’s president Bharrat Jagdeo says his government has secured an $18 million line of credit from India to build a new specialist surgical hospital in the South American country. The new hospital will offer specialized procedures such as organ transplants and cosmetic surgery to medical tourists looking for inexpensive medical care abroad, a practice known as medical tourism. Construction will start this year and end in early 2014. An Indian company will build the hospital and Indian medical specialists will operate it. Health Minister Dr Bheri Ramsaran adds, “A specialist surgical hospital will be a symbol of the country’s future. This will position Guyana in an advanced stance ahead of many Caribbean countries. This move will see not only Guyanese resident in Guyana, but Guyanese in the Diaspora and non-nationals coming to enjoy an international standard service while at the same time doing so at a facility that is located in a good environment. Plans are apace to promote the concept of health tourism.” Finance Minister Dr Ashni Singh reveals that over $1billion has been budgeted for the construction and maintenance of health sector buildings and infrastructure nationwide, including $150M to begin this 150-bed surgical specialty hospital offering invasive cardiology and radiation oncology.

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MALAYSIA: Malaysia expands health tourism and plans laws on fertility treatment

Fri, 11 Mar 2011 11:47:09 GMT

The Malaysia Ministry of Health has rolled out a number of activities in Southeast Asia to attract more foreigners for health tourism. The health tourism industry had been made a national key economic area and the Malaysian Healthcare Tourism Council will be restructured to coordinate the market promotion activities of the sector. The new downloadable Healthcare Malaysia magazine is proving popular. According to the ministry, 400,000 foreigners were healthcare tourists in Malaysia in 2010, generating revenue of USD101.65 million for the country. It is confident that the major programmes implemented by the ministry on the promotion of healthcare tourism, are moving on the right track .The country expects to meet or exceed the target set by the Malaysian government and expects to generate USD116.5 million in earnings this year. Private hospitals have been urged by the Ministry of Health to publish their rates on their websites. This is to ensure that patients are aware of the fees. Health minister Seri Liow Tiong Lai made the request at a recent meeting with the Association of Private Hospitals of Malaysia, “We have instructed private healthcare facilities to inform patients clearly about their charges, including any unanticipated charges due to complications. We are asking them to do so in order to avoid misunderstanding and disputes during and after treatment. By publishing the fees, patients will be protected and treatment costs better regulated in accordance with the ministry’s hospital fee schedule. Fertility treatment is unregulated but the Ministry of Health has initiated legislation for it and other reproductive issues with proposed legislation - Assisted Reproductive Technique Services Act. The drafting exercise is expected to be completed by 2012. The act will address issues such as surrogacy, sperm and egg banking, and sperm donation. The proposed act for fertility and reproductive issues is in the consultation phase -- involving legal parties, religious groups, non-governmental organisations, doctors and government ministries. Dr Prashant Nadkarni of KL Fertility and Gynaecology Centre is concerned that legalising surrogacy could pose problems if not done carefully, "We could become a rent-a-womb country. In some countries, the only way out for poor women is to be prostitutes or surrogates. We do not want Malaysia to be a have for that. There are places in Eastern Europe and India known to commercialise surrogacy. In some countries, paying money to carry someone’s baby is common and it has become a part of medical tourism. If there are no enforceable guidelines, commercial agents will get involved and it will be no different than any other business. That is why we need to legislate properly and not discriminate against genuine cases. The main issue is identifying who the mother is. By law, the person who gives birth to the baby is the mother. If there is no legislation, the surrogate mother can turn around and refuse to hand the baby over to the commissioning couple. Christians, Buddhists and Hindus believe that if the surrogacy is to bring life without causing harm to anyone, then it’s okay. But in Islam and Catholicism, there should not be a third-party in a pregnancy. The current situation is that doctors are supposed to follow guidelines set by the Malaysian Medical Council which state that in a surrogate arrangement, a woman agrees to become pregnant and bear a child for another person/persons and to surrender it at birth."

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USA: No rise in health insurer medical costs for first time in 10 years

Fri, 11 Mar 2011 11:30:14 GMT

For the first time in ten years, the US health insurance industry is expected to report no rise in medical expenses, according to a new study of 852 health insurers by Weiss Ratings, the nation’s only provider of independent insurance company ratings. Sceptics dismissing this as spin from a pro-insurance lobby group are wide of the mark as Weiss Ratings is far from popular with insurers as it offers free public lists of the 118 strongest and 100 weakest health insurance companies and regularly criticizes health insurers and Obama’s reforms. Weiss also predicts that future insurance increases will be far below what less informed analysts predict. With health reform meaning more Americans will have insurance, and with insurers paying only a fraction of the gross cost that those offering medical tourism compare themselves against, the analysis suggests that a key reason for Americans seeking overseas surgery unaffordable insurance will be a weaker driver than predicted. Overall, health insurers incurred medical expenses of only $234.9 billion in the first nine months of 2010, representing a $3.7 billion, or 1.6%, decrease from the $238.6 billion in medical expenses reported during the same period in 2009. Weiss Ratings estimates that medical expenses for the entire year will decline as much as $9.8 billion, or 3%, from $323.1 billion in 2009 to $313.3 billion in 2010. Gavin Magor for Weiss Ratings comments, “This is a critical change from the steady and rapid increases of prior years. If it continues in 2011, it should help boost health insurer profits while pressuring companies to curb premium increases and give consumers some much-needed relief.” The study also found that medical expenses increased sharply from 2005 through 2009, by 48%, an average annual increase of 10.3%, with double-digit increases in three out of the four years. The total number of individuals enrolled in health insurance was 145.0 million at the end of the third quarter, compared to 148.4 million one year earlier. The decline in medical expenses was reported by many companies. Martin D. Weiss of Weiss Ratings says: “Most large insurers should be able to handle the increased medical expenses expected under the new health care reform.” Health insurers incur medical expenses whenever they pay out health insurance claims, a cost that represents around 71% of their total expenses. The Patient Protection and Affordable Care Act will require individual and small group insurers to spend at least 80% — and large group insurers to spend at least 85% — of their premium dollars on medical care and on efforts to improve the quality of care. Some smaller health insurers may withdraw from the market, be acquired, or fail. However, most of the nation’s largest insurers have the capital and efficiencies needed to handle the expanded coverage and buy out the smaller companies. Another federal judge has thrown out a lawsuit claiming that President Obama’s requirement that all Americans have health insurance violates the religious freedom of those who rely on God to protect them. U.S. District Judge Gladys Kessler in Washington, D.C. dismissed a lawsuit filed by the American Center for Law and Justice, , on behalf of five Americans who can afford health insurance but have chosen for years not to buy it. The case was one of several lawsuits filed against Obama’s requirement that Americans either buy health insurance or pay a penalty, beginning in 2014. Kessler is the third Democratic-appointed judge to dismiss a challenge, while two Republican-appointed judges have ruled part or all of the law unconstitutional. Kessler decreed that the Supreme Court will need to settle the constitutional issues. Kessler ruled that Congress has the right to regulate health care spending under the Commerce Clause and that the individual mandate must be viewed not as a stand-alone reform but as an essential part of the law Obama signed 11 months ago aimed at reducing overall costs. She also said that anyone who objects to having health care for religious reasons can choose to pay the penalty instead — as the lawsuit said all five plaintiffs plan to do. Judges George Steeh of Michigan and Norman Moon of Virginia dismissed suits against the individual mandate last fall. Henry Hudson in Virginia ruled the insurance purchase requirement unconstitutional in December, while Roger Vinson in Florida ruled the entire health care reform act unconstitutional last month. The Obama administration is pushing back on the two federal judges’ rulings that declare unconstitutional the linchpin of last year’s health care reform legislation: the requirement that citizens buy health insurance. The Justice Department has filed a memo asking Judge Roger Vinson to clarify his January ruling that struck down the health care law, after concluding the so-called individual mandate was unconstitutional. He has been put on the spot and asked to "confirm that the declaratory judgment does not automatically relieve the parties of their rights or obligations under the Patient Protection and Affordable Care Act." Separately, the administration has asked the Court of Appeals to reverse the Virginia federal judge’s ruling that strikes down the individual mandate. The government argues the provision is permissible under the Commerce Clause, the constitutional power that allows Congress to regulate interstate commerce. All the state legal moves and politicking are ultimately no more than hot air as the U.S. Supreme Court will decide the issue. Meanwhile, the President has defused much opposition by agreeing to support bipartisan legislation giving states greater flexibility in implementing the health care law. This allows states to start designing their own health care plans in 2014, three years earlier than scheduled in the existing law.

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SOUTH KOREA: Medical tourism initiatives in South Korea

Fri, 11 Mar 2011 11:08:24 GMT

The local government of Seoul district Gangnam aims to promote the district to medical tourists. Shin Yeon-hee has been orchestrating strategies to make Gangnam a more internationally friendly district since last July. She explains that Gangnam is a representative district of not only Seoul but also Korea as a whole, “Unlike other spontaneously developed cities, Gangnam is a planned area. As Korea becomes globalized, Gangnam is also growing into a truly international district. Gangnam aims to attract at least 30,000 medical tourists by 2012. Medical tourism also benefits hotels, transportation and the restaurant business, creating more economic effects than just sightseers. There are many hospitals and clinics in Gangnam, renowned for cosmetic surgery and dermatology.” As Korea develops medical tourism, Yonsei Severance Hospital in Shinchon, northern Seoul is taking measures to ensure patient care is foreigner friendly. The international healthcare centre has coordinators for Russian, Chinese and English speakers.Yonsei Severance employs 13 bilingual interns to help manage the increasing inflow of foreign patients. A new international hospital in Incheon, set to open in 2015, will have features designed to accommodate international patients such as special beds to accommodate tall patients. Patients Beyond Borders will soon release a 32-page full colour standalone focus brochure on Asan Medical Center (AMC), profiling South Korea’s largest nonprofit hospital. It will feature the hospital’s world-class facilities, highlight its pioneering developments in areas such as organ transplantation and coronary artery intervention, and showcase centres of excellence. Established in June 1989 by Hyundai Motor Company founder Chung Ju-Yung, AMC’s mission was to create a hospital with an emphasis on caring for life and sharing with those in need and pain. Today, the main facility-one of the largest hospital campuses in the world-encompasses more than 4 million square feet and houses over 2700 beds. AMC also has longstanding partnerships with the University of Ulsan College of Medicine (Seoul), Partners Harvard Medical International (Boston), Imperial College London, and various hospitals across Asia. Josef Woodman of Healthy Travel Media comments,” Korea has some of the best healthcare and medical infrastructure in the world, and Asan Medical Center has clearly secured its place as one of the country’s leading providers. Revered for its high success rates with organ transplantation and treatment of cancer and vascular disease, Asan is also well known for disease prevention. And the savings are substantial-averaging 20% to 60% less than US costs." Offering patient-centred care and international partnerships for post-operative care, coupled with full-time English-speaking specialists, patient escorts and translation services, and other international patient services, the centre currently attracts more than 3300 global patients a year.

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EUROPE: New Eurobarometer survey supports cooperation on rare diseases

Fri, 11 Mar 2011 10:33:37 GMT

Rare diseases cause great suffering to many EU citizens. Up to 36 million Europeans are affected, and need proper diagnosis and treatment. A new Eurobarometer survey EB74-3 reveals widespread support for action on rare diseases at EU level. 95% believe there should be more European cooperation in this area and that rare disease patients should have the right to access appropriate care in another member state. John Dalli, European commissioner for health and consumer policy says, "I am encouraged to see that EU citizens want more European co-operation on rare diseases. This is important, because the required medical expertise may not be available within national borders." The survey was conducted in all 27 member states between 25 November and 17 December 2010, in order to examine Europeans’ awareness and knowledge of rare diseases and their support for policy initiatives and actions taken at national and EU level. Key findings:• Good general understanding, but detailed knowledge and awareness remain low.• Strong support for action at national and European level.• Almost all agree that national health authorities should give support to those suffering from rare diseases (96%) and fully reimburse their medication, even if it is very expensive (93%).• 95% agree that there should be more European cooperation, and that those affected should have the right to access appropriate care in another member state. The recently adopted EU Directive on patients’ rights in cross-border healthcare will benefit patients seeking safe and good quality treatment across EU borders. The directive foresees the creation of national contact points that provide information to EU citizens seeking healthcare abroad. It is especially helpful for rare diseases, where patients often deal with scarcity of expertise and delayed diagnosis. Measures foreseen in the directive will help with diagnosis when the best expertise is in another member state. The directive recommends that prior authorisation for cross-border treatment abroad should not be refused to a rare disease patient, without carrying out an appropriate clinical evaluation by an expert in that field. The new directive is expected to be fully integrated into law in 2013. Yann Le Cam of Eurordis, a non-governmental, patient-driven alliance of patient organizations that represents more than 434 rare diseases patient organisations in over 43 countries says, “One rare disease may affect only a handful of patients in the EU, and another may touch as many as 245,000.There are between 6000 and 8000 rare diseases affecting 30 million EU citizens. 80% of rare diseases are of genetic origin, and they are often chronic and life threatening. Patients with a rare disease face common problems: lack of access to correct diagnosis; delay in diagnosis; lack of quality information on the disease; lack of scientific knowledge of the disease; heavy social consequences for patients; lack of appropriate quality healthcare; and inequities and difficulties in access to treatment and care.” The European Commission has also joined forces with the National Institutes of Health, USA, to coordinate rare diseases research. Rare diseases affect 250 million people around the world. The definition of a rare disease is not the same around the world. In Europe a disease is considered rare if it affects one person out of every 2000 inhabitants, is characterized by being highly disabling, having no known medical treatment and the diagnosis is made on an average of 10 years after the symptoms are first noticed. In the United States, rare diseases include those that affect less then 200,000 people, and 30 million are affected by one of these diseases. There is a complication in that the availability of treatments for rare diseases differs from country to country.

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INDIA: Discover Motels launches first condotel (condominium hotel) with treatment centre

Fri, 11 Mar 2011 10:19:51 GMT

Discover Motels is a startup hotel chain owned by the Silvex Group of Mumbai. The company is currently soft testing its 216 keys property at the foothills of Matheran in the picturesque town of Neral, Raigad District, Maharashtra. The hotel is a brand franchise of Best Western International, USA, which is the world’s largest hotel chain with more than 4,000 hotels in 80 countries. The project has been designed by SKM Consulting of Australia. Discover Motels is the pioneer of condotel space in India and is currently expanding the network to 3 properties in Sri Lanka and one each in Alibag, Coimbatore, Mangalore and Chickmangalure. Over 500 rooms are planned each year for the next 5 years. A condotel is a condominium hotel, a hotel operating unit that is sold to individual investors where each owner acquires a room, whilst the whole enterprise is managed as hotel operation under a single brand. The business model is based upon value added services on the bare product, an extension of condominiums where groups of properties each with individual owners has in-house shared services. The new condotels include “Born Again”, a residential curative treatment centre aimed at addressing lifestyles diseases including diabetes, bone disease obesity, skin disorders, aging, digestive health etc. A curative treatment centre is one that is an ayurvedic naturopathic clinic that offers services with beds. It is for patients requiring diagnosis, treatment (whole range of ayurvedic and naturopathic treatments) or care for illness, injury, deformity or abnormality using the Indian/ holistic system of medicine run by trained medical professionals. Discover Motels plans to develop this into a high-end brand and expand it using the franchise model. Additionally it seeks to launch an assisted living and timeshare product when the other properties go into operation. The unique model is a mixture of hotel, holiday home, spa, medical tourism, assisted living and timeshare opportunities in a unique manner. The 500 hotel rooms based on modular building technology so can be transported from one location to another and used in Goa in the winter and Ooty in the summer. Radhika Mandrekar of Discover Motels says, “We are about to innovate and transform the hotel industry.” Charly Varghese adds, “Our focus is to deliver a great service product at the lowest cost in the sector. We also wish to aggregate small players across the country under the Discover brand to offer the customers a diverse offering in the economy resort market segment. Our target is to offer rooms at the US $20 to 50 range.” The reason for the soft launch of the new condotel is that it has so many different features from a traditional hotel that the product may have to be adjusted based on what works and what does not work. Combining hotels, medical tourism, franchising, timeshare and assisted living may be overly ambitious or a genius idea-time will tell.

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UK/EUROPE: University of York research project on cross border healthcare and patient mobility

Mon, 07 Mar 2011 12:28:12 GMT

To obtain reliable information on the numbers of UK patients seeking cross-border healthcare under the EU Treaty provisions, the NHS commissioned the Health Economics Consortium at the University of York to carry out a targeted research and information gathering study to collect intelligence on public and patient knowledge, attitudes and preferences with regard to the proposed directive, and to establish what the NHS was doing to ensure patients were able to access these rights. The main bulk of the research took place between November 2009 and March 2010. In a public survey of 1,004 adults, 62% would consider seeking planned healthcare abroad in the future with 50% citing avoidance of long waiting lists as the main advantages to going abroad. Disadvantages cited included not having family nearby, not being to speak the language and the costs of travelling. To the year ending 13 November 2009 the NHS paid for 747 cases where people were treated abroad. There were less people than cases as each pre-operation assessment, inpatient stay, rehabilitation and follow-up consultation is regarded as a separate case, even if for the same person. 50% of maternity cases were Polish women who wanted to go home to give birth. Only 108 cases were non-maternity, representing 64 patients of whom only 47 were British. Only seven of these had requested treatment abroad. 3 lived or planned to live abroad, and of the 40 sent abroad by the NHS for specialist treatment, these included 36 where specialist treatment for conditions such as epilepsy or cancer as treatment was unavailable in the UK.That the NHS is sending people abroad due to long waiting lists is a myth. All the 47 were sent to one of 11 EU countries (as the NHS will not send people long distance to Asia or America) That 12 went to Belgium and 13 to France illustrates that people prefer nearby countries. Taking evidence from the survey, the lack of translation of potential into current demand for overseas treatment could be that supply of healthcare in the UK meets current demand and so people do not need to go overseas. However, given the change in emphasis away from targets around waiting times, increases in waiting times or size of waiting lists may lead to more patients who seeking treatment abroad. Other EU studies agree that for state paid treatment, while many might consider travelling outside their country to receive healthcare, there is no evidence that numbers are likely to increase in the immediate future, although this may change several years in the future. The report analysed historic NHS experiments sending people overseas at a time when there were very long waiting lists. 0f 300 patients in a 2002 pilot waiting for ophthalmic or orthopedic treatment, only 190 actually went abroad for treatment in Belgium and Germany. Another pilot saw 600 people have hip and knee replacements in Belgium and another pilot ending in 2005 saw 1,000 from London treated in Belgium. The consensus was that doctors and local NHS hospitals hindered the projects, there were travel problems, and with complex problems arranging treatment in European hospitals, everything took a long time to organise. A similar pilot that the Norwegian health authorities undertook, sending 1,200 patients to five German hospitals, ran aground due to high treatment, travel and transaction costs. The lessons from all these are that translating the theory of cross –border treatment into reality can be time consuming and complex. Of 1,004 people in the public attitude survey, only 45(4%) had considered travelling abroad for planned treatment; and of the even smaller number who had previously travelled abroad for planned healthcare, only 3 individuals used the NHS as a primary source of funding. Younger people are more willing to travel but as this age group is less likely to require extensive treatment, this supports the notion that numbers requesting NHS healthcare abroad will not dramatically increase. When patient choice within the NHS was extended to allow patients to travel anywhere within the UK, few took it up, showing yet again that people prefer being treated near where they live. In the small focus groups, people were asked about attitudes to treatment abroad, whether self-funded or NHS paid. Many of those who received healthcare abroad made use of family connections, which seemed a significant driver. Those who did not have family connections undertook research via the internet. Reasons for seeking healthcare abroad were associated with waiting times, receipt of what they perceived to be better quality care, or receipt of private health care in a country where costs were lower than in the UK. Those who sought private healthcare in the UK were concerned mostly about waiting times. The majority might consider seeking healthcare abroad for similar reasons for planned diagnostic tests or minor surgery, or to receive treatment not available in the UK. Participants were not wholly in favour of seeking healthcare abroad: there were concerns about what to do about aftercare and complications. Reservations were expressed about going abroad for major surgery. Many had received dental care successfully abroad, both planned and urgent. Interestingly, the group was divided as to whether they would seek dental care abroad; aftercare was again a concern. Key findings:• Current demand for planned overseas healthcare funded by the NHS is very low. • While 60% do not appear to have any intrinsic barrier to receiving treatment abroad, the desire to be treated close to home in a system that is understood outweighs any perceived benefit from treatment overseas. • This lack of demand could be due to a lack of knowledge of rights EU citizens have to treatment abroad, especially to routine treatment where people may be more willing and indeed already be receiving treatment in the EU. • The new directive may raise the awareness in the population of their rights and so potentially raise demand. • An increase in demand could also arise if waiting times for treatment increase in the future as people indicate this as the main issue that would drive them to seek treatment abroad.• * Arrangements for NHS paid treatment abroad should be national rather than local commissioning.

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UAE: First TEMOS accredited dental clinic in the Middle East - GMC Dental Centre

Mon, 07 Mar 2011 11:57:02 GMT

Temos GmbH, a German based organization that specializes in quality assessment and certification of hospitals and dental clinics worldwide, has certified GMC Super Specialty Dental Centre as a member of the International Temos Network. GMC Dental Centre, part of GMC Hospital based in Ajman in the UAE, is owned and run by the Thumbay group, a local company that owns several hospitals in the region. It is the first hospital or clinic in the Middle East to achieve this certification. The GMC dental centre is a state-of-the-art dental facility opened in 2010. GMC Hospital is the first private teaching hospital in the U.A.E with a capacity of 250 beds in the heart of Ajman. Temos offers a seal of quality for internationally oriented hospitals and dental clinics. Its services are based on the international standard ISO / IEC 17020 and have been developed in cooperation with leading travel health, insurance and assistance services worldwide, with experts in quality management. After a self-evaluation questionnaire, a team of Temos experts including an internationally experienced medical doctor and a quality management expert do an onsite inspection of the hospital. Based on professional judgment and together with the management, ways and options for optimized care and services are discussed and realized. Hospitals meeting the requisite criteria/demands set by Temos and passing the process obtain the Temos Certificate, the seal of quality for high quality medical services for international patients. Temos offers an objective means of being assured of the general quality of certain services. They evaluate a vast range of hospital activities and governance, including management, equipment, clinical audit, research, training, and education, as well as clinical/medical activity. When the hospital or service meets the criteria, three years full certification is awarded. Temos has a new partnership agreement with Dr. Hashem Al-Fadel, who is now the regional partner for hospital and dental accreditation in Jordan and Saudi Arabia.

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MIDDLE EAST: Can Middle East countries stem the flow of outbound medical tourists?

Mon, 07 Mar 2011 11:37:18 GMT

Several Middle East countries have worked hard and been encouraged to see themselves as major medical tourism destinations. But despite development of new hospitals, marketing campaigns and high-profile conference attendance, the reality is that many more people are going elsewhere for treatment, than are going to the region, while much of the existing traffic is between countries and states in the area. For the Middle East medical tourism industry, the great hope has been the US market: if US patients and their insurers can be persuaded to undertake long–range travel, the industry will expand exponentially. But for the moment it is little more than a pipe dream, with surveys showing that US medical tourism numbers to be lower than hoped for. Insurance paid travel is held up by issues relating to liability, confidence and language, and show little sign of resolution. According to Frost and Sullivan, the business research and consulting firm, the medical tourism industry is currently a USD 78.5 billion industry, with just over three million patients who travel around the globe for medical care. The Middle East is one of the key source markets for patients, with one in five healthcare seekers worldwide from Gulf and Arab states. Significantly, patients from UAE alone spend about USD 2 billion in healthcare travel on an annual basis. While some Middle East organizations and countries are still hoping for an influx of business from other regions, others are realizing that their real markets are their own people who currently go abroad for treatment, and local markets. So competition between states is likely to increase. A key area is to bring the number and quality of local services up to international standards. A recent example is King Fahad Specialist Hospital in Dammam that has achieved Joint Accreditation International accreditation. This accreditation recognizes its commitment to excellence in patient care with the highest standards of practice. The hospital had successfully carried out 48 kidney, two liver and four pancreas transplants without any complications or fatalities. Recently two liver transplants were successfully performed. Some overseas healthcare providers see the region as having good potential for investment, mainly dealing with the increasing local nationals and the large expatriate worker populations-with any medical tourism as a bonus. The AST Rehabilitation Clinic in Cork has just announced plans for a major international expansion into Saudi Arabia. AST will be responsible for the establishment and management of a chain of clinics for the Saudi Arabian rehabilitation programme. AST have formed a partnership with Kussay Al-Rammah.The medical infrastructure is only beginning to develop in Saudi Arabia and Kussay has a vision of a first class health care system across the entire Arabian Peninsula. Adrian Tanzer of AST explains the new Saudi venture. “Initially, four treatment centres, catering for up to 300 patients per day, will be set up in different communities around the peninsula. These will be located in the provinces of Ad Damman in the Eastern Region, Riyadh in central Ar Riyad region, Jeddah in Makkah and Ha’il to the north.”

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NIGERIA: Nigeria develops inbound medical tourism; local doctors oppose outbound medical travel

Wed, 02 Mar 2011 09:15:54 GMT

According to governor Lyel Imoke of Cross River State, tourism is one sector where it holds a comparative advantage over other Nigerian states, although development of a tourist economy is at a very early stage. The local tourism bureau has been reformed, and is now looking for the private sector to invest in tourism. Governor Imoke says, “We believe that there is a growing demand for standard healthcare and specialist healthcare delivery. We are also embarking on a project that will be the first medical tourism facility in Nigeria.” Nigeria has a problem with outbound medical tourism, according to local doctors. A consultant orthopedic surgeon, Dr Felix Ogedegbe of Cedarcrest Hospitals, has been warning that the rate at which Nigerians seek medical attention abroad is gradually killing the country’s health sector and demoralizing medical practitioners in the country. He represents a group of doctors who warn of, “ The many risks involved when Nigerians decide to shop for medical treatment abroad, as in most cases they tend to compound their illness instead of curing it. Apart from the huge expenses involved, which if pumped into the health sector would yield positive result, many patients and their relatives have no clue about the doctors treating them and whether they are truly qualified to carry out the prescribed treatment. If this trend is not stopped and attention not focused on resuscitating the collapsing health sector, years from now the country will not have a health sector to boast of. Patients have returned from these countries with much more than bargained for. Some have had the wrong operation, unnecessary procedures and treatments and others have significant, lingering and life long complications. Although most hospitals have medical malpractice insurance to cover any unforeseen events, seeking damages is often impossible in cases of negligence, misdiagnosis or incompetence. There is a lack of follow up even when the treatment or operation has been concluded, demoralizing local doctors who feel unappreciated, leading to a brain drain of medical practitioners and most importantly the loss of $260 million to India for medical tourism.” Another surgeon, Dr Biodun Ogungbo, alleges that some doctors in Nigeria encourage patients to go to overseas hospitals abroad in exchange for a percentage of the treatment fees for every referral, “We have heard reports of patients and their relatives being asked to become touts in Nigeria for some hospitals abroad for a percentage of the treatment cost. Nigerian should embrace the culture of suing hospitals and doctors who assault, maim or kill their relatives as misdiagnoses, wrong treatment and unprofessional conduct should be punished". Although the Indian government is keen on promoting medical tourism, Indian High Commissioner Suresh Makhijani, perhaps unwisely, distances the government from any problems, “Medical tourism in India has nothing to do with the government. It is a private sector affair. Our duty here in the embassy is to grant visas to the patient and a family member. We have nothing to do with the hospital." There may be a solution that keeps patients and doctors happy. Rather than patients going to India, Indian hospitals see a potential in opening hospitals in Nigeria. The 120-bed Primus International Super Specialty Hospital has opened in Karu, a suburb of Abuja. Achia Dewan of Primus International says, We aim establish a network of world class centres in health care by providing state of the art facility and the creation of ethical, compassionate patient care through professional excellence. The need to reduce the cost of travel for prospective Nigerian patients was a key reason for building the hospital.”The hospital is keen to encourage inbound medical tourism as it has set up a special division to look after the needs of international patients.

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GERMANY, SAUDI ARABIA: Growth in inbound and outbound medical tourism

Fri, 25 Feb 2011 14:45:44 GMT

The Saudi Arabian market for both inbound and outbound medical tourism continues to grow, and a top destination for outbound Saudis is Germany. Lutz Vogt of German airline Lufthansa comments, "Saudi Arabia is an important source market for medical travel to Germany. And with the kingdom investing heavily in homegrown health care services and infrastructure as evidenced by plans to develop medical cities in Jeddah, there is a growing demand for inbound travel too. This augurs well for the industry and more health-related travelers to and from Saudi Arabia are to be expected.” Germany is believed to have received 68,000 travelers for medical treatment in 2008, mainly from Arab countries and Russia. This is thought to have increased since then. Lufthansa’s home base in Germany is a major destination for medical tourists as there are more than 2,000 hospitals with over half a million beds, offering up to date high-class treatment and care. Patients recovering from a treatment can also choose rehabilitation centers in Germany. There are more than 1,300 preventive health care and rehabilitation centers. Germany is not the only medical travel destination served by the airline. In Europe, Romania, Turkey, Bulgaria and Poland have become medical destinations, and in Asia, Thailand and Malaysia receive many international patients. Lufthansa has a network that connects 200 destinations worldwide via its hubs in Frankfurt and Munich- ideal for connecting patients to and from the United States, India, Turkey, Middle East and Western Europe as well as other popular medical tourism destinations. The airline has developed a specialty as a provider of state-of-the-art medical transport. A growing number of medical travelers are using Lufthansa’s Global Healthcare Mobility Partner Program. Lufthansa designed this to simplify the travel process and cater to the needs of international patients with comfort, flexibility and affordability. Lufthansa claims to be the only airline with a medical facility, which can be installed onboard. The airline offers a Patient Transport Compartment (PTC) on scheduled long-haul flights, which make no stopovers, such as for refueling. Compared with air ambulances, the flight time with the Lufthansa PTC is up to 50 percent shorter, making it easier for the intensive care patients and the medical personnel. Lufthansa also provides a flight attendant with medical training to look after the patient. The entire process of transporting the patient takes three days: Day 1: arrival of doctor from Germany; Day 2: medical check up to ascertain patient’s transport fitness level and if approved for travel, installation of the PTC onboard of the next flight from Frankfurt; and, Day 3: boarding the patient, return and deliver to hospital destination. The PTC can be installed within an hour on a Boeing 747 or Airbus A340-600 and is useable on flights to 62 destinations, as the demand for traveling with PTC has increased over the years. The PTC, is only used for cases with a severe condition preventing travel in a normal seat or using a stretcher, and is used 100 times each year. The airline also has 1000 cases a year where medical passengers travel on a stretcher, and thousands more as normal passengers.

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BARBADOS: Barbados Fertility Centre receives JCI seal of approval

Fri, 25 Feb 2011 12:52:06 GMT

Barbados Fertility Centre (BFC) has received the gold seal of approval from Joint Commission International. It has been reaccredited, meaning the clinic has maintained the highest standards since the gold seal was first awarded to them in 2007. BFC is the sole JCI accredited facility on Barbados. Ann Jacobson at Joint Commission International says, “The citizens of Barbados should be proud that Barbados Fertility Centre is focusing in this most challenging goal – to continuously raise quality to higher levels.” Joint Commission International is a US health facility accreditation programme that sets health care industry standards across the world, to give patients assurance that medical establishments have undergone stringent testing so that patients can make an informed choice within a level playing field. BFC was tested for patient’s pain assessment & management, the risk and safety assessment prior to treatments and medical procedures, the storage and handling of hazardous materials, the regular inspection and maintenance of equipment, the credentialing of staff including the ongoing and up to date training of medical staff and all areas of patient safety. BFC continues to boost medical tourism in Barbados as it assures patients that the quality of care they will receive when deciding on BFC for IVF treatment is as good if not better than clinics in the USA or the UK.The accreditation process is considered by BFC to be essential in improving the quality of care given to patients, and that by investing in new quality measurement systems, resources and staff training they are providing the best treatment for continued high success rates in IVF cycles. These quality standards also ensure continuous improvement as they are continually monitored. Since opening in 2002, it has year on year increased the number of couples conceiving through the creation of a stress reduced environment for couples under going IVF treatment. Couples from Barbados, the Caribbean, USA, UK, Canada and other European countries are now proud parents after successful treatment at BFC. BFC is one of the first IVF units in the world to offer a combination of medical tradition and a holistic approach by treating couples both mentally and physically with massage, reflexology, acupuncture and counselling on managing the whole IVF procedure. BFC believes that the approach of allowing couples to relax with their healthy mind and body programme whilst undergoing IVF treatment is one of the reasons why it is so successful. Dr. Juliet Skinner at BFC says, “We believe our high clinical and laboratory standards, and the relaxing environment of our beautiful island contribute to our high success.” BFC saw success rates in 2009 on women under 35 using Blastocyst with 71% achieving a pregnancy. In the under 40 age group they saw 56% success. For women under 38 who had IVF/ICSI at BFC success rates were 68%. This compares to a 42% success rate in USA and 22% in the UK in the same age group. Barbados Fertility Centre has a new online forum for patients suffering with infertility so patients can talk to each other, share experiences and support one another through treatment. Anna Hosford at BFC says, "We realised the importance of patients being able to speak to one another and have for many years been introducing patients to one another. We also host regular support groups ourselves, it seemed the next logical step to create an online forum for infertility patients to talk to one another. The forum we have created is for both men and women that are suffering with infertility and is there as a support network, it is open to everyone, not just our patients."

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INDIA: India discusses how to promote wellness tourism

Fri, 25 Feb 2011 12:26:54 GMT

The Ministry of Tourism has held a national workshop in Delhi on the promotion of wellness tourism and national accreditation standards for wellness centres. This was organized with the active participation of the Department of AYUSH, Ministry of Health, and the National Accreditation Board for Hospitals and Healthcare Providers (NABH). 150 participants representing the wellness industry were at the workshop to deliberate on the issues concerning ayurveda wellness centres, spas, skincare centres, cosmetic care centres, gymnasiums, fitness centres, preventive health care centres, and yoga centres. The objective of the workshop was to evolve a road map for formulating strategies for the development and promotion of wellness tourism to position India as the leading destination for wellness tourism, incorporating the country’s natural attributes including yoga, ayurveda, siddha, and spas; to increase the number of health tourists, lengthen the average stay and increase total expenditure by wellness visitors; and to increase professionalism and excellence amongst those delivering wellness experiences. Four groups deliberated on the four key topics; accreditation and the way ahead, capacity building and training of wellness professionals; promotion of the different components of wellness; and promotion of wellness tourism in India and abroad. Each group was targeted to come up with five to six recommendations for sharing with all participants for further deliberations. The resulting five recommendations for each group were presented to the Ministry of Tourism to help it develop the industry. The workshop saw the launch of the new accreditation standards for wellness centers prepared by NABH and approved by the Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH). The new accreditation standards for wellness centres provide a framework for quality of care for customers and quality improvement for wellness centres. The standards will help to build a quality culture at all levels and across all the functions of wellness centres. The NABH standards have ten sections incorporating 84 standards and 396 objective elements. There is now a complete set of standards for evaluation of wellness centers to enable them to be granted NABH accreditation. The standards focus on all aspects of service delivery including customer rights and education, infection control practices, trained and experienced staff, infrastructure, environment safety, processes and controls and statutory and regulatory compliances. The accreditation process involves a review of the documentation and two onsite visits by NABH assessors. Renewal of accreditation has to be done every 3 years.• Wellness is a state of optimal health covering physical, mental, social aspects of an individual.• Wellness centre is a healthcare facility that provides scientifically proven physical interventions with repeatable positive outcomes for improvement or maintenance of physical form, enhancement of functions or improvement of beauty for achieving the state of wellness of an individual-including gymnasiums, spas, skincare centres, cosmetic care centres, fitness centres, immunization centres, executive health checkup centres with associated advice. • Wellness interventions are those interventions that do not require overnight stay at the wellness centre for medical reasons; leaving the treatment after any stage should not cause any harm to the individual. India is a leading wellness destination that wants to fully tap the potential of wellness systems, developed through centuries of wisdom. This is being done by positioning India as a centre of ayurveda, yoga, siddha, naturopathy and spiritual philosophy that has been integral to the Indian way of life. The Ministry of Tourism has highlighted wellness in a through publicity and promotional activities. The growth of tourism in the country and demand for wellness centers has led to a sudden surge in wellness centers across the country. This gave rise to the concern for quality service and standards to be followed. This is why a system of accreditation that is uniform nationwide has been developed by NABH and AYUSH. The Ministry of Tourism has extended its market development assistance scheme to wellness tourism service providers including accredited wellness centers.

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UK: Cosmetic surgeons warn against illegal cosmetic surgery at home or abroad

Fri, 25 Feb 2011 11:09:36 GMT

Leading Midlands’ cosmetic surgeon Dalvi Humzah has warned the public to be aware of the risks associated with undergoing illegal cosmetic surgery abroad. His plea follows the death of British student Claudia Aderotimi who died after jetting to America for a low cost and illegal buttock enhancement operation in a hotel. The key word in his warning is ’illegal’. There are good and bad surgeons in every country. It is easy for cosmetic surgeons to raise concerns about going to another country for cosmetic surgery by highlighting a small number of deaths or problems. Every country has poor and dangerous cosmetic surgery; although there are millions of successful surgeries conducted each year on satisfied patients. Mr. Humzah’s private practice, Plastic and Dermatological Surgery is raising awareness of the dangers associated with any cosmetic surgery, whether at home or abroad. On both it is vital to check the official credentials of the person, place and procedure before agreeing to any treatment in a foreign country. At all costs avoid treatment that is too cheap or is undertaken anywhere other than a professional clinic or hospital. Humzah comments, “Cosmetic surgery is surgery – no matter how small it may appear it should be done by a fully trained surgeon and in the right clinical environment using the appropriate techniques. It is important that the facility where a procedure is being done is the correct environment for the specific treatment and certainly not a hotel bedroom. The use of injecting silicone for buttock augmentation in banned in both the UK and USA. If more young women decide to take an enormous risk in pursuit of a smoother, rounder bottom, it is vital they seek professional advice from a fully qualified surgeon on the best treatment available.” A new group of 40 cosmetic surgeons who are all members of the British Association of Aesthetic Plastic Surgeons (BAAPS) and/or British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) have created an organisation called Liberate as a service that liberates the consumer by giving them direct access to a cosmetic surgeon from the very first consultation and through the entire process including aftercare. The service allows the client to get to know the surgeon before the operation allowing them to make an informed and responsible choice. The Liberate slogan ’BYPASS’ – Before You Pay, Ask to See Surgeon - highlights the need for individuals opting to have cosmetic surgery to take control and be confident in their decision for cosmetic procedures. A new survey by Liberate highlights the need for women to be better informed of the dangers of cosmetic surgery abroad or in the UK. Claudia Aderotimi is not the only woman to have suffered serious damage after seeking to enhance her appearance with cosmetic surgery. Former Miss Argentina, Solange Magnano, died in November 2009 in Buenos Aires, due to complications following buttock surgery. Cosmetic Surgeon John Pereira of Liberate says, “ Cosmetic surgery is a medical surgical procedure and it should be treated as such. Research into the background and qualifications of the surgeon is critical for patient safety. Even in the UK, any doctor regardless of their qualifications can call themselves a cosmetic surgeon and legally perform surgery." While deaths from cosmetic surgery tourism hits the headlines, it is worth pointing out that in recent years, most deaths and problems in the UK, USA and Brazil have been where people went for treatment in their own country, not abroad. UK businesswoman Penny Johnson is currently suing a cosmetic surgeon for £54m after her partial facelift in Leeds in 2003 allegedly left her with a facial twitch, pain around her right eye and grimacing. She claims her career has been dramatically affected. In the most high-profile case of alleged negligence involving cosmetic surgery in the UK, Denise Hendry, wife of ex-Blackburn Rovers and Scotland footballer Colin Hendry, almost died in 2002 after liposuction she had at the Broughton Park hospital in Preston went badly wrong. Cosmetic surgery has the potential to be dangerous, and it is easy to demonize either cosmetic surgery or going overseas for any treatment. According to the American Society of Plastic Surgeons (ASPS), 13.1 million cosmetic surgery procedures, including those that are minimally invasive or surgical, were performed in the United States in 2010. Among the 1.6 million cosmetic surgical procedures -the top five were:• Breast augmentation (296,000)• Nose reshaping (252,000)• Eyelid surgery (209,000)• Liposuction (203,000)• Tummy tuck (116,000)

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IRAN: Why medical tourism has not taken off in Iran

Fri, 25 Feb 2011 11:01:53 GMT

A new study in the Research Journal of Biological Sciences, funded by the Iran University of Medical Sciences, on the challenges and opportunities for medical tourism in Iran says that so far there has been little success and changes are needed. The report writer gathered data by questionnaires answered by health services providers in the private sector and analyzed the results with professional survey techniques. The most important challenges faced by Iran are:• The need to create a dual market structure in health services.• Overcoming the lack of support of the private sector by the government.• How to increase access to potential medical tourism.• The need to grow private sector participation in health services. • How to decrease the number of patients from Iran who go abroad for treatment. The Islamic Republic of Iran is the 17th largest country in the world, in the Middle East. The country has 31 provinces and 885 cities with a total population of 70 million. The country is bordered on the East by Pakistan and Afghanistan, on the North by Turkmenistan, Armenia and Azerbaijan, as well as the Caspian Sea, on the west by Iraq and Turkey and on the south by the Persian Gulf and the sea of Oman. 830 hospitals have 120000 hospital beds. In the past, people from neighboring countries went to Iran for healthcare, but numbers fell due to local wars. There are no statistics on medical tourists other than various official guestimates in 2006 and 2007 of 20,00 or 30,000 that included spa and wellness trips. The study suggests that even a probably more accurate 2005 estimate of 17500 is too high for the current political and economic climate, and other local estimates put the figure as low as 7000. Patients go for cardiology, surgery, cosmetic surgery, fertility treatments and organ transplants. The main reasons patients go to Iran are:• Quality of health services and low cost of treatments and drugs in comparison with other countries of the region (Middle East and Middle Asia).• Access to advanced and new medical procedures, equipment and qualified professionals and medical staff.• Similarity of culture and language in some regions of Iran with neighboring counties such as Iraq, Azerbaijan and lack of some medical procedures, equipment, medical professionals and health infrastructures in those countries. Medical tourism in Iran has not developed with few hospitals seeking patients from other countries. The political problems between the US and Iran discourages Westerners. In Iran despite of its high potential for this industry focusing on low cost and high quality of healthcare services and access to Arab market at present, medical tourism has not grown well. Some hospitals and medical tourism agencies have begun to enter this industry but they have many challenges, particularly the one they have no control over, the image of Iran in the outside world. The main suggestion in the report is that medical tourism needs a lot more government support with practical help in targeting potential local countries that could provide patients, quicker processing of visas, but no direct government interference in the private health sector.

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CHINA: 1 in 7 Chinese leave communities for healthcare

Fri, 18 Feb 2011 15:22:44 GMT

As China starts the final year of its aggressive three-year plan to provide safe, effective, convenient, and affordable healthcare to all Chinese, about one in seven (15%) residents say at least one member of their household needed to travel to another community for medical care in the past year, according to a new Gallup survey. This percentage is lower than the average of 21% across 13 Asian countries Gallup surveyed. One of the primary goals of China’s healthcare reform is that residents will not need to travel far for care. The government agreed the construction of more than 5,000 hospitals in 2009. More than 10,000 health institutions and about 70,000 village clinics have been built. Healthcare services in rural areas of China lack the same level of access and quality present in urban areas, but rural Chinese are no more likely than urban Chinese to travel outside their city or community for medical care. The need to travel for medical care is more common in some regions of China where access to quality care may be less likely. Chinese living in the Southwest (8%) and largely urban eastern coastal regions (10%) are least likely to travel outside their communities for medical care, while those living in the Northwest (23%) and Northeast (20%) are the most likely. As in many other Asian countries, travel for medical care outside the country is low -- less than half of 1% of Chinese a year -- across all regions. Adequate regional access to care in a nearby city or area, the high costs of obtaining visas, and transportation may be a few reasons behind this low figure. The lack of personal networks in other countries to assist with medical care arrangements may also be a deterrent. Many Chinese say they do not have relatives or friends living in another country on whom they feel they can rely if they needed help; about 2% of Chinese say they do have this type of social safety net. Gallup results are based on face-to-face and landline telephone interviews with 4151 adults, 15 and older, conducted between June and July 2010 in China. A table of all Asia provides an interesting comparison. Please note that this is travel outside their own town/ city –not travelling to another country. In the past 12 months, have you or a member of your household had to travel to another city or area within this country to seek treatment for a medical condition? Yes No Nepal 54% 46% Afghanistan 38% 62% Bangladesh 33% 67% Mongolia 30% 70% Sri Lanka 25% 75% Vietnam 24% 76% AVERAGE 21% 78% India 21% 78% Philippines 20% 80% Pakistan 20% 78% Cambodia 17% 83% China 15% 85% Malaysia 12% 86% Indonesia 4% 96% Surveys conducted April to July 2010: GALLUP.

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SWITZERLAND: Health tourism on the rise along with European stress levels

Fri, 18 Feb 2011 12:07:21 GMT

According to European hotel bookings company EuroBookings.com increased stress directly correlates with a rising interest in health and wellness tourism in Europe. Professionals and business people looking for anything from a spa break through to medical treatment in Europe are not driven by price but by quality of care and the surroundings. One of the top European destinations for medical tourism is Switzerland. Their medical facilities are world-class with the latest technology. Add the clean air, high-class accommodation and that the country is geared up for all types of tourism, and you get an attractive destination. People do not go to Switzerland to save money; they go for luxury care and attention. The Swiss have made a conscious effort to promote medical tourism. The prices are very high and the services are marketed to the well off. Russia is a key market. Genolier Swiss Medical Network (GSMN) operates a network of clinics, and targets overseas patients for surgery. GSMN is a private hospital network operating mainly in the French-speaking region of Switzerland (Romandie). Its strategy is focused on building a national network by acquiring clinics and restructuring their operations. GSMN’s main aim is to offer first class hospital care to Swiss and foreign patients. GSMN manages six private establishments in Switzerland, including Clinique de Genolier, Clinique de Montchoisi, Clinique Valmont, Clinique Generale, Centre medico-chirurgical des Eaux-Vives and Privatklinik Bethanien, with 501 available beds. Medical tourists account for 5% of revenue, and this will rise as international promotion increases. The distinctive features of GSMN include its high quality services, its brand value, a pleasant working environment and an experienced management team with an entrepreneurial approach. GSMN ’s managing director, Antoine Hubert, is about to launch a public offer to the shareholders of the company, together with another unnamed investor. GSMN’s clinics are among those used by Switzerland Clinic, an agency that only offers leading Swiss clinics and Swiss spas for international clients. The network takes a close look at each clinic in Switzerland and reviews it from a medical and clinical point of view before deciding whether or not it qualifies to be part of the network. It is also linked to VIP tourism agency Rayan Partners that offers a range of services including treatment for stress, and a network of other services that are chosen purely on highest quality, not price;Russians are a primary market. Some regions in Switzerland are active in promoting and developing medical tourism while others are not. Switzerland is not competing with medical tourism destinations like India, Thailand, or Costa Rica. The clinics in those countries have a different business model and target cost-conscious medical tourists. Switzerland does not see those countries as competitors as it targets the top end of the price spectrum; it competes with Germany, UK, and USA and to a lesser extent, Singapore. In a recent survey of luxury travel who cater for upmarket travellers, the most important determining factors for clients when choosing a destination are:1. The right destination2. Value for money paid3. Once-in-a-lifetime experiences4. The services and activities available5. Price Although the top end of the market is not attracted by price, several recent travel market surveys on this sector all come to the same conclusion; the biggest change in the last two years is that customers are no longer prepared to pay top figures just for a destination, it has to be combined with value for money inclusive packages where they are not continually faced with demands for more cash for extras. Value for money is completely different from lowest cost.

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PHILIPPINES: Developments in Philippine medical tourism

Fri, 18 Feb 2011 11:05:27 GMT

Philippines estate developer, Century Properties Inc, has ventured into medical tourism, starting off with the construction of a $100-million facility. Jose E.B Antonio of Century Properties explains, "The potential of healthcare as a business is unimaginable. It will be an outpatient medical centre focusing on anti-ageing and wellness programmes. Centuria Medical Makati is a mixed-use medical tourism project. The 28-storey Centuria building will cater to both local patients and medical travellers. High-spending clients from the Middle East are giving a much needed boost to Philippine medical tourism. The main market is still Filipinos who work abroad or have migrated, mainly to the US and Canada, but numbers coming from the Middle East are increasing. These are medical tourists from Saudi Arabia, Kuwait, Qatar, United Arab Emirates, Bahrain and Oman. They come with at least one companion (many with their families), stay in hotels, travel and shop a lot – meaning, they spend more than just for medical expenses. Middle East clients include corporate buyers, such as the petroleum giant Aramco. In 2010, Saudi Arabia’s Ministry of Health spent $60,000 each for 80 patients it sent to Manila. That’s $4.8 million, excluding the expenses of travel companions for transportation, food and accommodation. Elizabeth Nelle at the Department of Tourism (DOT) says,” In a matter of months since we entered the Arab market, they started eye surgery visits to the Philippines and this opened their eyes to discover that the country has modern hospitals with state-of-the-art equipment and excellent doctors. This makes the Arab market a very good potential for medical tourism." The next niche markets are Nauru, Papua New Guinea, Guam, Palau and Micronesia whose citizens can use health facilities and procedures in the Philippines that are not available at home. The secondary markets, where price not availability is the driver, are Australia, Japan, South Korea, Taiwan and Europe. The Philippines is trying to attract the secondary markets by showcasing tourist attractions and special itineraries for those who are interested in combining treatment with leisure. The DoT estimates that 100,000 medical tourists visited the Philippines in 2009, and on average spent $2000.The DOT target for the Philippine Medical Tourism Program is 200,000 medical tourists a year by 2015.The main attraction for tourists from the United States, Japan, Korea and the Middle East is cosmetic surgery. To put health and wellness tourism in perspective, inbound visitors to the Philippines in 2010 reached 3.52 million surpassing the target of 3.3 million earlier set by the DOT.Visitors from East Asia accounted for 44.4% of the total visitor count in 2010 with Korea having the biggest share at 21% or 740,622 arrivals. This market grew by a hefty 48.7% against its 2009 volume of 497,936 arrivals, regaining its number one position among the major source markets. The USA ranked as the second main source market with 600,165 visitors for a share of 17% of total tourist traffic. Taiwan and Japan, which in the past years posted declines in arrivals, have rebounded with double-digit growth of 39.2% and 10.3%, respectively. Arrivals from China and Hong Kong posted 20.9% and 8.9% increases; this market is anticipated to pose continued growth as the DOT undertakes aggressive marketing and promotions to regain and re-establish confidence in the Philippines as a safe and secure tourist destination. Visitors from Australia recorded an all time high of 147,469 arrivals during the year, making it the fifth source market with 11.4% growth rate and one of the fastest growing. This market is expected to increase as JetStar Air commences flights between Darwin and Clark in 2011.Most European markets recorded double digit gain in 2010 with the Russian Federation growing faster at 33.6% followed by the Scandinavian countries (12%), France (11%), United Kingdom (6.5%), and Germany (5%). For the Middle East region, the United Arab Emirates and Saudi Arabia remained the key source markets as visitor arrivals grew by 21.4% and 16.3%. In addition, arrivals from Qatar and Bahrain exhibited significant growth at 15.2% and 10.6%.

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USA: Medeguide and AAPP form partnership to promote Doctors Online

Fri, 18 Feb 2011 11:01:56 GMT

Medeguide, a leading online international doctor directory, and the American Academy of Private Physicians (AAPP), a nationwide association of private doctors, have formed a partnership to promote global healthcare options to AAPP members and their patients. Under the agreement, Medeguide will feature a dedicated section on its homepage listing AAPP physicians. The new section will debut in March 2011, and is intended to provide American medical tourists with names of doctors in the US that provide pre and post medical travel support. According to Ruben Toral, founder of Medeguide, this collaborative effort will clear one of the biggest obstacles in medical travel today - continuity of care. "Working with the AAPP and its network doctors, Americans interested in medical travel will now have access to doctors around the country that understand it, support it and can help patients find the right doctor and medical treatment options internationally. Patients often travel for medical treatment without the support or supervision of their doctor. AAPP doctors will help fill that gap and make medical travel safer by providing medical support before and after treatment.” Dr. Marcy Zwelling of APP believes the initiative with Medeguide is the first step in getting US doctors to engage in global healthcare, "There is no doubt in my mind that healthcare is globalizing, and our doctors need to be aware of the treatment options that exist outside the US. Health reform has done nothing but provide uncertainty in the marketplace, and the US healthcare system is at risk of losing its competitiveness. Consumers, not insurers, should be driving the conversation in healthcare. I want to be able to bring the world’s opportunities for my patients’ health right into the exam room." By the second quarter of 2011, the partnership expects 250 AAPP doctors to be featured. Medeguide is an online directory of 2500 international doctors from leading hospitals in popular medical travel destinations. The site gives users the ability to search by specialty, hospital, country or procedure; recommend doctors; and request appointments. Among US hospital groups increasnng their marketing drive to be destinations for inbound and domestic medical tourism is Cleveland Clinic. Patients Beyond Borders, a consumer reference guide for medical tourism, will in March 2011 release a stand- alone publication profiling the Cleveland Clinic. Patients Beyond Borders Focus on Cleveland Clinic will provide global healthcare consumers with in-depth information on the hospital’s top specialities and doctors, achievements, accreditation, international concierge services, and patient case studies, as well as regional travel information. Cleveland Clinic has a network of medical facilities throughout northeast Ohio, Florida, Las Vegas, Canada, and Abu Dhabi, and welcomes more than 3.7 million patients annually from the US and 103 other countries. Josef Woodman of publishers Healthy Travel Media says, “Cleveland Clinic has served the international patient long before medical tourism became a buzzword, and has much to offer the discerning global medical traveler.” Cleveland Clinic caters to international clientele through its global patients services department. Services for international patients range from coordinating travel arrangements and arranging leisure activities for travel companions to providing translation services and catering to special cultural and dietary needs.

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CZECH REPUBLIC: One in four cosmetic surgery patients are medical tourists

Fri, 18 Feb 2011 10:43:19 GMT

A survey by the international cosmetic surgery portal Estheticon.com found that one in four cosmetic surgery procedures carried out in the Czech Republic in 2008/2009 were for international clients. This shows a significant rise from the year before when only one in five were from abroad. According to the clinics, the main reasons for the rise were the economic crisis (people were prepared to travel for cheaper surgery procedures) and the increase in quality of treatment, including complementary services such as accommodation. The Czech Republic offers patients skilled medical treatment for an extremely low price. Pavel Hilbert of Estheticon.com comments, “Many cosmetic surgery clinics have put great emphasis on their overall presentation together with quality, professionalism and range of services so there is no difference from reputable clinics in Western Europe. Good surgery alone is not enough nowadays. Clients expect excellent overall quality including consultations, professional staff, pleasant surroundings and various complementary services.” The number of foreign clients differs across clinics. 38% of all clinics report that international clients make up not more than 5% of their overall client number. In contrast, 26% of clinics (especially the bigger ones) report that international clients can be very important at 30% to 50% of their total clientele. Most of the international clients for Czech clinics come from Germany, Britain, Austria, Switzerland, Slovakia and the United States. A survey among doctors and clinics showed 92% of them stated that Germany is one of the top four countries for international clients, while 63% of doctors say that Britain is in the top four. Other countries mentioned ranked in the following order: Austria (one of the top four countries for 24% of doctors), Switzerland (20%), Slovakia (15%) and United States (11%). International clients also come from Italy, Canada, Ireland and Russia. Pavel Hilbert advises that when considering patient safety there are a few general recommendations that patients should be aware of when choosing a clinic or doctor:• Cosmetic surgery qualifications.• Membership in relevant cosmetic surgery society.• Years of experience.• Number of treatments performed.• Rapport with and confidence in the doctor.• Time to reflect on the procedure after initial consultation (14 days is recommended). A survey conducted by Estheticon.com in Germany showed that 44% would definitely not travel to another country to have surgery, however cheap the price is. ISCARE Clinic is to exhibit at London medical tourism show Destination Health. The clinic opened in 1995 and since then has offered a range of services in assisted reproduction. It has a high success rate. The IVF team was trained by leading specialists from Israel, where the success rate in treating infertility is the highest in the world. In 2005 it added the treatment of obesity, including bariatric and surgical methods. In 2007 the clinic added gastroenterology and cosmetic surgery.

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ASIA: Asian cosmetic surgery predictions for 2011

Mon, 14 Feb 2011 10:58:20 GMT

First appearing in 2009, the US based Asian Plastic Surgery Guide is an online global information resource on cosmetic care for people of Eastern and South East Asian descent. It aims to offer credible and balanced information in an intelligent format free of social network confusion, disguised marketing, bias or hype. Founder Steffan Cris says “While there are patients who leave the United States to seek medical care elsewhere, the inflow of foreign medical travelers is overwhelmingly higher. The main driver of medical travel is higher quality and not lower cost”. He offers his predictions for 2011: 1. Due to its sheer size alone, China will easily leapfrog the United States and Brazil to become the country whose surgeons perform the greatest number of surgical and non-surgical cosmetic treatments per year. 2. South Korea will successfully defend its position as the country with the world’s highest per capita rate of cosmetic surgery, as long as war does not break out. 3. The rate of cosmetic medical tourism within Asia will continue its meteoric bubble-like growth as young and middle-aged patients travel from less developed to more developed Asian countries. Most Americans, however, will stay put, most likely until just before the bubble pops (which won’t be in 2011). 4. Threatened by this still small exodus of cash-paying patients, Western surgeons will up the number and urgency of their public warnings about the dangers of obtaining treatment abroad. 5. Tapping into what is perceived as a neglected domestic market, a crop of new surgeons in the United States purporting to be experts at Asian cosmetic surgery will add to the already sizable increase in self-proclaimed specialists who have materialized in recent years. 6. The young Asian female in both East and West will remain the world’s most vulnerable cosmetic surgery target due to her age-related naiveté, willingness to be influenced by celebrity-driven social advertising, uncritical embrace of fads and scams, view of surgeons as a uniform commodity, and strong emphasis on capturing the lowest price possible above all else. 7. The cost of cosmetic surgery will rise modestly in the East while trending lower in the West, the result of supply and demand but also of advancing Asian economic parity. 8. Stimulated by the recession’s effect on disposable income and the consumer’s newfound reluctance to spend, marketing of less expensive but unproven or ineffective minimally-invasive treatments now strongly hyped in the West will gain traction in the East as well. 9. A backlash against undergoing surgical Westernization, while still a minor force, will take firmer hold in East Asia as the region continues to make strong gains in economic might, world status, and global cultural influence. 10. While seemingly inexplicable, the number of American women of European descent asking their surgeons to make them look more Asian will increase. 11. An avalanche of breakthrough press releases on new miracle stem cell rejuvenation therapies will… um, let’s not even go there. 12. Continuing threats of hostilities between the two Koreas will place a serious but temporary damper on some of the above.

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UK: New travel website launches for stressed out unhealthy Britain

Mon, 14 Feb 2011 10:45:01 GMT

A new online travel company called Health and Fitness Travel has launched. Their philosophy is to inspire holidays for your body and mind, from land and water sport activities to bespoke health and fitness programmes. They cater for everyone with diverse destinations and experiences, believing in the next generation of health and fitness travellers. Demanding workloads and longer commutes are eating away at free time, leaving the some Britons tired, unhealthy, and in need of a holiday to not only rest, but to put health and fitness back on their agenda. More people are choosing to move away from inactive type holidays and switching to more dynamic ones; holidays which offer health and fitness activities to break away and experience the associated physical and emotional benefits. Paul Joseph of Health and Fitness Travel says, “The culture of society is growing in self-awareness and we are becoming more conscious of the very limited time we have in our lives to look after ourselves. Holidays that promote discipline in key areas of health and fitness gradually change our attitudes in promoting a healthier lifestyle for us. The average person puts on 4 pounds of weight after every inactive holiday, meaning investing more time in exercise when they return home which is counterproductive. By hand picking resorts and tailor-making individual programmes, we offer a one-stop shop for everyone wanting a perfect health and fitness experience on their travels”. Health and Fitness Travel offers a varied collection of holidays from all inclusive health and fitness retreats in exotic locations to boot camp, spa, detox, ski, golf, tennis and yoga holidays in Europe and other destinations around the world. The second series of the UK’s only television chat show dedicated to cosmetic surgery and aesthetic treatments, MyFaceMyBody, is on Sky. Presenter Stephen Handisides, a cosmetic surgery expert, is seeking experts in the USA, for a series in late 2011, and in Australia, for 2012. According to Laurence Buckman of doctor’s professional body British Medical Association (BMA), the dramatic shakeup to the NHS could mean that,” patients will become internal medical tourists, flitting between doctors in search of new drugs and treatments in a system where affluent patients can shop around for GPs.”One of the key measures in the government’s NHS bill will force family doctors to band together to form GP consortiums to buy care for patients, controlling more than £70bn of taxpayers’ money. Dr.Buckman argues, “ GPs will have to compete to attract patients with emotive offers of treatments but only the richer ones will be able to exercise real choice. The more patients they attract, the more cash they will have to spend, and so family doctors will offer treatments such as expensive cancer care, IVF, weight reduction surgery or unrestricted kidney dialysis. I can see richer, healthy patients moving backwards and forwards in search of GPs that prescribe Herceptin [an expensive cancer drug], for example. This is the creation of internal medical tourism.” Under current rules, patients can only sign up with a GP within defined boundaries close to their home. Buckman explains the changes, "Once this is gone, I cannot see how doctors will fulfil their moral and contractual obligation. The scramble for patients could lead to GPs overspending and being taken over by multinationals. In recent weeks, a private firm has won a contract to run a hospital in Cambridgeshire and another is running a primary care trust in West London. We will quite quickly see failed consortia bought up on the cheap by foreign companies and see bits of the NHS run from abroad."

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MALAYSIA: Amendment to Dental Act will help medical tourism

Mon, 14 Feb 2011 10:42:08 GMT

The Malaysian government is now in the final stages of amending the Dental Act 1971, to strengthen the image of the dental industry and promote dental tourism. Health Minister Seri Liow Tiong Lai says the amendment is expected to be tabled in Parliament this year to allow dentists to advertise their services as a way to attract foreign patients to Malaysia,” I am very confident that we can expand this market especially now we have a small number of dental clinics all over the country. So we are in the process of amending our law to allow dentists to expand and project a corporate image. At present they cannot advertise. So now we will allow them to advertise and have their own promotional website." Global Capital & Development (GCD), a joint venture consortium tasked with the development of Medini, has announced a landmark deal with Malaysia’s leading healthcare provider, Pantai Group, to develop the Gleneagles Medini Hospital. The hospital will be in Iskandar at the southern tip of Malaysia in Johor. GCD is a consortium representing investors from the Middle East and Malaysia, including Iskandar Investment Berhad, which is partly owned by Khazanah, the investment arm of the Malaysian Government and Mubadala, the Abu Dhabi Government investment company. As a member of Parkway Holdings, Pantai’s development comes as part of its overall strategy to boost the region’s medical tourism industry across Asia. The hospital will be developed on 15 acres of land located in Medini North, the city’s lifestyle hub, and will be positioned as one of the premium hospitals of Parkway Health. The 300-bed private hospital will be completed in stages and will be Pantai’s 12th hospital in Malaysia. The development complements Iskandar Malaysia’s vision to become a regional healthcare hub and will reinforce Malaysia’s reputation for delivering world-class medical services for both Malaysian and foreign patients. Keith Martin of GCD says, “We will work closely with Pantai to develop a world class facility that will put Iskandar Malaysia at the forefront of healthcare in Southeast Asia. Gleneagles Medini Hospital will adopt global best practice for quality patient care to ensure world- class clinical outcomes delivered through a programme of thorough clinical governance.” Malaysia is one of the top five destinations for medical tourism in the world, with 35 private hospitals catering to the market. Its appeal lies not just in the low cost and world-class facilities but also the privacy it offers, particularly in cosmetic surgery, says Loraine Reinsfield of New Zealand medical tourism agency Beautiful You Holidays, a company which arranges medical trips to Malaysia’s capital city, Kuala Lumpur, “The cost advantage comes with the low cost of living and wages compared to New Zealand or Australia, coupled with the fact that there is no tax paid on treatments.” Rensfield credits the dedication of the Malaysian Government to install stringent accreditation and standardization processes to professionalize the industry. As a result the medical tourism industry in Malaysia benefits from the world-class facilities, expertise of its surgeons and excellent service.

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BAHRAIN: Bahrain competes with Jordan and the UAE for medical tourists

Mon, 14 Feb 2011 10:26:46 GMT

Bahrain, with its proximity to Europe, believes it has the potential to become one of the best medical tourism destinations along with the UAE and Jordan in the Middle East. The UAE and Jordan are attracting a large number of medical tourists from GCC countries and a few from Europe. Both have positioned themselves as medical tourism destinations. Bahrain has a first rate healthcare system that claims to be cheaper than both rivals and many Western countries. Bahrain is one of the fastest growing economies in the Middle East and is a peaceful nation. The country seeks to create a niche market and target tourists for open heart and cosmetic surgery, hip and knee replacements, and dentistry at affordable prices. What Bahrain does not have is a master plan and determination to implement it as the UAE and Jordan have done. It also needs to invest in hospitals, clinics, staff and other infrastructure. It lacks a skilled workforce that is needed to handle accommodation, travel requirements, marketing and other services to attract tourists. Bahrain plans to build Dilmunia Health Resort on one of its islands. The resort will include ultra-modern centres for diabetics, children with learning difficulties and other disabilities, maternity and neo-natal care, sport medicine and research. Medical tourism has investment potential for hospitals, specialised services, hotels and travel.

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EUROPE: European Cross-Border Health Care Organization launches

Mon, 14 Feb 2011 10:05:30 GMT

The European Cross-Border Health Care Organization (ECHO) is a new forum for the European cross-border healthcare sector, which aims to embrace members from all parts of the healthcare system, including:• Regulatory and supervisory bodies at all levels within the European Union, including national and regional participants.• State run and private health insurance companies as well as the national social security organizations.• Healthcare service providers including; hospitals and clinics; spas, rehabilitation and wellness; medical travel agents; and healthcare quality and accreditation bodies. The organization will be registered in Brussels as a non-profit organization (ASBL). The aim is to provide an open and neutral platform for stakeholders, providers and customers involved in cross-border healthcare. ECHO will offer its members:• A forum for debate and discussion on the route to the integration of cross-border healthcare.• An opportunity to influence and provide insight into the developments in cross-border healthcare. • Guidance in accreditation and certification.• Opportunities for networking within the industry.• Access to EU and other relevant documentation.• A newsletter on developments in cross-border healthcare.• Collaboration with events to help the development of cross border health care in the EU.• Access to institutions relevant to cross-border health care.• Information for patients about rights under the EU Directive.• Guidance to patients on questions of treatment in cooperation with national and international organisations in healthcare.• Advice on marketing cross-border healthcare services.• Provision of experts for special events, workshops and advice.• Listing of member details and contacts. Jane Billinghurst Urresti is co-founder and chairman of ECHO. Dr. Uwe Klein from EMTC 2011 is vice-chairman. Other board members include co-founder Martina Todchuk, Keith Pollard from Intuition Communication, Dr. Constantine Constantinides from healthCare cybernetics, Dr. Claudia Mika from TEMOS and Paul Vincke (European Healthcare Fraud & Corruption Network (EHFCN)). ECHO will have three advisory councils; standards and practice, ECHO development, and legal. There will be five working groups on hospitals and clinics, agents, spas, insurance and government bodies. The head office is in Brussels, Belgium, while the two local offices are in La Coruna, Spain and Bielefeld, Germany ECHO comes from a belief of Europeans in medical tourism that existing international organizations neither understand nor well serve the region at a time of great change. Several previous attempts at creating European medical tourism associations have failed to attract support. The most recent attempt, the Budapest based European Medical Travel Alliance, appears to have made little progress since being founded back in 2009.

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ALBANIA, ROMANIA: Medical travel news from the Balkan states

Thu, 10 Feb 2011 17:31:36 GMT

Romania is often seen as a place other Europeans travel to for low cost dental and cosmetic surgery. A new study reveals that Romanians also travel overseas for treatment. The reasons that Romanians choose medical treatment abroad are wide and varied: greater confidence in the professionalism of doctors abroad, the benefits of modern technology that may not be available at home, costs equal to or sometimes even less than locally, and the lack of appropriate treatment in Romania. In the first four months of 2009, 8500 Romanians received medical treatment in clinics in Hungary, Austria, Germany and Israel. The most sought-after medical services are cosmetic surgery, childbirth and stem cell transplants. In 2009 680 Romanians were treated abroad with the treatment costs paid for by the National Insurance scheme. To qualify for this money, they have to prove that the treatment they require is not available in Romania in a timely manner. The targeted replacement medical institution is preferably within the European area. Most requests come from patients suffering from advanced cancers, and hematological and cardiovascular diseases. Romanian doctors are increasingly familiar with the concept of medical tourism and guide their patients to hospitals that specialize in the needed treatment. A recent study shows that, among the Romanians seeking medical treatment abroad, 88% say they should choose this option only if they could not have access to it in Romania, and 83% would go abroad to receive better treatment than at home. 61% of those who choose medical tourism, choose patient care in a foreign hospital, and 57% to receive treatment in a shorter time than at home. Half say they would go abroad to have access to less costly treatment. According to the study, distance from home is the main reason why 66% would not choose medical treatment abroad. 42% say they would not go abroad for care because they are satisfied with treatment options in their country. 39% would not go abroad, because they do not know foreign languages and 67% because they cannot afford it financially. However, there are situations where some therapies and interventions that are prescribed in Romanian treatment schemes, for some reason cannot be achieved within the country. Spa and wellness products from Romania could soon be included in travel agency TUI Vital’s offerings for both Germany and Scandinavia, says the Ministry for Regional Development and Tourism (MDRT). MDRT representatives and those of the German concern TUI had talks about collaboration between the two parties on the occasion of launching Romania’s tourist brand in the German market in Munich. Albania’s tourism is a major factor in helping to turn the country into a modern European country. Captains of the tourist industry in Albania have created criteria for all business within this industry to work towards. These criteria are to be known as The Global Sustainable Tourism Criteria (GSTC) and are a set of 37 voluntary standards to help local businesses increase their revenue and success. The Global Sustainable Tourism Criteria and Authentic Albania Quality Mark will be launched in the next few months and will initially target accommodation businesses. Hotels and accommodation will be evaluated based on the Global Sustainable Tourism Criteria and then be awarded a gold, silver, or bronze classification that will be published on travel sites and in brochures and publications for foreign tourists. Ravin Maharajah, Albanian resort developer, says" This set of criteria offers simple and useful advice to small businesses to help them up their game plan. At Lalzit Bay Resort & Spa we are very keen for all companies within the tourism and related sectors to make a success of their businesses. Our development is situated in 20 hectares of frontline land with 300 meters of private beach. The resort will benefit from a beach club, sports and tennis club and a wellness centre."

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CHINA: How China is laying the foundations for medical tourism

Mon, 07 Feb 2011 16:09:21 GMT

In 2010, John Yang was given the task of marketing Shanghai as a preferred destination for foreign patients seeking advanced medical care. The ambitious target imposed by the authorities is that by 2012 China should have 200,000 medical tourists a year with an average expenditure of $10,000 per patient per visit. John Yang is chief executive of Shanghai Medical Tourism Products & Promotion Platform (SHMTPPP). His target is for China to compete with established competitors such as India, Thailand, Singapore, South Korea, Malaysia, and the Philippines. Many of these countries already have significant revenue from medical tourism. The country will soon take over from the USA as the world’s largest economic power, and has regularly confounded critics by becoming a major force and international investor in many industries. So a Chinese involvement in medical tourism could be a force to be reckoned with. But China has many problems of lack of health services, poor co-ordination of services for tourists, local and national government intervention, and mind numbingly slow officialdom. John Yang commented in a recent interview, "Foreign patients are interested in coming to China, but they do not know who to get in touch with as there are no readily available numbers or names to contact. The coordination of diverging interests is difficult. How do we bring all parties - hospitals, travel agents, airlines, trade offices, translators, and official bodies together? The answer is the establishment of SHMTPPP as a sole point of contact for foreign patients and as a promotional tool for medical tourism to China, specifically Shanghai.” SHMTPPP body has set up offices in Los Angeles and Jakarta, hoping to attract people of Chinese descent to Shanghai. The Los Angeles Chinese community alone numbers a million, while in Jakarta it is two million. In total, there are 40 million overseas Chinese globally. As some other countries have started to understand, targeting such a niche market that already has an affinity to the destination country is a huge advantage. Targeting this market also overcomes China’s problem that not enough people in the medical or tourist community speak good enough English to communicate effectively and safely with medical tourists, and very few are fluent in other European or Asian languages. Aiming at this community also overcomes the other barrier to medical tourism, widely differing cultures. SHMTPPP acts as a third-party administrator/agent, organizing a foreign patient’s medical, travel, dietary, and transport needs, including dealing with the often complex official paperwork. John Yang says, "From the moment the patient touches down at the airport, we transport them to the hospital or hotel, and organize all the paperwork needed by the hospital.” Personal assistants, fluent in English, are on 24-hour standby, as many Chinese Americans are not fluent Chinese speakers. SHMTPPP uses the top 20 hospitals in Shanghai. This includes the 850-bed Shanghai East International Medical Center, which already has partnerships with leading institutions such as the German Heart Institute in Berlin, the University of Maryland Medical Center in the US, and Universit Paris Descartes in France. The greatest attraction of China is the cost. The total cost of coronary bypass surgery for a foreign patient in a Chinese hospital is 40 % cheaper than in the United States. What may cause problems for competitors is that with high quality medical treatment, China is not the low-cost competitor that many expected. Shanghai hospitals are cheaper than Singapore, but slightly more expensive than India and on a par with Thailand. A combination of cost, quality and comparative culture could make China a serious competitor. The hardest work for SHMTPPP is to get China accepted as a serious destination, It does not intend to rush the process as it will take time for local hospitals and doctors to treat medical tourists differently from local patients. But once medical tourism takes off in China, Yang predicts that it could grow by as much as 100% or 200 % annually for the first three years. It will be a surprise if SHMTPPP reaches its ambitious target by 2012, but for China it is likely to be a question of when than if.

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USA: New research indicates changes in US healthcare in 2011

Fri, 04 Feb 2011 15:27:32 GMT

A potential decline in physician office visits, record spending on health information technology, a total redesign of insurance markets, and the creation of accountable care organizations are among the health industry trends in store for 2011, according to a Health Research Institute at PriceWaterhouseCoopers (PwC) report based on an online survey of 1,000 U.S. adults to assess consumer perspectives on health reform, healthcare usage, and payment for healthcare. The new health reform law will prompt most organizations to do strategy makeovers as they react to and prepare for new rules and payment models in 2011. Continuing cost pressures and new customer demands require a fresh look at existing roles of industry players. Industry changes wrought by health reform are far from over. In fact, they have only just begun. Health insurance deductibles for people in employer-sponsored plans rose an average of 77% between 2003 and 2009, while premiums for family coverage increased by 41%, The Commonwealth Fund recently reported. And that trend will continue in 2011, according to the report. In 2010, the most common plan had deductibles ranging from $400 to $999.As deductibles rise; patients will forgo medical care to avoid paying out-of-pocket costs. Couple the rising deductibles with the struggling economy, and patients are even more likely to skip doctors visits. With more employees being squeezed with high-deductible plans and coinsurance, their increased cost sensitivity will push them to make hard decisions on how often to go to the doctor or what prescriptions to fill. The primary focus of the insurance industry in 2011 will be the medical loss ratio (MLR) -- which mandates the proportion of an insurer’s revenue that must be spent on patient care as opposed to administrative expenses -- as well as the new health insurance exchanges. The Affordable Care Act (ACA) requires that, starting in 2011, insurers covering large groups must spend at least 85 cents per dollar of revenue on medical care or activities that improve healthcare quality (for small group and individual plans, they must spend 80 cents per dollar). Beginning in the second quarter of 2011, the federal government will provide grants to help establish insurance exchanges, and debate will intensify over what defines a qualified health insurer. According to the report, 13.8 million people are expected to enroll in health insurance exchanges in 2014. The healthcare reform law will create a new care model, called an accountable care organization (ACO). An ACO will be a group of providers that works together to treat a set number of patients, and splits the payments it receives for the care provided. Government will begin offering providers the option of forming ACOs with the hope that the setup will improve patient care and save money. Consumers need a better way to understand the value of their health insurance coverage. States, employers and health plans need to gain a better view of what their customers value and what drives their decisions. The US has often been portrayed as the driver of global medical tourism but the report does not even regard medical tourism as worth mentioning. In a country of 132 million, less than half a million travel abroad for medical treatment, compared to the UK figure of 60,000 from a population of only 60 million. The global medical tourism business needs to gain a better view of what US customers value and what drives their decisions, before government, employers, insurers and the public can take it seriously. Karen Davis of The Commonwealth Fund adds. "The Affordable Care Act is already benefiting Americans. Among those already being helped:* Adults and children with preexisting conditions, who now have access to affordable, comprehensive coverage.* Young adults up to age 26, who can stay on their parents’ health plans.* Small business owners who receive a tax credit to cover a portion of health insurance premiums for employees.” Karen Davis adds, “Many provisions in the Affordable Care Act will directly lower health insurance premiums such as increased transparency about insurance premium increases and rules on the percent of insurer premiums that go to administrative expenses and profits. By 2014, when key features of the law such as the state health insurance exchanges with subsidies for coverage and Medicaid expansions are in place, all Americans will have access to affordable coverage. The changes should enable us to enter an era of efficiency in health care that will make our health system truly sustainable. Health will provide all Americans with affordable health care and financial security.”

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JAPAN: Japan eases visa rules to attract medical tourists

Fri, 04 Feb 2011 15:25:57 GMT

Japan has eased visa requirements for patients seeking care at Japanese hospitals in a bid to promote medical tourism, particularly among wealthy young Asians. Under the new Visa for Medical Stay system, foreign patients can receive renewable, multiple-entry six-month visas, compared with single entry, 90-day visas previously available. Chief Cabinet Secretary Yoshito Sengoku said, "My feeling is that barriers between nations have to be low in the field of medicine." The Japanese government seeks to promote advanced medical treatment and health checks to wealthy individuals and their families, particularly from China and other Asian nations. Previously, Japan’s stringent immigration rules discouraged foreigners from choosing Japanese hospitals for healthcare. The 90-day visa was too short for many patients. It did not allow multiple entries and did not grant any special visit status for family members wanting to accompany patients during their stay in hospital. The new visa is only on a one-year trial basis. Japanese embassies have begun a campaign to promote the new programme. Hospitals in Japan are high quality but expensive, with some seeking to encourage a flow of wealthy travellers seeking medical treatment, as it improves their strapped cash resources. Last April Nippon Travel Agency Co. started to offer medical tours for wealthy Chinese tourists interested in PET scans. JTB Corporation launched a medical and health services centre in April that offers medical-related support services and medical tourism packages. Raffles Medical Group (RMG) will open in an area being developed near JR Osaka Station. The Singaporean medical group’s inroads into Japan could help grow the local medical tourism market, as unlike local hospitals, it has medical tourism experience gained in other countries. Hankyu Hanshin Holdings, developers of 24-hectare redevelopment area Umeda North Yard, Osaka Station, invited RMG and hopes to have outline agreement by the end of March. RMG plans to open an outpatient clinic staffed by Japanese doctors fluent in foreign languages. The clinic will target foreign residents, their family members and wealthy medical tourists from China and Russia. The group also plans to offer treatment at RMG’s affiliated hospitals in their home countries or at hospitals in Singapore. The next step for RMG is to establish a general hospital in Japan – but to do this is has to convince the Japanese government to ease regulations so foreign doctors can examine patients in Japan. The group operates clinics and hospitals in Singapore as well as general hospitals in Hong Kong and Shanghai. It has treated more than 1 million patients in Singapore, one-third of whom are mostly the many foreign residents of Singapore, and a small but increasing number of medical tourists to Singapore. The Development Bank of Japan has estimated potential demand for medical tourism in Japan at 430,000 medical tourists by 2020.

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EUROPE: Sustainable healthcare and hospital accreditation programmes

Fri, 04 Feb 2011 15:12:16 GMT

A recent detailed paper in the International Journal for Quality in Health Care by Charles D. Shaw; Basia Kutryba; Jeffrey Braithwaite; Michal Bedlicki; and Andrzej Warunek, raises interesting questions about healthcare accreditation in Europe. Healthcare accreditation has grown rapidly since the 1980s but critics question the value of accreditation rather than certification or inspection. The paper investigates the development of national accreditation organizations in Europe. The researchers conducted detailed surveys in 24 European countries on national healthcare environment, incentives, government policy, legislation, regulation; programme governance, development and funding. The survey identified 18 active national accreditation organizations in Europe. Older ones tend to be independent, profession-dominated, self-financing and rather slow growth. Newer ones have broad stakeholder governance, support from government policy and growth sustained by legal or financial incentives. Accreditation is moving towards a semi-regulatory model of external assessment. The principal challenges to sustainable accreditation appear to be market size, consistency of policy support, programme funding and financial incentives for participation. The growth of healthcare accreditation programmes accelerated globally in the 1980s and in Europe in the 1990s as regional and national strategies to improve the quality of health care. The earliest programmes were based on the North American models of the Joint Commission on Hospital Accreditation and the Canadian Council on Hospital Accreditation (now Accreditation Canada). Many accreditation programmes, for political, economic or technical reasons, have failed to meet initial expectations but others have flourished. ISO accreditation programmes were not included. Unlike ISO accreditation/certification of compliance assessment bodies, healthcare accreditation is characterized by peer review assessment of health care provider organizations against published standards that have been designed for that specific purpose. Eighteen national organizations were identified as active in Europe, providing accreditation services for secondary care at national or international level. Several accreditation organizations offer free online access to their standards, assessment procedures and indicative results (some including reasons for denial of accreditation), but this is restricted in older programmes. The European Commission is moving to regulate industrial accreditation of competent compliance assessment bodies with respect to goods and services but not yet healthcare. Healthcare organizations that accredit or certify services may need to negotiate a common position, if only to agree to share an understanding of the use of the term accreditation as applied to the teaching and delivery of health care. However, few healthcare accreditation organizations currently have a working relationship with their corresponding national accreditation service or with the certification bodies that it regulates. The original purpose of the international accreditation programme of ISQua was to build credibility and comparability for national organizations by harmonising standards and procedures on common international principles. Half of the reporting organizations in Europe claim to incorporate these principles in the design of their standards but only five have been formally assessed and recognized internationally. Among the research conclusions is that national governments and international organizations need to consider whether a critical mass is needed to run a comprehensive accreditation programme. Scale, organizing structures and funding arrangements are necessary to support an accreditation programme. Sufficient size, health system resources and structural frameworks seem to be preconditions for programmes to succeed. In smaller countries, it is difficult to form peer review teams without any conflict of interest, and fixed operating costs have to be shared between a small number of institutions. The question the researchers sidestepped, but hinted at, is “In the era of cross-border healthcare, would one accreditation body across the EU be more cost-effective, logical and easier for customers to understand?”

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AUSTRALIA: Australian government wants wealthy medical tourists

Fri, 04 Feb 2011 11:06:17 GMT

The federal Australian government is looking to cash in on lucrative medical tourism but the Australian Medical Association (AMA) warns that bringing in medical tourists could exacerbate pressure on the health system. The government is poised to spend $50,000 on a scoping study after a discussion paper concluded that fostering a medical tourism market could prove a boon for the health and tourism sectors. The discussion paper from the Department of Resources, Energy and Tourism said that Australia should target sophisticated, wealthy consumers from developing countries who are seeking to access higher standards of care and procedures that are not available in their home country. Australia could exploit its proximity to Asia, capacity in private hospitals, safe and clean environment, and niche medical expertise to attract medical tourists. Niches include implant surgical procedures such as hip and knee replacements, hearing and cardiac implants; laser, burns, eye, vascular, sleep disorder treatment; regenerative and stem cell treatments and cancer -says the discussion paper. Dr Steve Hambleton of the AMA-an organization that has always been strongly opposed to outbound and inbound medical tourism- says, “Now is not the right time. We already know that we have a shortage of practitioners in this country. We have increased our number of medical students. We are having trouble with training those medical students.’ We need to make sure we do not utilise our expert medical capacity in a way that would impact on training or impact on service delivery for our own country.’’ The discussion paper highlights that ’medical tourism is not without risks- it could prejudice Australians’ access to health services, add to the shortage of health professionals, pose threats to public health and mean extra costs when patients suffer complications or are the victims of mistakes. So when does the AMA think that it will be the right time for medical tourism? ’’In 10 years’ time when all those young doctors who are now graduating are trained, it may be a different scenario altogether’’ The scoping study will assess the current and future demand for Australia as a medical tourism destination, identifying specific markets and specialties; the capacity of the system to deal with this demand; and the broader costs and benefits associated with Australia’s growth as a medical tourism destination. New research from Australian travel agency Travel.com.au suggests that one in three Australian women would consider going overseas for a medical procedure. The Travel Trends Survey conducted in June 2010 asked 500 Australian travellers ’Would you consider going overseas for a medical procedure?’ Lisa Ferrari of Travel.com.au believes that medical tourism will continue to become an emerging travel trend for Australians over the next few years, particularly as more countries promote themselves as medical tourism destinations, "Thailand, India, Malaysia, Philippines and South Africa are popular destinations of choice for Australian’s seeking a medical procedure. Shorter waitlists, less expensive procedures and the option to spend their recovery time in an exotic location, are amongst the factors contributing towards this trend. These aspects are enticing more and more Australians to weigh up the alternatives and consider heading overseas for medical procedures.” Responses from different age groups did not vary with the exception of the 65+ age bracket where only 20% said they would consider going overseas for a medical procedure. Women from the Northern Territory are the most prepared to become medical tourists with 80% willing to travel for a medical procedure, Queensland came in second with 37%, followed by New South Wales with 34%, Western Australia with 31% and Victoria with 30%, South Australian with 24%. Lastly, those in ACT are not prepared to travel, with the result being 0%.

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INDIA, PHILIPPINES: Medical tourists will need special medical tourist visas in India and the Philippines

Fri, 28 Jan 2011 10:28:24 GMT

The Philippines will introduce special medical visas for foreigners, as the country seeks to grab a bigger share of Asia’s booming health tourism industry. The medical tourist visas, to be introduced later this year by the Bureau of Immigration, will allow foreigners to stay in the country for six months without having to apply for extensions, as regular tourists are required to do. The government is banking on its English-speaking and internationally trained doctors among its advantages, as well as medical and surgical costs that are up to 50 % cheaper than the United States or Europe. It is optimistic that by offering this visa, it will get more medical tourists from Europe and the United States. The Philippines’ health department launched a programme in 2004 to promote medical tourism by encouraging state hospitals and specialised private institutions to compete with medical organisations elsewhere in Asia. But despite many initiatives, actual numbers have been far lower than set targets. The proposed visa will also help the government earn income from the visa fees and charges. The Bureau of Immigration is preparing the proposed guidelines for the visa, for approval by the Department of Justice and the President. Under the proposed guidelines, the visa holder may stay in the Philippines for six months without having to secure an alien certificate of registration or identity card. Medical tourist visa holders will also exempted from paying the annual report fee levied on foreign residents. Visa holders will be required to post a bond based on the value of their airline tickets, to help ensure that the foreigners will not violate the conditions of their stay in the Philippines. But local medical tourism businesses are unhappy that making patients post a bond goes against the point of launching the visa; and if a customer has to pay visa fees and arrange a bond, it could drive them to countries with a less bureaucratic approach. The Immigration Act currently allows the extension of tourist or temporary visitor’s visas only to foreigners who come to the Philippines for business or pleasure. Foreigners are initially allowed to stay for either 21 days or two months that may be extended every month up to a maximum of two years. India has now exempted foreign tourists from the mandatory two-month gap to re-enter the country for regular onward medical treatment. A circular issued by the Ministry of Home Affairs said,” For persons coming for medical treatment, there is a separate category of medical visa. Foreign nationals coming for medical treatment will have to come only on medical visa and not on tourist visa. But this is subject to their submission of a detailed itinerary and supporting documentation (ticket bookings." Medical tourism in India has grown. The government estimates, although there are no real figures, that in 2002 150,000 foreign patients visited India for treatments, and this could reach 500,000 this year. India has recently clamped new restrictions on foreign tourists visiting the country on tourist visas to avoid misuse of such visas which entailed tourists had to give a mandatory two-month gap before re-entering India. So foreign nationals holding Indian tourist visas with multiple entry facility have to make a two-month gap mandatory between two visits. India issues tourist visas to foreigners who do not have a residence or occupation in the country, will now allow foreign tourists who after initial entry into India plan to visit another country as part of neighborhood tourism-related travel and allow them to re-enter India before their final exit to have two or three entries.

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EUROPE: European Commission issues advice on patients' rights in cross-border healthcare

Fri, 28 Jan 2011 09:55:06 GMT

The European Commission has provided answers to some frequently asked questions on the cross border healthcare directive. Q A Polish woman would like to receive hip surgery in the country where her grandchildren live and work but how can she organise this from Poland? A Portuguese man seeks cataract surgery from a specialist in Spain but will he be reimbursed? These are just a couple of cases where a patient may need clarity on rights and rules for cross-border healthcare. AA newly adopted EU law clarifies patients’ rights to access safe and good quality treatment across EU borders, and be reimbursed for it. Patients travelling to another EU country for medical care will enjoy equal treatment with the citizens of the country in which they are treated. It will help patients who need specialised treatment, for example those who are seeking diagnosis or treatment for a rare disease. QWhat scale are we talking about? APatients prefer to receive healthcare in their own country. That is why the demand for cross-border healthcare represents only around 1% of public spending on healthcare, which is currently around €10 billion. This estimate includes cross-border healthcare that patients had not planned in advance (such as emergency care). This means less than 1% of the expenditure and movement of patients is for planned cross-border healthcare, like hip and knee operations or cataract surgery. Q What about the existing legislation in this area? A• Citizens needing care (including emergency care) when temporarily abroad will continue to benefit from the existing regulations and be provided with the care they need.• For planned care, a patient can already apply for prior authorisation. This cannot be refused if he/she cannot be treated within a time limit that is medically justifiable. QWhy do we need this new legislation then? A• This Directive will not affect the benefits already offered to citizens through existing regulations. Although the existing rules have been in place since 1971, clarification was needed on the rights of EU citizens to receive healthcare in another member state.• In the case of hospital care, one of the main achievements of this new Directive is that patients will be able to choose their healthcare provider.• For non-hospital care, patients will be able to seek healthcare abroad without prior authorisation or formalities, and claim reimbursement upon their return home. This directive covers not only public, but also private providers.• For both hospital and non-hospital care, patients will have access to information on the quality and safety of the care they will receive.• This directive also seeks to address other practical questions: where can I find information on quality standards applied by the hospital? How much will I be reimbursed? QDo I need authorisation from my national authority before going abroad for treatment? ANational authorities can introduce a system of prior authorisation in three cases:1) For healthcare that involves overnight hospital stay of at least one night.2) For highly specialised and cost-intensive healthcare.3) In serious and specific cases relating to the quality or safety the care provided abroad.In these three cases, patients may need to ask for permission in advance from their national health authority in charge of reimbursement. QCan this authorisation be refused? ANational health authorities can refuse authorisation if the treatment in question, or the healthcare provider in question, could present a risk for the patient. Also, if appropriate healthcare can be provided at home in good time, authorisation can be refused but member states will need to explain why such a decision is necessary. QWhat if I am refused authorisation? APatients have the right to request a review of any administrative decision on cross-border healthcare for their individual case. QHow much will I be reimbursed after receiving a treatment abroad? APatients will be reimbursed the same amount as they would receive in their own country for the same type of healthcare. Member states where care is free of charge will need to inform patients about their reimbursement tariffs. QCan I seek healthcare abroad if the treatment is not available in my country? AYes, if a treatment is unavailable in a member state, the national health authorities cannot refuse authorisation to a patient seeking it in another EU country. However, patients will be reimbursed for such treatment provided it corresponds to the national health benefits package. QDo I need to pay for cross-border treatment upfront? AYes, generally the patient pays upfront and would then be reimbursed by their national authority as quickly as possible. The law also foresees that member states can choose to confirm the amount of reimbursement in writing upfront, on the basis of an estimate presented by the patient. QWhere can I find more information about my rights to healthcare abroad? AThis new law foresees the establishment of a contact point in each member state to provide information on patients’ rights to healthcare across Europe. These centres will exchange information between them and will be able to provide practical information to patients on conditions and levels of reimbursement, possible treatments, providers, procedures for redress, etc. Patients will consequently have a clearer idea on the quality and safety of healthcare provided abroad, which will lead to more informed decisions on cross-border healthcare. QCan I transfer my medical data to the member state where I will be treated? AThe country of origin will ensure that the healthcare provider in the country of treatment can have access to the patient’s written or electronic medical records. Enhanced cooperation on eHealth between member states will ensure that health IT systems will be able to talk to each other. QWhat should I do if something goes wrong whilst receiving treatment abroad? AThe new law sets out both the country of treatment and the country of reimbursement’s responsibilities with regard to complaints and redress. National contact points will provide patients with the information they need in this respect. QHow can I be sure that the treatment I received abroad will be followed up properly on my return home? ASeveral measures are foreseen to ensure continuity of care. The country of treatment will ensure that patients have access to their written or electronic medical records related to the treatment they received. The home country will ensure the medical follow-up is of the same quality regardless of where in the EU the treatment took place. QWhat remains to be done? A• At national level, member states will establish at least one national contact point that provides all relevant information to patients. • They need to ensure that administrative procedures on the use of cross-border healthcare and on reimbursement of costs are in place, including complaint procedures as well as mechanisms to calculate costs.• The Commission will set up networks to foster EU cooperation on health technology assessment and eHealth. It will also help facilitate the recognition of cross-border prescriptions. QWhen will this law come into effect? ANational governments have 30 months to integrate these measures into national legislation.

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EUROPE: Reaction to the EU cross border healthcare directive

Fri, 28 Jan 2011 09:32:33 GMT

Last week, MEPs approved the EU Directive setting out patients’ rights to seek medical care in another EU country. The legislation clarifies the rules for reimbursement, including when advance authorisation may be required. French MEP Françoise Grossetête, who led discussions in Parliament, commented: "Patients will no longer be left to their own devices when they seek cross border healthcare and reimbursement. This directive will at last clear up patients’ rights because until now they have been very vague." John Dalli, European Commissioner for Health and Consumer Policy said, “This vote marks an important step forward for all patients in Europe. The Directive will benefit patients across Europe by clarifying their rights to access safe and good quality treatment across EU borders, and be reimbursed for it. Generally speaking, people prefer to receive their healthcare closer to home. No one wants to travel further than necessary when they are sick. However, sometimes the need for certain treatment leads patients to go abroad. Another reason could simply be that the nearest hospital lies across a border. In addition to providing a clear and coherent set of rules on cross-border healthcare, this Directive will benefit patients in several other ways. It will help patients who need specialised treatment, for example those who are seeking a diagnosis or treatment for a rare disease. It will bring about closer and improved health cooperation, including the recognition of prescriptions, between member states. Health experts across Europe will be able to exchange best practices and mutually benefit from innovations in health technology assessment and eHealth. I look forward to a swift implementation of this directive by the member states". While most political groups in the European Parliament hailed the new legislation, left-wing MEPs denounced the implicit discrimination for poorer people who cannot afford to pay for procedures upfront and then wait to get reimbursed later back home. Dutch Socialist Party MEP Kartika Liotard said, "Care is not a commercial, tradable good; it is a basic need for everyone. The new EU directive will mean that insurers drive patients abroad in search of cheaper treatment. But patients - especially if they are seriously ill - just need care in their region, close to their family and a doctor who speaks their language. Health tourism will be a logical consequence of this law, with patients from rich countries able to travel to less expensive countries, where they may be given priority over the local, poorer patients.’ In the UK, reaction was mixed. London Liberal Democrat MEP Sarah Ludford said: “The new rules represent a real milestone for cross-border healthcare in Europe. They provide a coherent framework for UK patients seeking treatment in another EU country. The right balance has been found between protecting national health systems and strengthening patients’ rights. The new rules guard against health tourism, with foreign patients coming to the UK having to pay the full NHS cost of treatment.” But UKIP MEP Gerard Batten disagrees, “The financial burden of offering cross-border healthcare in the UK to all EU citizens falls on the British taxpayer.” John Lister of the campaign group Health Emergency, said: "Overseas patients could become the sought-after patients for NHS trusts, exactly like foreign students are for universities. It could have very detrimental effects in British hospitals that are already working to capacity.” But a spokesman for the NHS Confederation, which represents health trusts, said the rules contained a clause which made it an obligation for health services to prioritise their own citizens if necessary, “ This is particularly relevant for NHS organisations providing highly specialised services, for which a possible surge of incoming patients could lead to negative implications in terms of increased waiting times for NHS patients. The number of British patients seeking NHS funded treatment elsewhere in Europe in 2010 was just over 1000". Medical tourism guru Constantine Constantinides says, “But if one reads carefully, it really changes things very little - prior approval is still in place; What constitutes in-patient and out-patient care is still very much a grey area – they talk about duration of care – less than a day – and more than a day – when a lot of surgery is now day surgery; what expenses will be reimbursed - and how and when; countries / hospitals are not obliged to accept all comers (besides, many of them have waiting lists of their own); The role of the private sector has not been clarified; only in 2013 will EU Member Countries start being pressured to comply; what about EU Member Countries like Cyprus which do have a national health system; and there also other essential sticking points that they conveniently avoid referring to.” UK Liberal Democrat Liz Lynne comments, "I think we have found the right balance between protecting national health systems and strengthening patients’ rights. Crucially, patients will receive important information of the quality and standard of care, as well as the kind of treatment they are likely to receive in another EU member state. The new rules are not designed to encourage health tourism. Patients are only entitled to reimbursement for treatment that their home health authority would normally provide - travel or hotel costs cannot be claimed back. And patients from other member states travelling to the UK specifically for healthcare will have to pay the full NHS cost of treatment. NHS doctors will have to give prior authorisation for treatments abroad that can be reimbursed. But there will be clearer rules and guidelines for doctors, and decisions must be taken on a case-by-case basis. Crucially, patients will receive important information of the quality and standard of care, as well as the kind of treatment they are likely to receive in another EU member state." Parliament’s president Jerzy Buzek says, "Patients will no longer be alone in the bureaucratic jungle of so many different health insurance schemes when they decide to get treatment in another EU member state. After long and hard negotiations with member states, parliament finally achieved what we were looking for: a solid legal basis for dealing with cross-border healthcare in the EU that was hitherto in a legal grey zone. We unified the different standards set by the European Court of Justice and we created thus a clear and objective system of references." S&D deputy leader Dagmar Roth-Behrendt said parliament had achieved a balance between the right of EU patients to seek the best treatment and the protection of the "financial sustainability of national social security systems.” We have made sure that there will be legal certainty on reimbursement rules and on prior authorisation that have finally been introduced for hospital and specialised care. The directive guarantees reimbursement of healthcare costs for treatment in another member state at the same level as in the state of affiliation." UK Socialist Linda McAvan cautioned, "We shouldn’t get carried away. These rules will make little difference to most people who will want to be treated by staff in their local hospital. We have worked hard to put these new rights into place in a way that will give patients choice. However, we cannot allow a situation to develop in which people with personal wealth are able to access publicly funded treatment abroad, while those without large savings cannot." The text approved by MEPs is the result of an agreement reached with the European Council, which must also give its formal approval. Once signed into law, member states have 30 months to make changes to their national legislation.

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EUROPE: European Parliament passes EU cross-border healthcare directive

Thu, 27 Jan 2011 17:32:50 GMT

An historic vote in the European Parliament on 19 January paves the way for residents to seek health care anywhere in the European Union, expanding rights that will particularly help patients with rare diseases seeking advanced treatments, people living along borders where the nearest hospital is across the line, or those who work in one country but want to get treatment near family members in another country. The directive passed a second reading in the European Parliament in Strasbourg, so the new rules will apply across the EU in about two years’ time. When a hospital stay is required, the directive says health services can request prior authorisation from doctors in the patient’s home country. The prior authorisation clause is intended as a safeguard against any unexpected surge in foreign patients. According to a parliament report, "the aim is absolutely not to encourage cross-border healthcare as such, but to ensure its availability, safety and quality". Health systems are primarily the responsibility of EU member states, but in some cases, as confirmed by several European Court of Justice (ECJ) rulings since 1998, EU citizens may seek health care in other member states, with the cost covered by their own health systems. This can occur in instances where healthcare is better provided in another member state, for example, for rare conditions or specialised treatment. It may also be the case in border regions, where the nearest appropriate hospital may be in another European country. Health services were excluded from the general Services Directive in spring 2006, despite many ECJ rulings that they are an economic activity and that Community law applies to them. To provide clarity and legal certainty on the issue as well as support for co-operation between national health systems, the European Commission decided to establish a EU framework to ensure cross-border access to healthcare services. According to the EU executive, the current scale of cross-border mobility amounts to 1% (€10 billion) of overall EU-27 states public health spending (€1,000 billion). And the Commission estimates the cost increase under the new rules will be just €30 million a year. The European Parliament adopted the cross-border directive in April 2009, but it had been stalled ever since at the European Council, where health ministers have struggled to pass the deal, and where MEPs, health ministers and individual governments all had their own –often highly contrasting views on the eventual shape of the legislation. The Cross-border Health Care Directive is now expected to come into effect in 2013. Exactly when it will come into operation in each country is uncertain, as several countries opposed to the principle and agreed detail are notorious for not implementing EU laws until several years after deadlines (e.g. an EU directive on timeshare holidays has a deadline of February 2011, but Spain will not pass its law until at least late 2012). But while the directive mandates a kind of EU universal health coverage, it is not universally supported. Portugal, Austria, Poland and Romania rejected it in the European Council, and Slovakia abstained. UK Conservative MEP Marina Yannakoudakis says, ’’Cross-border health care can be a very useful tool in patient care, giving choice to the patient and taking pressure off national health systems in areas where a backlog exists.” To discourage health tourism, patients will only be reimbursed at home-country rates; so if a treatment costs more in another country the patient will have to pay the difference. There are other safeguards; in cases where the treatment is very expensive or the patient must stay in a hospital, the patient must get prior authorisation from their own national health system. The directive also includes an exemption for long-term care and organ transplantations. Although the United Kingdom supports the proposal, Nigel Farage, leader of the UK Independence Party, says, ’The rules will turn the UK’s NHS into a bureaucratic nightmare. Extra staff will be needed to chase up getting the money we are owed from countries such as Romania.” The European Consumers’ Organisation (BEUC) is unhappy that bureaucracy (either ingrained or deliberate) will make the theory unworkable in some countries, with delays and form filling stopping patients accessing their rights. Ophelie Spanneut of BEUC says, “We are bewildered by the time limit. The vague time frame may lead to inequalities between counties and ultimately force health ministries to define what is reasonable before the European Court of Justice. We suggested a simple time limit of a response to a patient request within 15 days, but the final version allows individual countries to "set out reasonable time limits" to reply.” Under the directive, a request can only be refused if the treatment could quickly be obtained in the patient’s current country, or if there are doubts about the qualifications of the physician. Each country must establish at least one national contact point for patients to get information about health providers, reimbursement procedures, and when prior authorisation is needed. Patients can choose between public or private doctors. The Standing Committee of European Doctors was disappointed by the lack of information available to patients before treatment and that vulnerable or disabled patients will not receive special consideration. But the group is pleased to see a call for increased international compatibility on health technologies to share patient information, plus more references to data protection. German MEP Dr. Peter Liese welcomes the agreement, saying it would improve access to treatment for patients and cut hospital waiting lists, but concedes that parliament has been unsuccessful in securing some of its demands during the protracted negotiations with the other EU institutions. These included a clear definition of "undue delay" and the possible grounds under which a member state can refuse a patient’s request for treatment abroad. I accept that it is a compromise but it is better to have a compromise than nothing at all. The directive is unlikely to lead to a dramatic increase in cross-border healthcare but will appeal to patients who have spent considerable time on a waiting list or live near the border of another country. I live in Germany, near the border with eastern France so it will be easy for me to go for treatment in Strasbourg. At present, the waiting list for hip replacement in the UK is over 12 months, so a British person waiting for a hip replacement will be able to go for an operation in France and be reimbursed for the bulk of the cost by the NHS in Britain. The directive is long overdue and will profit all patients. It will definitely give patients more rights and is to be welcomed. Patients’ rights will be more transparent and easy-accessed across Europe. Waiting lists in countries like the UK and Germany will fall as more patients go to another member state for treatment. I am confident the directive will have a positive impact on healthcare systems in member states with shorter waiting lists and improved quality of medical treatment. As the member state of residence in question has to reimburse the costs that would be incurred for the same treatment in their own country, I expect the responsible authorities will strive to keep the earnings and patients in their own country." There are many amendments from what the European Council agreed. Ones that stand out are- * Costs incurred by the individual over and above the level reimbursed by the Member State of affiliation shall be borne solely by the person, unless the Member State of affiliation decides also to reimburse the person for the costs incurred in excess of that level.* Each country must list and advise the European Commission of healthcare that may be subject to prior authorization.* A Member State may provide for a system of prior authorisation if the absence of prior authorisation could seriously undermine or be likely to undermine either the financial balance of the Member State’s social security system; and/or the planning and rationalisation carried out in the hospital sector to avoid hospital overcapacity, imbalance in the supply of hospital care and logistical and financial wastage, the maintenance of a balanced medical and hospital service open to all, or the maintenance of treatment capacity or medical competence on the territory of the concerned Member State.* Prior authorisation application systems must be made available at a local/regional level and must be accessible and transparent to patients. The rules for application and refusal of prior authorisation must be public and available in advance of an application so that the application can be made in a fair and transparent way. For full details of the Second Reading and how it differs from the previous European Council position see here.

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GLOBAL: What will make medical tourism a success?

Thu, 20 Jan 2011 16:17:02 GMT

Greg Bledsoe, founder of Freelance MD, an active community of physicians around the world who are early adopters, thought leaders, entrepreneurs, and influencers, asks what will make medical tourism a success? His perspective is from the USA. According to Dr Bledsoe, “5 things will probably need to happen before medical traveling gains enough traction to be a real player in healthcare. In spite of research reports, white papers, industry analyses and industry marketing hype, professional medical travel/medical tourism is still an early stage industry looking for the correct formula for fulfillment.” He continues, ’’For my part, five things will have to happen before professional medical tourism and global healthcare referrals come on traction:1) the advance of a sustainable business design2) global healthcare IT connectivity and integration3) doctor generated global healthcare referral network4) an international regulatory, legal and socioeconomic ecosystem5) patient awareness and acceptance.” The Business model“Industry players including payers, providers, partners and facilitators continue to be searching for the most successful solution to make money and scale the work. With an eye towards what went down when Expedia disrupted the travel agency business, participants recognize that margins for traveling arrangement services are thin and therefore there exists high price elasticity for global health-related care. Few have realized the special moment key that suits the lock that opens the doors to profits. Payers and employers are hesitant to accept the significance proposition without a better method to reduce their risk and demonstrate tangible, meaningful personal savings to their insureds and employees. Global healthcare IT connectivity and integration “The US national healthcare information architecture is evolving. Eventually, the network might be a portal around the globe and definitely will permit seamless, secure, confidential transfer of non-public health information thus assuring some continuity of care and quality improvement. Similarly, it will require some time for health information systems to evolve in host countries that may communicate with non-host systems. Temporary solutions, like personal health records or mobile health applications, might fill the void temporarily.” Doctor generated global healthcare referral network“Most healthcare tourism models connect patients to healthcare facilities, bypassing doctors in the early stages. Doctors can get amongst people when the model feels better, and they’ve got the time and capability to make referrals to consultants directly. Given the rise of international members, professional health-related societies really should be more proactive in building global referral networks, as an alternative to seeing them as threats to existing domestic members.” A global regulatory, legal and socioeconomic ecosystem“The barriers to adoption and penetration of health-related travel are numerous and include liability, reimbursement, quality assurance and impediments to continuity of care. As healthcare goes global, policies and regulations facilitate or obstruct its use. Why not consider a new world trade organization treaty on professional medical travelling?” Patient awareness and acceptance“According to recent polls, 50% of consumers understand the term “medical tourism”. Online social network buzz and media stories discover the clinical traveling story sexy, particularly given all of the noise about escalating healthcare costs and consumers, employers and payers are hungry to read more. Moving patients from awareness to intention to decision to action, however, is going to take additional time and use innovative marketing approaches directed towards market segments.”

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USA: US hospitals promoting inbound and domestic medical tourism

Wed, 19 Jan 2011 17:12:59 GMT

Several recent research projects have suggested not only that the “millions of outbound US medical tourists“ claim is an exaggeration, but also that there are probably at least as many inbound medical tourists, if not more. These figures are a hotly disputed topic within the industry, but what is undeniable is that there is much activity from US hospitals seeking inbound and domestic medical tourists. More importantly, many are succeeding in attracting business. Medical tourists going to the USA do so, not for cost saving, but because they want specialist care that may not be available at home. There is a huge variation in US hospital prices, over 100% between two similar hospitals for the same operation is not unusual, and between package and list prices. US hospitals are often forced to give insurance companies massive discounts on domestic business, so want medical tourists who will pay at or just under the full list price. More US hospitals are looking to bring in patients who pay the bills themselves. Some US hospitals have a reputation for treating certain ailments, especially rare ones such as infant heart defects. Michigan hospitals, including Henry Ford Hospital, Detroit Medical Center, and Beaumont Hospitals draw patients from India, Brazil and Turkey who need procedures that are not widely available at home or who have rare conditions that cannot be treated there. Patients go to Michigan from all over the world to receive robotic procedures and high-beam radiation treatments for cancer, as well as spinal cord rehabilitation and treatments for epilepsy and blinding eye conditions in babies. Individual hospitals are seeking affluent medical tourists from other countries, as they cannot compete on price. The University of Chicago Medical Center and Rush University Medical Center in Chicago both get overseas patients willing to pay $120,000 for heart surgery and $40,000 for a prostate operation. Canadian patients tired of waiting for procedures in their country’s national health system go to Michigan hospitals. Affluent Russians generally go to Los Angeles, New York or Miami. Baptist Health of Florida claims to have treated more than 10,000 international patients, mainly from the Caribbean and Latin America, over many years. Baptist and Detroit Medical Center and Texas Children’s Hospital in Houston all have international patient centres to offer packaged services foreign patients. 71% of Texas Children’s international patients come from Latin America, with most of the rest from the Middle East. HCA-owned Wesley Medical Center, a 524-bed Wichita, Kansas, hospital, has agreed to buy physician-owned, 82-bed Galichia Heart Hospital in Wichita. The reason is that healthcare reform law includes restrictions on the growth of existing physician-owned hospitals. Galichia started to market itself as a domestic and inbound medical tourism destination in 2009, and is expected to generate $1 million for the hospital in 2011. Las Vegas Bariatrics weight-reduction surgery clinic is seeking patients from across or outside the country. Also in Las Vegas, Cleveland Clinic sees medical tourism as a top local priority. Medical tourism has a long history in Las Vegas, but as even top hospitals have only a handful of medical tourists a day, it is unlikely to be the answer to the city’s dramatic fall in numbers of tourists. Those investigating the potential for Las Vegas agree that for medical tourism to succeed:• Prices must appeal to a patient paying part or all of the bill. If an insurance company is involved, prices must be low enough to justify sending someone out of the provider network.• People will travel to a particular hospital only if it has developed a specialty generally regarded as superior to anything else within a radius of perhaps hundreds of miles.• People will travel to a hospital that has a wide range of specialties on site.• The image of the location itself matters. Las Vegas does not come to mind as a destination for the ill, but one for gambling and entertainment. The availability of inexpensive international and domestic flights has made travel more accessible and affordable to everyone. Patients from around the state of Georgia and across the country are traveling for cosmetic surgery to Atlanta, where breast augmentation procedures are state-of-the-art and highly personalized operations. The Swan Center for Plastic Surgery has a new partnership with the nearby St. Regis Hotel Atlanta, offering discounted rates to patients.

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EUROPE: European cross-border healthcare deal waits on 19 January vote

Wed, 19 Jan 2011 17:06:36 GMT

Despite opposition, plans to let Europeans seek medical treatment in other countries in the 27-countries of the EU moved forward in late December when EU countries gave their stamp of approval at ambassador level. This paves the way for a vote in Parliament on 19 January and increases the chances that the cross-border healthcare directive could be in force as early as 2013. Françoise Grossetête (European People’s Party) and rapporteur on the draft bill comments,” Negotiations have been tricky, since many member states were reluctant for a proposal for a directive. Patients will benefit from clearer rules when they decide to go to another EU member state to receive healthcare treatment.” The new rules will especially help retirees living abroad, people with rare diseases and those living near borders to get the best health care. Currently, only about 1%, or €10 billion, of public health budgets are spent on cross-border health care yearly, although that figure could rise with standardised rules for authorisation and reimbursement. The Parliament, Council and Commission agreed to some significant compromises in December including• Prior authorization will be restricted to what is necessary and proportionate, and may not constitute a means of arbitrary discrimination or an unjustified obstacle to the free movement of patients.• National contact points must be established in an efficient and transparent way and able to consult with patient organisations, health care insurers and health care providers.• If cross-border treatment exposes the patient or the general public to a risk that overrides the interest of the patient, the member state can refuse a request for prior authorization.• Patients with rare diseases are those with a prevalence of under 5 per 10,000, that it is serious, chronic and often life threatening. In all there were an additional 106 amendments, but final negotiations still have to deal with some key problem areas on e-health objectives and health technology assessments. Health systems are primarily the responsibility of the member states, but in some cases, as confirmed by several European Court of Justice (ECJ) rulings since 1998, EU citizens may seek health care in other member states, with the cost covered by their own health systems. This can occur in instances where health care is better provided in another member state, for example, for rare conditions or specialised treatment. It may also be the case in border regions, where the nearest appropriate facility may be situated in another country. Health services were excluded from the general Services Directive in 2006 despite the many ECJ rulings showing that they are to be considered as an economic activity and that Community law applies to them. To provide clarity and legal certainty on the issue as well as support for co-operation between national health systems, the European Commission decided to establish an EU framework to ensure cross-border access to healthcare services. The European Parliament adopted the cross-border directive in April 2009, but it has been stalled ever since at the European Council, where health ministers have delayed on the deal and unsuccessfully tried to frustrate and obstruct the will of the Council and MEPs with private agreements that would have made the directive unworkable. The latest agreement on the long-contested patients’ rights directive is an important step for EU health policy, although the draft is still narrower in scope than that originally envisioned by the European Commission. Crucially, the law will require patients to get advance permission from national authorities before going abroad if their treatment involves a hospital stay of more than one night, hi-tech equipment, is risky, or raises quality or safety concerns. National authorities can also refuse patients permission to go abroad if the treatment would expose the patient or others to risks (e.g. infectious diseases), or if the standard of healthcare in the other country raises safety concerns. Governments may also turn down requests to go abroad if they can justify the waiting time on medical grounds. As the agreement was made just before the Christmas recess, the full paperwork has been delayed so full details of the agreements are not available. The European Parliament lost a bid to require national governments to reimburse patients their travel expenses and hotel costs. Instead, the draft simply states that governments may decide to do this. Member states also weakened provisions on European co-operation on e-health and safety standards, although they did not succeed in removing them altogether from the draft. The draft still has to pass two formal hurdles – a vote in the European Parliament, expected in January, and approval by EU ministers, expected in February or March. This will pave the way for the law to come into force in 2011, although governments will have 30 months to write it into domestic law. 2013 is still optimistic as even if the Directive is in place it will have to be implemented in the member states, some of who are infamous for enacting EU legislation years after the deadline. Bearing in mind that at every stage and in every discussion so far, a host of amendments have been made, there is still plenty of scope for MEPs and ministers to make changes or even go back on what are assumed to be agreed deals, in a climate where several EU economies (Spain, Greece, Portugal, Ireland) are still on the brink of disaster. Next Step* 19 Jan 2011: European Parliamentary vote.

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GLOBAL, INDIA: Fortis Healthcare expanding across the world

Wed, 12 Jan 2011 17:08:22 GMT

Fortis Healthcare has global ambitions. In October they agreed to buy the healthcare assets of Hong Kong-based Quality HealthCare Asia and had previously tried to buy Singapore hospital operator Parkway but lost out to Malaysian state investor Khazanah after a bidding war. Quality HealthCare is a physician led provider group offering an integrated range of healthcare services with a network of more than 580 Western and Chinese medical centres and clinics, and 47 dental and physiotherapy centres in Hong Kong, for residents and medical tourists. The group is likely to be renamed with Fortis added to the title. In December, it bought a 30% stake in Dental Corp, Australia and New Zealand’s largest operator of dental practices with 135 practices located across Australia and New Zealand. Fortis’ latest acquisition, marks an important step in achieving the Singh family’s vision of creating a premier global healthcare group outside India.Malvinder Mohan Singh of Fortis Global Healthcare said, ’Their model of business partnership with principal dentists is a significant point of differentiation driving the success of the business and its rapid growth, while being the most effective way to manage high performing professionals. We believe there are tremendous opportunities for Dental Corporation’s expansion, both in Australia and beyond." Fortis Healthcare in India has launched national stand-alone speciality medical centres, to concentrate on the cure of metabolic diseases, diabetes and hormonal disorders. Fortis now has 48 hospitals in India, with ten more in the pipeline, still plans to buy more, and is expanding into IVF treatment and medical spas. Fortis has tied-up with RAK Hospital in Dubai and Regency Medical Centre (RMC), Dar-Es-Salaam, Tanzania through one of its subsidiary, Fortis Escorts Heart Institute (FEHI). FEHI will set up a pediatric interventional cardiac unit at RAK Hospital in Dubai. The emirates located hospital; RAK is set to extend its portfolio of cardiac care services by adding an array of cardiac surgeries. Ashish Bhatia of Fortis Healthcare said, “This association is in line with our vision to become a global healthcare service provider. As we move ahead, our focus is to set new standards in medical excellence and compassionate patient care, not just in India but also beyond. We look forward to serving the patients of Emirates & Africa. “RAK Hospital will establish Ras Al Khaimah as a destination of choice for medical value travel. “ Indian companies are hungry for overseas assets and have many overseas mergers and acquisitions in the past few months across Europe, America and Asia. Last year, cross border deals in and out of India were five times the total value of 2009.India is the world’s fastest growing large economy after China. Indian companies want access to European domestic and business consumers. Fortis has been recognized as the ’Best Healthcare Service Provider Company’ at the Frost & Sullivan 2010 India Excellence Awards. These awards seek to recognize companies that have pushed the boundaries of excellence, rising above the competition and demonstrating outstanding performance across South Asia. The high level of deals on healthcare from Indian, Thai and Malaysian companies is partly fueled by the view that within a few years, across Asia, healthcare and medical tourism will mainly be controlled by large groups with the muscle to spend on investment in services and marketing. Another deal driver is that South-east Asian countries have agreed to form a free-trade zone by 2015. It will be hard for small players to survive after then. The bitter battle between Malaysia’s Khazanah and India’s Fortis Healthcare for Parkway, Asia’s biggest listed hospital operator, last year, shows the increased competition in healthcare.

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CHINA: China opens the door for foreign healthcare providers

Wed, 12 Jan 2011 17:00:49 GMT

The government of China is to encourage the development of the private healthcare sector in the country. This paves the way for foreign firms to gain greater access to the Chinese private healthcare market. The State Council – China’s cabinet office –is backing investment from the private sector. The new policy will provide overseas healthcare companies with more flexibility in establishing a new business within the private health sector. The move is designed to encourage investment from overseas business to meet the increasing demand for private healthcare services in the country stemming from its rapidly expanded economy. Economic expansion has brought increased affluence among the population of China, which in turn has lead to a growth in demand for private healthcare. Current Chinese regulations only allow foreign firms to enter the private healthcare sector in China through a joint venture with a Chinese partner, together with a cap on the level of capital that may be held in a Chinese operation. There will be a gradual easing on the level of investment permitted by a foreign firm in the private healthcare sector. The new policy also allows the conversion of some government run hospitals into private medical facilities. Joint-ventures will still be able to get official approval from provincial authorities, while the new arrangements for foreign firms wishing to set up a completely foreign-owned private healthcare facility will need to receive approval by the Ministry of Health and the Ministry of Commerce. This is to encourage foreign healthcare providers to establish larger-scale hospitals throughout China. The majority of partially foreign healthcare providers already present in China offer small to medium sized medical centers providing a range of procedures and healthcare services. These are predominately in the largest cities such as Shanghai and Beijing, taking advantage of demand from expatriates and the more affluent local population seeking private medical care. Although it may take several years to happen, the opening up of China’s private-sector health system could allow the country to become a key destination for medical tourism, rather than as a source of business for Taiwan, Hong Kong and some Asian countries. China has very low labour rates and overheads that could lead to keen pricing to draw in larger numbers. Already, both private and government hospitals in China are quietly offering treatment to patients from overseas, although development of the medical tourism sector is in its early stages. Initially wholly foreign-owned enterprises will encourage investment in central and western China and foreign investment will be permitted on a pilot basis with priority for investment from Hong Kong, Taiwan and Macau. As central government approval takes longer and may be subject to more stringed review, investors may be inclined to adopt a joint venture structure, particularly as the cap on foreign investment is lifted. Privately invested medical institutions will be eligible for the same land use policies as state-owned medical institutions and will enjoy the same prices as state-owned medical institutions with respect to utilities (including electricity, water, gas and heat). Positive support will also be provided to privately invested medical institutions with respect to construction, equipment purchase and personnel training. Central government in 2009 instituted policies to extend health insurance to 90% or more of the populace by 2011. It is as yet unclear whether current restrictions on foreign investment in this sector, based on it being regarded as part of life insurance, will be relaxed to enable foreign-invested health insurance companies to play a larger role.

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GLOBAL: MediTour Expo announces its 2011 World Medical Tourism Conference

Wed, 12 Jan 2011 16:04:11 GMT

MediTour Expo announces its 2011 World Medical Tourism Conference: “Pioneering The Future in Global Healthcare.” The event will be held May 23-24, 2011, at the South Point Hotel Casino and Spa in Las Vegas, Nevada. This two-day conference will feature specialized topics on the globalization of healthcare. Leading industry and legal professionals from the medical and wellness travel industries will come together to present and discuss international medical travel, tourism, investment opportunities, marketing strategies, insurance and legal issues in this rapidly growing industry. The conference will include presentations by some of healthcare tourism’s most influential leaders. Expecting to draw delegates from all around the world, this event is a must for people looking to increase their contacts in the international healthcare industry. In addition to presentations, the conference will offer exhibit halls, discussion panels, and workshops. There will be numerous networking opportunities throughout the event. The conference will also feature the launch of a new non-profit organization, IntHealthCert - an international healthcare quality organization developed to ensure the highest standard of care for the medical traveler. According to Ian Jacobs, CEO of MediTour Expo, “This conference will address both the risks and benefits of international medical travel. In particular, issues and concerns surrounding healthcare quality control will be examined, with a special focus on opportunities in Mexico.” Below are some of the event’s highlights: • New strategies for marketing medical tourism • Business opportunities for travel and tour operators • Integrating spa and wellness tourism with medical travel • International MediTour Zones (IMTZs) – Healthcare facility development and investment opportunities • Workshops in medical travel, insurance and international legal issues • Private meeting rooms for business meetings • Networking lunches and cocktail parties For more information about the event, you can visit www.meditourexpo.net. For sponsorship and exhibitor opportunities, please e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it..

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GERMANY: German health and wellness tourism targets Middle East

Wed, 05 Jan 2011 10:20:33 GMT

The Middle East is one of the largest potential source markets of patients due to the high costs of healthcare and limited facilities in some states. Some trade estimates suggest that one in five global medical tourists and a significant percentage of health and wellness travellers are from Gulf and Arab states. Patients from UAE alone account for $2bn in healthcare travel on an annual basis. As a result, many countries are targeting the region. Germany has long been a popular destination for those from the Middle East. Brenner’s Park-Hotel & Spa, in the Black Forest in Baden-Baden, offers a natural medical spa experience as part of the Oetker Hotel Collection - a European luxury hotel group. Brenner’s Park is a luxurious hotel and medical spa where specialist doctors offer advanced diagnostic techniques in aesthetic dentistry, dermatology, naturopathic detoxification and elimination therapy, in addition to nutrition coaching, weight-loss programmes and beauty packages. Samir Daqqaq of Oetker Hotel Collection explains,"The Middle East is one of the most important markets for us. Over the past few years, there has been a rapid increase in the number of GCC tourists to Germany.” Hans-Peter Veit, at Brenner’s Park-Hotel & Spa, adds, "We are happy to invite Middle East tourists to enjoy the world-renowned natural and holistic medical care on offer at Brenner’s - a hotel with an international reputation for over 135 years that has been a medical spa for over 25 years. We guarantee a unique experience for our guests - healthcare for the body, mind and soul and a medical spa like no other. With 20 treatment rooms and customized spa programs, our guests enjoy a comprehensive therapeutic care in comfort." Statistics by the German Federal Statistics Office show that the number of overnight stays by GCC nationals in Germany during the first five months of 2010 was 243,759 nights - an increase of 16.4% compared to the same period in 2009. When compared to the same period in 2008, the number of GCC visitors to Germany rose by 30.3% - among the highest from any region in the world, making Germany the preferred destination for travellers and medical tourists from Gulf states. Health and wellness holidays are one of the main marketing themes for Germany in 2011. The campaign features three key themes: spas/health resorts, wellness/beauty hotels and medical tourism, showcasing the modern and cutting-edge medical facilities, luxury hotels, spas and spa-towns. More than 400,000 tourists already visit Germany for health-oriented vacations, as do 70,000 medical tourists, and these numbers are growing. The German National Tourist Office markets “Wellness &Beauty” with a cross-media concept that centres on hotels and is supported by the independent hotel sector and wellness tourism brands.

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EUROPE: Comparative costs of dental treatment

Wed, 05 Jan 2011 10:00:40 GMT

According to a recent study of the comparative cost of dental treatment in nine countries, the most expensive country for dental care is England. Cost saving is the primary driver of outbound UK dental tourism. This study determined that in nine countries the total cost of a standard filling ranged from €8 in Hungary to €156 in England. This total included the cost of the dentist’s time, overhead, drugs, materials, and X rays. Although dental care was the most expensive in England, at about €156 for a filling, it was closely followed by Spain at €125 and Italy at €135. The costs in the other western European countries were less than half that much and ranged from €46 in France to €67 in Germany. The primary purpose of the study was to determine differences in the costs of a filling. The countries that were the least expensive for dental treatment were Hungary at €8 and Poland at €18 which are the primary destinations for dental tourists from the UK. Of the estimated 60,000 people who traveled abroad from the United Kingdom for medical treatment in 2010 it is estimated that half of them traveled in search of dental care. That a considerable sum of money can be saved is why there are clinics and agencies that arrange for the dental treatment in lower priced countries. The most important driver of dental care costs is labour, which accounts for 70% of total dental care costs in the UK. England was closely followed by Spain and Italy, but costs in other Western European countries, such as France and Germany, were less than half the price of those in England. Unsurprisingly, the countries, which rated lowest in the study, Hungary and Poland, have emerged as the most popular destination for British dental tourists. An increasingly large number of Irish people are heading abroad for cheaper dental treatment. Since cutbacks last January over a million people have lost financial benefits and now have to pay full-rate prices for dental care. New cuts announced in December for 2011 can only increase the problem that people are finding it increasingly difficult to afford treatment in Ireland and are choosing to travel abroad in a bid to save money on dental care. Many Irish people are now travelling over the border to Northern Ireland, where treatment is significantly cheaper and some are making the journey to Eastern European countries, including Hungary, Romania and Bulgaria for treatment; fees in this part of Europe are up to 60 % lower than those in Ireland so a considerable saving can be made even when you take the cost of accommodation and flights into account. A group representing 32 national dental associations and chambers from 30 European countries and 320,000 dentists has warned of the dangers of dental tourism. Writing in a position paper for an EU directive on cross-border healthcare, the Council of European Dentists (CED) emphasises the importance of continuity of care and of a strong dentist-patient relationship,” Dental treatment often requires a series of visits to the dentist to properly plan and carry out the treatment, and to provide post-treatment care. Where patients spend only a short time in the vicinity of the dentist, as is often the case where patients receive care abroad, the overall quality of the health service is difficult to ensure. The CED therefore does not believe that patient mobility in the area of dental care should be actively promoted." For any agency promoting dental tourism, The EU Manual of Dental Practice, freely available online from the CED, provides comprehensive and detailed information on the legal and ethical regulations, dental training requirements, oral health systems and the organisation of dental practice in 32 European (EU and EEA) countries, including Croatia, which is due to join the EU this year. The practising arrangements, the regulatory frameworks and systems within which dentists work in the respective countries are compared. There is also country specific information on the dental specialities that are recognised.

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GLOBAL: IFHP comparison of international healthcare costs shows price differences of more than 300 %

Tue, 04 Jan 2011 17:16:56 GMT

The International Federation of Health Plans, a group of 100 health funds and insurers across 30 countries, has released its ’2010 Comparative Price Report’ detailing its annual survey of medical costs per unit. The study is done to help member plans better understand why health care costs are so much higher in some countries than others. Prices for the same medical procedures, tests, scans and treatments vary widely from country to country. The survey data showed that, on average, U.S. prices for procedures were once again the highest of those in the 12 countries surveyed for nearly all of the 14 common services and procedures reviewed. For example, total hospital and physician costs for delivering a baby are $2,147 in Germany, $2,667 in Canada, and an average of $8,435 in the United States. The survey shows that the cost for a hospital stay is $1,679 in Spain, $7,707 in Canada, but these costs can range from an average of $14,427 to $45,902 in the United States. In addition to providing comparative cost data across the countries, the survey provides information about the wide range of costs being charged in the United States for common services, procedures and drugs. One example from the survey is hip replacement surgery costing $12,737 in the Netherlands, but ranging from a low of $21,247 to a high of $75,369 in the United States. The differential between unit prices was greatest for surgery. One of the highest differentials was for cataract surgery; the range for cataract surgery ran from $1,667 in Spain to an average of $14,764 in the United States. Tom Sackville of IFHP says, "As countries around the world look at the impact of their health care systems on their economies, the cost per unit of services, procedures and drugs is a key factor that needs to be understood. The total cost of care in each country is obviously driven very directly by the fees charged by the doctors, hospitals, and drug companies in that country. We hope the release of this updated report on our price survey will be a key step forward in creating a more informed base of knowledge for all our member countries and allow them to better assess the impact of unit prices on the cost of health care." The IFHP’s survey covers current 2010 provider fees and drug costs in 12 countries. The 12 countries studied were- Argentina, Australia, Canada, Chile, France, Spain, Switzerland, Germany, Netherlands, New Zealand, United Kingdom and United States. The 14 items examined include angiograms, CT and MRI scans, office visits, newborn deliveries, appendectomies, cataract surgeries, hip replacements, hospital stays, bypass surgeries and angioplasties. Costs for three widely prescribed drugs - Lipitor, Nexium and Plavix – were also reviewed. The data for the report was gathered from IFHP member organizations in each country.

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GLOBAL: Top ten global spa trends for 2011

Tue, 04 Jan 2011 17:05:25 GMT

SpaFinder, the global spa and wellness resource, has identified global spa trends that will influence experiences for consumers and the industry in 2011 and for decades to come. The report called ’2010 International Report, Spas & the Global Wellness Market: Synergies & Opportunities’ is based on analysis from a large team of experts who visit hundreds of spas each year; interviews with top industry analysts; ongoing research across the spa, travel and beauty sectors; and data derived from SpaFinder’s relationships with over 9000 spas across the globe. 1 )Ageing customersBaby boomers are the fastest growing demographic in the world, and spas are showing more awareness of the needs of older spa-goers. Many spas are now incorporating physiotherapists, chiropractors and osteopaths who focus on rejuvenation of joints, pain relief and mobility. Thermal bathing is also seeing a renaissance as the benefits of soaking are rediscovered. Woe is the spa that attempts to label this active affluent group. The days of ’over 65’ as a catchall category will soon become ancient history. There is a huge difference between a 70 year old who plays tennis three times a week and an 85-year-old seeking pain relief. 2) Asia as a destinationAsia has had a profound impact on the spa industry. Yoga, Thai massage, Ayurvedic medicine and acupuncture are staples on many spa menus, and the Zen nature of Asian design can be seen in spas worldwide.There is an explosive growth of hotel/spa development within Asia (a market of 4.1 billion people), especially within the two fastest-growing world economies, China and India. These markets are developing at breakneck pace, unleashing massive opportunities for hotel/spa development. Asia-Pacific has the largest number of spas and hotels under development of any region in the world, and by 2015, China will have 100 million outbound travellers, many seeking a luxury break that includes a Westernised spa experience. 3) More saltHealing traditions that involve basking in salt caves or water may be centuries old, but they are coming of age in some of the most modern spas. The benefits to skin, breathing and rejuvenation are making salt therapy one of the hottest trends to watch in 2011. Clinical trials reveal salt is beneficial for respiratory illnesses like asthma and skin conditions such as acne and psoriasis. Spas are finding stylish new ways to recreate the natural salt cave microclimate, infusing salt and negative ions into the air. Some examples have encrusted, stalactite-drenched grottos of tons of imported Himalayan salt crystals, or have created hyper-modern rooms made of sea salt blocks. 4) Branding experiencesTraditionally the territory of standalone spas, the industry is moving rapidly in the direction of branded experiences. 2011 will be a watershed year for franchised/branded spas as consumers seek the consistency of treatments they know and love, and major players expand into new markets. Look to see a brand new world of spa lines going global and offering consumers a consistent experience wherever they travel. 5) Price dealsGone are the days when coupons were unfashionable things people snipped out of the newspaper and spas would not dream of using the term deal. Internet coupons and online group-buying deals have burst onto the global scene, and the old-fashioned deal has morphed into an online industry. With spa and wellness deals a mainstay of some sites, millions of people are now expanding their spa horizons, trying new experiences they would not have without the ’50%-75% off’. 6) Scientific proofIs there scientific proof that massage reduces stress? Are mudpacks and mineral-baths medically proven to alleviate pain? The answer, in many cases, is yes. Get ready for a new era where more questions about the effectiveness of spa therapies will be asked, as the emphasis on the science behind spa health heats up. With more medical professionals embracing integrative/alternative medicine, expect clinical studies to accelerate. These promising evidence-based initiatives may ultimately prove the bedrock for future industry growth. 7) Local sourcingA current trend that complements the move toward branded spas is the desire for authenticity and immersion in the traditions and elements of a spa’s local environment. It’s not just about sourcing the restaurant menu from local suppliers; there is an increase in spas who have fully embraced the local trend with the farm-to-table movement and have extended it to farm-to-massage". Locally sourced fruits, herbs and honey are grown on site, and then dished up in both meals and in spa treatments. 8) Search for beautyBeauty-seekers are taking treatments are far beyond Botox into stem-cell facials and plasma therapy. People are tolerating more pain as long as it delivers results. Derma-rolling hurts, chemical peels can be uncomfortable and the zapping of lasers is painful. Then there are boot camps, Rolfing and Bikram yoga, where pain meets pleasure. 9) Fast spas"In a New York minute" is jargon for how things move faster in hectic New York City. It is also the name of a suite of mini (15- to 30-minute) spa treatments. The spa industry is responding, with early and late-night opening for money-long time-short customers. The trend toward express, sampler or mini-sized treatments will continue to rise. The explosion of airport spas worldwide plays into the express trend neatly, as does the decline of elaborate rituals at many spas, to get right to the heart of the matter: the therapeutic treatment.The quest for stress-free spa efficiencies will mean more spa-goers embracing 24/7 online appointment booking, and mobile apps helping them find and book spas on the fly. 10) Special eventsIncreasingly, spas are developing distinctive specialty programs to draw customers seeking a unique group experience. While destination spas have been offering yoga and healthy cooking weeks for years, retreats now span everything including a high-flying trapeze experience. Spas and resort destinations will find creative new ways to attract consumers.

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GLOBAL: Flying hospitals are not imaginary, and need your donations

Thu, 16 Dec 2010 14:41:57 GMT

The idea of flying hospitals may sound like a fantasy, but there are organizations promoting this concept to provide travelling care to countries that need urgent help. Global Flying Hospitals (GFH) is a charity organization with its US office in Palm Beach Florida, and its Asia office in Macau. It seeks to assist developing countries to become self-sufficient and sustainable with healthcare for their citizens who lack or cannot afford medical care. This vision includes the building of a fleet or aircraft with four Boeing 747’s, refurbished as teaching hospitals and each designed for a group of differing medical specialisms, four Hercules C130’s ferrying high-tech field medical clinics, medical equipment, emergency modular housing, sanitation, water purification and solar power equipment. And four Pilatus PC12 single engine turbine craft, for micro-insertion of medical professionals, patient evacuation and rendezvous of supplies or patients with the Boeing’s and Hercules. A special MediVac helicopter division is being planned. Global Flying Hospitals says it is a comprehensive new model for humanitarian healthcare that totally supersedes the old band-aid methods and thinking of the past, caused by a lack of resources and dis-interest by the world towards developing countries. GFH offers a solution to the humanitarian medical challenges of this now uncertain and ailing world. A completely separate organization is The Flying Hospital. The Flying Hospital is a 36 year-old aircraft; a refurbished 1974 Lockheed 1011, that is the product of the organization, “Operation Blessing International”, founded by Pat Robertson. A company was formed, The Flying Hospital Inc. to operate and manage the aircraft, receive donations and support. It was meant for launching various medical missions, for one and two week time-slots. Admirable work was conducted and thousands of medical procedures were undertaken, during its initial tour to a number of countries. The aircraft was grounded in 2001 and mothballed in the desert, in Tucson, where it has sat for these many years and is now nearing obsolescence. Although it is possible to resurrect the aircraft, it is old and not many Lockheeds fly, thereby making parts procurement very difficult and costly. Bill Horan of Operation Blessing states: “I don’t see it as impossible that this plane might fly again, but it is very unlikely for a variety of reasons. That being said, we continue to try and find a good home for this plane." Global Flying Hospitals commends the efforts of The Flying Hospital, as it served humanity well. However, there is no relationship, connections or cross purposes in either organization. GFH explains that as far as it knows, only one other such organization exists, the charity Orbis’s Flying Eye Hospital. The Flying Eye Hospital is a hospital with wings that brings together dedicated eye care professionals and aviators to give the gift of sight to developing countries around the world. Onboard the refurbished DC-10 jet aircraft, local doctors, nurses and technicians work alongside Orbis’s international medical team to exchange knowledge and improve skills. The mobile teaching hospital is a unique tool in the fight against preventable blindness in developing countries. In the 48-seat classroom at the front of the plane, doctors gather for lectures, discussions and live broadcasts of surgical procedures being performed nearby in the Flying Eye Hospital operating room. Prior to the start of a Flying Eye Hospital visit, local doctors pre-select patients whose conditions are relevant. Priority is given to children, individuals who are bilaterally blind, cannot afford to have the surgery otherwise, and represent good teaching cases. Local doctors maintain oversight of patients before, during and after surgery. Upon the Flying Eye Hospital’s departure, videos of the surgical demonstrations are left with local institutions to be used in further training. Since its first program in 1982, the Flying Eye Hospital has travelled to more than 70 countries and saved the sight of millions of people. By training local doctors and eye care workers, who in turn teach their colleagues; it is strengthening the capabilities of local health care communities in blindness prevention and treatment. Both GFH and The Flying Eye Hospital welcome donations and volunteers, but The Flying Hospital is inactive. GFH warns that there are fraudsters purporting to be fund raising for The Flying Hospital to by accepting charitable donation. GFH states, “ At this date it is a fabrication and illegal.”

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USA/UK: North Korea attack exposes challenges of medical tourism

Thu, 16 Dec 2010 14:32:47 GMT

PHM International, a US based healthcare consultancy, claims that the current military skirmish between North Korea and South Korea exposes a fundamental challenge of medical tourism. The company’s view is that board members, investors, executives, insurance companies and others that promote medical tourism can be put in jeopardy by referring patients to high risk countries. When a patient is referred to a medical treatment facility in a region of the world with known risks, that company has made a business decision that may prove detrimental to the individual patient. Known risks include military intervention, civil insurrection, drug wars, and natural catastrophes. Hank Kearney of PHM International comments,” Risk management is more sophisticated than a disclaimer of responsibility and utilizes an array of tools to keep current of the constantly changing global risk map. Companies need to fully understand the risks, policies, and geo-politics of the global healthcare sector. Particularly for US companies, the liability exposure of medical tourism needs to be mitigated in a way to protect the patient, but also the company’s reserves, the board members, and investors. Disclaimers and sending patients to JCI accredited hospitals are simply not enough protection, particularly when that hospital is in a known high risk area.” The possibility of legal comeback may seem a far-fetched scenario to medical tourism intermediaries accustomed to working in an unregulated market. In many countries, arranging travel and accommodation overseas as an intermediary is subject to regulation and licensing. In many countries, civil law is designed to protect consumers from businesses who put them in harm’s way. By calling themselves facilitators, some medical tourism agencies are either by ignorance or design, avoiding the issue that there is little difference between a licensed bonded and accredited travel agent selling a spa/wellness package to a customer, and an unlicensed medical tourism agent selling a medical check-up or dental treatment package to a customer. Using the UK as an example; The Package Travel, Package Holidays and Package Tour Regulations 1992 are overseen by the government’s Department for Business, Innovation & Skills. In the UK, anyone who (other than occasionally) sells or offers for sale package holidays must comply with these regulations that set out travel organisers’ responsibilities to their customers and the remedies available should there be a breach of the regulations. The definition of a package holiday is complex, but a package holiday must: Be sold or offered for sale Be sold at an inclusive price Be pre-arranged Include a minimum of two of the three elements of: - transport - accommodation - other tourist services (not ancillary to transport or accommodation) accounting for a significant proportion of the package, such as a tour guide. The Court of Appeal’s judgment in The Association of British Travel Agents v Civil Aviation Authority [2006] identified that in determining whether a package is being sold, a key question will often be whether the relevant travel services are sold as components of a pre-arranged combination or as separate services. These regulations require organisers of package holidays to provide protection for money and to bring customers home if necessary. Although medical travel, health travel, health tourism, dental tourism etc are not specifically included within the regulations-neither are they specifically excluded either. UK civil law is based on “ what would the average person believe’ and using this basis, it would be difficult to persuade a court that a health travel package is not meant to be included within the regulations. The regulations provide consumers with statutory legal rights against tour operators by making clear to operators that they have legal responsibilities to their customers. The regulations also enable dissatisfied travellers to pursue their case with a single supplier, the travel organiser, instead of with individual suppliers such as airlines, hoteliers, hospitals and clinics. UK agents needing advice on whether they are abiding by the Package Travel Regulations should contact their local Trading Standards Department. The Department for Business, Innovation and Skills (BIS) regulates many of the UK laws, regulations and guidelines on advertising, package travel, pricing and product description that helps protect consumers and businesses from unscrupulous practices. They want consumers and businesses to be able to trust advertisements, fairly compare prices and find goods that are honestly labelled, and services that are properly delivered. And they want to help businesses know the rules and regulations that apply to them and not have to face unfair competition from other traders operating illegally. The Coalition government has a planned programme that includes tightening up consumer law and removing legal loopholes.

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GLOBAL: Improving efficiency of delivery is key to curbing spiralling healthcare costs

Thu, 16 Dec 2010 14:30:32 GMT

Governments must make their health care systems more efficient if they are to maintain quality of care without putting further stress on public finances, according to a new 200 page OECD report, ’Health Care Systems: efficiency and policy settings. The OECD warns that cash-strapped governments no longer have the option of boosting spending to improve health outcomes, as they have done over the past several decades. Angel Gurria of OECD says, "Healthcare is now one of the largest government spending items, representing on average 15% of government spending across the OECD, and costs are still rising. The economic and financial crisis has weighed heavily on public finances, reinforcing the need to improve health care efficiency." The OECD report recognises that the sharp rise in healthcare spending - which has grown by more than 70% per capita in real terms since the early-1990s - led to steady improvements in health outcomes across the OECD. Life expectancy has increased by one year every four years, survival rates from diseases like cancer are up, and premature births and infant mortality have dropped dramatically. Cross-country comparative analysis highlights the uneven healthcare efficiency performance across the OECD countries. Australia, Japan, Korea, Switzerland and Iceland get the best health outcomes for money spent. Denmark, Greece, Hungary, the Slovak Republic and the United States have the widest margin for improving health outcomes without increasing spending. The report says that exploiting efficiency gains would allow countries to continue improving the quality of care while holding costs constant. Adoption of best practices could reduce costs by nearly 2% of GDP by 2017 across the OECD, as compared to a no-reform scenario, while savings could be above 3% of GDP in Greece, Ireland and the United Kingdom. If all countries were to become as efficient as the best performers, life expectancy at birth could be raised by more than two years on average across the OECD area, without any increased health care spending. A 10% increase in health care spending would only increase life expectancy by three to four months, if the extent of inefficiency remains unchanged. The new report is based on unique healthcare policy data gathered from 29 OECD countries, grouped into six newly-defined types of health care systems, ranging from those that rely principally on private insurance and markets to those where governments take the lead. The report investigates the links between policy choices and health system efficiency and makes specific suggestions for improvements on a country-by-country basis. It seeks to compare quality of healthcare between the countries. It uses many criteria but admits that comparing quality is far from easy. Every country has minuses and pluses. What it does highlight is that simplistic comparisons such as healthcare/hospitals/doctors in country A are better than country B, are statistically unprovable and dangerous; you can suggest that country A has a higher admissions or lower fatality rate on a specific chronic disease such as heart failure than country B, but this is a very rough and ready comparison as there may be specific country factors other than healthcare that affect outcomes. It says that increasing patient choice on where and when they can be treated enhances customer empowerment and stimulates competition. It highlights the increased patient choice in the UK, Norway and Sweden. It shows the many different ways countries seek to improve and regulate healthcare- some offering a free market, and others with highly controlled pricing. What it does highlight is the very different ways that countries offer healthcare, state v private, private insurance v state insurance, compulsory insurance v voluntary insurance etc. The message to any destination or healthcare provider marketing medical tourism, is that each of the target country markets has its own unique mechanisms on providing healthcare, and unique advantages/ disadvantages on price and care; you cannot lump all of Europe or all of Asia together and market to each country in that group in exactly the same way.

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THAILAND: Thailand medical tourism back on track

Thu, 16 Dec 2010 14:03:24 GMT

The Tourism Authority of Thailand (TAT) has told tour operators that Thailand tourism and medical tourism are back to normal following political clashes that took place in May. The country has welcomed 10 million tourists for the first eight months of 2010, a 30% increase over 2009. TAT has launched its e-marketing campaign for medical tourism in Thailand. Suraphon Svetasreni of TAT said, “The online campaign will boost the number of medical tourists as well as increase the average time they stay in Thailand. And this will help other tourism related businesses, such as hotels, spas, and restaurants. It will benefit all the tourism industry and follow the Thai government’s strategy of promoting Thailand as the medical hub of Asia.” TAT has just launched “Healthy Beauty Holiday in Thailand”. This sales promotion offers exclusive rates for dental treatments, Lasik corrective surgery, cosmetic surgery, holistic and anti-aging treatments, and medical check ups. For this campaign, TAT has joined with partners including Royal Orchid Plus, which offers 1000 mileage bonus points when booking medical services under the campaign. Websites are also taking part, including Asia Web Direct and Phuket Hotels and Travel Guide. December sees the launch of a “You are in Good Hands” campaign to emphasize the credibility and safety of medical services offered in Thailand. TAT has chosen the 12 finalists of the Thailand medical tourism blog contest that attracted 219 applicants from 24 countries. The 12 finalists, selected on reputable profiles relevant to tourism and medical tourism, will compete in the final round in Thailand.Throughout their seven-day stay in Thailand, TAT has arranged visits for the 12 final contestants to over 50 health and tourist establishments, ranging from hospitals and clinics to spas in six destinations: Bangkok, Phuket, Chiang Mai, Pattaya, Samui and Hua Hin. And they will get to experience a variety of Thailand’s medical and wellness services, including medical check-ups, dentistry, skin laser treatments, botox courses and health spas. The 12 Finalists will then submit their blogs promoting medical tourism in Thailand referring to their experiences during the seven days. The blog with the most votes during the two-month voting period will win an assortment of prizes worth up to US$ 20,000. The 12 Finalists come from the United States, the United Kingdom, Sweden, Malaysia, Singapore, Vietnam, the Philippines and Indonesia. Sansern Ngaorungsi of TAT explains, "From our research into the web blogs on tourism and medical tourism, there were few that mentioned Thailand and the services we offer. This meant medical tourists were not able to access information on Thailand’s comprehensive healthcare and tourism offerings. So we decided to launch this promotional campaign to encourage bloggers to write about their experiences in Thailand as medical tourists and serve as sources of reliable information for potential medical tourists around the globe. This campaign aims to create awareness and increase online information and on medical tourism in Thailand to make it more readily accessible. It will also serve to inspire confidence in the standards and quality of Thai medical tourism."

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JAMAICA: Barriers to Jamaica's pans for development of health tourism

Thu, 09 Dec 2010 17:06:37 GMT

Dr Patric Rutherford of Andrews Memorial Hospital argues that the Jamaican government’s reluctance to cut customs duties on medical supplies is stifling the prospects of health tourism – an area that could earn significant revenues in the long term while boosting the local health sector, "It is not just equipment that we import. We have to import a host of supplies on a monthly basis, which are millions of dollars worth of goods, but they make the decision to keep the system as it is and not remove the duties," Rutherford argues that shortsighted policymakers do not understand that in return for losing the immediate taxes of health-related import revenues, they will get more revenue in the longer term from encouraging a local industry that needs help. Andrews Memorial Hospital is a private Adventist-affiliated hospital, and Rutherford complains about the shortage of local qualified nurses and other health professionals. There are many Jamaican nurses that have qualified and work overseas. Dr Evangeline Javier at the World Bank Human Development Department explains that a recent study indicates that although there is a skilled labour force in Jamaica, there is a shortage of workers, which is increasingly hampering the country’s competitiveness, "These shortages are being greatly felt in the health sector, weakening the quality and efficiency of health services. The shortage of nurses will get worse with the ageing of the Caribbean population.” An in-depth analysis of the report by World Bank officials indicated that migration was a major factor for the shortage, with more than 80 % of Jamaican nurses surveyed considering leaving the island. The report showed that approximately 75 % are dissatisfied with working conditions. Another problem is limited training facilities outside the classroom, and restrictive practices by local nursing bodies. Jamaica seems unable to compensate for health professional migration by attracting people from elsewhere; salaries are too low and working conditions poor. A paper from The Private Sector Organisation of Jamaica agrees with Rutherford that Jamaica needs tax reform that promotes economic growth and acts as a catalyst for development, is characterised by simplicity, equity and competitive rates, and is administered in an efficient and effective manner.” The roadmap for tax reform includes legislation and implementation. It has to be put in context that there is a massive fiscal crisis faced by the government so that a single low rate of corporate tax is not possible in the upcoming budget. The second best alternative is to adopt a 10% rate of corporate tax for international traded services-including health tourism. The key is to put in place policies that encourage the growth of new industries and to create an actively enabling environment for areas of obvious additional potential, such as tourism and health services. Health tourism would be regarded as a reverse export and would pay corporate tax at only 10 per cent. US hospital groups would also be able to take advantage of Jamaica’s double taxation treaties to offset this tax against their US taxation. Rather than a cash-strapped government giving the new industry additional tax incentives, the government could give the business land in return for a quota of Jamaicans who would receive free health services. The Government could reform customs duties across the board to a low flat fee that would allow the importation of the very expensive specialised equipment that such a business would require. A sufficiently big industry of this type would produce enough revenue to cover most of the health needs of the entire Jamaican population - true free health care for all. “ Minister of Tourism Edmund Bartlett says that health and wellness tourism has great potential for development in Jamaica. The Minister urged Jamaicans to recognise and support businesses owned and operated by nationals. He was speaking at the launch of Jencare’s latest international clinic in Miramar, Florida, USA.Jencare Skin Farm started as a modest shop in Kingston, Jamaica. It quickly grew in Jamaica and has expended into international markets, with clinics in Miami, New York and Trinidad to cater for migrating Jamaicans as well as global clients.

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SERBIA: Accreditation of health institutions and licensing of health workers important for patient safety

Thu, 09 Dec 2010 16:51:56 GMT

Serbia’s Minister of Health Tomica Milosavljevic has stated that the accreditation of health institutions and licensing of health workers will increase the level of patient safety and improve efficiency in Serbian hospitals. He has set up an Agency for Accreditation of Health Care Institutions, tasked with developing an accreditation programme modelled on the most successful such programmes in Europe. The EU has endorsed this project with funding of €1.5 million. One of Serbia’s key partners will be the UK’s National Institute for Health and Clinical Excellence (NICE). NICE International works with individual governments or funding agencies to support local teams develop local solutions. It offers strategic advice, technical support, and input on strengthening existing or designing new decision-making frameworks. Recent European projects have been in Georgia and Estonia. Snezana Manic is director of the Agency for Accreditation of Health Care Institutions and emphasizes those health workers and patients will benefit from accreditation. She notes that according to the law on health care, accreditation is voluntary, but the agency is contemplating the introduction of a form of obligatory accreditation so that all institutions will be forced to meet a minimal standard of quality and patient safety. External assessors have already been appointed and trained. Serbia is a destination for dental tourism but not surgery. The government and local businesses see better long-term potential in spa and wellness tourism. Prime Minister Mirko Cvetkovic said at the opening of the renovated hotel Izvor in Arandjelovac that Serbia has potential to develop spa tourism. Cvetkovic called on investors to invest in other spas in Serbia, and pointed out, “2011 is the 200th anniversary of existence of Bukovicka spa. It is a great jubilee, which shows a long tradition of spa tourism. It is often thought that Serbia is not a significant tourist destination like some other countries that have sea and mountains. However, we can be proud of spa tourism. Businessmen have recognised this and this hotel in Arandjelovac confirms that it is time for Serbia to start with revitalisation of spa tourism. The support in this undertaking must be provided by local communities and the Serbian government as well.” The five-star hotel Izvor in Arandjelovac has been opened after seven years of reconstruction. It is the first luxurious conference, spa and wellness centre in Serbia, whose reconstruction cost €35 million. The hotel can host 550 guests and has 165 rooms. The completely new facility has three equipped conference rooms, six swimming pools, wellness and spa centres, which can host 3500 people. ALCO group built the hotel. The group is building four other four and five star hotels in Serbia, while preparing to buy or build other hotels in tourist areas in Belgrade and other parts of Serbia.

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RWANDA/SOUTH AFRICA: Improving African healthcare

Thu, 09 Dec 2010 16:47:58 GMT

A day after unveiling Rwanda’s first ever magnetic resonance imaging machine, King Faisal Hospital in Kigali, received the results of the final survey for an international accreditation program, with the hospital scoring a record high of 98 % from the surveyors from the Council for Health Service Accreditation of Southern Africa (COHSASA). To be fully accredited, a hospital has to score 90 % or more in every service element. COHSASA carries out internal and external assessments using international standards. The quality improvement and accreditation process started in June 2008 after the Ministry of Health approved a strategic plan to turn the hospital into a world-class centre of excellence. The first assessment was conducted in February, where the hospital scored 86%. In November, the COHSASA surveyors went through all documents and evidence of the clinical and non clinical services at the hospital and were impressed by the major achievements realized by the hospital in only 9 months since their last survey in February 2010. Services provided by the hospital were evaluated for performance including management and leadership; access to care; management of information; prevention and control of infections; health and safety; quality management; and patient and family rights. With this accreditation program, KFH- Kigali is the first hospital in Africa with the exception of South Africa government supported hospitals to attain this level of accreditation in a period of two years. KFH Kigali is also the first hospital in the region to get accredited. Founded in 1991, the hospital is Rwanda’s premium referral hospital and has 145 beds. It operates as an acute care facility with full-time specialists in most major fields. Juliet Mbabazi of King Faisal Hospital Kigali says, "The accreditation will enable the hospital to stimulate integration and management of health services and provide better education and consultation to its patients. KFH has benefited from the accreditation process in the sense that is definitely helping the hospital improve the standards of care and accountability to our patients in our quest for excellence." There are only 17 healthcare accrediting bodies in the world that are recognised by the International Society for Quality in Health Care (ISQua), the global authority that accredits the accreditors and the standards they produce and South Africa is represented among them. The Council for Health Service Accreditation of Southern Africa (COHSASA) in Cape Town has been operating as a not-for-profit enterprise in the field of quality improvement and accreditation in Southern Africa for the past 15 years and has conducted 683 external surveys in 437 facilities in private and public sectors with 104 of these currently accredited, including hospitals, clinics, hospices, rehabilitation centres, sub-acute care facilities and environmental health offices. Recently, four sets of healthcare standards developed by COHSASA have been accredited by ISQua as meeting principles set out by the international body. This is the third successive occasion that COHSASA has had its standards accredited and over the past decade and a half COHSASA has continuously refined and reviewed its standards to make them user-friendly, precise, easy to measure and easy to understand. As well as South African hospitals, COHSASA now offers an international accreditation service for Botswana, Rwanda, Swaziland, Nigeria and Lesotho. While only 6 hospitals and clinics are currently accredited, 48 more are in the process. In South Africa, the government is to establish an ombudsman-type office to deal with complaints of poor service provision by both public and private hospitals, in a move to improve the provision of quality health care in the country. Minister of Health Aaron Motsoaledi said the office of the health ombudsman will consist of an inspectorate to conduct regular and unannounced examinations of conditions at private and public hospitals and oversee the accreditation of such facilities, “ No health facility in this country will be under the national health insurance scheme unless it gets accreditation from this office of standards compliance. In other words if you are not accredited by the office, no NHI for that facility. Any member of the public who has a complaint about a broad range of things, like having been to hospital and been ignored for four hours, queuing for a long time, wrong attitude of staff, they can go to the office. The powers of sanction of the ombudsman will be dealt with during the processing of the national health amendment bill, which proposes the establishment of the office of the health standards compliance.’

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LEBANON: Lebanon attracting cosmetic surgery tourists

Thu, 09 Dec 2010 16:43:42 GMT

Tourists from across the Middle East are travelling abroad for cosmetic surgery. Their destination is often Lebanon, a country whose obsession with physical perfection has transformed it into a specialist destination. The Lebanese cosmetic surgery industry has flourished in recent years with surgically enhanced beauty becoming increasingly desirable among image-conscious locals. Lebanon’s First National Bank even offers loans of up to $5,000 for cosmetic surgery. With recent conflicts such as the 2006 war between Israel and Lebanon over, the country is attracting many more clients from further afield eager to take advantage of Lebanon’s medical experts. Roger El Khoury at the Beirut Beauty Clinic reports that the clinic has experienced a 25 % increase in foreign patients over the past 12 months with clients arriving from other Arab countries in the Gulf and North Africa. There is also huge demand from Lebanese expatriates. Sami Saad, Lebanon’s representative at the International Society of Aesthetic Plastic Surgery, estimates that 20 % of business is people from abroad. The procedure most requested by foreign clients is rhinoplasty, nose jobs. Dubai-based Image Concept is an agency set up to help medical tourists book their trip to Lebanon, finds them the right accommodation and the surgeons to perform the desired procedures. Zeina El Haj, Image Concept’s founder, launched her company in June 2009 to market the country’s cosmetic surgery industry. Since then, business has grown with clients mainly from the United Arab Emirates, Kuwait, Saudi Arabia and Qatar, and a handful from Europe, the United States and New Zealand. Demand has been increasing. People want to look like the stars they admire -- they want the nose, or the cheeks, or the teeth of certain celebrities. They want to look good. The country’s attraction is the affordability of its surgeons and its convenient location. Although Lebanon welcomes the increase in cosmetic surgery tourists, local specialist warn people to be wary of unqualified surgeons trading on the country’s reputation. Their advice is to ensure any medical procedures are performed by specialists registered with the Lebanese Society of Plastic Reconstructive and Aesthetic Surgery (LSPRAS), an internationally-endorsed body set up to regulate the industry. LSPRAS explains a problem, “The provision of information by physicians to their patients is at the centre of the process of valid consent; this however, must be distinguished from advertising, an issue of controversy for several years and strictly forbidden by Lebanese law and the Lebanese Medical Code of Ethics.” The importance of getting the right surgeon is emphasized, as litigation against surgeons is almost unheard of and impossible to pursue successfully. Political stability is fundamental to Beirut’s role as a destination for cosmetic surgery in the Middle East. Tensions between Middle East nations and Israel and Iran could damage trade. Although the Ministry of Tourism claims a slight increase in tourism in each of the last three years, neither it nor the trade have any real handle on the numbers coming into the country for cosmetic surgery.

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GERMANY: Changes in management at ADAC Service GmbH

Thu, 09 Dec 2010 16:38:51 GMT

Karin Schinagl becomes the new Managing Director of ADAC Service GmbH and will be responsible for the medical assistance area. Mrs. Schinagl replaces Alfred Mayr, who has left the company. In addition to her new responsibility, Mrs. Schinagl keeps her position as Manager Insurance Provider Management in the ADAC insurance sector. Dr Michael Meyer, Medical Director in the third-party clients sector of ADAC Ambulance Service faces new challenges. From the beginning of this month he will assume the position of Medical Director for the entire ADAC assistance sector. Michael Meyer’s professional background is in Anesthesiology Emergency Medicine as Senior Consultant at the University Hospital in Erlangen. He replaces Dr. Michael Herold, who has been responsible for the ADAC membership/insurance programme for 10 years.

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51st hospital in Fortis Network: Fortis-Vivekanand Hospital

Thu, 09 Dec 2010 09:40:40 GMT

Fortis has recently added another hospital to its network deepening its presence in UP and making Fortis a 51-Hospital-strong network. The Vivekanand Hospital & Research Centre is a 150-bedded Multi Specialty Hospital located in Moradabad, Uttar Pradesh and offers comprehensive services with a special focus on Cardiology, Gastroenterology and Neurosurgery. The hospital has been signed up as a Fortis facility and reflects Fortis strategy to expand reach and provide access to quality healthcare to population in smaller towns in India. The rechristened Fortis-Vivekanand hospital was initially set up in July 1989 by the Moradabad Charitable Trust with the intent to cater to the huge need for a well-established medical treatment centres in the district. The hospital has a built up area of 198000 sq ft and is located on a 6.3 acre plot, which also houses a Nursing College and Nursing School. It has four well-equipped Operation Theatres, a Cath Lab with a 10 bedded Heart Command Centre, and a Rotary blood bank. Under this agreement, Fortis shall revamp the infrastructure, help overcome operational challenges faced by the hospital, add to depth and width of the medical programme currently being offered and fund the expansion and growth of the hospital. We will bring in the Fortis brand while introducing all of our processes and practices to this institution. Fortis Hospital Noida will act as a “Mother” hospital for the Moradabad Facility. So, the growth story at Fortis Healthcare continues and these remain very exciting times in our organization.

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KUWAIT/SAUDI ARABIA/ BAHRAIN/IRAN: Mixed news for medical tourism in the Middle East

Thu, 09 Dec 2010 09:20:08 GMT

In Kuwait, according to reports in the local media, Ministry of Health officials have found that dozens of Kuwaitis were improperly referred for medical treatment abroad after using forged medical reports. The fraudulent claims were reported by the manager of the ministry’s foreign medical treatment section, Dr. Mohammad Al-Meshaan, when he heard about the existence of a professional counterfeiting gang who had been using real senior doctors’ names and officials seals without their knowledge to forge the documents needed to receive medical treatment abroad. There are suggestions that doctor, working in collusion with a number of secretaries and other ministry staff, may be responsible for the forgery operation. This could be very embarrassing for heads of ministry departments and doctors as their names and official seals and signatures were used in the transactions without their knowledge. The gang got patients to pay for the forged documents to be sent to places such as London for a week for treatment. It is alleged that neither the patients nor their companions were actually ill, but just enjoying a holiday at the government’s expense. Allegedly, even doctors and nurses went with so-called patients for treatment abroad, despite all being in excellent health and with no need of medical treatment. It seems that this is a considerable criminal operation, impossible to run without inside help from medical staff and government officials. It is embarrassing for the government as it both shows a large-scale fraud, and that despite attempts to promote the quality of local health service and develop medical tourism, is paying for residents to go abroad for treatment. The investigation is expected to reveal both the number of genuine residents being sent abroad, and the number who enjoyed a cheap holiday after paying for forged documents. Saudi Arabia is another country keen to encourage medical tourism and stress the quality of local treatment. King Abdullah bin Abdelaziz al-Saud, 86 years old, is suffering from a painful but not serious condition that requires rest. Instead of being treated locally, he flew to the USA. In Bahrain, a new private hospital, the four-storey Royal Bahrain Hospital with 670 beds has just opened. The hospital is run by the KIMS Management Internationale, a UAE subsidiary of an Indian medical group. The hospital claims to have one of the best cosmetic and dental surgery clinics in Bahrain. The hospital is targeting people living in Bahrain and aiming to promote medical tourism so that instead of going to European countries, Middle East patients will go to Bahrain. In Iran, Mohammad Nahavandian of Iran’s Chamber of Commerce claims that the country is increasing its global share of medical tourists. He argues that low costs and hospital capacity, could make Iran an attractive destination. Others in Iran promote a hard to believe claim that it is already a top ten medical tourism destination with most of their patients coming from England, Sweden and Persian Gulf countries. It is probably true that it gets some patients from Persian Gulf countries. Whether those from Europe are expatriate workers, expatriate Iranians, business travellers or holidaymakers, is not stated. Like other countries claiming a top ten place (and there are many more than ten making that claim!) there is a lack of credibility as there is a complete lack of numbers and statistics. The claims were made on an Iranian television station, Russia Al Youm. The report suggested that people come just for spinal implant and cosmetic surgery, as the price is a quarter of that in America, Britain and Turkey.

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USA: American insurers and employers back domestic medical tourism

Mon, 06 Dec 2010 11:24:59 GMT

Self-funded and fully insured employers are jumping on the domestic medical tourism bandwagon, offering the option in their healthcare benefit packages, says David Goldstein, of medical tourism agency Health Options Worldwide. The agency claims that companies are moving away from traditional medical tourism where patients would travel abroad for surgery or other types of non-emergency medical treatment. The latest demand is for domestic medical travel, whereby patients seek low-cost alternatives in other regions of the United States. David Goldstein argues that what is keeping patients in the United States as opposed to going overseas where the savings are substantially higher is that domestic medical travel’s largest appeal is comfort and convenience, "It is easier, physically and emotionally, for someone to travel within the US and obtain follow-up care than it is for them to go abroad. By encouraging domestic medical travel, employers can reduce employee downtime, improve employee retention and become more competitive in the marketplace." Employers and insurers are offering enticing incentives to employees for using the domestic medical travel option. Cash bonuses, waived co-payments, free companion travel can be offered in return for using an American-based doctor or facility. Healthcare plans can also offer lodging and meal expenses." According to Goldstein, several insurers including Anthem Blue Cross and Blue Shield, WellPoint, Health Net of California, Blue Cross Blue Shield of South Carolina and UnitedHealth are adding domestic medical tourism options or launching pilot programs to test effectiveness, “This is a big deal because these insurers, such as Blue Cross Blue Shield, have always been conservative. So to see these giants join the trend signifies that we are the cusp of something big in the healthcare market. The price differences are so substantial, it is a no-brainer. More insurance groups are offering domestic medical travel plans to employers and more employers are offering them to their employees.” Devon Herrick of the National Center for Policy Analysis adds, “In the USA, healthcare providers often charge substantially different prices for medical procedures. This means there are opportunities to reduce costs by directing insured patients to a hospital across town or in another state. But health insurers and employer health plans must identify providers offering quality services at lower prices and reward enrollees who use them. Provider networks are competing on price for the business of insurers and employer health plans.” Herrick has identified a trend, “Two U.S. hospitals in the same provider network may charge much different prices for the same procedure. In response to this price variation, some health plans are creating exclusive provider networks for certain procedures. This strategy, called selective contracting, lowers costs for two reasons: 1) Health plans are able to negotiate better prices with providers because they purchase large volumes of health services; and 2) Their bargaining power vis-à-vis providers is enhanced by the possibility that they will direct enrollees elsewhere, which encourages aggressive price competition.” Goldstein believes that domestic medical travel will continue to gain momentum and offers the following tips in creating a destination hospital:• Stand out - Choose a key service that you excel in and market it. Be the market authority in that specific service, because the more popular hospitals have narrowly defined differentiation strategies that enable them to distinguish themselves.• Make yours a destination hospital in your marketing efforts - Emphasize that key service and shop it around to businesses, insurance companies and consumers.• Negotiate partnerships with businesses – Offer services in your key healthcare area, which will result in increased traffic, more staff experience and higher quality. Steven Cyboran of Sibson Consulting advises that, in 2008, 40% of US companies were investigating overseas medical tourism, but the number now actually offering it is well under 1%. He suggests that the hesitation is due to concerns about the lack of data on overseas hospitals; the potential risks associated with political unrest, natural disasters, terrorist acts, or pandemic outbreaks; and questions about whether employees are willing or able to travel. Rachel Fields of The Delta Group adds, “Driven by the need for high quality and low cost care, health plans are considering an alternative to overseas medical tourism or local treatment: sending members to high-volume, high-quality medical centers in another state or region. This trend means discounts for insurance providers and higher case volume for proven centers of excellence throughout the country. Shane Wolverton of The Delta Group, adds, “Medical tourism is moving from overseas travel to domestic travel. Employers are choosing to recommend domestic medical tourism to target those individuals who cannot afford to take time off work to travel internationally. And it is a lot more comfortable to travel from Greenville to Phoenix than to travel across the ocean. The packaged price of medical travel demands collaboration between physicians and hospitals to promote cost savings. Hospitals with a distinctive competency are most attractive to networks and patients. Those that will benefit immediately from the trend of medical travel are those that can promote an area of expertise that distinguishes them from other hospitals."

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UK: New television channel dedicated to safe cosmetic surgery

Mon, 06 Dec 2010 11:20:31 GMT

Headed by leading cosmetic surgeons, Avia TV is a new television channel aiming to provide accurate and balanced information on cosmetic surgery procedures Avia TV has launched a search for men and women to receive up to £30,000 worth of free surgery each to make a real change in their lives. The successful applicants will appear in the company’s flagship programme “It Changed My Life” where some of the UK’s top cosmetic surgeons will offer anything from simple to complex cosmetic surgical procedures to help patients get their lives firmly back on track. Avia TV’s consultant surgeons are already well known for their work on such shows as Extreme Makeover, Embarrassing Bodies and The Ugly Face of Beauty. Around 1.6 million people are estimated to be considering cosmetic surgery. It Changed My Life will tell some of their stories - why they want surgery and what they want to change. We will see them living their lives before surgery, meeting their surgeons to discuss their problems and learn how responsible surgical procedures can help. Only once the consultants are satisfied someone is a suitable candidate will they be accepted. Avia TV will then show the operations in detail, the patient’s recovery and reveal how surgery has really changed a life for the better. All of the Avia TV consultant surgeons are fully accredited and are on the specialist register of the General Medical Council. Avia TV aims to cut through the myths about cosmetic surgery to provide accurate, reliable and balanced information. Online you can watch films about operations, how to choose a surgeon or a hospital and hear from the surgeons themselves about what they do and what motivates them. Avia TV also wants to inform and educate its audience and the medical profession about existing and emerging techniques in surgery and to invite viewers to ask the experts personally about procedures and their concerns. Peter Arnstein of McIndoe Surgical Centre, a co-founder of Avia TV says: "Cosmetic surgery is sometimes a misunderstood and often controversial industry so we wanted to devise a web channel dedicated to giving the facts to enable patients to make the right decisions for them. We never forget that the safety and welfare of patients is paramount. It Changed My Life will take care of people and, we hope, will show viewers how responsible surgery should be done." John Pereira, also of the McIndoe Surgical Centre and co-founder of Avia TV adds, "The new web TV channel is about giving information to viewers. People who appear on It Changed My Life will, through their experience on screen show others what happens during the process of consultation, decision making, surgery and recovery in a factual way that is easy to understand. We have to show people what surgery involves, including the new developments and constant evaluation and re-evaluation of techniques and attitudes. It is a myth that surgery is all about vanity. For me, that means someone who is already beautiful trying to go one stage further. It changes lives, as we see people who have lost all confidence in themselves and what they do in life. Grandmothers who miss out on time with their grandchildren because they feel too embarrassed by their tummy shape to put on a swimming costume and take them to the pool or seaside. Older ladies who have a rejuvenating facelift to restore their self-confidence and enable them to get back into their public lives.” Stephen Cohen advises, “The web channel is just the first stage of the Avia TV project. From early 2011, millions of viewers will be able to tune in when we launch the broadcast channel on TV screens across Britain.” We are confident that the UK audience will seek out a dedicated source of information about cosmetic surgical procedures, which provide a unique opportunity to change people’s lives for the better. Too often, surgery programmes on television deal with what went wrong or just speculate about the operations celebrities may, or may not, have had done. We are creating a TV channel which gives viewers the facts in a calm and honest way.’’ The co-founders are not fans of cosmetic surgery tourism and argue, “A worrying trend has emerged as some are combining their holiday time with cosmetic surgery abroad and booking a sun, sea and surgery getaway. We would never advise this option. Frankly we feel that it is extremely dangerous to undergo surgery at an unfamiliar hospital in a country where you may not even speak the language. The Ugly Face of Beauty on Channel 4 recently highlighted the very real risk of surgery abroad, and McIndoe Surgical Centre saw those patients first hand when some of our surgeons were asked to perform corrective surgery on a number of ladies who had received substandard surgery abroad.” McIndoe Surgical Centre urges patients to remain in the UK, and advises anyone considering surgery at home or abroad.• Aftercare is one of the most important aspects of surgery and ideally you should have somewhere within the UK where you can go for aftercare check ups, or for any questions that are linked to the clinic abroad. It is not easy to pop across to another country if you feel you are not healing properly.• Thorough research should be done into the clinic and the surgeon who will be performing your operation. Check they are registered with the GMC (General Medical Council) or that they have specialist qualifications and experience in performing the surgery you require. You should be able to meet your surgeon in the UK before booking the procedure so you can have a detailed consultation and ask plenty of questions.• The price of surgery is obviously important to many people, but be aware that the poor quality cosmetic clinics often do not charge any less than good well equipped hospitals or specialist centres because of the add on charges that appear on the final bill. Check the price quoted is fixed and includes surgical, anaesthetic, hospital, medicines and dressings. Ensure that you are guaranteed free revision surgery should your initial result be substandard and it is appropriate to make alterations.• The best advice of all though, if you want your holiday to be restful, worry free and relaxing is to leave the surgery until you come home and then use a reputable hospital close to home where you can be supported after your surgery. Every surgery comes with risks and to be thousands of miles from home is no joke if things go wrong.

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TAIWAN: New medical tourism zone for Taiwan

Mon, 06 Dec 2010 11:13:35 GMT

Taiwanese health authorities plan to establish a special zone for medical tourists near Taiwan Taoyuan International Airport, the island’s major international airport in the northern county of Taoyuan. The government aims to attract local and international investors, including hospitals and hotels. Sources differ as to whether private interests are expected to provide all the money to develop the zone or the government plans to invest at least US$130 million in the project. Health authorities expect that in its first four years of operation the zone will attract 45,000 foreigners. Taiwan has been promoting medical tourism in recent years, and mainly competes with Japan, Singapore, Malaysia, South Korea and Thailand. The number of medical tourists who went to Taiwan to undergo medical checkups or receive cosmetic surgery in 2008 was about 5000, and by 2009 that increased to 40,000. Almost all are Chinese on group tours as members of medical clubs. A legislative body that advises the government has suggested that there is a need for the government to amend medical laws to bar hospitals located outside special medical tourism zones from treating or seeking medical tourists. In its study of medical tourism, the Organic Laws and Statutes Bureau said the government should amend articles 61, 88 and 91 of the Medical Care Act to only allow medical institutions located within the special zones to offer medical tourism services. The bureau argues that this is needed to avoid a public backlash, and the government should never provide subsidies drawn from state coffers to such institutions. It also suggested that the government should amend the National Health Insurance Act to exclude medical procedures provided by those hospitals from National Health Insurance coverage. And in addition, the government should amend the Communicable Disease Control Act to bar hospitals in the special zones from attracting patients from epidemic areas and set a ceiling on the number of foreign patients allowed to travel to Taiwan for medical tourism to prevent outbreaks of infectious diseases. Taiwan has endeavored in recent years to develop medical tourism. Although it has promoted the country, it is now clear that a divide has developed in the authorities, between those who want to encourage it, and those who want to limit and control it. The Taiwan government is committed to the policy of allowing visits by individual Chinese tourists and business visitors but details of the plan are still being worked out.

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DOMINICAN REPUBLIC: Medical tourism rises, but cholera is a new problem

Mon, 06 Dec 2010 11:03:58 GMT

Doctor Tomás Vargas Martinez of the Institute Against Blindness from Glaucoma says that health tourism has reached an importance as evidenced by in an increase in the number of foreigners and non-resident Dominicans who go to the country to get good quality medical treatment for their health problems. He wants the Tourism Ministry to promote the segment, rather than leaving it to a handful of agencies and clinics. He said patients from Puerto Rico, Jamaica, San Martin, Antigua, El Salvador, Honduras, New York, Boston, Miami and Atlanta go there for treatment, aware that the country’s specialized clinics are as advanced as those of any other nation in the region, including the United States. Another speciality of the country is cosmetic surgery, with promotion by Dominican surgeons going abroad to contact patients. Other popular specialties include ophthalmology and prevention of blindness from glaucoma and diabetes. The Ministry of Tourism reports that tourism in total, including medical tourism, to the Dominican Republic has, unlike most countries, grown in the last two years. During the January-October season in 2009 the number of tourists was 2.8 million and in 2010 it was 2.9 million. The Dominican Ministry of Health announced that upon receiving information that a Haitian national was detected of having cholera in a Dominican hospital, it immediately isolated the patient and took all the necessary measures to avoid the spread of the illness. Wilmon Louwes, a Haitian national living in the Dominican Republic, is reported as the first cholera case in the Dominican Republic. He visited his family in Haiti, where he picked up the illness as there is a major cholera outbreak there. The Dominican health authorities, assisted by the Pan-American Health Organization, have taken extreme measures to prevent the spread of the illness. Following the protocol established by the World Health Organization, they quickly identified and isolated the country’s first reported cholera case. The Dominican health authorities explained that Louwes first exhibited signs of the illness during his return trip to the Dominican Republic. He was immediately assisted by the health authorities and is recovering in a local hospital. The Minister of Health has introduced various health control mechanisms along the DR/Haiti border in order to prevent the cholera outbreak in Haiti from spilling into the Dominican Republic. The Dominican authorities also ran a media prevention campaign and strengthened health controls along the border region. All eight international airports are open and receiving commercial flights. All beaches, hotels, resorts and tourism businesses are conducting normal business operations. All security, health, communication and transportation systems are all operating normally and effectively.

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ISRAEL: Israel's medical tourism industry under scrutiny

Mon, 06 Dec 2010 10:26:16 GMT

Israel’s Health Ministry has appointed Dr. Ronny Gamzo to head an investigation committee to probe the medical tourism industry in Israel. The six committee members appointed by Gamzo includes hospital officials, public officials and academics. Their deliberations will be published before the end of 2010. This follows a series of articles in Israeli newspaper, The Haaretz. The paper claimed that medical tourists to Israel enjoy medical conditions that Israelis can only dream of, including very short waiting times for procedures, the right to choose their own doctor and private rooms. Dr. Gamzo commented, "The issue of medical tourism is complicated and the question of how to wisely balance the industry’s advantages and disadvantages should be examined. The committee will check what the right balance is, and at the same time examine a way to increase resources that would allow the development of the medical tourism industry that does not come at the expense of Israeli patients." Currently, Israel gets an estimated 30,000 medical tourists a year, mostly from the former Soviet Union, but with increasing numbers from Africa and the Middle East. Israel’s medical establishment is eager to get more medical tourists, as they are more profitable than local patients. Neighboring Jordan claims 210,000 medical tourists a year. The Ministry of Tourism launched a marketing campaign a few months ago aimed at attracting medical tourists, particularly Americans of Jewish ancestry and Western Europeans. The committee is to investigate if medical tourism is a benefit. Advocates argue that it brings money into Israel’s perennially cash-strapped health system that will enable hospitals to hire new staff, open new wards and purchase new equipment. They say it is not at the expense of Israeli patients, because medical tourists are treated only after 3 P.M., when the official hospital working day ends. Another area to be looked at is that there are no regulations on the use of Israeli hospitals and clinics for medical tourism, other than an ancient 1995 directive issued by the Health Ministry’s director general, which states that medical tourism must not come at the expense of the Israeli patient. The Health Ministry is concerned that medical tourism services will undermine the medical service given to Israeli residents. How does Israel’s medical infrastructure compare to other Western countries? Israel has two hospital beds per 1,000 residents, compared to an OECD average of 3.8. Among OECD nations, only Mexico fares worse. One result is long waiting times for non-emergency procedures. A ministry report last year found that the wait for an ear, nose and throat operation was six to seven months at Sheba Medical Center in Tel Hashomer and 13 months at Western Galilee Hospital in Nahariya. Danny Angel of the private Assouta Medical Center in Tel Aviv, argues, “Medical services received by tourists in Israel must be identical to those received by Israelis, with one exception. Service must be quicker in the diagnostic sphere. If a tourist has to wait 10 days for a CT or MRI scan, that would make his treatment significantly more expensive and less attractive.“ Opponents argue that if medical tourists are pushed to the front of the line for such tests, waiting times for ordinary Israelis will inevitably lengthen - especially in the departments most frequented by medical tourists, which include the cancer, cardiac and in vitro fertilization units. The newspaper report says that the argument that medical tourists are treated only after regular hours is misleading as not only must you care for in-patients all day, but hospitals also treat many Israelis after regular hours. Doctors earn extra pay from the hospital’s research fund for such overtime operations, and it also reduces the pressure during regular hours. If medical tourism begins occupying more of the overtime hours now utilized by Israeli patients, then waiting times for all Israelis will grow. The newspaper also says there is no guarantee that hospitals will invest the revenues from medical tourism in new staff or equipment that would benefit all Israelis, as they might prefer to use this money for other purposes. It argued that medical tourists get preferential treatment and quoted examples of operations where Israelis would have to wait months, but medical tourists could be operated on almost immediately as a few appointments are reserved each day for them. It also claimed that while medical tourists are allowed to choose their preferred surgeon, Israelis are not. The Health Ministry has avoided regulating medical tourism. If it restricts hospital activities, then hospitals will ask it for more money to compensate for the lost income. If it ignores it, Israeli patients who have longer delays, will be upset and exert political pressure. The committee could solve the problem for the government, or it could leave it in a worse position having identified pluses and minuses, but hovering between the two. A handful of local hospitals are doing well out of medical tourism. Between 2005 and 2009, Tel Aviv’s Ichilov Hospital saw medical tourism revenues increase more than fivefold, while Assaf Harofeh Hospital in Tzrifin saw its revenues quadruple. Professor Gabi Bin Nun of Ben-Gurion University is against medical tourism, "The right way to operate medical tourism is by first solving Israel’s existing problems. Given the existing problems, it is hard to understand how the Health Ministry can be interested in expanding medical tourism." The Health Ministry will discuss options with the Tourism Ministry and the Finance Ministry once it has the report.

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GERMANY: Germany increases health insurance prices

Mon, 06 Dec 2010 10:12:55 GMT

The rising cost of healthcare in Europe was put into focus when the German parliament passed healthcare reform to overhaul the country’s cash strapped mandatory health insurance scheme and plug a threatened 11-billion-euro shortfall in the public health system for 2011. Germany’s highly regarded health system covers 72 million people via state health insurance and 8.5 million via private schemes. Mandatory health insurance contributions will require an equal split between employers and employees in Germany, with the contribution increasing by 0.6 percent from 14.9 percent to 15.5 percent of gross wages; the increase being from January 2011. Any future increases in mandatory contributions will be borne solely by employers. The reform in German health law is seen as a fair way to maintain the high standards of the Germany public healthcare system faced with an aging population and a shrinking German work force. The Federal Ministry of Health’s network includes 2,200 hospitals and 300,000 doctors, with the German healthcare system responsible for 4.3 million of the country’s total workforce. The overhaul is seen as vital for Germany to stem increasing costs associated with its public healthcare system. The German public healthcare system is one of the most expensive in the world. Germany, like other western countries including the United Kingdom and the USA, has taken steps to undertake radical reforms in their healthcare systems to meet changing circumstances and rising healthcare costs. The German healthcare system is noted for the high standards of medical care provided. Health insurance in Germany is not one state pool, but a collection of large and small private health funds that administer the scheme, and there is no price competition. Two of the largest health funds have dabbled in medical tourism for ancillary care such as spa and dental treatment, both covered by health insurance, but only in a few neighbouring countries. Germany is very pro-Europe, so it is highly unlikely that they would consider treatment outside of Europe, and almost certainly would not consider surgery outside of Germany. The reform aims for more competition among the health insurance funds to maintain diversity and increase efficiency and quality in health care provision; so some may want to compete by offering treatment in other countries for ancillary services. The health system may seek to increase income from inbound medical tourism. Although they cannot compete on price with Asia, Germany is probably the advanced nation in the world on healthcare technology and treatment.

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CAYMAN ISLANDS: Shetty making gestures to help get medical tourism project started

Thu, 25 Nov 2010 15:27:38 GMT

Dr Devi Shetty has signed an agreement with the Cayman Islands government to establish a heart unit at the George Town Hospital. The cardiac surgeon’s Narayana Group will fund and manage the special unit, which will give Cayman’s heart patients access to proper cardiac care for the first time. The unit will save money for government, as funding overseas health treatment was one of its biggest costs but would also save patients the need to travel. The unit will be up and running in about eight to nine months time as some modifications needed to take place in the operating room. The gesture by the Indian surgeon will do home no harm to his bid to set up a medical tourism hospital /health city on the island. This is a harder task than once thought as it is now clear that the creation of new legislation and law reform are essential to the development of Dr Shetty’s proposed health city. The Cayman government must change the Health Practitioner’s Law and legislate for tort reform as well as introduce a new law to allow organ and tissue donation before the project goes ahead. Dr Shetty believes American patients will come to Cayman, but as he plans to use doctors with Indian qualifications rather than with US ones, he needs the government to change the laws to accept Indian doctors and their qualifications. Despite it being a high cost to location to live in, he aims to attract patients from the US at 50-60% of the cost there in a place that Americans will feel comfortable. Shetty argues that Cayman is an attractive destination for quality medical staff, not just from India but also from the US, where the heads of departments at his hospital will come from. Critics argue that the flaw in his logic is that to offer care at such a reduced rate he must be paying doctors less than in the US, so with an increasing shortage of doctors there, why would they go to Cayman for less money than they can get in the US? Others point out that the number of Americans travelling abroad for major surgery, rather than weight-loss surgery or dentistry, is actually much smaller than most estimates and far below the projections that were around when the project was first mooted. Also he will have to compete with Mexico on price. And many Americans will go to Cuba for medical treatment once Cuba has opened up to the US. Dr Shetty argues that Cayman, which already has the infrastructure related to existing tourism, could become a significant medical tourist destination. With its proximity to the USA and that the destination is considered safe, patients will feel comfortable going there to be treated and the necessary medical experts will also want to live there. Shetty argues, “We are confident Cayman will be a success because America will move to a social form of medicine where waiting lists will be introduced. Waiting lists will drive medical tourism because patients, especially elderly ones, do not want to wait. He pointed to the aging population in Florida that would increasingly need access to affordable and immediate health care, as well as assisted living.” Critics counter that even before healthcare reform, those using state healthcare get free treatment, while those paying for it already go private, so waiting lists are an irrelevance. Shetty’s local team hopes to break ground sometime in the second quarter of 2011. They will not reveal which locations are being considered. But they admit that the start of the project is heavily dependent on the legislative changes and they cannot move forward until the regulatory issues are resolved.

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IRELAND: The way forward for cross-border healthcare

Thu, 25 Nov 2010 15:23:07 GMT

Ireland is one of the EU countries suffering the most from economic problems, and has recently accepted a 90bn euro (£77bn, $122bn) rescue package from the EU to shore up its ailing economy. Ireland is set to unveil a four-year plan which will require total cuts of 15bn euros ($20bn; £13bn), or 11% of the Irish economy’s annual output. The cuts will inevitably impact the cost and availability of healthcare in Ireland. The recession will make health inequalities in Ireland worse with growing evidence that the public is opting out of medical services they have to pay for, a survey has found. The latest annual Pfizer Health Index report, which surveys more than 1,000 Irish adults every year, has found that people are going to the doctors and taking screening tests less often and also not attending hospitals as much. The most vulnerable section of society is the C2s or skilled manual workers who constitute nearly a quarter of the population and have been especially hard hit by the recession. A third of them have neither a medical card nor health insurance while in general only one in four of the population has neither. Among the middle-class, two out of three have private health insurance. Private health insurance in Ireland is becoming more expensive as it is a limited market of three major insurers, each with individual problems. Although prepared to pay for treatment overseas, or across the border in Northern Ireland (part of the UK) for treatment not available in Ireland, all have held firm against allowing medical tourism for their customers. None of the three is prepared to be the first to offer it. Opposition party SDLP health spokesperson Tommy Gallagher has said huge savings and a better service can be achieved through cross border healthcare. Speaking at the SDLP Annual Conference, he said, “A joint North South study report commissioned by the two governments in 2007 includes recommendations on radiotherapy provision at Altnagelvin and transplant services. The Irish government has now committed the money to jointly develop the radiotherapy unit at Altnagelvin. The business case has now been completed by the Western Trust and it is for the Health Department at Stormont to now move ahead. Yet our health minister is refusing to publish the report on the grounds he is not convinced of the need. This position is at odds with the present realities.The list of cross border initiatives is growing every year. There is a cross-border diabetes network. There is a pilot study on ENT services based at Monaghan that might serve the people of the wider border region. There are numerous examples of ongoing co-operation between the health services on both parts of the island. The dialysis unit at Omagh hospital regularly takes patients from across the border when services at hospitals such as Sligo are under pressure. Northern patients receive treatment for brain injuries in Dublin. Ambulance and fire service crews frequently attend incidents on the other side of the border. In Dublin there is a high level of interest in planning for delivery of health services on a North-South basis because there are significant savings to be achieved for the government and there are of course better outcomes for the populations of border counties. Rural communities through out Ireland face problems to access hospital services because of the centralisation of key services in a small number of large hospitals. We have begun a dialogue on better North-South co-operation can deliver mutual benefits. There are difficulties to be overcome-and they can be overcome if the political will is there. Despite the government’s lack of interest the SDLP want to press ahead with these initiatives.”

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UK/GLOBAL: Keeping your medical tourism website legal

Thu, 25 Nov 2010 15:12:30 GMT

With the proposed changes to online advertising rules some timely advice on how to keep online advertising and website sales copy on the right side of the law may be useful. Jill Benbow of Keystone Law advises; “The web is the fastest growing medium and lets you reach a very targeted audience. It also allows you to monitor the success of your advert. There has been a lot written about how to advertise and how to use pay per click, but what should you actually say and not say in your advert? Here are some simple rules to help you keep the right side of the law when writing your own website copy- Your businessYou do not have a free rein in relation to the content or arrangement of your websites. Certain details concerning the business must be provided on the site in an easily accessible manner. You must specify your business’s trading name and the name of any company it trades through, the names of the directors (or a statement that such names are available for inspection at your registered office), the address of your registered office and your company registration and VAT numbers. You must also make it clear where you can be contacted, by phone (legally you do not have to give a phone number, but can you afford not to?), email, fax etc. and a correspondence address should also be specified if it is different to that of your registered office. It is a criminal offence to miss out these basic details. Your services The Trade Description Act applies to what you say on your website, just as it would to your paper adverts, as will the consumer protection from Unfair Trading Regulations. Traders must not make commercial communications to consumers, which are:• Actually misleading (by act or omission);• Aggressive, i.e., by suggesting that if you do not take this offer up NOW, something terrible is going to happen;• Accurate; it may well be the best service in its class, but to say so can lead to accusations that you have incorrectly described the service. One common way round this is to refer to survey results or an independent publication, e.g., ’eight out of ten people said it is the best in its class’, Try and stick to the facts, and steer clear of claims you cannot prove; • Complete; you must give the consumer sufficient information to make an informed transactional decision. An omission can be just as serious as an inaccurate description. You will need to ensure that all of this information is either in one place, or can be read together, relatively easily, using links or references. Promises madeIf a buyer of your service argues that a statement that appeared on your website which induced them to buy your service and the statement is subsequently found to be untrue, you are in trouble. Such statements are a representation by you about the service and they need to be accurate. Performance indicators often cause the biggest problem. Do I really have to comply with these requirements? Trading Standards are very hot on compliance with the law and have the power to take down your website. Consumers and buyers are often clued up on their rights and won’t stand for breaches of their rights. They may sue you and win or report you to Trading Standards. Cases of fraud or obtaining money by deception attract serious civil and criminal penalties. Lastly, and most importantly, in this day and age of rapid information transmission and so much choice, your reputation matters."

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SINGAPORE : Singapore medical tourism business grows despite competition

Thu, 25 Nov 2010 15:08:37 GMT

Singapore’s medical tourism business is growing slower than nearby countries such as Korea, Taiwan and Malaysia, as competition is intensifying. According to research and consulting firm Frost & Sullivan, Singapore attracted 665,380 foreign patients in 2009 – a 3% increase on 2008 with 646,000, and 571,000 in 2007. Pawel Suwinski of Frost & Sullivan estimates that Singapore will get 725,264 foreign patients in 2010. In 2011 and 2012, he forecasts annual growth of 9 %. This is low compared to the 15 to 30 % growth that Malaysia, Thailand and South Korea are enjoying, but the higher priced Singapore gets more revenue per head. Dr Suwinski says, ’We have to remember that there are different business models in operation, with Singapore focusing more on quality rather than volume as in Thailand and India. This is best seen when comparing the revenue per patient figures, with Singapore the undisputed leader.” Foreign patients in Singapore generated US$1.4 billion in revenue in 2009 - US$2111 a head. This is higher than in Malaysia, South Korea, India or Thailand, where revenue per patient ranged from US$227 to US$2,016. But India is closing the gap, with projected revenue per patient of about US$2100 in 2010. 2010 will also be the year that India overtakes Singapore in volume terms, as it will have an estimated 731,400 foreign patients in 2010. Thailand has consistently been at the top, despite its political woes. The company estimates Thailand received more than 1.2 million foreign patients in 2009 and will get 1.5 million in 2010. According to the company, the high revenue per foreign patient in India is largely a result of outsourcing. An arrangement between India’s Apollo Hospitals and US insurance firm Blue Shield allows Apollo - India’s largest hospital group - to treat Blue Shield’s corporate clients, who usually are high value. Dr Suwinski adds: ’Hospitals in India are medically equipped to handle European and American patients during their stay after medical procedures. The cost and time of travel also become an incentive, with the US and EU relatively closer to India than South-east Asia.. He argues that if medical outsourcing is taken out of the equations Singapore is the regional leader in medical tourism, but should look at potential partnerships with Western healthcare benefits providers. There are problems with the figures Dr Suwinksi uses. The latest available medical tourism statistics from the Singapore Tourism Board show that visitors who went to Singapore for medical treatment or related reasons grew 13 percent to 646,000 in 2008 compared to 2007. But 370,000 visitors actually went to Singapore for medical treatment. The other 230,000 are family members of the patients who accompanied them and had no treatment. According to The Tourism Authority of Thailand (TAT), Thailand currently gets 920,000 travelers visiting the kingdom annually as medical tourists. The often-quoted larger figure of 1.4 million is medical tourists and other non-nationals, including business and holiday travellers and expatriates.Indian tourism authorities recently estimated the figure for India to only be 500,000.This throws a different light on his comparisons to the other countries. And Dr Suwinski defines a foreign patient as a person who undergoes any medical procedure outside their home country. He includes people on business trips using medical services, (who are not medical travellers) but excludes expatriates. These different definitions of what a medical tourist is, makes it hard to directly compare figures for different Asian countries. Singapore too should be wary of relying on US outsourced insurance business, as the actual numbers going to India are tiny and have no real impact on numbers. Information just emerging from the US shows the insurer he mentions as moving to domestic US medical tourism to cut costs and reduce travel times for customers (more on this story next week) Dr.Suwinski warns that intra-regional movements are volatile and difficult to predict, as many countries - for example, Indonesia - will definitely try to reverse the tendency of their patients going abroad by providing better-quality care quality at home, “We can already see this trend, with modern healthcare facilities being established in Jakarta that boast the best equipment and personnel in the region. It is a warning to Singapore and Malaysia, as they are the biggest recipients of Indonesian patients annually. Between the two, Malaysia is in the more difficult position because it is focuses purely volume, which is highly price-sensitive, and any local competition can substantially decrease the traffic visiting another country.”

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DUBAI: Dubai Healthcare City celebrates but local hospitals fail inspections

Thu, 25 Nov 2010 14:55:05 GMT

Dubai Healthcare City (DHCC), the world’s first integrated healthcare free zone, has successfully completed eight years of operations. DHCC provides a comprehensive range of medical services. Dr Ayesha Abdullah of DHCC says, “DHCC hosts over 2,000 licensed healthcare professionals offering over 60 specialties and speaking 30 different languages. The free zone is home to over 90 facilities with two internationally accredited hospitals. Our ambition is to create an integrated healthcare city. Our strategy is based on extensive research that highlighted significant expenditure by the UAE residents on overseas treatment, outflow of healthcare professionals seeking medical education and research opportunities, as well as a fragmented healthcare system that impacted patient outcomes. To ensure patients receive the highest quality care and clinical services in a safe and reliable environment, the Centre for Healthcare Planning and Quality (CPQ) was established jointly with Harvard Medical International, as the independent regulatory body. CPQ is responsible for implementing rigorous standards that are aligned with international best practice. DHCC has grown into a major medical community and we have greater plans to deliver health and wellness services that compete on an international scale.” DHCC was intended to attract medical tourists, which it has but in much smaller numbers than expected, bearing in mind the large number of “international” hospitals and clinics on site. A more important function was to reduce the large numbers of Dubai and other UAE state citizens, going to other countries for healthcare. DHCC may have reduced the outflow but many still feel happier being treated overseas. Governments have consistently defended local health provision, but their citizens remain unconvinced. They are right to be wary as a recent leaked report shows. According to Arab media coverage of the leaked report, in January 2010, a US-based organisation was appointed to review the status of 14 hospitals, 67 primary health centres, three dentistry centres, 10 preventive health centres, four nursing schools and the blood bank over six months. The media coverage says that poor nursing services and incomplete infrastructure prevent Ministry of Health facilities achieving international healthcare standards. The report identified the shortcomings that the Ministry needs to rectify in order to achieve international standards. The assessment of healthcare facilities, commissioned earlier this year by the ministry, is an attempt at acquiring international accreditation and improving the quality of health services in the country. The healthcare facilities were also judged on the standards of interior environment, compatibility to emergency and disaster situations, human resources management, infection and patients’ safety control, information and medical records department, healthcare department, medical and technical staff, building safety, nursing treatment and services, quality assurance, medical reports documentation and patients’ rights. The report did not provide the confirmation that the ministry expected…..that most facilities were ready for international accreditation. It has not been published, and information on it has been subject to long delays. The Ministry of Health created Federal Health Authority had approved the project for ministry hospitals and health centres. Officials will have to bring their hospitals up to a higher standard before they can apply for international accreditation.

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BAHAMAS: Second medical firm targets the Bahamas

Thu, 18 Nov 2010 16:35:06 GMT

A second company interested in offering health-related services from the Bahamas, boosting efforts to stimulate medical tourism, is expected to submit documentation to the National Economic Council (NEC) for approval, says the Minister of Tourism. Nettie Symonette, owner of Nettie’s ’Different of Nassau’ resort on Cable Beach, has confirmed that she has received an offer for her property from addiction treatment providers, Ibocure - already with final approval from the NEC to set up in the Bahamas. Ibocure believes that her property as an ideal location for its addiction treatment centre. Ibocure’s owner, US-based Dr Mark Puleo, says the company - which has received the backing of the Ministries of Tourism and Health and the Bahamas Medical Association - could begin offering its Ibogaine drug to medical tourists by early 2011.The drug has not been approved by the Federal Drug Administration (FDA) in the US, and is said to eradicate substance abuse in less time than other addiction treatments. $2 million has already been raised to start-up the project, and several other US investors are investing. Dr Puleo no longer has the right to practice medicine in the US after being cited by the State of Florida for reselling and redistributing prescription drugs, an act that was prohibited under the supplier’s terms. Ibocure recently trademarked a treatment using the psychedelic drug ibogaine as "nature’s cure for addiction". Made from the root of an African shrub, Ibogaine is currently undergoing clinical trials in the US, where it has been illegal since the 1960s. It is said to eliminate drug craving among addicts with minimal side effects. The Ministry of Tourism has declined to identify the second firm until it has submitted documentation to the National Economic Council for approval. The ministry says it has identified the business, identified the location and the investors who were prepared to fund it so the only things left are approval from the Medical Association and the NEC. It also says that other companies are expressing interest in potential medical tourism ventures in the Bahamas, particularly on cosmetic surgery, treatments that have been authorised in some developed countries but are still awaiting approval in the US, and treatments that require long periods of rehabilitation. Medical tourism offers the Bahamas an opportunity to expand the economy and raise employment levels. The immediate advantages to medical tourism companies are a tax-free income and a more relaxed regulatory environment. The danger for the local tourist is of attracting companies because of looser regulation that may be unable to set up anywhere else. Healthcare consumer group Bahamas Patient Advocacy comments, "The cost savings of medical treatment in the Bahamas are a worthy consideration for medical companies: lack of regulatory effectiveness = lack of accountability = savings on operating costs = greater profits. There is nothing inherently wrong with a tax-free income that enhances profit. One likes to believe that the primary objective of a healthcare company is quality service and positive patient outcomes. But a company locating in the Bahamas intends to enhance the profit aspect of the business, because regulatory environment requirements are less, and the track record shows that such requirements as may exist here are not enforced. Economic benefits have to be balanced by effective provision for the welfare and safety of the patients, the same people expected to generate these economic benefits.” Concern is real, as the island has had problems before. In 1997 American psychiatrist Dr William Rader opened a centre in Nassau to offer controversial stem cell treatments. He refused independent testing of his product by legitimate researchers and claimed to have discovered a cure for AIDS. A critical US television report prompted the government to close Rader’s clinic in 2000. The Immune Augmentative Therapy Centre opened in Freeport in 1977 promoting a treatment that claims to restore the body’s natural ability to kill tumours, although there is little evidence that it works. In 1985 there were reports of HIV contamination of treatment materials and the clinic was closed on the advice of the Pan American Health Organization. But after taking preventive measures, it was allowed to reopen. Despite this track record, local health groups accuse the Ministry of Tourism of favouring treatments that have been authorised in some developed countries but are still awaiting approval in the US; including high intensity focused ultrasound therapy for prostate cancer, and minimally invasive heart valve replacement. The National Ethics Committee reviews all proposals on a quarterly basis. Facilities also must be approved by the Bahamas Investment Authority that seeks the advice of the Ministry of Health. Once approved the project must apply for a business license and any necessary work permits. This process can be lengthy.

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BARBADOS: Barbados promotes health and wellness tourism

Thu, 18 Nov 2010 12:00:55 GMT

On the Caribbean island of Barbados, the idea of health and wellness tourism is gaining popularity. Many businesses have been set up to offer services and treatments that cater to health, beauty and wellness. Such services include acupuncture, reflexology, yoga, reiki, ear candling, and fitness. They can be provided by medical practitioners or experts from local health spas. The Barbadian government is promoting and encouraging their health and wellness tourism. The target market is mainly an aging population that has increased demands for fitness programmes, beauty treatment, cosmetic surgery, spas and retirement communities. But the island is also attracting younger customers keen on a healthier lifestyle, looking for vacation destinations that offer spa facilities, fitness and addiction treatment. The main market is Americans. As the island has an established tourism infrastructure with high quality transport and hotels, it is as an ideal platform on which this new tourism market can be built. The climate is excellent, labour costs are low, communications and transport are reliable, Barbados hotel and tourism services are good, the population is well-educated and both public and private health and medical services have well-trained practitioners. Many hotels are finding that it pays to have excellent amenities that support fitness and healthy lifestyles. Examples of hotels that provide fitness centers and spas are: Sugar Cane Club Hotel and Spa, Turtle Beach Hotel, The Crane Resort and Residences, Hilton Barbados, Accra Beach Hotel and Spa, Bougainvilla Beach Resort, and Divi Southwinds. Barbados intends to create a tourism product that is unique amongst others in the Caribbean region. It is setting up a National Health Care Quality Council to attract more tourists for health and wellness. This intends to check that high quality standards exist so health tourism can be expanded within the island. A report by the Caribbean Commission on Health and Development suggested that health tourism is essential to the region, but many obstacles hat currently hinder development need to go. The problems are medical practice, financing of care and insurance coverage, accreditation and standards, immigration and foreign exchange requirements and competition within the region. Despite several reports, many talks and conferences, there seems little real willingness for Caribbean countries to work together. They realize, without publicly admitting it, that their real competitors are not far off countries, but that they are individually competing for a limited local market on medical and health tourism.

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USA: Health care reform on track?

Thu, 18 Nov 2010 10:51:37 GMT

Recent elections in the USA have led to speculation that Obama’s healthcare reform will not happen. Much of the speculation has come from Republicans and right-wing think tanks who are opposed to the reforms. The reality is that although reform may be tinkered with, it is now almost impossible to reverse the progress of the reforms which require myriad new laws and regulations on a federal and state basis. Those hoping that this new uncertainty will drive insurers and employers towards overseas medical tourism should tread carefully; employers will not make major changes to health care provision if they are unclear of the legal situation. For a studied take on the probable effect on healthcare of the recent US elections, we turn to Paul Keckley of Deloitte Center for Health Solutions whose views can be summarized as follows:1. The Patient Protection and Affordable Care Act (PPACA) was a factor in the mid-term outcome and will likely continue to be one of the focus points.2. The promise to repeal and replace is problematic. The Senate is controlled by the Democrats and the White House has veto power so repeal may be difficult. More likely, certain provisions may be challenged in courts, and bi-partisan agreements may be reached on minor changes.3. The costs of health care entitlement programs (Medicare and Medicaid) will become a central focus as recommendations from the National Commission on Fiscal Responsibility and Reform are presented to Congress. The potential to reduce costs via PPACA’s delivery system reforms—Accountable Care Organizations (ACOs), value-based purchasing, bundled payments, comparative effectiveness, and medical homes—will be a focus of policy-makers.4. States will be the frontline as governors and new legislatures tackle PPACA requirements for health exchanges and insurance plan oversight and increased Medicaid and Children’s Health Insurance Program (CHIP) enrollment without additional federal funding and at a time when state deficits are soaring. Health reform is more than PPACA; it is a series of legislative and regulatory actions intended to reshape the financing and delivery of care in the U.S. system. Americans are paying attention and have strong opinions—it matters! President Obama offers a solution, “If the Republicans have ideas for how to improve our health-care system, if they want to suggest modifications that would deliver faster and more effective reform to a health-care system that has been wildly expensive for too many families and businesses and certainly for our federal government, I’m happy to consider some of those ideas. So there are going to be examples where we can tweak and make improvements. But I don’t think that if you ask the American people, should we go back to a situation where people with pre-existing conditions can’t get health insurance, should we allow insurance companies to drop your coverage when you get sick, even though you had been paying premiums, I don’t think that you’d have a strong vote for people saying those are provisions I want to eliminate.” The reality is that national health reform is here. The health reform bills (HR3590 and HR4872) are now law and will trigger sweeping changes over many years. The PPACA signed into law on March 23, 2010, requires that beginning in 2011, insurance companies meet new medical loss ratio requirements designed to ensure premium dollars go to health care. The National Association of Insurance Commissioners (NAIC), an organization of state insurance commissioners, issued their Medical Loss Ratio Regulation (MLR Regulation) as required by the Patient Protection and Affordable Care Act to require NAIC to adopt uniform definitions and standardized methodologies to calculate the medical loss ratios of health insurers in the individual, small group and large group markets. Health insurers are required to pay rebates to their insureds if their medical loss ratio is less than the minimum established by PPACA (80% for the individual and small group markets, 85% for the large group market). The medical loss ratio is the ratio of premiums expended on reimbursement for clinical services plus expenditures on the improvement of health care quality and total premium revenue minus taxes and fees. The MLR Regulation becomes effective on January 1 2011.Until they have sorted out the practicalities of the new laws, insurers are going to very wary of considering medical tourism deals as nobody is certain if the travel and other non-medical costs would be counted within or outside the loss ratio figures. The law tasks the NAIC with a number of additional provisions to consider, including rate review and consumer information.

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US healthcare: Supreme Court refuses law appeal

Thu, 18 Nov 2010 10:10:20 GMT

The US Supreme Court refused to hear a legal challenge to President Obama’s healthcare reform law, with the case not yet having wound its way through the lower US courts. The Supreme Court, the judicial authority of last resort, declined to hear the case brought by Steve Baldwin and the Pacific Justice Institute, which had filed a federal lawsuit in California challenging the new massive health care law. The plaintiffs asked the court to determine whether Congress has the constitutional power to decree that every American must purchase health insurance by 2014, as mandated in the law. The justices declined to take the case without comment. The case has yet to receive a ruling from an appeals court in California, making it premature for the Supreme Court to intervene. Republicans recently took control of the House of Representatives, but Democrats maintained control of the Senate and still hold the White House. Both chambers would have to approve revisions, with President Obama likely to veto any changes to what has been a major domestic win for his administration. Obama has challenged the Republicans seeking to delay or derail the bill to come up with a better solution - the silence is deafening. David Cordani of Cigna warns those seeking to stop or delay healthcare reform. "Repealing the new U.S. healthcare law would be a waste of time, but there is room to improve it. I don’t think it is in our society’s best interest to expend energy in repealing the law. Our country expended over a year of sweat equity around the formation of it." Evidence that reform is needed more than ever is shown by headline figures from the Centers for Disease Control and Prevention (CDC) - the full report is not yet released. 59.1 million Americans went without health insurance coverage for at least part of 2010, many of them with conditions or diseases that needed treatment. 4 million more Americans went without insurance in the first part of 2010 than during the same time in 2008. Dr. Thomas Frieden of CDC says, "Both adults and kids lost private coverage over the past decade. Congress passed provisions expanding free health coverage for children. As private insurance coverage fell, the safety net protected children, but did not protect adults. 9% of adults lost private insurance, and public insurance picked up just 5%. 22% of adults aged 18 to 64 are uninsured. The data allows us to debunk a myth about health care coverage. The myth is that it is only the poor who are uninsured. In fact, half of the uninsured are over the poverty level and one in three adults under 65 in the middle income range between $44,000 and $65,000 a year for a family of four - were uninsured at some point in the year." The analysis found that in the first quarter of 2010, an estimated 59.1 million people had no health insurance for at least part of the year, an increase from 58.7 million in 2009 and 56.4 million in 2008. Blaming healthcare reform for the increased numbers is totally inaccurate, as it will be several years before the main thrust of almost compulsory insurance for all, actually takes effect. There is a much more basic reason. Thousands of American businesses have gone under and many have reduced the workforce and employee benefits such as healthcare insurance. One in ten Americans is unemployed, and many more are on reduced hours and pay. Millions have had their homes foreclosed; millions more are way behind with their mortgage payments. So health insurance is way down the list of essential purchases. Before the medical tourism industry rejoices at a huge new potential market, it should stop and think that most of these people will not be able to afford any healthcare, however low-price or essential it is. The mood of the government, business and people is against overseas outsourcing of any services, as the US looks increasingly inward to rebuild the economy.

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EUROPE: EU patient mobility law to spark eHealth revolution

Wed, 10 Nov 2010 16:40:14 GMT

Whatever the final version is of the Cross-Border Healthcare Directive, it will only work if there is a revolution in health technology. New EU laws allowing patients to travel across borders for health care will be a driver for the development of e-health services in Europe. Incompatible IT systems are a major obstacle that unless overcome, will make the directive almost impossible to implement. It is not just incompatibility between countries, and the language problem, but in many EU countries there are several incompatible systems within each hospital. Sharing test results and medical imaging between hospitals can prove challenging. Language and terminology differences, as well as data protection concerns, make sending information between member states a problem. One of the aims of the EU Directive is to allow patients with rare diseases to access specialist centres anywhere in Europe, through eHealth. This would save time, money and stress associated with travelling to see specialist doctors. This, say patient advocates, can only be achieved if there is investment in technology. A major problem is, who will pay for the changes? Getting doctors and nursing staff on board will be the key factor that decides whether eHealth succeeds. Clauses in the Cross-border Healthcare Directive covering eHealth were watered down by EU health ministers but have been strengthened by MEPs who see the new rules as a chance to boost quality of care, save money and stimulate a new market for high-tech companies. The Council of Europe, worried about costs, has weakened what the Directive says about eHealth but Parliament is determined to restore this and make sure it survives in the final compromise text. Bulgarian MEP Antonyia Parvanova is convinced that eHealth can contribute to patient safety and innovation in the health technology sector. However, she says interoperability between systems remains a huge challenge as technology is now an indispensable part of health care and can provide real added value if national and European authorities cooperate. Patients will still need someone to interact with, says Parvanova, and the public will not be satisfied if they are expected to talk to a screen. John Dalli, EU commissioner for health and consumer policy, argues that new technologies can help put patients’ rights, patient safety and access to health services at the heart of policymaking, "Technology will also save health professionals’ time if they don’t have to move around from one hospital to another to provide services. We can have a few centres of excellence accessible even to those who do not live nearby. For patients with rare diseases this is particularly important. We can have focal points of expertise that can then deliver services to all corners of Europe. Systems must be able to speak to one another within hospitals, between hospitals and ultimately across borders. Political will is needed to make eHealth a reality. Member states are responsible for health but we must bring people together to discuss cooperation if we want to make the most of eHealth and cross-border collaboration. When investing in healthcare, sustainability is essential. In economic terms, eHealth can help make savings by cutting out duplication of work and reducing the travelling costs for patients." Health systems are under pressure from ageing population, rising costs of new technology and medicines, heightened patient expectations and global economic challenges. Everybody is looking for solutions. eHealth has an important role to play in delivering efficient and effective health care. Dr Simonetta Scalvini says it is time to stop caring for diseases and start looking after patients. She believes there is evidence that telemedicine can reduce mortality while increasing quality and cutting costs, but "The biggest problem in applying new technology is resistance from doctors. The medical profession must change its mentality". Pascal Garel of HOPE is positive about what technology can do to change health services but warns there is a long way to go before the potential is realized as health workers have seen a series of technological failures over the years which can breed a degree of scepticism. Fabian Zuleeg at the European Policy Centre warns that public financing will be very scarce in Europe for some time to come, "Where will the investment come from? We have to look at business, public private partnerships and the profit-motive in the provision of health care. Some of the funding may have to come from the patients themselves." Florian Lupescu of the European Commission’s directorate-general for the information society, makes the point that patients crossing borders have the right to receive the best possible care but Europe must ensure the appropriate mechanisms and legal framework are in place, "eHealth can make this possible. The possibility for systems to understand each other despite languages, and cultural differences is something we cannot afford to miss. We have the political commitment from health ministries. We have the support of stakeholders, patients associations, professionals, and consumers groups. Now we need the legal certainty." The EU may have the political will to implement cross-border healthcare and technology, but getting that to work properly will take decades, not years. This offers the European medical tourism industry a window of opportunity as people will become more aware of the availability of treatment outside their own country, but for many years yet will be frustrated by practical problems if expecting the state to pay for treatment.

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USA: Cleveland Clinic and Mayo Clinic compete for medical tourists

Wed, 10 Nov 2010 16:33:05 GMT

Cleveland Clinic has launched an international website focused on providing Middle Eastern visitors with streamlined access to information on diseases, conditions and treatment options. The site features an interchangeable Arabic/English option, enabling visitors to learn more about Cleveland Clinic’s world-class care in their native language. The new website utilizes the existing internet platform with a focus on providing health information on diseases and conditions that are prevalent in the Middle East region. The site also provides contact information, resources to make travel arrangements easier and an overview of services available through the international patient office. For patients and families, there are translated resources to help with making an appointment and coordinating a visit. There are also condition-specific guides to better understand diagnosis and treatment including cardiovascular disease, women’s health and epilepsy. The website has profile information about 1,800 doctors, including languages spoken and diseases/conditions treated. Patients can select the best practitioner to meet their individual needs. Bill Ruschhaupt of Cleveland Clinic says, "For many years, we have treated patients from all of the Middle East countries. This website is just one way in which we are continuing to provide all of our patients, and prospective patients, the best experience possible." Cleveland Clinic in Cleveland, Ohio, is a not-for-profit academic medical centre that integrates clinical and hospital care with research and education. It operates nine regional hospitals in Northeast Ohio, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas and Cleveland Clinic Canada. Patients come for treatment from every state and from more than 80 countries. Mayo Clinic has joined the medical network of UnitedHealthcare, making it cheaper for 20 million of the insurers’ commercial members around the country to seek care there. This is the first national contract Mayo has signed and is part of a move by Mayo to shed its aura of expensive exclusivity. UnitedHealth members will now pay in-network prices if they go to Mayo, which can offer significant savings over out-of-network prices. This national agreement with UnitedHealthcare covers all Mayo’s group practices and hospitals in Rochester, Jacksonville, Phoenix and Scottsdale. Mayo had smaller, specialized contracts with UnitedHealth in the past. Since 2004, it’s been part of UnitedHealth’s transplant network. It also has contracts with other national insurers, but those agreements only cover people in some regions of the country. Mayo has a reputation for being more expensive per procedure while UnitedHealth has a reputation for driving a hard bargain with providers. The promise of more commercial business is attractive to Mayo because after barely breaking even in 2008, it only managed a small profit in 2009. Mayo treated 528,000 patients last year. Currently, 20 to 30% of patients travel more than 500 miles for treatment. Cleveland Clinic is also benefiting from several company and insurers deals where US patients travel some distance for certain procedures. Lowe’s home improvement stores recently offered employees free trips to Cleveland Clinic for cardiac surgeries in return for lower cost sharing. 44% of its heart surgery patients are not from Ohio. Lowe’s deal, rolled out in February, is a success, with 19 employees (15% of those likely to be eligible for the surgery in any given year) taking advantage to date. Lowe’s expects to break even or save money on each operation, even after providing financial incentives such as waiving the deductible and paying all travel costs for the employee and a companion. One of the first employee patients, who faced a particularly complex heart problem, cost the company $469,000, compared with the $531,000 local hospitals would have charged. US insurers and top hospital groups have accepted the benefits of US domestic medical tourism, and are embracing President Obama’s entreaties to increase jobs by increasing exports, and attracting medical tourists from overseas into the USA. President Obama is focused on promoting economic growth, to create job opportunities for US workers, and export opportunities for service providers. His administration sees Asia as a key target market for goods and services. The National Export Initiative (NEI) aims to double US exports by trade deals and encouraging US businesses to invest overseas. Ironically, this means that US businesses that may have considered medical tourism for employees are now in an environment where the government is actively against any overseas outsourcing of goods or services.

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SAIPAN: Travel agencies stop tickets for medical referral patients

Wed, 10 Nov 2010 16:28:52 GMT

Medical referral patients who need treatment outside the Commonwealth island of Saipan may not have that option for a while after travel agencies stopped issuing them airline tickets due to the government’s nonpayment of $180,000 of arrears owed. Department of Public Health secretary Joseph Kevin Villagomez confirmed to the Saipan Tribune that travel agencies suspended the processing of travel documents for off-island medical referrals. So far, five to 10 medical referral cases have been affected, all of which are for follow-ups. The CNMI government owes Wings Travel, Pacific Sky, and World Tour and Travel a total of $180,000, admitted Villagomez, and payment for each vendor has been delayed by over a month. “Right now, we are working with the Department of Finance to pay the travel agencies. They have not been paid for awhile so they stopped the processing of medical referral travels for now until they collected the $180,000 obligation.” Villagomez is working out a payment plan for the government that is so broke that it cannot give a date as to when the payment will be released to vendors, “The Medical Referral Office are communicating with Finance, but I do not know exactly when the cheques will be released because of the cash flow problem of the government.” Payments for the medical referral vendors are separate from the budget of the Department of Public Health, which is too broke to finish its own website, because the money comes from other funding sources. Since the news broke, only one travel agency allowed medical referral trips to Guam while a total ban was placed on trips to the Philippines and Honolulu. The two other travel agencies implemented a complete ban on all these destinations. Villagomez admitted that emergency cases are the biggest worry they have, “The affected cases are for follow-ups and there is no immediate repercussion if we will delay it by a day or a week. But if we have emergency cases tomorrow, what course do we have other than to plead with these travel agencies to at least temporarily lift the travel ban? We will pay the obligation and it is just a matter of time.” The Department of Public Health spent $16.3 million in the last four fiscal years, ending in fiscal year 2009, to send Commonwealth patients to various medical facilities off island for treatment. Saipan is the largest island of the United States Commonwealth of the Northern Mariana Islands (CNMI), a chain of 15 tropical islands belonging to the Marianas archipelago in the western Pacific Ocean. The population is under 60,000. It is a popular tourist destination in the Pacific, 190 km north of Guam. Travel to and from the island is via Saipan International Airport. Tourism has long been a vital source of the island’s revenue, although the industry has undergone a serious decline, while the other export earner, garment making, closed last year. Some major airlines have since ceased regular service to the island. With medical facilities on the island poor, people go to Guam or further afield for treatment. In the last two years, other Asia-Pacific islands have had difficulty paying the bills for medical treatment overseas. Those medical tourism destinations seeking business from overseas governments should learn the lesson that it is not a risk free business, as they will certainly be paid late, and maybe not at all.

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GLOBAL: SpaFinder readers identify top spas in the world

Wed, 10 Nov 2010 15:54:01 GMT

SpaFinder, the global spa and wellness resource, has unveiled the winners of its 2010 Readers’ Choice Awards - honouring spa-goers’ favourite spas across the globe, along with their top ten picks in 31 categories. Based on votes submitted worldwide at SpaFinder’s global websites and by readers of SpaFinder publications. Susie Ellis of SpaFinder says, "There are now more than 15,000 hotel, resort and destination spas worldwide." In addition to nations traditionally recognised by the awards, ten new spa markets were added in 2010: Bulgaria, Chile, Cyprus, Czech Republic, Egypt, Hungary, Morocco, Portugal, Turkey and the United Arab Emirates. The Crystal Award recognises the number-one spa on each continent.• Africa: One&Only Cape Town (Cape Town, South Africa)• Asia: Ananda in the Himalayas (Narendra Nagar, India)• Australia: Gwinganna Lifestyle Retreat (Queensland, Australia)• Europe: Hotel Adlon Kempinski Berlin (Berlin, Germany)• North America: Golden Door (California, United States)• South America: Kurotel Longevity Center and Spa (Gramado, Brazil) Awards were given for the favourite spa in 29 other countries/regions-• Argentina: Four Seasons Hotel Buenos Aires• Austria: The Balance Resort• Bulgaria: Kempinski Hotel Grand Arena Bansko• Canada: Ste. Anne’s Country Inn and Spa• Caribbean: Parrot Cay (Turks and Caicos)• Central America: Tabacón Grand Spa Thermal Resort (Costa Rica)• Chile: The Ritz-Carlton, Santiago• China (Hong Kong): Four Seasons Hotel• China (Mainland): The Ritz-Carlton, Beijing• Cyprus: Le Méridien Limassol Spa & Resort• The Czech Republic: Mandarin Oriental, Prague• Egypt: Four Seasons Hotel Alexandria• France: Guerlain Spa at Trianon Palace Versailles• Greece: Porto Elounda De Luxe Resort• Hungary: Danubius Hotel Gellért• Indonesia: Conrad Bali• Ireland: Inchydoney Island Lodge and Spa• Italy: Lefay Resort & Spa Lago Di Garda• Japan: The Ritz-Carlton, Tokyo• Malaysia: Shangri-La’s Tanjung Aru Resort & Spa• Maldives: One&Only Reethi Rah, Maldives• Mexico: Rancho La Puerta• Morocco: La Mamounia• The Philippines: The Farm at San Benito• Portugal: Four Seasons Hotel Ritz Lisbon• Russia: The Ritz-Carlton, Moscow• Scandinavia: Blue Lagoon (Iceland)• Singapore: Willow Stream Spa at Fairmont Singapore• South Pacific Islands: Four Seasons Resort and Spa Bora Bora• Spain: SHA Wellness Clinic• Switzerland: Victoria-Jungfrau Grand Hotel & Spa• Thailand: Kamalaya Wellness Sanctuary and Holistic Spa• Turkey: Four Seasons Hotel Istanbul at the Bosphorus• United Arab Emirates: Burj Al Arab• United Kingdom: Gleneagles Hotel (Scotland)

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KOREA: Developments in Korean medical tourism

Wed, 10 Nov 2010 15:31:54 GMT

Planet Hospital, one of the pioneering medical tourism agencies in the U.S., is hoping to send more medical tourists to Korean hospitals next year. The company has so far sent less than 20 medical tourists to Korean hospitals. Rudy Rupak of Planet Hospital says, "We would like there to be a lot more. We want at least 100 patients in 2011. We are also looking at opportunities in Russia. America is not the only place that tourists should be coming from. They should be coming from Europe, Africa, Asia and other developing countries as well." Planet Hospital is partnering with the Korea Medical Institute (KMI), which will take care of the medical tourists, and is working with the Korea Tourism Organization to promote medical tourism. Korea is trying to build up its medical tourism program, in an effort to compete with Thailand, Singapore and India. Korea currently attracts around 50,000 medical tourists annually. On the resort island of Jeju, the government is building Health Care Town, a 370-acre complex of medical clinics and apartments surrounded by 18-hole golf courses and beaches, to attract foreigners in need of medical care. At Inchon, a new town is being built to attract foreign visitors, including medical tourists. South Korea clinics and the South Korean government are trying hard to attract these tourists, who not only bring in money for cash-strapped hospitals but also help the economy. The government has revised immigration rules to allow foreign patients and their families to get long-term medical visas and has altered laws to permit local hospitals to form joint ventures with foreign hospitals. Wooridul Spine Hospital had 1,000 foreign patients in 2008, with patients from 47 countries, about a third from the United States. Wooridul plans to build a hospital, apartments, a concert hall and an art museum on the Jeju island as part of its medical tourism offering, in addition to the golf course it has already built. The government-run Jeju Development Center says the town will specialize in medical checkups, long-term convalescence, cosmetic surgery and dentistry. A local survey of 29 hospitals showed that they treated 38,822 foreign patients - which includes holiday and business travellers and US armed forces but excludes long-term Korean expatriates - between January and August, compared with 15,680 in 2007, according to the government-financed Korea Health Industry Development Institute. It said 25 percent of those patients were from the United States, and 10 percent each were from China and Japan. Seoul National University Hospital plans to open a marketing office in Los Angeles, and hopes to attract medical tourists from the pool of two million Korean-Americans.

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PHILIPPINES: Philippines competes for medical tourists

Mon, 08 Nov 2010 10:17:27 GMT

The Philippines faces a tough task as it seeks to compete with established Asian competitors for medical tourists. For several years it has promoted its lower medical costs, advanced medical technology, caring healthcare workers who can speak English, and wide choice of destinations. But apart from Filipinos living overseas, it struggles to attract people, so continues to fall well short of targets. An annual target of 700,000 medical travellers was set by the government in 2008, and the latest target is a million by 2015. Although higher figures are frequently quoted, the latest official national figures from the Department of Tourism is that 100,000 medical travelers visited the Philippines in 2009, each estimated to have spent at least $2,000. Earlier this year the government and the private sector partnered to form HEAL Philippines, the Health and Wellness Alliance of the Philippines. The alliance includes hospitals, clinics, spas and other medical tourism providers. It is now educating local governments about medical tourism so they can make the much-needed improvements to the local infrastructure. 39 hospitals and clinics around the country, mostly in Manila, are accredited under the government’s medical tourism programme. To achieve its targets, the government has to be very aggressive in its marketing efforts, says Elizabeth Nelle of the Department of Tourism. She argues that a bigger marketing budget is needed and a single agency must be tasked to carry it out, as Singapore has done, rather than the complexity of competing local organizations. She says that most medical tourists are people seeking cheap cosmetic, eye and dental surgery. In these areas, she says the country is cheaper than Thailand, Malaysia, Singapore and India. But for medical procedures, the Philippines can be more expensive than in Thailand, India and Malaysia. In recent years, says Nelle, most medical travellers to the Philippines have been Filipinos based overseas, mainly the United States and Canada. Eva Trinidad of Philippine Medical Tourism sees potential from Japan, but admits that Filipino health workers will also have to learn to speak other foreign languages, such as Japanese, to be able to properly deal with non-English-speaking patients. The Tourism Department says primary markets include the Middle East. Korea and Pacific island states and territories, while secondary markets include Australia, Japan, South Korea, Taiwan and Europe. Middle Eastern tourists are particularly lucrative because they come with their families, stay in hotels, travel a lot, and do a lot of shopping. Residents of Micronesian states such as Guam and Nauru choose the Philippines for essential medical treatment because they must go overseas and choose somewhere close by and affordable. Where the Philippines is doing much better is wellness tourism, with thousands of spas all over the country, most of which promote traditional Filipino healing massage.

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GLOBAL: Global initiatives for the medical tourism industry

Mon, 08 Nov 2010 10:15:08 GMT

KEMP Healthcare With patient care and safety emerging as a major concern, a US/UK healthcare company plans to launch a certification service for hospitals in India in early 2011. KEMP Healthcare Ltd plans to launch a Quality of Care certification service that will bring to a hospital evidence-based quality improvement measures that have been tried and tested in international healthcare systems as reliable processes. The company is targeting hospitals that are keen and committed to provide better care to their patients and want to build on their existing strengths to excel on the 5 stars of quality, safety, timeliness, effectiveness of care, and patient satisfaction. Appraisal of successful incorporation of these 5 stars by KEMP Healthcare would result in achievement of certification and the hospital could promote itself as a ’KEMP 5 Star Certified Hospital’. The aim is to enable consumers of healthcare in India to make an informed decision when choosing hospital for themselves and their families. The company says it will give the hospitals additional credibility, confidence and visibility within an increasingly competitive market and claims to make them more attractive to foreign patients visiting India for medical tourism. KEMP Healthcare is a trans-Atlantic co-operation that brings US and UK healthcare expertise together, to provide evidence-based solutions to healthcare systems globally so as to improve efficiency and deliver quality. How a company that has no international track record in this sector, and with a name that means nothing to medical tourists or agencies, plans to compete with established international accreditors and persuade hospitals to use it instead, is an interesting question. Mercury Healthcare Mercury Healthcare of the USA has launched a UK subsidiary in London to help it develop in Europe and Commonwealth countries. It will provide training, consulting, and support services to the Central and Eastern European medical tourism markets and government agencies throughout the Commonwealth and the European Union. Mercury Healthcare is also a medical tourism agency with a network of hospitals and other healthcare providers in more than 25 countries, including more than 200 hospitals and over 15,000 doctors, dentists and allied health providers. MedRetreat With global growth and many newcomers attempting to enter the business, hospitals may find it hard to decide whether an agency is reputable and likely to bring it volumes of good business, or one just seeing the industry as a quick way to make money with little effort and no long term concern on whether patients or hospitals get what they want. Patrick Marsek, of MedRetreat, a US based medical tourism agency warns, "The best agencies have trained staff, industry experience, and proven processes that guarantee a safe and stress-free experience for medical travelers. Unfortunately, some may not possess the qualifications necessary to ensure a positive medical travel experience. To ensure that the medical tourism industry continues to flourish, overseas hospitals must take great care when choosing agencies as affiliates. A single patient mishap can effectively put an overseas medical provider out of the health tourism business for good. Even if a hospital has provided superior quality care, it may lose business if a medical tourist who is dissatisfied with the service speaks to the media about having a bad overseas experience. That there is no official accreditation agency to identify and evaluate quality standards for agencies makes it difficult for international hospitals to know which offer top quality.” Marsek continues- “Until such an agency exists, all international hospitals should take the following five steps before agreeing to an affiliation with an agency for the purpose of attracting patients.• Develop an affiliation approval process.• Verify that the agency is a legitimate business in good standing.• Insist that the agent visit your hospital.• Ask them to disclose their processes and fee structure.• Determine the level of service the agency provides.

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EUROPE: Bulgaria loses legal case on cross-border healthcare

Mon, 08 Nov 2010 09:53:06 GMT

A new legal ruling will affect new EU rules on cross-border health care. A series of rulings by the European Court of Justice (ECJ), beginning over a decade ago, established that healthcare could be sought by EU citizens in any member state, while patients seeking such cross-border healthcare were entitled to have their costs covered by their own health systems. This prompted the European Commission to adopt a proposal for a directive. The proposal was intended to provide more clarity about possibilities to seek healthcare in another member state and to set out rules on responsibility insofar as quality and safety of care in cross-border settings are concerned. The proposal was confirmation of the ECJ rulings that citizens could seek treatment anywhere in the EU and be entitled to claim reimbursement in their home countries. Patients could therefore seek non-hospital care, such as dental treatment and medical consultations, without prior authorisation but they were obliged to obtain prior authorisation in relation to in-patient procedures, such as surgery. A ruling delivered in October by the ECJ dealt with cross-border healthcare in the EU. It went one step further from the proposed directive. The court was asked by a Bulgarian court to give a preliminary ruling on whether the national health system of Bulgaria was obliged to pay for the medical treatment abroad of any Bulgarian who was unable to receive treatment in the country within the time normally necessary for the treatment, after taking into account the patient’s current state of health and the probable outcome of the medical problem. Georgi Elchinov was diagnosed with malignant cancer in his right eye. Bulgarian doctors recommended eye surgery, a procedure that could be carried out in Germany, but could effectively save his eye, unlike the procedure carried out in Bulgaria. He applied with the national health insurance fund to be allowed treatment abroad, but since the case was urgent and the answer took a long time, Elchinov left for Berlin, only to learn later that payment for the surgery had been denied. He underwent treatment in Germany and his eye was saved. Elchinov sued the fund in the Sofia Administrative Court and won. The fund then filed appeal proceedings before the Supreme Administrative Court, and eventually the ECJ was asked to give a preliminary ruling. In its decision, the European Court held that the refusal on the part of the health insurance fund was out of line, and maintained that the fund was obliged to pay for healthcare and treatment of Bulgarian citizens abroad if they could not receive such treatment in the country at all or on time, depending on the ailment. The court established that excluding in all cases payment for hospital treatment given in another member state without prior authorisation was unreasonable, especially in those situations where the patient is prevented from applying, or unable to wait, for such authorisation. So, if a patient sought treatment abroad before having the agreement of the fund, the patient is still entitled to reimbursement in circumstances where the member state could not provide timely or alternative cure. In coming to its decision, the court rejected the argument put forth by the insurance fund and the Bulgarian government that the occurrence of such situations could undermine hospital planning and the financial balance of the social security system. The court ruled that Bulgarian law constituted an unjustified restriction on the freedom to provide and obtain services. This legal ruling is significant, as the legislation of a member state cannot exclude across the board reimbursement for hospital treatment given in another member state to a patient without prior authorisation. While this judgement was given in relation to a specific case, national institutions of other member states are still obliged to follow the guidelines established by this ruling in setting out their own policy on entitlement to reimbursement for cross border healthcare since the court’s decisions are mandatory for all similar institutions with similar cases across the EU.

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USA: New hospital study of inbound US medical tourism

Mon, 08 Nov 2010 09:45:10 GMT

Rush University of Chicago, in partnership with the University HealthSystem Consortium (UHC), has been awarded a three-year $500,000 Market Development Cooperative Grant from the U.S. Department of Commerce to help boost medical travel to U.S. academic medical centres. The goal of the project is to stimulate growth in the number of patients from abroad choosing U.S. academic medical centers for care through better data that tracks medical care exports, networking across institutions, and the implementation of best strategic business development practices. Medical care exports are defined as medical care in the U.S. purchased by individuals outside the country. The grant is intended to help further President Obama’s National Export Initiative, announced earlier this year, which aims to double exports by 2015 in support of several million U.S. jobs. The U.S. is experiencing increasing competition from hospitals abroad for patients with specialty care needs. In Rush’s Department of Health Systems Management, Andrew Garman and Tricia Johnson will develop the methodology to value medical care exports and assess the impact of these strategies on exports over the next 3 years. Garman and Johnson, in a study to be published later this year in Health Policy, estimated that in 2007 between 43,000 and 103,000 foreigners went to the U.S. for medical care, and between 50,000 and 121,000 U.S. residents traveled abroad for care. The outbound figure is significantly less than the numbers often quoted within the medical tourism industry. Under the Commerce grant, the researchers expect to be able to set up a system to better track these figures and obtain more precise numbers. At UHC, Steven Meurer and Samuel Hohmann will establish a forum for international patient programmes; create a standardized set of data elements to be reported on international patients; host a series of meetings focused on strategies to increase the global competitiveness of U.S. academic medical centers and develop strategic relationships with foreign ministries of health and private payers. UHC of, Chicago, Illinois, formed in 1984, is an alliance of 107 academic medical centres and 246 of their affiliated hospitals representing approximately 90% of the nation’s non-profit academic medical centres.

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EUROPE: The outlook for medical tourism in Europe from 2009 to 2014

Mon, 08 Nov 2010 09:43:04 GMT

ICON Group has a new 54-page report as part of its global series on medical tourism, ’The 2009-2014 European Outlook for Medical Tourism.’ This econometric study covers the outlook for medical tourism in Europe. For each year considered, the estimates are given for the latent demand, or potential industry earnings (PIE), for the country in question (in millions of U.S. dollars), the share in percent of the country in the region and the world. These comparative benchmarks allow the reader to quickly assess a country vis-à-vis others. Using econometric models that project fundamental economic dynamics within each country and across countries, latent demand estimates are created. This report does not address specific players in the market serving the latent demand, nor specific details at the product level. The study does not consider short-term cyclicality that could affect sales. The study is strategic in nature, taking an overall view and long term, irrespective of the players or products involved. This study does not report actual sales data (which are simply unavailable, in a manner similar or compatible in almost all European countries). This study gives estimates for the latent demand for medical tourism in Europe. It also shows how the pie is divided between the national markets of Europe. For each country, it shows estimates of how the pie grows over time (positive or negative growth). The concept of latent demand is rather subtle. The term latent typically refers to something that is dormant, not observable or not yet realized. Demand is the notion of an economic quantity that a target population or market requires under different assumptions of price, quality, and distribution, among other factors. It is a measure of potential industry earnings (P.I.E.) or total revenues (not profit) if a market is served in an efficient manner. It is typically expressed as the total revenues potentially extracted by firms. The latent demand for medical tourism is not actual or historic sales. Nor is latent demand, future sales. In fact, latent demand can be lower or higher than actual sales if a market is inefficient. Inefficiencies arise from a number of factors, including the lack of international openness, cultural barriers to consumption, regulations, and cartel-like behavior on the part of firms. In general, however, latent demand is typically larger than actual sales in a country market. In order to estimate the latent demand for medical tourism in Europe, the author used a multi-stage approach. Latent demand functions relate the income of a country, city, state, household, or individual to realized consumption. For firms to serve a market, they must perceive a latent demand and be able to serve that demand at a minimal return. The single most important variable determining consumption, assuming latent demand exists, is income. It considers the latent demand for medical tourism across all the countries in Europe. The smallest have fewer than 10,000 inhabitants. The countries included are Albania, Andorra, Austria, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Italy, Kazakhstan, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Moldova, Monaco, Netherlands Norway, Poland, Portugal, Romania, Russia, San Marino, Slovakia, Slovenia, Spain, Sweden, Switzerland, United Kingdom and Ukraine.

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EUROPE: MEPs vote on EU cross-border health care

Thu, 28 Oct 2010 16:18:23 GMT

European Parliament MEPs have voted on new EU rules on access and rights to cross-border healthcare. The vote strikes a balance between guaranteeing patients’ rights to cross-border healthcare and safeguarding the provision of quality health services at national level. Patients have the right to get hospital treatment in other member states and be reimbursed as they would for receiving the treatment at home, however this right should not be at the expense of the viability of national health systems. The proposal will allow member states to establish a reasonable system of prior authorisation for treatment, but MEPs succeeded in significantly narrowing the list of reasons for which a patient can be refused cross-border treatment. An important change from earlier drafts is that member states will not be able to refuse reimbursement after prior authorisation has been granted. MEP’s hope that The European Council will take these improvements on board, so that the legislation can be finalised as soon as possible. At present if a European citizen wants to get treatment in another country they do not know if they will be refunded and how that may happen. There have been difficulties that citizens have brought before the European Court of Justice. So the European Parliament must legislate to solve this problem. This directive is designed to allow patient mobility. We already have mobility of workers and students. It is part of the fundamental rights of European citizens. This does not encourage medical tourism, but simply to allow a wider range of public health for patients, especially in border regions. If the directive is approved, patients will have a choice about the place where they seek treatment and the possibility of having the best possible care. There will be centres with national contacts to access information relating to health care in other countries. Cross-border healthcare * 1% of public health budgets spent per year on cross-border healthcare.* 30% of EU citizens are not aware of the possibility to receive healthcare outside their country.* 25 millions of European citizens suffer from rare diseases. If someone needs permission to go and receive care in another EU country, the payment will be paid directly by the country of the patient to the country where the medical care is received. Many EU countries have resisted this proposal, as they fear an invasion of patients and an increase in healthcare costs. While most now accept the outcome as inevitable, some countries are reluctant. Poland, Slovakia and Portugal voted against the proposal in Council last month, and Romania abstained. Cross-border medical care is only a very small portion of public spending on health. In most cases patients can be reimbursed for treatment in another country only if this treatment is covered by their national system, and the level covered in their state. For example, if in Germany patients are not entitled to dental care reimbursement and they go for treatment in France, Germany will not have to repay them. There will be no way for a patient to obtain a financial benefit related to reimbursement. There were 227 amendments to the plan, and six consolidated amendments, but verbal agreements were made over the following three points:* Patients can seek medical care in another country without prior authorisation. However, for hospital stays and specialised care, patients could need pre-authorisation from their national health system.* A country can only refuse to authorise cross-border care in a very limited number of circumstances.* The 25 million Europeans with rare diseases will be covered under the proposed law. Normally, people prefer to stay close to home and family when in need of medical care. They usually only travel far when they need specialised treatment, or when better facilities are just across the border. This is frequently the case in Luxembourg, where a lot of residents go to neighbouring France, Belgium or Germany for treatment. About 7% of the country’s medical payments are cross-border, the highest in the EU. Most countries spend 1% or less of their national health budgets on cross-border care. The proposal now has broad support in the Parliament, and consumer advocates are in favour. European consumer organisation BEUC supports the European Parliament’s position, and says, ’’Patients do not like to be cared for far from home in another member state, but if they want or need to they should be entitled to the same rights for information, treatment and reimbursement". Timeline July 2008: European Commission proposalApril 2009: European Parliament first readingJune 2010: Council’s of EU ministers reach their positionOctober 2010: Report scheduled for adoption in EP committee, 2nd readingJanuary 2011: EP plenary sitting, 2nd readingJune 2011: Adoption of the directive

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SOUTH AFRICA: South Africa agrees national health insurance scheme from 2012

Thu, 28 Oct 2010 09:59:42 GMT

South Africa’s ruling party, the African National Congress (ANC) has finalized the plan to mandate universal access to healthcare through a National Health Insurance Scheme. It has to be debated in parliament, and although details may be altered, the principle is unlikely to have enough opposition to stop it happening. The ANC’s National Health Insurance plan aims to ensure access to healthcare is based on need rather than the ability to pay, with the intention of doing this through a single payer health insurance system. The initiative will focus on local primary care networks rather than large-sized hospitals. South Africa currently spends just over 8% of GDP on healthcare every year, almost all on the private healthcare system, even though 64% of the South African population relies upon the public system. The scheme will be funded by general taxation, while additional financing may be sought through a surcharge on taxable income; an increased value-added tax dedicated to the scheme, and payroll taxes for employers and employees. The first phase of the project will begin in 2012, and will focus primarily on bringing services to areas with little or no access to quality healthcare. A number of other key areas of attention include investing and rebuilding the country’s public health infrastructure, developing human resources to fill the national shortage of qualified health workers, and establishing a national health fund that will operate autonomously from government departments. The plan is a long-term one, the first stage being for 14 years. The South African government is seeking the advice of British health experts on the imminent implementation of the National Health Insurance (NHI) in South Africa. The scheme is an ambitious health reform. South Africa is to learn from UK experience of how health services can be delivered based on principles of honesty and respect, with a culture of safety, quality, openness, accountability and collaborative teamwork that can promote responsiveness to a patient’s needs. The objective is to put in place the necessary funding and health service delivery mechanisms that will enable the creation of an efficient, equitable and sustainable health system in South Africa. The country’s five major hospitals are to undergo major rehabilitation to prepare them for the NHI. The hospitals are the Chris Hani Baragwanath, George Mkhari, Limpopo Academic, King Edward in Durban and Nelson Mandela Academic in the Eastern Cape. They will all be given a new look and in some instances may undergo a complete rebuilding. The government is likely to bring in a new system of hospital accreditation. Affluent South Africans will still be able to use private healthcare, through the purchase of private medical insurance and use of private hospitals. The plan will effectively mean that public hospitals will have neither the time, money or bed space to offer medical tourism. But in the future, if more locals are dealt with for free, then the private sector, much of which has been rather condescending about medical tourism, may have to look at medical tourism to fill bed space.

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USA/GLOBAL: US media investigates alternative health and wellness tourism

Wed, 27 Oct 2010 12:13:51 GMT

A new US television programme on a national cable network from Bullseye Productions, ’The Health and Wellness Travel Show’ is recruiting American men with non-life threatening ailments such as lower back pain, adult acne, ED, irritable bowel syndrome, sleep apnea, migraines, and tinnitus. It wants to use them as guinea pigs for alternative medicines and procedures that claim to provide a cure or relief. All the programmes will feature treatments available outside the USA. Volunteers will travel to the far corners of the Earth to witness first hand and take part in some of the world’s most amazing, extreme and ancient practices. Participants will work with a diverse team of local medical practitioners in exotic international locations - from traditional doctors to shamans and tribal healers - to explore the culture’s treatments for common medical ailments. Some will be a participant; others will just be an observer. This is not a magical cure for a serious health issue, or for people suffering from a life threatening or debilitating illness - this all-expense-paid trip is a health exploration around the world.

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GERMANY: Germany plans to profit from wellness and medical tourism

Wed, 27 Oct 2010 12:12:41 GMT

Germany plans to cash in on the worldwide wellness industry. 415,000 international visitors took a health-oriented holiday in Germany in 2008. This is in addition to 70,000 medical tourists. The main source market was Switzerland, accounting for 57% of visitors. Final 2009 figures are not yet available but are expected to be higher. According to the ’Quality Monitor’ German tourism industry survey, 40% of international visitors go to Germany for rest and relaxation while 14% specifically want to enhance their health and fitness. The German National Tourist Board (GNTB) is gearing up to make 2011 the year of wellness tourism marketing. Petra Hedorfer of the GNTB explains, "We want to boost the number of overnight stays by specifically promoting Germany as a destination for health and fitness holidays." The 2011 theme year concentrates on three main areas: spas and health resorts, wellness and beauty hotels and medical tourism. One of its main marketing tools is the www.germany.travel website, which offers extensive information about health and fitness holidays. The theme year content will be expanded and a special section on medical tourism will be added in readiness for 2011. Print products for each area will be available in various languages. The GNTB will also promote the theme year and its three areas of focus on fact-finding tours, in workshops and at trade fairs and roadshows. Germany’s spas and health resorts are a destination of choice for preventive care, rehabilitation and treatment of chronic illnesses. As preparation for the theme year, the GNTB has signed a cooperation agreement with the German Spa Association (DHV) to launch a global image campaign showing Germany’s spas and health resorts as unspoilt destinations offering innovative health treatments. GNTB is marketing wellness and beauty with a cross-media concept that centres around hotels and is supported by the independent hotel sector and wellness tourism brands. They are joining forces to promote Germany’s wellness and beauty hotels as oases of calm and well-being, offering high-quality treatments with which guests can spoil themselves. The key markets of the global image campaign are the Netherlands, Belgium, Switzerland, Italy and Spain. Germany already receives many visitors who come for medical treatment. German clinics are renowned for their excellent quality and reasonable prices. GNTB will reinforce this image, highlighting the top clinics for international patients and the tourist attractions of the nearby towns and cities. It is targeting the United States, Russia, the Arab Gulf States and selected European countries. The wellness-hotel sector caters for the middle- to high-end market. For well over a decade, most 4-star and 5-star hotels have provided comprehensive wellness areas with high-tech saunas, steam baths and jacuzzis to their clients. Despite competing with Switzerland and Austria, Germany remains Europe’s largest wellness market. In the competitive, sophisticated market, client expectations are constantly on the rise, along with the growing number of services and providers. Four- and 5-star hotels must regularly renovate their facilities to stay in the wellness race.

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JAPAN: Japanese government looks online to attract medical tourists

Wed, 27 Oct 2010 12:08:57 GMT

To expand medical tourism, the Japanese government plans to make it easier for Chinese and Asians to obtain short-term medical service visas by providing information on websites of Japanese embassies and consulates. The aim is to make the country’s advanced medical services accessible to wealthy Chinese and Asians. Medical travel is now part of the government’s strategy to boost the economy. So the country is promoting medical services including routine checkups and treatment. The government hopes to increase the number of medical tourists without changing the current visa system. For short-term visas for medical treatment in Japan, applicants are required to provide certification of their ability to pay for the travel, besides the documentation required for ordinary visas such as flight information. Currently, the websites of Japanese embassies and consulates provide information on documents required to obtain visas to visit relatives and acquaintances as well as for sightseeing and short business trips. However, those seeking information about medical service visas need to visit embassies and consulates. The government is also expected to issue multiple-entry visas for people who need follow-up medical treatment. On the websites, the government plans to add the category "stay for receiving medical services" and provide information on the required documents. Though medical visas have been available for some time, their existence is not widely known. Dokkyo Medical University and the World Heritage-listed Nikko Toshogu shrine are partnering to help the nation’s tourism agencies and hospitals look into ways of attracting people to visit Japan for medical checkups. Hotels in the Kinugawa onsen hot spring resort, one of Nikko’s top attractions, are offering medical service packages, which include a hotel stay and a complete medical checkup. The packages are targeted at both the domestic and international tourism markets. Four Chinese visitors have visited the medical tourism department since it was set up in April with a resident Chinese nurse. Dokkyo Medical University’s Nikko Medical Center and Nikko Toshogu have together launched the International Association of Tourism Medicine (IATM) –which is not a medical travel association but a forum. According to Takaaki Nakamoto of Nikko Medical Center, medical facilities in major Chinese cities like Shanghai are not much different from those in Japan, but the quality of medical technology and level of dependability are considered higher in Japanese hospitals. The Nikko Medical Center has entered a collaborative arrangement with Tongji University Hospital in Shanghai, establishing a system for follow-up monitoring of their patients after they return to China. As comprehensive medical examinations are not yet widely available in China, Chinese patients have demanded not just check-ups during their stay in Japan but treatment as well. So IATM has been set up as a forum in which healthcare providers and other involved parties can review case studies and exchange information crucial to establishing a full-scale medical tourism industry. Since the founding of IATM there are plans to standardize the content of physical exams at all participating hospitals and collaborate with travel agencies.

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IRELAND/EUROPE: Irish being driven overseas for dental treatment

Thu, 21 Oct 2010 15:55:47 GMT

Ireland has suffered badly from the economic crisis and has taken tough measures that have seen many people take a substantial salary cut. Included in the government cutbacks are reductions in the amount that the state pays for dental care. Ireland is an example of how government health cuts can drive people to look for treatment abroad. It is a pattern that is may be repeated in other countries. The Irish Dental Association (IDA) called on the Minister for Health, Mary Harney, to carry out an immediate evaluation of the effects of the wide-ranging reductions to the PRSI and Medical Card schemes. The answer was blunt- no change, no review. The government restricted the PRSI Dental scheme so that from 1st January 2010 eligible patients are only entitled to a free check-up. Previously, over 2 million Irish taxpayers and their dependent spouse or partners were entitled to free and discounted dental treatment (e.g. on fillings, extractions, root canal work or dentures) under the PRSI scheme. Fintan Hourihan of the Irish Dental Association says, “The failure of the Department of Health to evaluate the effects of the cutbacks shows head in the sand thinking is alive and well in the department. The failure of the minister to evaluate the effects of the cutbacks on 1.9 million Medical Card holders beggars belief. We have warned that they are storing up huge problems for the dental health of the nation for the future. If people are denied treatments now, the remedial treatment needed in a few years time will be more painful and much more expensive. So these cuts are not just unfair they simply don’t make any financial sense. Whatever the reason it is grossly irresponsible and patients down the line will suffer. When implementing the cuts to the dental schemes, the government said it was doing so to protect services for children and those with special needs. The promise to look after children and special needs groups rings hollow.” Reduced state funding to the dental benefit scheme has and will have serious consequences for those who cannot afford to pay for private dental treatment and have an impact on the income of those dentists who operate the scheme. Private dental treatment in Ireland is not cheap, and the IDA’s complaints are as much about protecting the income of their members as protecting consumers. Problems of accessibility to dental services are not solely a result of the withdrawal or curtailment of state. Many patients find it considerably cheaper to travel across the border to Northern Ireland (which is part of the United Kingdom, while Ireland is an independent EU state) or to Eastern Europe for dental treatment. Many Irish people continue to travel to Budapest to get dental treatment that they find unaffordable at home. The IDA has consistently defended what many in Ireland regard as the prohibitive costs of getting private dental treatment in Ireland. While state and private employees have been forced to accept substantial salary cuts, or lose their job in a market where getting a new one is far from easy, dentists, hospitals and clinics in the country may have seen a reduction in business, but show no willingness to cut prices. In a biting recession health providers have to offer realistic and affordable treatment. With other countries following Ireland with lower salaries and drastic cuts in health expenditure, people will increasingly be driven into the private health sector. Whether this is at home or overseas, will depend very much on whether or not local providers can or are willing to offer cheaper services. So the growth of outbound medical tourism will depend not just what destination countries are offering, but whether local providers are prepared to compete for domestic and European custom.

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THAILAND: Thailand launches medical tourism website and blogger competition

Thu, 21 Oct 2010 15:37:39 GMT

The Tourism Authority of Thailand (TAT) has launched a new blog contest to promote medical tourism. It wants bloggers experienced in writing on the subject of either tourism, medical or/and medical tourism for a medical blog contest. A first prize is $10,000 in cash with a further $3,000 in hotel vouchers. Criteria to be amongst the twelve finalists will include; an ability to demonstrate knowledge of medical tourism and/or medical tourism in Thailand, innovative ideas for promoting a medical tourism blog, and the ability to show enthusiasm. Between the 20th of November and the 26th of November, finalists will be treated to a luxury, all-inclusive seven-day medical tourism familiarisation trip. Finalists will travel either to Phuket, Chiang Mai, Pattaya, Koh Samui or Bangkok. During their times at these destinations they will receive familiarisation tours of hospitals and healthcare facilities. And they will enjoy special trips and excursions, put on by TAT, to help them both experience and better understand the many and diverse attractions Thailand has to offer as a world class tourist destination. Whilst staying in Thailand they will have to write a blog of their daily experiences using stories, photos and videos. The goal for the contestants is to inform a global audience about the facilities available, for any prospective visitor. The blogger should also engage a reader’s interest sufficiently for them to want to seek out further information relating to medical tourism within Thailand. The overall winner must look to attract the highest number of visitors to their blog site. And they will also be judged on the accuracy, quality, clarity and persuasiveness of their blog. Thailand has embarked on an aggressive digital campaign to win back tourists who were discouraged by reports of political violence in the country this year. It has also identified a new target market of retirees to whom it wants to market specialised, transparent and simple packages that include medical and wellness tourism. Meanwhile, tourism continues to grow. In the first half of this year, Asian countries contributed the largest number of foreign tourists, followed by East Asia, non-Scandinavian Europe and Scandinavia. According to TAT, Thailand currently gets 920,000 travelers visiting the kingdom annually as medical tourists. The often-quoted larger figure of 1.4 million is medical tourists and other non-nationals, that includes business and holiday travelers and expatriates. The largest group coming for medical tourism is from the Middle East with UAE at 44% of the total, followed by Qatar 9% and Oman 6% and less from Bahrain and Kuwait. TAT has also launched a new website ThailandMedTourism.com, to provide information on surgical procedures, health service providers, packages and promotions, destinations, and up to date articles and news. TAT has set ambitious targets for future arrivals. As part of their overall marketing strategy, in order to achieve these targets, the new website is designed to bring together a whole range of information to assist prospective visitors. Medical treatments available are listed and also explained. Each treatment carries a general description along with information relating to the length of treatment or surgery, benefits, ideal candidates, planning, preparation, recovery and potential risks, complications and side effects. TAT is undertaking a proactive and interesting approach, with the aim of increasing current revenue to $2 billion annually, and reviving Thailand’s rather battered global reputation.

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GLOBAL: Indian hospital accreditation programme goes global

Thu, 21 Oct 2010 15:05:54 GMT

India’s national hospital accreditation programme- National Accreditation Board for Hospital (NABH), run and managed by the Quality Council of India, is going global. In India, 55 hospitals have formally received NABH accreditation while another 365 have applied for it. Accreditation remains a voluntary process in India. NABH will begin in the Philippines and plans to extend into Bangladesh and Nepal by the end of 2010, and into Sri Lanka in 2011. Future plans are to extend into Middle Eastern countries, starting off with the state of Dubai. NABH also sees African countries such as Kenya and Nigeria as logical future destinations, as Indian hospital chains see great potential in Africa. NABH has set up a separate division to look after its overseas operation, National Accreditation Board for Hospitals and Healthcare Providers (NABH) International. The driver to service international hospitals is the expansion of large Indian hospital groups into subsidiaries or joint ventures in an increasing number of countries globally. Girdhar Gyani of NABH explains, "The vision to go global has been there for a while but the opportunity arose when hospital managements which already have NABH accreditation in India started demanding accreditation for their overseas hospitals as well. We are ready for competition from the American, Canadian and other international accreditation agencies which are already present in the targeted countries." Hospitals have been complaining that international accreditors in a competitive market are too expensive and inflexible on costs. NABH say that a three-year accreditation from JCI in the Philippines costs close to $46,000, while a comparable NABH accreditation costs a little over half that amount. Although initially aimed at hospitals and clinics, NABH International will also offer accreditation to spas and wellness centres. Through its exclusive Philippine representative, HealthCORE, NABH International has been launched to improve conditions, systems, processes, and skills of hospitals and professionals in the country. Dr. Sanjiv Malik of NABH says, "Accreditation is a practical solution to one of the main issues in medical tourism, which is quality and safety assurance. NABH International allows hospitals to build credibility and confidence, which generates recognition among foreign patients, thereby promoting medical tourism." The Department of Tourism (DoT) believes that accreditation is the key for medical tourism to truly flourish in the Philippines, as it will recognize the Filipino healthcare providers to be at par with world-class standards. NABH International’s accreditation process entails onsite visits to assess if standards on access, care of patients, management of medication, patient rights, and infection control are met. Standards on continuous quality improvement, good governance, facility safety, human resources, and information management system are evaluated by highly qualified and well-trained assessors who are doctors, healthcare administrators, or nursing supervisors.

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MEXICO, USA: Mexico expects more medical tourists as US outbound medical tourism stagnate

Thu, 21 Oct 2010 14:53:31 GMT

Mexico is experiencing an increase in medical tourists and this year the number will comfortably exceed the 50,000 in 2009, says Health Digital System (HDS). Between January and September of this year, 44,512 foreigners checked in to Mexican hospitals, 25 percent more than the 35,610 who did so during the same period in 2009. Last year, some 50,000 foreign patients were treated in Mexico and each one spent an average of $13,000 per week on medical care, for a total of $650 million, according to an HDS study. HDS expects this sector to continue growing and that in two years it will generate revenues of about $1.2 billion. The good quality of care and the low charges, which are about half the equivalent medical costs in the USA, spurs foreign patients to come to be treated in Mexican hospitals. Most come from the United States and Canada for everything from regular checkups to dental and cosmetic surgery, and more recently there has been an increase in those seeking major surgery. Jaime Cater of HDS says, "Mexico has managed to increase the development of its health system and in private hospitals as well as federal ones emphasis is being decisively placed on strengthening this type of tourism." The Mexican government is working with U.S. insurance companies to get their customers treated in Mexico, but the stumbling block is that only 2% of the hospitals and clinics in Mexico have Joint Commission International accreditation. This is why the federal health department is working on new certification for hospitals both on the northern border as well as in the centre of the country. These numbers actually understate the number of people crossing the US border into Mexico for treatment, as they would not count as foreigners, Mexicans who live and work in the USA and go back to Mexico for medical care. Neither do the figures include much of the mostly daycare treatment of the increasing number of cross-border insurance schemes that allow Americans and Mexicans living in border states, the option of treatment in the USA or in Mexico. HDS estimates that only 300,000 U.S. citizens now travel abroad for medical care. According to some estimates, five years ago, about 750,000 Americans sought medical care in other countries. But there were just 540,000 medical travelers in 2008, according to a 2009 report by Deloitte Center for Health Solutions. Researchers at Deloitte predicted medical tourism would rebound in 2009 and 2010 from a pent-up demand for elective procedures, with an annual 20% growth rate. But that did not happen. In a local paper, Paul Keckley of Deloitte said, "The economy has beaten down the anticipated 20% growth," Patrick Marsek, of MedRetreat, an Illinois-based medical travel agency that was one of the first when it started in 2003, reported booming business in 2007, but says that business has been down 30% since the end of 2008. "The people we would normally service are the people who are struggling right now financially, who are trying to figure out a way to pay their mortgage and to pay for food." Medical tourism experts thought the drop in health travel during the recession would be temporary, and that a substantial recovery would soon follow. Instead, the anticipated rebound has not happened due to the slow economic recovery in many countries, the uncertainties of health reform in the USA, and high unemployment. Individuals do not have spare cash to pay for treatment, while companies are reluctant to consider including medical tourism in health plans while the details of health reform are in a state of flux. With fewer people traveling outside the United States for elective procedures, medical tourism agencies have had to make changes in their business plans or consider closing down. MedToGo of Arizona is finding fewer takers for elective procedures such as hip replacements and dental, so are offering bone marrow and kidney transplants, and other life-saving procedures. MedToGo is negotiating with two hospitals for the transplants to be done in Mexico.

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EUROPE : A French view on the EU cross-border healthcare plans

Thu, 21 Oct 2010 14:34:09 GMT

Presenting to fellow European members of parliament her recommendations on cross-border health care for a second reading, French rapporteur Françoise Grossetête insisted she would be uncompromising on the issue of prior authorisation. While she does not question this principle, she rejects the quality and security criteria added by the Council, which would make it possible for a member state to arbitrarily refuse to grant authorisation to a patient, “I believe that this criterion is unacceptable because it would make it possible for prior authorisation to be refused at any time without explanation. It is inconceivable and would, in the end, lead to new appeals before the European Court of Justice”. The objective of the proposal for a directive is to standardise case law of the Court of Justice of the European Union and avoid the ambiguity faced by patients. The Commission is attempting to clarify the rights of patients treated in another member state, including the issue of the reimbursement of care. As a general principle, it establishes that patients treated in another member state will receive the same level of reimbursement anticipated for the same treatment or for a similar treatment in their national health system, if they are entitled to this treatment in their country of affiliation. Grossetete is an influential MEP and her stance could help influence changes in the Second Reading later this year. Her worry is that the latest version still enables member states to limit the application of rules relating to the reimbursement of cross-border health care by demanding prior authorisation for certain treatments. According to the rapporteur, prior authorisation must be based on the need for health care planning and rationalisation, but cannot be abused in order to deny patients the right to travel for treatment. She therefore proposes even tougher restrictions- limiting prior authorisation to hospital treatment (a stay of more than one night in hospital), specialised care or treatment that poses a particular risk to the patient or the population. Grossetête believes that this text must be urgently concluded under the best possible conditions because the question has been open for too long. She makes a valid point that less than one per cent of the European population would even consider state paid healthcare in another country, as most people prefer to be treated at home. Her argument is that if states are offered the opportunity for prior authorisation and reimbursement, unless carefully controlled, the practice in some member states will make the whole concept unmanageable. Grossetête will be intransigent on the issue of rare diseases, as she wants patients suffering from rare diseases to have access to care in another member state and be reimbursed, particularly if the treatment is not provided in their member state. She joins an increasing number of MEPs arguing that rare diseases must not be subject to prior authorisation. She points out an area that was not resolved in the latest version from Council, but appears to be yet another get out clause agreed earlier this year by health ministers. This is the stipulation that patients who have obtained prior authorisation must provide advance payment to the hospital .Her argument is that this makes a nonsense of the whole agreement and the logic must be that if any advance payment is allowed, then this should only be in those few countries where at home, the patient has to pay an advance fee to the hospital before reclaiming from the state after the treatment.

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UKRAINE: Ukraine gaining in popularity for health tourism

Fri, 15 Oct 2010 14:32:00 GMT

Medicare Europe is a British medical tourism agency that focuses on Eastern European countries for dental care, IVF, eye care and cosmetic surgery. It has set up a European office in Kiev in the Ukraine, as that country is increasing in popularity for offering high quality care at a reasonable price. More patients from Western Europe are seeking dental care in Ukraine, as the treatment costs are much cheaper than most European countries. Originally, most dental tourists came from other post-Soviet bloc countries. Now, every year sees an increasing number from Canada, USA, Germany, UK, Ireland and continental European countries. London based business consultant Panamedical Consulting, in cooperation with Ukraine based surrogacy agency IRTSA, has organised an information seminar for the public and medical profession.” Infertility Treatment and Reproductive Technologies in Ukraine" on 23 October 2010 at Nov NOVOTEL Hotel, on Southwark Bridge Rd, London. The seminar will cover a range of issues related to medical, organisational and legal aspects of reproductive medical treatment and technologies. Recent advances in reproductive technologies make it possible for men and women who previously were not able to have children to become parents. The seminar will cover common types of infertility treatment - IVF, egg sharing/donation, ICSI and surrogacy as well as most recent developments in the science of human reproduction. Ukraine is one of the most popular destinations in Europe for couples or single individuals looking to become parents for the first time. Many prospective British and European parents go to Ukraine for treatment. Recently, Ukraine has become the top destination for same sex couples who, because of religious prejudice, governmental policy of lack of tolerance within the society cannot use assisted reproduction treatment in their own country. The seminar will cover this issue in depth and present various options open to same sex couples who want to become parents. Legal aspects of assisted reproduction treatment are of paramount importance. A child born in Ukraine to a European mother or to a Ukrainian surrogate mother will need to go home with his/her parents to their respective country. Different countries have different policies with regards to children born overseas and these will be discussed by Ukrainian medical and immigration lawyers. Panamedical Consulting LTD (UK) is seeking entries for the launch of the first annual International Medical Tourism Directory 2011. The directory seeks to be a trusted source of useful information on medical and health clinics offering their services to clients around the globe in dentistry, cosmetic surgery, reproductive medicine, ophthalmology, orthopaedics, cosmetology, spa/wellness, and surgery. The directory also provides essential information on medical technologies and tourist information on countries, currencies, accommodation, transport, regional cuisine and various helpful tips one may need in a foreign country. The International Medical Tourism Directory 2011 will be available in business centres and offices of leading international companies, banks, law firms, hotels, sports clubs, and beauty saloons throughout Western Europe, Asia, Middle East, USA, Russia, Ukraine, Kazakhstan and other countries, and also distributed to high networth individuals and professionals. All entries have to be paid for. The 616-page colour directory will be published in English and Russian, with 8,000 printed copies in each language.

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NEW ZEALAND: Opportunities for medical tourism to New Zealand

Fri, 15 Oct 2010 14:27:50 GMT

International consultant Deloitte has conducted a strategic study for an unnamed client investigating the potential benefits medical tourism could bring to the New Zealand health sector and the wider economy. Findings highlight the competitive advantages and potential benefits of medical tourism for New Zealand. Key findings- If the New Zealand health sector is able to attract medical tourists then the spare capacity in private hospitals could be filled with patients who bring a greater economic benefit to the wider economy. These medical tourists are likely to spend time in New Zealand after their operation recuperating, contributing further to the local economy. The greatest and most lucrative market concentration of potential medical tourists for the New Zealand market is the West Coast of the USA. With only a 12-hour non-stop flight from either Los Angeles or San Francisco it makes New Zealand relatively accessible in comparison with Asian countries involved in medical tourism. The level of care and skill level of surgeons and anaesthetists are similar to the U.S. in the core procedures being targeted for medical tourism. This is an important factor to reassure patients and medical insurers who are looking at offshore medical procedures that they would be receiving a similar level of care as in the U.S. New Zealand is an attractive destination because procedure costs are less than half the cost compared to the United States, which makes it more affordable for uninsured patients paying for medical procedures and also for medical insurers. New Zealand is a first world country with similar values and culture so is likely to make it a more attractive destination for medical procedures than countries such as Thailand, Korea, India and Malaysia. Deloitte accepts that medical tourism, despite attempts to promote it to US customers, is so small as to be almost non-existent. It estimates that the current medical tourism market in New Zealand is very small, with 150 overseas patients a year. The New Zealand private health system could develop and capitalise on the competitive advantage identified. Opportunities to expand this potential market are now being explored by a number of organisations involved in private healthcare. Medical tourism as a viable way for private hospitals to supplement their current patients, and boost the utilisation of their hospital bed nights. Agencies keen on promoting the country point out - It has a very low level of violent crime and murder. No terrorism problem Political stability Foreign travellers are welcome. Extremely low rates of the infectious diseases MRSA, hepatitis A, VRE, tuberculosis, and HIV. No need for vaccinations for typhoid, malaria, rabies, hepatitis A, and Japanese encephalitis. Traveling to New Zealand requires no vaccinations. The food is safe and the water is clean. Hospitals and clinics are clean and state-of-the-art, all using the latest technologies. English is the primary language, a factor that is so important when discussing a major medical treatment such as knee or hip replacement surgery. Direct flights from Los Angeles to Auckland in 12 hours. For the second year running, New Zealand is the most peaceful nation on Earth, according to the findings of the Institute of Economics and Peace. The 2010 Global Peace Index ranks 149 countries according to their degree of peacefulness.

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USA/GLOBAL : Survey on American travellers interest in medical tourism

Fri, 15 Oct 2010 14:25:42 GMT

Medical tourism is one of the topics covered in a new survey of outbound US travellers. The ’Ypartnership/Harrison Group 2010 Portrait Of American Travelers’ is a survey of the travel habits, intentions and preferences of Americans living in the USA.The national survey of 2,524 US households who are active travelers was conducted in February 2010. The results provide an in-depth examination of the impact of the current economic environment, social values and media habits on the travel habits of Americans with an annual household income of $50,000 or more. Ypartnership is a leading marketing services company serving travel, leisure and entertainment clients. The agency’s Insights group is a leading source of market intelligence on emerging business and leisure travel trends. Harrison Group is a leading market research and strategy consulting firm specializing in market strategy, market analytics, survey and forecasting services. This year’s survey was an in-depth examination of the impact of the current economic environment, prevailing social values and emerging media habits on the travel behaviour of American travellers. It seeks the underlying motivations with an emphasis on how they plan, purchase and share travel experiences; rather than a simplistic view of past travel habits. For the first time, the annual survey investigated medical tourism. The survey is only about attitudes and the figures do not reflect anything on actual numbers who have travelled. In consumer research, attitude/intent is not necessarily transferred into actual purchase in any meaningful way. 50% of leisure travelers are now familiar with the concept of medical tourism, and 17% would consider having a medical procedure done outside the U.S. assuming it is perceived to be of comparable quality. 22% are not sure, suggesting they would also be open to considering this as an alternative to treatment at home if certain conditions were met. Among adults who would consider traveling outside the U.S. for major medical care, 84% cite the lower cost as the primary reason why. 66% mention comparable or a better quality of care, while 43% cite access to medical treatments or procedures that are not covered by their insurance at home, and 41% mention shorter waiting periods to access care .22% cite access to experimental or non-FDA approved treatments and 20% mention concerns about privacy Among countries measured in the survey as possible medical tourism destinations, Canada reigns as the number one choice. The top eleven countries: Canada (42%) United Kingdom (32%) Germany (31%) Sweden (28%) France (24%) Mexico (13%) India (11%) Singapore (10%) Costa Rica (9%) Brazil (7%) Puerto Rico (7%) These figures are on the basis that they are paid for by health insurers, financial incentives from insurers and/or employers are at least comparable to treatment in the USA, and quality of care is also equivalent. The figures do not reflect intent or willingness to travel for self-payers. These results are another confirmation of a trend that many medical tourism experts accept, but others continue to deny, that travel time and nearness of destination are key to where medical tourists are prepared to go, not cost alone. American preference is within the American continent, followed by Europe, with Asia much less popular.

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UK/GLOBAL: British government funds major academic study of medical tourism

Fri, 15 Oct 2010 14:19:04 GMT

Medical tourism is to go under the microscope in a major new 18-month study from November 2010, led by an academic from the University of York, which aims to assess its potential advantages and disadvantages. "Inward and outward implications for the NHS of Medical Tourism" is funded by the National Institute for Health Research (NIHR), and will examine the motives people have for travelling across national boundaries to receive treatments such as dental services, elective surgery for hip or joint replacement, cosmetic surgery and fertility treatment. Dr Neil Lunt, of the York Management School, will head a team of researchers that includes health economists, social scientists and clinicians who will research four aspects of medical tourism. They will spend the 18 months studying the economic impact, consumerism and patient decision-making, quality, safety and risk, and industry development. In the UK, medical tourism is 99% privately funded and the researchers will seek to establish the amount people are paying for this healthcare and its economic impact. They will also examine the potential savings for the NHS that contracting out treatments to other countries might bring. This will be linked to a review of potentially negative impacts on the NHS, such as the need to ensure continuity of care for people who have been treated abroad and the cost of treating complications. The work will contribute towards understanding quality, administrative and legal dimensions of medical tourism as well as unintended consequences. The research team will explore how patients make their decisions concerning treatments and destinations, what information they use – such as websites, friends, internet chat rooms – and how informed their choices are. Patients will also be asked about their experiences of treatment abroad. Neil Lunt says: “We will advance knowledge of patient treatment experience and how consumers think about choice, and how risk and safety are managed at the consumer and organisational levels. Our work will contribute towards understanding quality, administrative and legal dimensions of medical tourism as well as unintended consequences. The study will be of interest to those working within and making decisions about the NHS, policy-makers, regulators, providers, clinicians and consumer organisations as well as patients. My main research interests are around the organisation, management and delivery of health and social services, the role of research within policy and practice, welfare policy, migration and welfare, and medical tourism. I have particular interests in comparative dimensions of public sector reform and welfare restructuring (South Korea, Australasia, Singapore, China). I am keen to supervise PhD candidates on these and related topics.” The research team includes Professor Stephen Green of Sheffield Teaching Hospitals Foundation NHS Trust; Dr Mark Exworthy of the School of Management at Royal Holloway, University of London; Professor Russell Mannion of the Health Services Management Centre at the University of Birmingham and Professor Richard Smith, of the Department of Global Health and Development, London School of Hygiene & Tropical Medicine. The National Institute for Health Research (NIHR) commissions and funds NHS and social care research to support decision making by professionals, policy makers and patients. It funds open access research, not implementation or service development. The key objective is to improve the quality, relevance, and focus of research in the NHS and social care by encouraging initiatives that increase the potential for quality research to be widely disseminated and freely accessed. This is the first time that any UK government funded body has paid for original research on medical tourism. Neil Lunt has published several academic studies on medical tourism- Lunt, N. and Carerra, P. (2010) ’Medical tourism: assessing the evidence on treatment abroad’, Maturitas: an International journal of mid-life health, 66, 27-32. Carrera, P. and Lunt, N. (2010) A European perspective on medical tourism: the need for a knowledge base, International Journal of Health Services, 40, 3, 469-484. Lunt, N., Hardey, M. and Mannion R. (2010) ’Nip, Tuck and Click: Medical tourism and the emergence of web-based health information’, Open Medical Informatics Journal, Volume 4, 1-11, doi: 10.2174/1874431101004010001 http://www.bentham.org/open/tominfoj/openaccess2.htm

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GLOBAL: Wellbeing Escapes launches 'Mind Unwind' health tourism

Fri, 15 Oct 2010 14:12:18 GMT

When it comes to advising people how to take care of themselves, UK based Wellbeing Escapes, spa and wellbeing holiday agents, say they are in tune with what makes people tick. Recognising that their clients lead stressful lives and as a response to the additional pressures many of them have been under this past year, they have launched Mind Unwind offering tailored breaks designed to give their clients the tools to cope with the strains of life and work, as well as tips and guidance once they return home to ensure long-term support. The company says, "The state of the psyche is key to wellbeing which in turn affects performance, and an increasing number of people are beginning to realize the importance of addressing the health of the mind as a vital part of their keep fit regime. We are increasingly looking for guidance on how to take care of our emotional wellbeing, and searching for ways to stay in peak mental condition." Meditation is a generic term for techniques used to quieten the mind into a deep state of relaxation. Meditation is considered as a serious form of treatment by the medical profession and used as an effective tool for depression, heart disease and diabetes. Purported benefits include: Productivity• Increased concentration and clarity of thought• Increased memory and stronger decision-making abilities• Increased efficiency and time management Stress Levels• Reduced anxiety, depression and anger• Increased tolerance to minor irritations and preoccupations• Increased focus• Younger and healthier appearance Creativity and happiness• Increased self-awareness• Increased ability for intuitive thought Health conditions• Effective complementary tool in managing heart disease and diabetes• Preventative technique for avoidance of disease (reduced stress levels)• Can help in quitting harmful addictive habits such as smoking and excessive alcohol• Can help in reducing symptoms of PMS and menopause• Reduces insomnia Each Mind Unwind holiday has been tailor-made to appeal to their broad client base, featuring packages aimed at de mystifying meditation and making it accessible for both newcomers and those keen to reconnect with the practice. Each package combines personal meditation instruction by experts with extensive experience and intensive practice with holistic activities and mind-clearing treatments such as Reiki and Indian head massage. While meditation can be done at home, a Mind Unwind holiday enables people to dedicate time and attention to learning to meditate without the usual daily life pressures, in a beautiful and comfortable environment. Mind Unwind is aimed at the upper end of the market as it uses a selection of the world’s most luxurious destination spas, including; Ananda in the Himalayas, India; Kamalaya Wellness Sanctuary, Koh Samui, Thailand; Uma Paro, Bhutan; Longevity Wellness Resort, Portugal; SwaSwara, India and SHAWellness Clinic, Spain.

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USA/GLOBAL: Medical tourism - the view from ten thousand feet

Fri, 08 Oct 2010 11:09:09 GMT

American academic Professor Glenn Cohen has been investigating some ignored legal aspects of medical tourism from the USA. ’Medical tourism: the view from 10,000 feet’ is a short paper in leading bioethics journal the Hastings Center Report. A longer just-published paper in the Iowa Law Review is ’Protecting patients with passports: medical tourism and the patient protective argument’. In the longer paper Cohen looks at the motivations and demographics of medical tourists: • Some are uninsured or underinsured patients seeking cost savings (in some cases upwards of 80% savings compared to U.S. prices) on procedures like hip replacements or cardiac bypass by seeking them in countries like India or Thailand. • Some are part of a growing industry of insurer-prompted medical tourism — individuals who have insurance but whose insurers incentivise or allow treatment abroad. • And failed attempts (a bill that died in the West Virginia legislature) to have government prompted medical tourism where state health insurance schemes incentivise (or much less plausibly require) travel abroad for health care. Cohen argues that these types of medical tourism raise significant legal and ethical issues:• "Domestically we treat advance contractual waivers of medical malpractice rights as unenforceable, such that you cannot bargain for a better price with your doctor by waiving those rights, even in the extreme case where you might not be able to afford the surgery without that price discount. How should we feel about the way in which medical tourists will (due to several interlocking facets of American civil procedure, and sharply less remunerative foreign law) essentially waive medical malpractice recovery rights by seeking care abroad in order to achieve costs savings? How should we regulate the insurer-prompted medical tourism market? Does the existing state insurance architecture of regulation suffice? What about self-insured plans? What are the dynamic effects on U.S. health care markets of competition from medical tourism centers? What are the effects of medical tourism on health care access in the destination country and should they matter to us? How will the recent Obama health care reform initiatives change the playing field?" So far, much of what Cohen investigates is not new to the medical tourism world. But then he ventures into an area that few in the business like to consider, • "There is medical tourism for services illegal in the home country but legal in the destination country (abortion tourism, reproductive technology tourism, euthanasia tourism, stem cell therapy tourism) and for services illegal in both places but with grey or black markets in the destination country (organ tourism). Here we face questions of whether the USA should extend its domestic criminal prohibition extraterritorially in the model of the Protect Act (child sex tourism) There are also hard questions about the obligations of doctors in the home country as to patients who have returned with illegally purchased organs, as well as their obligations to inform or not inform patients about the option of going abroad." ’Medical tourism: the view from 10,000 feet’ highlights concerns on the single/dual illegality matter, • If a foreign country criminalizes organ sales but has a lax enforcement regime, that effectively tolerates a grey market. Should the USA use its criminal law against citizens that purchase organs abroad? US laws on child sex tourism are the nearest equivalent where the law can be applied to the acts of a US citizen outside the USA.• Another approach on such organ tourism is to extend Medicare regulations that require doctors to tell patients that if they buy illegal organs abroad, the doctor could refuse to supply aftercare or drugs.• Should US law default to what is legal in the USA or what is legal in the destination country? Cohen says, ’If we try to reign in the activities of US citizens abroad, then we face legal challenges in designing regulation and detecting it where the activities are legal or illegal and not policed in destination countries. He mentions the dilemma of making Americans into criminals when US laws, government interference in research, and inadequacies of the system have created the US demand for organ and fertility tourism. An area that Cohen touches on but ultimately skates over is whether or not the USA has any right to impose its views and laws on US citizens just because other countries have different legal ethical and medical views on areas such as same sex fertility tourism, organ transplants, surrogacy and assisted suicide. David Young-Cheol Jeong comments, "As for the legality of certain treatments, it might be interesting to think about overseas manufacturing activities at lower wage, lower occupational safety and health standards, or lower environmental regulations and enforcement. US multi-nationals run factories in China, Guatemala or Cambodia, so if you can establish the basis on criminal liabilities for rendering medical services, it might be applicable to multi-nationals who buy labour in violation of their home country laws. The punishment should come from the home country." Cohen’s next paper will be a longer piece that looks at normative justifications for extending a state’s criminal law outside the USA, and what they can tell about medical tourism for services legal in the destination country but not the home country of the patient. Another area Cohen has investigated is whether medical tourism hurts access to medical care in destination countries by driving up costs and using resources in the country. He presented a paper at a conference in June but has yet to get it published in an academic journal. Cohen comments, "While one can specify triggering circumstances that would make a negative effects from medical tourism on destination country access to healthcare more likely, and while one can find authors making these claims and some anecdotal evidence for the effect, I have yet to find any empirically rigorous demonstrations of the effect. Even if the effect was demonstrated, there are interesting questions of whether this should create an obligation on the part of home countries or international organizations to prevent some forms of medical tourism due to this negative effect."

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JAMAICA: Health tourism could boost Jamaica's economy

Fri, 08 Oct 2010 11:05:42 GMT

A leading Jamaican cardiologist Dr Ernest Madu believes a number of Jamaica’s health and economic problems could be solved if a proper infrastructure is put in place to establish health tourism on the island. Dr Madu of the Heart Institute of the Caribbean (HIC), argues that Jamaica is not benefiting from the number of patients seeking health care outside of their countries, “The most booming trade now is health tourism, but they are not coming to Jamaica, and this is not just because the crime is bad; if they come we have to give them what they need and what is the international standard. To meet the required standards in health care it will require money for the importation of medical equipment and trained specialists, particularly where it affects heart diseases. Jamaica simply does not have the infrastructure to offer treatment to Americans who can go to India or Thailand. So we have to ask the question, why is it that we have not developed the facilities for them to come to Jamaica? Once the infrastructure is put in place, the problem of access would then have to be addressed. Cardiovascular diseases can be treated in Jamaica for 10 per cent of the cost in Miami. The Heart Institute is able to treat most of the heart disease-related cases, but more centres will have to be established.” Jamaica’s investment and export promotion agency JAMPRO has secured technical assistance from the Commonwealth Secretariat for a development project on the growth of health and wellness tourism in Jamaica. This is a research project to find out if Jamaica could be a realistic destination, what the target market would be, and what is needed to make it happen. For this project, the Commonwealth Secretariat will provide funding to engage the services of a consultant, who will work closely with JAMPRO to identify the critical prerequisites and success factors for the sustainable development of health and wellness tourism in Jamaica. This partnership between the Commonwealth Secretariat and Jamaica represents the latest in a series of projects focused on the socio-economic development in the country. JAMPRO will be driving the project, in collaboration with the health and tourism ministries, to primarily develop a detailed strategy and action plan aimed at creating investment promotion and industry development frameworks for the establishment of internationally competitive healthcare services. Sancia Bennett-Templer of JAMPRO says, "As a critical part of our mandate, JAMPRO is charged with not only promoting established sectors for investments, but also identifying and diversifying Jamaica’s offerings for both local and foreign investments. We are committed to increasing employment, and the health and wellness sub-sector presents those opportunities. Much research has already been done in the area of medical tourism in Jamaica, with information dating back to the 1990’s. In partnering with the Commonwealth Secretariat, it is important to update existing information with new findings and avoid reinventing the wheel in the process. We will focus on developing a plan of action with key initiatives and important deadlines for stakeholders to partner with JAMPRO in executing, so that the required accreditations, guidelines for operation and legal requirements are in place early. This will make it easy for investors and medical tourists to do business and receive optimal care in Jamaica.”

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BARBADOS: Barbados targets American women for fertility treatment

Fri, 08 Oct 2010 10:39:27 GMT

A recent survey of American women aged 25 to 45, by Barbados Fertility Centre found that most women who would consider In Vitro Fertilization (IVF) would also consider travelling outside of the United States for the procedure. 74% of these women would be willing to travel if there was a significantly lower cost and higher pregnancy success rate. Among these women, better pregnancy success rates are a more compelling factor than lower cost (72% vs. 64%). However, having the procedure covered by insurance is also a motivating factor as 81% of those who would consider IVF at home say they would be likely to seek treatment abroad if this were the case. Dr. Juliet Skinner of Barbados Fertility Centre, in Barbados says, “Dealing with infertility is an anxiety-ridden and costly experience for many American women and couples. I have seen significant increases in the number of American patients and inquiries over the past few years as IVF costs rise in the US. Our study shows American patients are willing to look beyond local medical providers when they find a cost-effective alternative that provides exceptional care. Over the past eight years, many of our American patients who previously had multiple unsuccessful cycles at home have had positive outcomes at our clinic.” Depending on maternal age, the IVF success rate at Barbados Fertility Centre is 54%, compared with the US national average, according to the Centers for Disease Control (CDC) of 42%. Using blastocyst, Barbados Fertility Centre is achieving a 71% success rate for women under 38. The high success rate is attributed to both rigorous clinical and laboratory standards, as well as the level of relaxation patients experience while visiting Barbados. The centre is accredited by Joint Commission International (JCI), the US health international accreditation body that ensures operating and safety procedures are comparable or exceed US standards. The high cost of IVF treatment in the US, particularly in California and New York where costs are the highest, can compound the stress of the procedure. The average cost of IVF in the US is $14,000 for one treatment cycle alone. In contrast, Americans travelling to Barbados pay an average of $5750, which is less than half the cost of receiving treatment at home. Even with the travel and medication costs factored in, the entire cost of the procedure is still significantly lower due to the rising costs of healthcare services in the US. Other survey findings regarding medical tourism include that 42% would consider any medical treatment outside of the US. The most common reasons for not considering foreign elective treatment are perceptions that savings are not worth the risk (42%) and standards are just not as high (21%). Since 2002, Barbados Fertility Centre has been helping infertile couples from around the world achieve their dream of having a child. The centre offers an attractive, affordable alternative for fertility treatment that has proven to be effective. 1936 adult American women aged 25-45 years were surveyed by Ipsos Public Affairs between June 7th and 14th, 2010. Interviewing was conducted via an online survey utilizing the Ipsos iSay pre-recruited panel in the US. A representative sampling matrix according to age, region and household income was utilized to ensure a representative sample of the target audience was achieved. An oversample in New York and California was used to ensure a more robust base size for sub-group analysis. Weighting was then employed as needed to balance demographics and ensure that the sample’s composition reflects that of the target population.

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MALAYSIA: Relaxation of rules on advertising may help medical tourism to Malaysia

Fri, 08 Oct 2010 09:48:07 GMT

After much pressure on the Malaysian government to remove advertising restrictions that were harming medical tourism, it has finally relented. Private hospitals and clinics will now be able to advertise their services online and offline, following the government’s decision to liberalise provisions under the Medicines (Advertisement and Sales) Act 1965. 7,000 private clinics and 200 private hospitals will be affected. Health minister Seri Liow Tiong Lai says this will allow private healthcare providers to advertise their services to potential medical tourists and is in line with the government’s plan to promote health tourism in Malaysia and raise the number of medical tourists by 20% annually from 336,000 visitors last year, “The immediate liberalisation of the provisions will allow private hospitals, clinics and dental clinics to advertise their facilities and services in newspapers, the electronic media and on the internet. They can also advertise abroad but they will have to abide by the laws in those countries as well as the laws here. They can mention the latest equipment or treatment they have but they are not to use superlatives like ’best’ or make comparisons. There should not be any laudatory promotion of individual practitioner’s skills or experience. Misleading claims with the intention of encouraging the public to procure unnecessary medical services should not be published. The use of superlatives, patient testimonials, financial inducements and downplaying of risks are not allowed." Until the change, hospitals and clinics were only allowed to advertise through healthcare magazines and related publications and were not allowed to place advertisements outside Malaysia. But the state is not prepared to make Malaysia equal to competitors, as it still demands control over all advertising. Although the ministry’s Medicines Advertising Board has shortened the time to approve applications for advertisements under the latest advertising guidelines for healthcare facilities and services from six weeks to between three and five days, it will still watch for unapproved advertising and those flouting the law could face a heavy fine and a year or two in prison. A Malaysian company plans to work with Johns Hopkins University from the USA, to set up a medical science teaching facility and a new hospital in Malaysia, within a new medical city in central Selangor state, to provide a boost to medical tourism in the country. The venture is a private undertaking being promoted and financed by investors from the United States of America and Malaysian. The agreement related to the project is expected be signed soon, when the parties to the deal will be revealed.

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USA: US hospitals offering substantial discounts for domestic medical tourists

Fri, 08 Oct 2010 09:38:40 GMT

A firm that arranges surgeries for self-paying patients gets an increasing number of inquiries from surgical hospitals in the United States about its rates. When hospitals learn they need to provide steep discounts, four out of five never follow up, says Rick Baker. But the increasing number that agree to the discounts, ranging from 50-85%, are rewarded with substantial volumes with the bill paid completely before surgery begins. The agency, based in British Columbia, books five patients a day in U.S. hospitals for a wide range of treatments from simple hip and knee replacements, to complex cardiac bypass surgery. North American Surgery uses 22 hospitals in 10 states, including Maryland, Oklahoma, Nevada, Arizona, Montana, South Dakota, Washington and Kansas. Most of the sites are physician-owned surgery hospitals with underutilized operating rooms, making the extra volume worthwhile, even with the discount. North American Surgery only sends American and Canadian patients to U.S. hospitals as it argues that other countries pose greater risks, such as parasites or typhoid fever, and the long plane ride home can harm recovery. Two-thirds of Baker’s customers are Canadians and one-third are Americans who tend to be self-employed with substantial incomes but no insurance coverage. The company was founded in 2003 to provide immediate access to surgery for Canadians, who often wait two years for surgery, cannot buy private insurance at home, so seek to pay out-of-pocket for surgery abroad. The American division launched in 2006. The company does not negotiate prices as each hospital sets its own price, but to gain referrals, its discount needs to be in line with that of other participating hospitals. The patient pays the full cost before surgery in the form Another US agency, BridgeHealth Medical of Colorado, originally just offered treatment outside the US, but demand has made them offer US surgery too. It says that self-insured employers can save anywhere from 15 to 50 percent by sending patients out of town. BridgeHealth uses 25 hospitals across the country for orthopaedic and bariatric surgery, heart valve replacement, and Cyber Knife, a radiation treatment. The company negotiates fixed rates with healthcare providers and then collects a fee from the insurer. The company also has contracts with 35 hospitals in 15 countries, but is increasingly attracted by domestic medical tourism as it offers a higher comfort level for patients, with only short flights and no cultural differences. With BridgeHealth, the surgery and all after care are paid for up front at a flat rate. So even if minor complications occur and the patient spends more time in the hospital, the health plan doesn’t pay any more. The advantage for doctors, hospitals and surgery centers is they don’t have to wait as long as 90 days for insurance reimbursement to come in. David Goldstein of Health Options, another agency promoting domestic medical tourism, acknowledges that overseas hospitals and doctors may be well qualified, but argues. "There is the question of legal action, if a patient were to have a malpractice case overseas - what recourse do they have? What if you were to experience complications on the way home? Domestic medical tourism is on the rise, because American healthcare providers are trying to remain competitive in this emerging market, and are lowering their prices in order to compete. With stringent medical regulations and legal protection, the patient is protected all around, eliminating the need to travel anywhere else for affordable healthcare."

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GRAND BAHAMA: Medical tourism plan for Grand Bahamas now unlikely to happen

Thu, 30 Sep 2010 17:02:10 GMT

The Grand Bahama Port Authority (GBPA) has been trying for several years to get plans for medical tourism started. It has had many problems with the concept, but the latest one could be fatal. Back in October 2009, Hannes Babak, then chairman of GBPA, proudly announced at an economic symposium that the company was close to making Grand Bahama a perfect new location for medical tourism. A developer investor kit had been sent to the top 10 to 15 hospitals in the United States to bring them to Grand Bahama to build new hospitals. GPBA had also identified the need for specialist hospitals for cardiovascular medicine and orthopaedic medicine. Babak also claimed that to make medical tourism a success on the island they would have to be the best in the field, "We have to be a leader and not a follower, we want to lead medical tourism and that will help local practitioners and give them a great facility in terms of a hospital." The concept was to help a struggling economy and diversify tourism that had been hard hit by the US recession. The island was clear that the target was almost exclusively US medical tourists. Minister of Health Hubert Minnis supported the venture, who said that once a plan was properly put in place with its guidelines the Ministries of Health and Tourism would work together to ensure its success, "This would be an excellent form of revenue so we are working aggressively and progressively trying to find new tourist markets. The island should no longer rely solely on cruise ships for the basic tourist product and is perfectly suited for medical tourism. We think that the whole idea of medical tourism is an excellent one. There will be opportunities for great facilities to complement the ones that currently exist. It will also provide an excellent boost for Grand Bahama to help with its unemployment rates. We are very much pro-medical tourism." Insurance companies were also expected to support the plan, as many persons were expected to travel outside of the United States for certain procedures because they would be cheaper than they are in the U.S. A year on, Babak has left, the government has made it clear that the only support it will offer is words of encouragement, not hard cash. US insurers show no interest in using the island, at least not until there is a hospital there, and they certainly are not prepared to fund any ventures. The targeted hospitals also show a distinct lack of enthusiasm, and none so far has been prepared to spend development money. GBPA president Ian Rolle recently told local newspaper The Freeport News that a couple of American medical tourism consultants had shown interest in assisting them to develop the concept. The stumbling block is that these consultants required a significant amount of money for something that was not guaranteed to ever get off the ground, "They basically required us spending an arm and a leg. While nothing is guaranteed we would at least felt some comfort that these people were working and earning their monies. We ran into some difficulties with people who wanted to be used as consultants." While medical tourism may still be still on the GBPA’s long-term agenda, Rolle says that it is not high on the list of things to do, because he is not prepared to pay large fees to consultants. A massive pine barren just over 50 years ago, the city of Freeport is now the commercial, industrial and tourist centre of activity on Grand Bahama Island. The Bahamas is member of the Commonwealth of Nations that became independent from the United Kingdom in1973. The official language is English. Grand Bahama Island is in the Caribbean, in the Atlantic Ocean, 200 miles west of Nassau, 55 miles from Southwest Florida and northeast of Cuba. The population is a mere 47000.

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CYPRUS: Cyprus announces strategic plan to promote health tourism

Thu, 30 Sep 2010 16:59:31 GMT

Cyprus’s commerce minister has presented a strategic plan to develop and promote health tourism in Cyprus. Antonis Paschalides says the target is to take the correct steps to promote Cyprus as the ideal destination for tourists in health matters. Alecos Ouroundiotis of Cyprus Tourism Organisation (CTO) adds that health tourism has two categories: medical tourism, which includes specialised medical therapy; and well-being therapy which includes spas, alternative medicine relaxation and rejuvenation, "The target is to combine health treatment with holidays, recovery with relaxation. Cyprus is the ideal location to attract this type of health tourism due to its climate and geographic location in conjunction with its excellent healthcare facilities." Dr Michael Guiry from the Center for Medical Tourism Research comments that despite the many advantages that Cyprus has in attracting health tourists, there are also several disadvantages. These include Cyprus being associated with a history of turmoil and also that the island is mostly associated with recreational tourism as well as the fact that Cyprus does not have a medical school. Dr Polis Georgiades of healthcare consultant firm Quale Vita argues that health tourism accounts for approximately 2.5 per cent of total international tourism but has direct competition from Hungary, Greece, Spain, Syria, Egypt, and Turkey. He suggests that rather than promoting everything to everyone, Cyprus should target specific areas such as cosmetic surgery, IVF, prevention therapy and dental treatment in an attempt to attract more health tourists. He concluded that Cyprus should adopt a value for money approach, as it could not hope to compete directly with the lowest budget health tourism countries such as India. Local newspaper Cyprus Mail is not a fan of health tourism, and in an article targeted at those reading about the new promotion plans, made several points including -* In the last three years the government has spent €106 million sending patients abroad for medical treatment. For many cases this was justified, as the required medical treatment could not be provided on the island, but in others it was not. There could be no justification, it argued, in sending patients to Israel, the UK or Greece for open heart surgery, when this can be done at Cyprus’ private hospitals.* In February 2009, the Council of Ministers amended the regulations governing the sending of patients abroad for treatment, making it possible for someone to go abroad even if he or she could be treated in Cyprus. The old regulations had made it compulsory to use the local health sector, if the required treatment was available. The health minister makes the final decision as to where a patient would be treated.* The health minister recently went to Israel to negotiate better prices, after Israeli hospitals raised their prices.* Local hospitals still charge the rates agreed some 10 years ago.* Why would anyone come to Cyprus for medical treatment when the health minister has so little trust in local doctors and hospitals that he sends patients abroad for treatment they could receive at home? A Cypriot fertility clinic has closed down after questions about its involvement in selling human eggs. The clinic, situated in the village of Zygi, Southern Cyprus, dealt mostly with donors from Russia and Eastern Europe, in violation of Cypriot law, which permits only donors’ expenses to be paid. It mainly targeted people from overseas, particularly Italy, who paid money out but have not received treatment.

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GLOBAL: The globalisation of fertility treatment

Thu, 30 Sep 2010 16:54:34 GMT

A huge variation in the availability and practice of fertility treatment is revealed in a new survey of 105 countries from the International Federation of Fertility Societies (IFFS). The UK has 66 clinics, Germany 120, Spain 200 and Italy 360. Japan has 615 clinics, and in India there at least 500 clinics. Surveillance 2010 was compiled by Professor Ian Cooke of the IFFS, who says: "What is considered acceptable varies from country to country. These great differences in clinical practice do not show up in other fields of medicine, indicating that social or religious attitudes, rather than the best practice of medicine, often drive what is allowed. In Italy, the legal need to replace fertilised embryos goes against all clinical thinking. The variation in international laws relating to infertility treatment is one of the reasons that cause couples to seek cross-border treatment. Whilst this is unavoidable we call for international standards to ensure these patients receive consistent advice and safe treatment. Although a country’s law or professional society guideline for treatment may reflect the overall cultural view in that jurisdiction, it does not necessarily mean that all that country’s residents have the same view. They may then seek access to the treatment abroad." The survey shows that many Catholic countries have strict controls on the use of embryos. Costa Rica declared IVF unconstitutional in 2000 because it regards the embryo as a person from the moment of conception. Costa Rica is the only one of 43 countries where IVF is illegal. The huge variety of what is or is not allowed, helps create cross-border fertility treatment. Many people travel abroad for fertility treatment and have success with no legal difficulty. The review of reproductive health services highlights large discrepancies in regulations and practice in several nations. As a consequence, some patients who go overseas may face legal or medical issues. A third of the 43 countries do not permit surrogacy The European Society of Human Reproduction and Embryology (ESHRE) and IFFS are concerned that the safety of patients crossing borders is no longer assured due to lack of uniform clinical and safety standards between the different countries. ESHRE, in co-operation with national and statutory organisations, is developing a code of practice on cross border reproductive care that will lay out a set of rules that protects and reassures patients, donors, surrogates and future children. Françoise Shenfield, of ESHRE’s cross border task force and author of the first study of European patients crossing borders to obtain fertility treatments says, "Although in principle the care of foreign and local patients should essentially be the same and fit the best possible standards, there is evidence that it is not always so." Both international organisations support the rights of patients to travel to receive the best treatment. Ideally this should take place in their home country, but if patients need to travel to receive the best treatment, both societies support this decision. At the same time, ESHRE and IFFS call for the harmonisation of national standards to increase the safety of patients crossing borders to obtain fertility treatments in the hope that uniform standards of practice can ensure equitable treatment for all citizens.

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EUROPE: Patients with rare cancers will benefit from EU cross border healthcare directive

Thu, 30 Sep 2010 16:48:54 GMT

Irish Labour MEP Nessa Childers told a seminar in Brussels, "Access to cross border healthcare will be considerably easier and more patient-friendly if the proposed new EU Cross Border Healthcare Directive is adopted." Hosting the Second Forum Against Cancer in Europe, Childers said: "Patients with diseases such as rare cancers, and residents of border counties from Louth to Donegal will see considerable benefits from the proposed EU Cross Border Healthcare Directive. Under normal circumstances patients prefer to be treated near to their homes. But sometimes the specialist expertise they need, particularly in the case of those with rare cancers is provided in another member state and not in their own country of residence. If adopted the directive will allow patients such as those with rare cancers and other rare diseases to have access to the best clinical trials and specialised treatments available in the EU. It is envisaged that this will happen in a much more straightforward and responsive way than is currently the case. Clear and precise information will be available from designated national contact points where your rights as a patient will be clearly explained. Practical questions to do with the need to have prior authorisation for certain procedures and treatments and the payment of costs would be addressed here also. The European Parliament needs to advance the rights of patients to access the best available care. We need to clarify rules about access to healthcare in other member states and the basis on which it will be provided, including administrative procedures and guarantees of objective and timely handling of requests especially in the case of patients with rare cancers and other debilitating rare diseases." Healthcare is primarily the responsibility of the member states and the proposed directive does not create any new rights. Rather it aims to achieve legal certainty for patients who need to travel for the best available treatment and care, codifying a series of European Court of Justice judgements about the rights of EU citizens to access planned healthcare in another member state and their right to reimbursement of costs from their national health authority. On Monday 13 September in Brussels, the Council adopted its position on a draft directive on safe and good quality cross-border health care and to promote health care cooperation between member states. The Polish and Slovakian delegations voted against and Romania abstained. As a general rule, patients will be allowed to receive health care in another member state and be reimbursed up to the level of reimbursement applicable for the same or similar treatment in their national health system if the patients are entitled to this treatment in their home country. The Council’s position includes a double legal basis in the draft directive, striking a balance between the case law of the European Court of Justice on the application of Article 114 to health services and the member states’ competencies recognised by the treaty for the organisation and provision of health services (according to Article 168 on public health). The draft directive is part of the social agenda package of 2 July 2008, focusing on a triple objective: to guarantee that all patients have care that is safe and of good quality; to support patients in the exercise of their rights to cross-border health care; and to promote cooperation between health systems. The Council’s position will now be sent to the European Parliament for a second reading.

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ASIA: Many in Asia travel domestically for medical care

Thu, 30 Sep 2010 16:43:10 GMT

One in five households across 11 Asian countries say at least one member had to travel to another community for medical care in the past year. Nepalese households are the most likely to have had a member seek treatment outside the community, while those in Indonesia are the least likely. While Gallup has previously studied Americans’ willingness to travel abroad for medical treatment, these findings represent Gallup’s first measure of medical travel among households in Asia. In several countries, rural households tend to be more likely than urban households to report travel outside their city or community for medical care. While these disparities are clearly evident in South Asian countries such as Afghanistan, Sri Lanka, and India, they are virtually nonexistent in Southeast Asian countries such as Indonesia and Malaysia. Asians are far less likely to report traveling to another country for medical care than they are to travel within their own country. Afghan households are most likely to report having someone leave the country for medical care in the last year, most often to Pakistan and Iran. War and occupation, a large refugee population among national porous borders, and lack of cohesive development of a healthcare infrastructure are possible factors that could make Afghans more likely to seek treatment elsewhere than their regional neighbors. When a medical necessity arises, Gallup data show many Asians, particularly those in rural households, are leaving their communities for treatment elsewhere. Fewer are traveling to other countries for care. While the quality and availability of national and local healthcare services undoubtedly play a role in these results, the findings point to a willingness among Asian households to seek solutions to their healthcare needs wherever they can find them. Results are based on face-to-face interviews with 17,141 adults, aged 15 and older, conducted between April and June 2010 in Afghanistan, Nepal, Cambodia, Pakistan, Malaysia, India, Philippines, Singapore, Bangladesh, Sri Lanka, Vietnam, and Indonesia. The question on within country medical travel was not asked in Singapore. The methodology and high sample numbers mean that the results are very accurate statistically. Travelling outside their own community and travelling to another country are two completely separate concepts. Most of the travel outside their own town/village/city is within their own country, not to another country. Nepal • 52% travelled outside their community• 5% travelled to another country• 47% stayed in Nepal Afghanistan • 35% travelled outside their community• 18% travelled to another country• 17% stayed in Afghanistan Bangladesh• 33% travelled outside their community• 1% travelled to another country• 32% stayed in Bangladesh Vietnam • 24% travelled outside their community• under 1% travelled to another country• over 23% stayed in Vietnam Sri Lanka • 20% travelled outside their community• 1% travelled to another country• 19% stayed in Sri Lanka India • 19% travelled outside their community• 1% travelled to another country• 18% stayed in India Philippines • 18% travelled outside their community• 1% travelled to another country• 17% stayed in Philippines Cambodia • 52% travelled outside their community• 2% travelled to another country• 50% stayed in Cambodia Pakistan • 16% travelled outside their community• 2% travelled to another country• 14% stayed in Pakistan Malaysia • 12% travelled outside their community• 1% travelled to another country• 11% stayed in Malaysia Indonesia• 5% travelled outside their community• under 1% travelled to another country• over 4% stayed in Indonesia

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Laser dentistry at CTG Healthcare in Turkey

Thu, 30 Sep 2010 15:10:35 GMT

Merging clinical care and patient comfort Tooth enamel is the hardest material in human body. No wonder dentists have always resorted to tough tools to work on. Now there is a gentler way to fix decay and CTG HEALTHCARE has just launched this technology into their facility. It’s more comfortable CTG HEALTHCARE’s Laser Dentistry uses laser energy and a gentle spray of water to perform a wide range of dental procedures – without the heat, vibration and pressure associated with the dental drill. With many procedures, it’s possible to use less anesthetic, and often no anesthetic at all. It’s more convenient Your CTG Dentist can often get you in and out of the dentist chair faster, since it’s less likely that you’ll need an injection – research shows that the vast majority of patients don’t. It’s nice to avoid that shot, isn’t it? Not using anesthetic can allow your dentist to perform procedures that used to require more than one visit in a single appointment. Also, a CTG Dentist can perform procedures that once meant an additional trip to a specialist, saving you even more time. It’s more precise Lasers have long been the standard of care in medicine for many surgical and cosmetic procedures such as LASIK, wrinkle and hair removal and many others. Laser dentistry was approved for hard tissue procedures in 1998 and since has been cleared for numerous additional dental procedures. Thousands of dentists around the world have performed thousands of procedures with less need for shots, anesthesia, drills and post-op numb lips. Patient comfort Heat, vibration and pressure are the primary causes of pain associated with the use of the traditional dental drill. Since cutting both hard and soft tissues (teeth and gums) with the laser dentistry does not generate heat, vibration or pressure, many dental procedures can be performed with fewer shots, less need for anesthesia, less use of the drill and fewer numb lips! Additionally, using the laser dentistry for gum procedures reduces bleeding, post-operative pain, swelling and the need for pain medication in many cases. Accuracy & precision CTG dentists are able to remove tooth enamel decay (the hardest substance in the body), bone and gum tissue precisely while leaving surrounding areas unaffected. This conserves and allows you to keep more of the healthy tooth structure. Reduced trauma High speed drills can cause hairline cracks and fractures in the teeth that eventually lead to future dental problems. Laser dentistry reduces damage to healthy portions of the tooth and minimizes trauma. Improved cavity fillings Laser dentistry cavity preparations can increase bond strength of tooth-colored restoration resulting in longer lasting fillings. Less bleeding & swelling Due to its conservative, gentle cutting action and coagulating capabilities, the Laser dentistry performs many soft tissue (gum) procedures with little or no bleeding and less post-op swelling. Fewer dental visits Since you often do not need shots or anesthesia, a Laser dentistry dentist can perform cavity preps in all areas of the mouth in just one visit. This technology also gives trained Laser dentistry dentists the ability to perform many procedures that were previously referred to specialists. Versatility The Laser dentistry is extremely versatile. It can be used for a wide range of hard and soft tissue procedures. From decay removal, cavity preparation, root canals, smile design, gum and bone surgical procedures and many others.

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Health and Medical Tourism show returns to London

Mon, 27 Sep 2010 15:24:13 GMT

Destination Health, the Europe’s only consumer event dedicated to health and medical tourism is set to return to London on 15 – 16 April 2011. Treatment Abroad and IMTJ are once again supporting the event as media partners. Destination Health 2011 is expected to attract an estimated 100 hospitals, clinics, spas and wellness resorts from more than 40 countries, who will have an opportunity to promote their services to medical tourists from the UK. Commenting on the show, Event Director Nav Mann said: “Having launched the event in 2010 under extremely challenging circumstances, we are delighted to team up with Treatment Abroad and IMTJ to bring this event back to London in 2011. We have changed the open days to incorporate a ’trade day’ on the Friday 15th with Saturday 16th dedicated to medical tourists. “We are also planning a major conference to run alongside Destination Health for the medical tourism sector as well as a consumer programme of seminars and demonstrations for potential medical tourists”, said Nav Mann. The organisers are offering a 10% discount to medical tourism companies, hospitals, clinics spas and wellness resorts who are currently advertising on the Treatment Abroad and IMTJ websites. An additional discount of 15% is also on offer for the first 10 exhibitors to book their stands before 30th September.

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UNITED KINGDOM: Medical tourism to the UK

Mon, 27 Sep 2010 15:15:45 GMT

A new analysis of UK inbound tourism reveals useful figures on medical tourism, and spa/wellness tourism. The UK is the sixth most visited destination by international tourists. Outbound travel from countries in developing parts of the world is growing rapidly, but international travel is primarily intra-regional rather than inter-regional, so Western European markets continue to offer growth potential for Britain’s inbound visitor economy. VisitBritain’s latest report ’Overseas visitors to Britain, understanding trends, attitudes and characteristics’ is a detailed analysis of inbound UK tourism. The number of tourists (holiday, business and anything else) visiting the UK from the fast-growing economies of Brazil, Russia, India and China is set to leap. Visitors from China are predicted to rise by 89 per cent, bringing just under an extra 100,000 travellers to these shores, by 2014, the fastest increase in tourism to the UK from any country. While the bulk of the increase in tourism to Britain over the next four years will continue to come from the UK’s traditional European and North American markets, the speed with which tourism from these four countries is increasing is significant. In four years time, there will be 35,000 more from Brazil, 100,000 more from India, and 50,000 more from Russia. Although the acceleration among emerging nations is impressive, the largest numbers of new visitors will continue to come from France, Ireland, the USA, Germany and Spain – the UK’s traditional top five markets for visitors - bringing 3.3 million more visitors to Britain by 2014. Tourists increasingly come to Britain seeking spas, health and beauty centres, separate from the numbers coming as medical tourists. Wellness has become more than a trend, it has become a need. Health is now about empowerment of self-treatment and exploring new medical techniques. Spa visits, medical tourism, anti-stress therapy, anti-obesity retreats and a long list of other therapies are one of the contributing reasons for people to visit Britain. Technology is shaping how customers decide where to go. They use it to choose a destination, as well as book travel and accommodation. Most importantly, they now tell the world about their experience, with user generated content; moving from just posting comments on websites and social media, to uploading videos. The report says that according to the independent International Passenger Travel Survey (IPS), in 2009, 50,000 medical tourists came to the UK. The IPS is a survey of a random sample of passengers entering and leaving the UK; over a quarter of million face-to-face interviews are carried out each year with passengers entering and leaving the UK through the main airports, seaports and the Channel Tunnel. Those who travel for medical treatment spend on average more than double the average tourist spend. Visitors from the Middle East account for more than 50% of spending by those who come for medical treatment. Visitors are categorized as business, holiday or other. While few business visitors seek out spa and wellness treatment, other visitors do. In 2007, 2008 and 2009, the IPS found that just 2% of all visitors made use of a spa, wellness or beauty centre; so between 500,000 and 600,00 visitors a year. It is not possible to say if spa and wellness was the whole or partial reason for the visit, or just ancillary to a holiday or visiting friends/relatives. The report also reveals a statistic that medical tourism has long sought. In the USA, the proportion of adults holding a passport is now 33% (94.5 million), according to Donald N Martin and Company. The number of US visitors to the UK has declined substantially in the last two years. Other official ONS statistics show an increase in 2010 in both outbound and inbound travel. This is good news after figures showed that visits abroad by UK residents fell in 2009 by the fastest rate since the 1970s; 58.4 million, compared to 69 million in 2008, although the last quarter of 2008 also saw a fall.

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GLOBAL: Offshore financial centres and medical tourism

Wed, 22 Sep 2010 16:37:21 GMT

The banking crisis in the last three years has hit countries that depended on offshore financial services being attracted to them by taxation, laws and other benefits. Many have seen businesses leave. This is a key reason why places like Bermuda and The Cayman Islands have suddenly become interested in medical tourism. The Cayman Islands hopes to set up a hospital mostly for medical tourists from the USA. The latest news from the islands is that the government is considering making organ transplants legal, so the hospital can target the long list of Americans needing organ transplants. While locals and organ transplant specialists are shocked at this news, it is not surprising as offshore financial centres have made their living by a liberal interpretation of national and international laws; attracting honest and some questionable financial organizations. Many offshore financial centres are also expensive tourist destinations, and they have been hit a lot harder than most countries by the recession. Some of these countries seeing a decline in tourism and offshore finance are left with very little else bringing in income. International consultant Mark Nestmann suggests that offshore financial centres are now less attractive for global banking and finance, as international pressure has forced OFCs into onerous compliance requirements while disallowing many advantageous features of their tax and legal framework. So the centres must look at alternatives, including medicine. Nestmann says, "In the USA, medicine suffers from excess regulation and litigation. To avoid lawsuits, doctors practice defensive medicine. In the EU, the prevailing socialized medicine model has led to rationing of care. In both systems, it is cheaper for governments to let you die, than to treat you with whatever state-of-the-art medications or procedures are available." He notes that medical schools have set themselves up in offshore centres. So these countries should enact enabling legislation to establish themselves as favoured destinations for state-of-the-art treatment denied by medical bureaucracies in the USA and EU. Nestmann adds that offshore financial centres have an existing infrastructure for captive insurance and other insurance products so could set up medical insurance, "Incentives can be put in place to allow doctors and patients to choose the course of medical treatment, rather than have the insurance carrier have a financial interest in your death (a potent moral hazard). Exploring new treatments or insurance options that aren’t acceptable in other locations isn’t much different than financial products that aren’t acceptable in other jurisdictions." Nestmann is being deliberately provocative to make his point that offshore centre countries have to look at new ways of earning money, and that if they want to encourage medical tourism, just setting up a hospital will not work unless they can find a way to offset their uncompetitive high-cost base by using their long standing flexibility with finance and the law.

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MALTA: Opportunities for Malta in medical travel

Wed, 22 Sep 2010 16:26:33 GMT

Malta is a small island in the central Mediterranean that is charming and relaxing. Throughout history, Malta has often been referred to as "the hospital of the Mediterranean", due to the prominent role the island played over the centuries as a prime location for medical treatment and the care of the sick. Today, Malta is building on this reputation and is an excellent destination where one can receive medical and surgical treatment. While it is a medical tourism destination, particularly popular with the British, it is also a spa and wellness destination. Claire Zammit Xuereb, who manages some of the leading hotels in Malta, explains the current position: • Medical tourism Malta is also increasingly becoming a destination for medical tourism due to the significantly cheaper cost of treatment as well as its perfect setting and climate, ideal for recovery. Most Maltese specialists have trained in Malta, Europe, the UK or the USA and work in professional modern clinics, adhering to EU standards and regulations. Cosmetic surgery is becoming more and more popular all over the world, and no less in Malta. As a result there are now a number of procedures available on the island, including face-lifts, rhinoplasty, tummy tuck, liposuction, breast augmentation, breast reduction, and others. • Health spas On this tiny island, you can find some forty spa and health centres, each with their own state of the art equipment and highly trained, professional staff. These vary in size and specialization and may include large spa facilities as well as smaller specialized centres. Oriental treatment clinics have recently opened in various localities to provide health and wellness treatments and massage.The treatments cater for men and women and are incredibly varied. These include mud baths, head massage, hand and foot massage, full body massage, 4-hand massage, hot stone massage, Swedish massage, stress buster massage, oriental treatments, body wraps, depilatory treatments, laser hair removal, Botox, professional acrylic or gel nails, several different facials, acupuncture and the use of facilities such as heated indoor pools, saunas, steam-rooms and plunge baths. These can be found at several 5 star hotels as well as other private institutions. • Spa holidays Choosing a spa holiday does not necessarily mean staying in an expensive spa hotel or resort. On the contrary, there are several Malta hotels that may arrange a package for you in collaboration with a spa centre in order for you to get exactly what you wish for. Alternatively you may choose a luxury hotel and visit the spa yourself or perhaps a different spa every day and choose to indulge in one or several treatments, as an alternative to whole-day packages provided by a leading spa hotel. • Wellness Gyms and sports centres are also abundant, with popular classes including Pilates, dance, yoga, aerobics and kickboxing. During the milder season, hiking, cycling and country walks are popular. There are also several opportunities for a wide variety of sports including squash, rock-climbing, paragliding, diving, golf and even snooker.

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ST VINCENTS: Foreign investors to set up medical tourism project in St Vincents?

Wed, 22 Sep 2010 16:23:40 GMT

St. Vincent and the Grenadines offers an unhindered and stable foreign exchange regime, stable labour relations, an independent and efficient judiciary system, significant tax holidays, tax-free status for international entities, a tradition of support for foreign private investment, excellent telecommunications and low operating costs among other investor benefits. One of this country’s major money earners, the tourism sector, may soon get a boost as a foreign company shows interest in investing in a medical tourism project. Government minister Saboto Caesar explains, "I was in conversation with Steve Ivankovish, an investor from Groupo Cé. And the issue of medical tourism was being explored. Here is an investor from the United States searching for a place to invest here. The global financial downturn will not last forever. The world will recover. And in the process of the recovery, we have to ensure that we have our international airport so that they can fly directly into St. Vincent and the Grenadines." Ivankovish has made it clear that the development of the Argyle International Airport is vital to the feasibility of the project. 32 islands and cays make up St Vincent & the Grenadines. The official language is English. The population is approximately 110,000 with around a quarter living in and around the capital, Kingstown. The ethnic heritage is predominantly African. St. Vincent and The Grenadines is an independent parliamentary democracy and member of the Commonwealth of Nations. It had 271 000 tourism visitors in 2009.

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INDIA: Where do Indian medical tourists come from?

Wed, 22 Sep 2010 16:20:21 GMT

The International Wellness and Healthcare Travel Association (IWHTA) recently analysed where Indian medical tourists come from. Their analysis confirms that although Europe and the USA are often mentioned as a source of medical tourists, together they only account for one in ten travelers. The analysis provides the following breakdown: • Bangladesh/Nepal/Sri Lanka 19%• Iraq 18 % • Middle East 16 %• Africa 9%• Afghanistan 9% • Europe 6% • USA 4%• * Non resident Indians from all countries 22% Naresh Jadeja of IWHTA also analyses the current position of India:• The last five years has changed Indian hospitals and services by adding thousands of hospital beds and a number of world-class hospitals with state of the art health care and technology. • Many Indian hospitals are not attracting international patients not because they are not up to the mark but because they are running at their capacity as both health insurance and the healthcare demands of India’s middle class rocket.• Although the Indian health care industry is advertising less it is enjoying a substantial share of international patients from around the world. More than 580 multi specialty hospitals and over 400 single specialty clinics in India are treating international patients.• A key market is non-resident Indians who visit their home town every year or every other year and opt for diagnostic and wellness tourism activities as it is time consuming and costly in their countries. Hospitals promoting executive checkups are trying to build trust through feel good visits to show people their quality commitment and technology.• IVF and infertility procedures are offered by hundreds of clinics in India.• Alternative medicine such as yoga and ayurveda is very popular and wellness treatments are attracting many visitors. Hotels with these options and medical spas are in big demand. • Dental tourism is a growth area.• There are two totally different types of patients going to Indian hospitals. Those from less developed countries do not expect any added services or soft skills from medical staff, but those from developed countries do expect this and more.

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TAIWAN: Taiwan wants to speed up promotion of medical travel

Wed, 22 Sep 2010 16:19:25 GMT

Jeff Chu of Taipei based travel agency, Grand Travel, wants Taiwan make a more concerted effort to enhance the appeal of its medical tourism sector, especially as interest in visiting Taiwan for medical checkups is growing among Chinese nationals. "The combination of sightseeing and getting a checkup or other procedures done in Taiwan is very appealing to many Chinese because Taiwan offers high-quality health care at a relatively low cost. At present, however, only a limited number of the more than 1 million Chinese who visit Taiwan annually can receive medical services in Taiwan because of visa and itinerary limitations," Chu urges China’s government to issue medical visas to citizens who would like to get treatment or checkups in Taiwan. Chu also recommends that Taiwan’s medical institutions, health evaluation centres and spas work together to develop a new, integrated travel option for overseas visitors. Special customized tours, for example, could be arranged for people interested in getting beauty and massage treatments and having cosmetic surgery. Customized services can also be arranged to cater to the needs of individuals, such as people accompanying major trauma patients, who need to stay in Taiwan for a longer period of time. Min-Sheng General Hospital’s Dialysis Center is promoting its services to medical travellers, by offering treatment to travellers with renal problems. When Prince Court Hospital in Kuala Lumpur, Malaysia, looked for a dialysis center to treat one of its patients planning a trip to Taiwan, it contacted Min-Sheng General Hospital to make the arrangements. This underlines the plight of thousands of people with renal problems who require dialysis several times a week, whether they are at home or travelling abroad. People with such condition should not be deterred from travelling; they just need more planning and attention. The Dialysis Center at Min-Sheng Hospital is a 56-bed centre is equipped with the latest Fresenius machines and staffed with four nephrologists, forty-two nurses and two technicians. The centre offers conventional hemodialysis, high efficiency hemodialysis, high flux hemodialysis, and peritoneal dialysis. With a focus on quality care and safety, the centre implements strict infection control procedures; hollow fibers membranes are single-use only, all the equipment goes through stringent daily monitoring and is maintained by a team of in-house experienced technicians. In 2009, Min-Sheng General Hospital’s Dialysis Center was the first hospital in the world to be awarded CCP (Clinical Care Program) Certification for its chronic kidney disease program. Min-Sheng Hospital is a 600-bed hospital in Taoyuan, Taiwan, near the international airport. It was the first hospital in Taiwan to receive the international JCI accreditation and is active in the field of international health care having a department dedicated to those patients. Min-Sheng hospital specializes in minimally invasive surgeries, bariatric, cardiac, orthopedic and urologic treatment.

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TURKEY: Turkish Airlines supports medical tourism

Fri, 17 Sep 2010 12:00:05 GMT

Turkish Airlines has a new support package for hospitals and clinics that promote medical tourism. Deals have been signed with many hospitals in Turkey. The package offers special discounts and incentives for those who come to Turkey for medical treatment - • Travel from the USA to Turkey: Up to 25% discounts on first, business and economy class fares.• Travel from other countries to Turkey: 20% discount on first and business class fares, 10% discount on economy class fares.• 10kg excess luggage allowance.• No rebooking penalty if the rebooking is required because of medical complications.• Up to two companions travelling with the patient are entitled for the same discounts. Passengers travelling for medical purposes must present an acceptance letter from a hospital or clinic in Turkey that has an arrangement with Turkish Airlines. Patients travelling from the USA have the alternative of presenting a referral letter from a hospital in the USA. There are restrictions:• Discounts cannot be combined with other discounts. • No discounts on promotional fares. • No discount for stretcher.• Turkish Airlines flights only. Code share flights are not included.• 32Kg per piece maximum luggage allowance.• Passengers will be charged if upgrade is necessary or other fees are required. In Turkey, there are six categories of hospitals - state hospitals (two categories), private hospitals, international hospitals, university hospitals and military hospitals. Turkish health care reforms must be put into the wider picture of a country that had to recover from a serious economic crisis early in the new millennium. Over the best part of the last decade, government efforts have focused on improving public health care whilst attracting investors to open private hospitals. Private health care is of a high standard while access to and general provision of public health care is improving. A new market research report, “Emerging Medical Tourism in Turkey”, has been published by international research group RNCOS. Turkey has emerged as one of the most popular destinations in Europe for medical tourism. It is anticipated that the number of medical tourists will rise at an annual rate of 28% during 2010-2013 because of government support on promotional activities to boost the nation’s medical tourism industry. The country has one of the highest numbers of JCI accredited hospitals in Europe. With the very low cost of treatments and sophisticated technology equipped hospitals, the number of medical tourists will rise.

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BRAZIL: Brazil bids to be a major medical tourism destination

Fri, 17 Sep 2010 11:58:27 GMT

For many years, Brazil has been known as a destination for Americans seeking cheap cosmetic surgery. The local medical tourism industry claims that Brazil has grown from 48,000 foreign patients in 2005 to 180,000 in 2009, and that numbers are growing by 30% every year. These figures are at best, rough estimates, and may be accurate or a wild exaggeration; there is no way of knowing. Brazil now wants to attract more medical tourists from other South American countries, the USA and Canada, for cosmetic surgery, dentistry and surgery. Medical tourism is part of Brazil’s efforts to increase the number of tourists expected around the 2014 World Cup and 2016 Summer Olympics in Rio. Attracting tourists is relatively easy, but attracting medical tourists who happen to come to watch football or athletics is not an easy task; attempts to do this in South Africa for the 2010 World Cup failed. The country recently hosted its first medical tourism conference in Sao Paulo. Ruben Toral spoke of Brazil’s world-famous reputation for cosmetic surgery. Mariana Palha, of Prime Medical Concierge commented, “People don’t come to Brazil because it’s cheap; they come because it’s good. Brazil is known for its cosmetic surgery and also known for its beaches.” Panel discussions found that while people wanted the country to be famous for cosmetic surgery, they also wanted to promote other surgery. And while promoting quality, some also wanted to promote low prices. Others argued that they were not low prices, as they could not compete with India on price. Doctors from Sao Paulo’s prestigious Hospital Israelita Albert Einstein admitted they were only interested in promoting the hospital’s brand as the first internationally accredited hospital in 1999, not low prices. While Brazil has spare capacity on cosmetic surgery, some conference attendees pointed out that selling surgery was difficult as Brazil’s hospitals are already full. The Porto Alegre Health Care Cluster is a public-private organization promoting medical tourism for local government, clinics, hospitals, doctors and others in Porto Alegre, the largest city in southern Brazil. The aim is to promote the region as a group, rather than leaving it to individual businesses. Brazil’s health system is one of the world’s largest, with an estimated 16,000 facilities, including clinics, hospitals and local health centers that are staffed by more than 200,000 qualified physicians. The country provides some of the most advanced medical care, and treatment is among the cheapest. In recent years, the devaluation of Brazil’s currency against the US dollar has made the country a choice for low-cost, high-quality medical treatment for foreigners. In particular, Brazil has become world-famous for cosmetic surgery as millions of Brazilians use it. The wealthy have been visiting Brazil for years in order to maintain their youthful appearance and their anonymity.

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POLAND: Recovery of medical tourism in Poland is encouraging

Fri, 17 Sep 2010 11:30:19 GMT

Increasing numbers of foreigners are again seeking medical care in Poland. Although many in the nation complain about its national health system, medical treatment received by foreigners is bringing both private clinics and the state budget substantial revenues. According to the Izby Gospodarczej Turystyki Medycznej (Poland’s Chamber of Commerce for Medical Tourism), in the first half of this year 120,000 foreign patients spent over 125 million euros at Polish clinics. Each medical tourist spent on average 1,000 euros on treatment. Like many other medical tourism destinations who had publicized medical tourism visitor numbers prior to the downturn, Poland failed to report numbers in 2009. Before the recession, the organization had reported annual growth of 10% to 20%. They and other organizations differed on actual figures, but it reported numbers of around 300,000, while travel bodies put it at a less believable figure of 500,000 for 2008. Many medical tourism destinations have suffered significant falls in business between late 2008 and early 2010; a decline of anything up to 40% has been the norm. Getting actual figures is difficult….while everyone is happy to promote their medical tourism numbers when they are increasing, they tend to go silent when they fall. Although lower than previous figures, 120,000 for the first half of 2010 is encouraging, and could mean 250,000 or more for the full year. This is one of the first signs of recovery in the European medical tourism market. The Economy Ministry has already put medical tourism on a list of 27 sectors, from which by mid-September, the sectors considered to represent Poland most favorably and accurately will be chosen. The sectors that make it to the final list will receive substantial EU subsidies for promotion. Foreigners decide to undergo treatment in Poland because it is much cheaper than in their home country, especially when it comes to cosmetic surgery and dentistry. Patients from the UK who need a dental implant can pay 1,500 euros and more ($1845) for one at home but only 500 euros ($638) in Poland. The vast majority of medical tourists to Poland are not from the UK, but from Germany, with an increasing number coming from Russia. The association has over thirty members, and on satisfactory completion of a long detailed information questionnaire, and approval by the association’s medical council, offers annual quality certificates for dental clinics, clinics and hospitals, rehabilitation centres and medical assistance companies.

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INDONESIA: Indonesian hospitals banned from branding themselves international

Fri, 17 Sep 2010 11:25:20 GMT

The Health Ministry of Indonesia has banned local hospitals from branding themselves as international hospitals. The ministry’s Farid W. Husein says, "By August this year, hospitals must have removed the word international from their brand unless they are internationally accredited." The Health Ministry added that ten local hospitals have planned to apply for international accreditation this year with The Joint Commission International. The ministry will pursue any hospital using global or international labels to which they are not entitled. A number of the country’s private hospitals are now known by a new name following the government ruling barring hospitals from using the often misleading attributes: international, global or anything else referring to worldwide networks or high quality of health care. The Bintaro International Hospital (RSIB) has adopted its new name, Bintaro Premier Hospital. The hospital argues that the stripping of the international attribute does not necessarily mean a lower quality service, “The change of the name has been carried out because we have to meet the prevailing regulations.” The hospital formerly known as Omni International Hospital in Serpong, Tangerang, Banten, dropped its middle name, now renamed Omni Hospital. Dr. Supriyantoro at the Health Ministry comments, “The existence of such international attributions did not guarantee the quality of a hospital’s service to the public.” The use of those attributes has been widely criticized by the public amid reported cases of malpractice involving doctors from several so-called international hospitals. In one recent case Prita Mulyasari was imprisoned and fined by a civil court for allegedly defaming an international hospital following complaints made by her via email over receiving poor medical services. The case sparked widespread protest and led to an unprecedented campaign over social networking sites such as Facebook and Twitter to raise money to help Prita pay off the fine. Public pressure eventually saw the court acquit the case, while the hospital has not yet retracted its lawsuit against Prita. Dadang M. Epid of South Tangerang Health Agency has called on the hospitals that have stripped their international names to inform the public of the change, “With the announcement, hopefully, there will be no more misunderstanding among the public. People will no longer regard those hospitals as hospitals operating under international standards.”

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GLOBAL: Pacific Asia Travel Association (PATA) to sets up healthcare travel advisory task force

Fri, 17 Sep 2010 10:41:39 GMT

The Pacific Asia Travel Association (PATA) aims to set up a healthcare travel advisory task force. PATA was formed over 50 years ago with headquarters in Bangkok. PATA is a membership association acting as a catalyst for the responsible development of the Asia Pacific travel and tourism industry; with over 2,500 members comprising 42 member destinations and their airlines, hotel groups, tour operators and travel agents. The task force is being set up in conjunction with MEDICO Services International, Bangkok. PATA, is seeking volunteers and vital contributions from PATA members with knowledge of, and experience in, this fast-expanding niche market across the Asia Pacific region. The advisory task force will meet periodically and comprise of ten-15 members from all sectors of tourism. Meetings will be conducted either electronically or in the form of workshops, most probably alongside other major PATA events. The two parties have already identified several key issues that should be addressed: Liability issues of medical tourism. Guidelines to creation of medical tourism destinations. Medical travel insurance. Increased cooperation across this niche market. Networking and data exchange for medical tourism specialists. Greg Duffell of PATA says, “We recognise the importance of this emerging tourism market segment. We are keen to identify both the opportunities and challenges in this niche for our members and potential new members. Medical tourists are customers for airlines, hotels, tour operators and insurance companies, as well as hospitals and wellness spas. I welcome expert contributions and expressions of interest in joining our new advisory task force. This new advisory task force will conduct surveys, gather opinions, enable debates, and push for solutions to share with the industry at large, which we hope will encourage new membership from businesses providing healthcare services to join PATA as an authority in this area. We also envisage a programme of specialised conferences and workshops for industry stakeholders.” Dr Zadok Lempert of MEDICO adds, “Medical tourism is quickly gaining awareness in consumer markets. Over the past decade, Asia has been the preferred destination for many people seeking less expensive, but high quality, medical treatments. The increase is partially due to high medical costs paired with long waiting periods in the United States, United Kingdom, Europe and Australia. Specialised treatments, surgeries and therapies are being offered in Asia at a fraction of the cost yet with bigger perks, when it comes to hospitality and patient comfort. Waiting times are minimal. Favourable exchange rates with regional currencies in Asia make medical procedures an incredible value-for-money option to residents in Europe and the USA. Cheaper medical costs mean more money is available for family members and friends to accompany the patients. It is those family and friends that seek accommodation near the hospitals so they can visit the patients, yet at the same time, have a comfortable stay affording them access to the rest of the city’s or country’s attractions.”

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GLOBAL: New reports on spas and the global wellness market

Fri, 10 Sep 2010 12:03:55 GMT

Commissioned specifically for the 2010 Global Spa Summit in Istanbul, a report "Spas and the global wellness market" by research group SRI International highlights key areas of opportunity where the spa industry can take advantage of growth and partnership opportunities, including with medical tourism. The wellness cluster is a US $1.9 trillion global industry made up of:• Spa — $60 billion• Complementary and alternative medicine — $113 billion• Healthy eating/nutrition/weight loss — $277 billion• Preventative/personalised health —$243 billion.• Wellness tourism — $106 billion• Medical tourism — $50 billion• Workplace wellness — $31 billion• Fitness and mind-body — $390 billion• Beauty and anti-aging - $679 billion. SRI estimates that there are 289 million wellness consumers in the world’s 30 most industrialised and wealthy countries, and 81% of consumers are extremely or very interested in improving their personal wellness. The report made recommendations-• Partner with the medical tourism industry to create complementary services for medical tourists.• Partner with conventional medical establishments to deliver complementary and integrated healing services to medical patients.• Partner with the medical industry to encourage and conduct evidence-based research.• Repackage existing offerings and develop new offerings to define and market spas as a wellness necessity.• Provide continuity of care to customers.• Deliver executive health services. Another related new report is ’The New Priorities of Today’s Spa Consumers’ a survey by Coyle International on what currently drives consumers to spas; consumer internet adoption and the impact of online information; and what makes or breaks the spa experience. Key findings• The number one reason consumers visit spas (89%) is for relaxation/stress management.• The primary reasons spa consumers visit websites are to find spa deals (62%); view spa menus (57%); and read customer feedback (48%).• The top three online resources that are used by global spa consumers: SpaFinder.com (44%); search engines (43%); Facebook (25%).• There is a disconnect between consumer adoption of/openness to online spa booking and the number of spas providing that functionality. Among spa-goers, 47% have booked a massage online, and 89% would, but only 30% of spas offer an online booking solution.• Social media usage for sharing spa experiences is growing: 59% are likely to email friends; 48% to write an online review; 41% to become a fan on a social networking site; and 37% to post on a social networking site.• 88% of consumers report that they would be comfortable receiving follow-up from a spa post-visit, with the number one preferred method being an email from a spa manager inquiring about their satisfaction with their visit (83%). Taking the two reports together there are implications for medical tourism businesses:• Businesses should work more closely with the spa and wellness industry, which is more mature, has a good handle on customer needs, and co-operates without conflict. • Web presence and the ability to quote online is a given for any company.• Every customer should have a follow-up to determine levels of satisfaction.• Ignore social media at your peril.• Customer reviews are not a nuisance; they are vital to gaining (or losing) future business.

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GLOBAL: Spa cruises increasing in popularity

Fri, 03 Sep 2010 10:58:02 GMT

The medical travel business world is debating the potential merits and problems of using cruise ships as a base for medical travel. The majority view seems to be that using ships in international waters for surgery has many practical and legal problems, and that with increased competition for medical travellers, as cost savings can be made in many countries, the risk to investors and patients far outweighs the rewards. Meanwhile, although the travel trade has suffered greatly from the global economy in recent year, cruise travel has gone from strength to strength with a record 14 new ships launching last year. A specialist area that shows an increase in popularity is health cruises. Cruises used to be for older passengers seeking rest and relaxation, but modern cruise passengers are as likely to spend their time swimming and exercising. Whichever category they are in, on a two or three week cruise, even allowing for days at various port stops, there is a lot of time to fill. So the use of spa and beauty treatments of all types is a good way to fill the time. Unlike many holidays, passengers have every chance of leaving the ship lighter, fitter and younger looking than they did at the start of the trip. Modern cruise ship spas are every drop as luxurious as you can find in the world’s premier hotel resorts. Costa cruise line recently introduced the spa cabin—a special class of cabin with easy access to the spa and amenities like special, high-end toiletries, yoga mats and Nintendo Wii machines with keep-fit programmes attached. Celebrity’s AquaSpas, offer thalassotherapy pools (treatment using seaweed and seawater minerals) and Rasul treatment, with quiet rooms, heated reclining chairs, fragrance rooms, robes and slippers and healthy snacks. These cruises are all about recharging mind, body and spirit. Cruises offer swimming pools, pilates, gyms with state-of-the-art equipment, tai-chi classes on deck and bamboo massage, to a younger clientele seeking activity holidays. For people not interested in the spa angle, Royal Caribbean International’s Independence of the Seas offers an18-night Mediterranean cruise this winter with 15 decks of activities, including a Flowrider surf park at sea, an onboard ice-skating rink, rock climbing wall, a children’s water park, a teen-only nightclub, basketball and volleyball courts and a miniature golf course. Celebrity Eclipse features a real grass lawn larger than eight tennis courts. Jogging tracks and state-of-the-art fitness centres are standard on most big ships, but increasingly so are wellness education classes, metabolic testing and cutting edge fitness classes, from kettlebell workouts to TRX suspension training, which borrows technology from U.S. Navy Seals. The Epic, Norwegian Cruise Line’s newest ship, has a Pulse Fitness Centre offering a seminar ’Secrets to a Flatter Stomach. Princess Cruise Lines offer state of the art gyms where cruisers can play Wii Fit skiing and hula hooping games, or workout to exercise classes on stateroom TV. A new offering is Fit and Funny cruise seminars on selected Carnival Cruise Lines sailings from Galveston, Texas, aimed at developing healthy habits with a light hearted approach. The new Norwegian Epic offers Botox treatments, acupuncture and shiatsu massage for couples, a hot stone massage, Rasul rooms (to cover yourself in mud and steam it off), a hydrotherapy courtyard and thermal suite. The 39 spa cabins include access to the hydrotherapy area and thermal rooms, and eight suites have their own in-room whirlpools. The Norwegian Epic has the largest spa at sea: 31,000sq ft with 24 treatment rooms. Similar facilities are available on P&O’s new Azura, where the spa package includes treatments, events and gifts, plus a priority spa service. The Oasis Spa has a private outdoor terrace for alfresco massage, and all treatment rooms have balconies for outdoor pampering. On MSC’s Magnifica, guests can enjoy a candle massage, or one using heated pink clamshells instead of hands and a facemask of scallop shells over the eyes to reap the benefits of colour through chromotherapy. On Carnival’s Carnival Dream in the Cloud 9 Spa, warm bamboo shoots soaked in essential oils are combined with deep-tissue massage. Celebrity’s newest ship, Eclipse, like her sister Equinox, has 130 AquaClass staterooms where guests receive a choice of aromatherapy scents and access to the AquaSpa relaxation room, the Persian Garden steam room and exclusive meals in healthy-eating restaurant Costa’s new Deliziosa has 52 cabins and suites with direct access to the adult-only parts of the two-deck 11,480sq ft spa. The spa package includes two exercise classes and two treatments from a range of massages and facials, including with hot stones. As well as access to the thalassotherapy seawater pool, thermal area, relaxation area and the wellness restaurant, guests get a low-calorie room service and a shower that filters impurities for super-soft skin. Silversea’s latest ship, Silver Spirit offers Botox and other treatment to help take the years off.

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USA: Advice for domestic US medical travellers

Fri, 03 Sep 2010 10:57:06 GMT

Domestic medical travel is an emerging trend with the ability to impact healthcare in the United States in a big way. David Goldstein of Health Options Worldwide (HOW), an online medical travel agency, says, "The reason we advocate domestic medical tourism is that we give patients another option besides going overseas for medical care. It is very possible to get safe, quality care that is cost-effective right in this country. The most important aspect in traveling to a hospital outside of your own region is to make sure that you are not only saving money, but you are getting safe, high quality care, and that is best guaranteed in the USA.One major benefit of domestic medical tourism is the ease of coordinating follow-up care between the patient’s local physician and the surgeon.” US domestic medical tourism will only really take off if American hospitals can establish themselves as specialized centres of excellence. Orlando, Florida, which is already a well-established vacation destination, is beginning a citywide promotion to distinguish it as a medical tourism destination. The city is developing a 7,000-acre complex called Lake Nona Medical City, which will be attached to the new University of Central Florida Medical School, will include five local hospitals, and is expected to open in 2011. Another major advantage of domestic medical travel is that all American medical facilities and physicians are regulated by accredited organizations. American physicians need to go through a rigorous credentialing process and complete an American residency program in their specialty to be board certified. Other benefits to domestic medical tourism include:• Access to legal recourse• Low cost for elective high-cost major surgeries• No language or cultural barriers• Shorter traveling distance compared to international medical tourism When it comes to domestic medical travel, HOW offers these helpful tips:• Research on the internet about any offered location on details on U.S. doctors, hospitals and healthcare facilities.• Check accreditation – Joint Commission accreditation is mandatory but also look for proof of excellence, especially in the surgical procedure you are researching such as proven evidence-based guidelines and comparisons with other hospitals.• Check doctor credentials – Find out how many procedures they have performed and their outcomes; more experience means better the outcomes.• Talk to the doctor – This will provide you an opportunity to get your questions answered.• Travel with a companion – This person will be your support and your advocate.• Find out hospital travel logistics – Usually a patient care department can assist you with this. Some hospitals allow companions to sleep in the hospital room during recovery.• Arrange follow-up care and set up a conference between your personal doctor and your surgeon – It is the best way to ensure continuity of care in case a problem arises.

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CYPRUS: The latest trend in healthy holidays fitness and weight loss

Fri, 03 Sep 2010 10:56:04 GMT

Health travel is increasingly about prevention, rather than just seeking a cure for a problem. A particular type of healthy holiday may be totally contrary to what most people want to do on vacation. It is easy to criticize the health systems in the UK and USA, but both governments are ahead of many other countries in encouraging healthy and fit living, rather than concentrating on the more expensive cures. It is fair to say that obesity is a serious problem in both countries, and the state systems can only afford to spend limited amounts on dealing with the consequences. This offers many opportunities for private weight loss treatment, including weight loss treatment overseas. But increasing availability of treatment and lower costs, mean that weight loss tourism could decrease as the comparative cost saving of going overseas reduces. While governments can encourage healthy living, they cannot afford to pay for it. But this does not matter; as there is increasing realization that health and fitness are part of the move to decreased reliance on the state and increased personal responsibility. Private healthcare companies are seeking ways of encouraging health and fitness by making it enjoyable. Everyone likes having a holiday, particularly somewhere different at home or abroad. So it makes sense to combine holidays with fitness. Fit for a Princess was first set up in 2003 as a personal training business. Then in 2006 the idea and a gap in the market was soon discovered – what about teaching a group of women in the great outdoors? This is where Fit for a Princess group outdoor workouts and bootcamps were created and expanded to 6 London locations. Requests to set up Fit for a Princess workouts outside of London led to national franchises, a pilot one is underway. Founder Janey Holliday created a unique concept of workouts that combine the fun factor with carefully put together exercise combinations that can change women’s body shapes and give women a more positive approach to training. Janey Holliday explains the expansion into overseas holiday fitness, “Research demonstrates that exercising outside can burn up to 30 per cent more calories than doing the same workout indoors - a statistic that makes venturing away from the gym a tempting prospect. Couple this with further research that shows people who exercise in the morning are 75% more likely to still be exercising a year later, and you have the perfect excuse to re-invigorate your workout. Then throw in the motivation of a sunbed, a pina colada and a sun-kissed pool attendant and you have all the incentive you need to sign up to a Cyprus Bootcamp, where the motto is train hard in the morning, play hard in the afternoon. Following the huge success of our UK Bootcamps, we felt this was the natural next step to motivate our clients. We offer workouts all year round, rain or shine, but for those that just cannot face the thought of hitting their local common at 6am on a frosty autumn morning this overseas Bootcamp is the perfect alternative.” Janey will be leading the Cyprus Bootcamp that runs from Saturday 16th October to Saturday 23rd October at the 5 star Coral beach hotel where the Olympic teams trained and stayed before Athens.

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CANADA: Transplant tourism carries risks for Canadians

Fri, 03 Sep 2010 10:21:20 GMT

20 Canadians seek organs for transplant on the black market in countries such as India, China and the Philippines each year. In doing so, they may be risking their own lives, suggested experts from four countries at the 23rd International Congress of The Transplantation Society. 5000 delegates attended the conference in Vancouver. Transplant specialists are concerned about exploitation of the world’s most impoverished people who donate organs to get money. Dr. Graham Sher, of Canadian Blood Services, said the most recent data he has seen shows 215 Canadians sought transplants outside Canada from 1995 to 2004. It is not known how many clandestine transplant operations are being done in countries like China, India, Pakistan and the Philippines, but medical tourism is believed to be a small industry relative to the 100,000 legitimate transplants done throughout the world each year. Yet the consequences for even a small underground industry are grave. Dr. Francis Delmonico, a transplant surgeon point out the dangers as evidenced by University of Toronto researchers in a study led by Dr. Ramesh Prasad, which revealed that new kidneys obtained through such means can result in far higher surgical complications, infections, transplant failure and even death. The Prasad study looked at the outcomes of 22 Canadians who purchased a new kidney and transplant in countries throughout Asia and the Middle East. One-third of all the patients transplanted outside of Canada required immediate hospitalization on their return to Canada, primarily for serious infections. Another third required eventual hospital admission. Two patients required repeat transplants and nearly 40 per cent had drug-resistant infections. Another 14 per cent got tuberculosis. Despite countries making laws to ban or restrict transplant tourism, transplant specialists are worried that with an increasing number of desperate patients seeking organs outside North America, countries around the world have to do more to increase the number of donor organs. Dr. Luc Noel of the World Health Organization says, “Transplantation has become such a routine procedure that we all expect to get an organ if we need one.” Israel was praised for passing legislation that prevents insurance companies there from paying for black market organ transplant procedures. In Canada, medical tourists who procure underground organs in other countries pay out of pocket and provincial governments in Canada will pay for the complications arising from transplant tourism. Canada’s doctors are the first in the world to develop an official policy in which they have the authority to refuse to treat transplant patients who ignore their medical opinion and insist on becoming medical tourists

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THAILAND: Phuket and Bangkok compete for Thailand's medical tourism business

Thu, 02 Sep 2010 17:07:57 GMT

Thailand’s troubles earlier this year hit medical tourism badly, particularly in and around Bangkok. Phuket suffered very little and is keen to promote itself as a safe and affordable destination, even at the cost to local rival Bangkok. Medical and healthcare providers on the island of Phuket can expect to get a large slice of the 402.9 billion baht that the Ministry of Health (MoH) expects Thailand’s medical tourism industry to take over the next five years, says Dr Wiwat Seetamanotch of Phuket Public Health, “Over the past five years, Phuket has enjoyed great success in health services provided to tourists and earned a huge amount of money. In addition, health services here are cheaper than in neighboring countries.” The MoH, according to its current five-year plan for 2010 to 2014, expects medical tourism to generate 400-billion-baht .The previous plan, for 2004-2008, concentrated on providing medical services to patients from abroad. Under that plan, the MoH aimed to make Thailand the centre of excellent healthcare in Asia through treatment businesses, health supplement businesses, health products and Thai herbs. The current plan targets developing the same businesses and products, but adds more services in the realms of Thai traditional medicine and alternative medicine. The move follows Thailand’s enjoyment of huge growth in its medical tourism over the past decade. According to MoH statistics, although these are only estimates based on information from hospitals and include holidaymakers, business travelers and expatriates, 550,161 foreign patients received treatment or healthcare in Thailand in 2001, while in 2007 that number had swelled to 1,373,807. Most were Japanese, followed by Americans and Europeans. Although key markets claimed are Japan, Australia, New Zealand, USA, Myanmar and Indonesia, in reality, 80% come from South-East Asia including Japan and Indonesia. An estimated 70% of the foreign patients during that period were medical tourists, with 25% being expatriates and less than 5% being tourists. The most popular health services during that year were health checks, heart operations, knee replacements, cardiovascular surgery, cosmetic surgery, gender reassignment surgery, dental care and Lasik corrective eye surgery. Dr Wiwat expects the number of medical tourists to Phuket to increase dramatically in the coming years, “In addition to three government hospitals in Phuket, there are also three private ones that are recognized as international standard.” Julie Munro of InterMed Global thinks that Bangkok can regain its top place in Thailand, but it will require more work than the authorities are currently putting in: “Whether Bangkok can restore its prominence as a medical destination hinges on how the Thai government, specifically Tourism Authority of Thailand (TAT), acts to promote Thailand for medical tourists in the coming year. Sustained and cohesive promotion efforts are not likely to happen soon. While TAT has been working on a medical tourism marketing plan for almost a year, it has faced leadership changes and budget cuts. It has had to put other priorities, namely bringing back tourists - any tourists - ahead of promotion of medical travel and health tourism. TAT has, however, announced that it will continue promotion of Thailand’s spa, wellness and medical services in the Middle East, but not medical tourism. The private hospitals have their own problems.” Munro also argues that hospitals have work to do, “With droves of expatriate foreigners having moved out of Thailand, hospitals like Bumrungrad International and Bangkok Hospital Medical Center are working on solidifying their home base and focusing efforts on bringing back local Thai residents, who often view these high end private hospitals as too expensive. Both hospitals continue to draw medical travellers from surrounding countries like Burma, Bangladesh and Indonesia, and from the Middle East. Thailand as a medical destination was not put on the medical travel map by government policies, it was the top hospitals, and they will continue to do this, with or without official government support.” Without coordinated promotion of medical tourism by government and trade groups, will hospitals like Bumrungrad International or Bangkok Hospital Medical Center be able to maintain their position within the global or even regional medical tourism industry? Will Bangkok lose out to the northern city of Chiang Mai or the tropical island of Phuket? Munro argues, “What remains of Thai medical tourism will continue to favor Bangkok. Phuket has daily international flights by regular and discount airlines to dozens of regional cities, and it has lovely resorts - now mostly empty. But its two private hospitals, Phuket International and Bangkok Phuket, are considered by most local expat residents a clear second choice, and prefer flying into Bangkok for care. The two private hospitals are considered expensive, with high hospital costs and doctor fees.” Phuket is to be the home of the country’s first purpose built “Health Promotion Hospital”, co-funded by the Chinese government. The Kamala Public Health Center will incorporate traditional Chinese medicines into its array of medical services. To be completed next year, it will initially offer health checkups and traditional Thai massages to both Thais and foreigners.

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HAWAII: Medical travellers with brain cancer to benefit from new gamma knife in Hawaii

Thu, 02 Sep 2010 16:43:58 GMT

Surrounded by thousands of square miles of ocean, Gamma Knife Center of the Pacific is the only Gamma Knife center in Hawaii. Since 1998, Gamma Knife Center of the Pacific has treated more than 1300 patients, many not from the island. The radiosurgery centre has retired its first Leksell Gamma Knife system and replaced it with Elekta’s latest generation radiosurgery system, Leksell Gamma Knife Perfexion. Gamma Knife radiosurgery is a gentler alternative to traditional brain surgery for illnesses such as metastatic disease, which is cancer that has travelled to the brain from elsewhere in the body. With pinpoint accuracy, the system delivers up to thousands of low-intensity radiation beams to one or more targets in a single session. Perfexion provides even greater speed and ease of use than previous models. Neurosurgeon Dr. Maurice Nicholson explains, "Perfexion is a much faster, more efficient machine to treat multiple metastases in a single visit. This is important because the pendulum is swinging toward treating with stereotactic radiosurgery [SRS] rather than whole brain radiation therapy [WBRT]. Studies have shown that there is decreased mental function at four months in a higher percentage of WBRT patients. Perfexion will be good for the patients and good for doctors." More than one-third of the 140 patients who come to Gamma Knife Center of the Pacific each year have brain metastases. The numbers are rising due to advances in tumor imaging and better screening, which result in earlier detection and diagnosis. With new treatments, people who are diagnosed with cancer live longer; therefore, there is a greater chance of developing metastases." With Perfexion, the center’s staff of eight neurosurgeons, five radiation oncologists and one physicist is well equipped to handle increasing demand. The new system allows them to easily double the number of patients they have been treating. This extra capacity means the centre can now actively seek medical travellers , rather than just wait for them to approach. Gamma Knife surgery is usually a single-day procedure with no specific convalescence associated with it, making this therapy ideal compared to radiation therapy or open surgery in which the combination of treatment and recovery may entail weeks or months. Gamma Knife Center of the Pacific has been the focus of this activity for years, treating patients from Australia, New Zealand, Samoa, Guam, Taipei and Canada. Sean Nicholson says "Our location in Honolulu, just 10 minutes from Waikiki, presents a great opportunity for people seeking Gamma Knife treatment in close proximity to one of the world’s most famous vacation destinations. We always strive to provide access for patients outside of Hawaii. Our staff works closely with patients to schedule and coordinate appointments, assist with travel arrangements and lodging, provide cost estimates and work with insurance companies to secure payment."

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MEXICO: Developments in Mexican medical tourism

Thu, 26 Aug 2010 11:23:50 GMT

Monterrey boasts four Joint Commission International (JCI) accredited hospitals within its city limits, half the JCI hospitals in all of Mexico, and many other private international specialty hospitals and clinics. Patients Beyond Borders has teamed up with Monterrey Healthcare City (MHC), to produce Patients Beyond Borders: Monterrey, due for publication in February 2011. Monterrey Healthcare City (MHC) is an association established by 10 local hospitals. Readers will learn about Monterrey’s impressive commitment to healthcare (including two first-rate medical schools, the new Universidad Autonoma de Nuevo Leon and the Monterrey Institute of Technology and Higher Education) and why thousands of medical travellers are going to Monterrey for medical treatment, including cosmetic surgery, dentistry, bariatrics/weight management, IVF/reproductive services, orthopaedics, cardiology, cancer treatments, and more. Jesus Horacio Gonzalez Trevino, of the Monterrey Health Care City Association says, "We are very pleased to be partnering with Patients Beyond Borders to produce and distribute our Monterrey City Edition. With medical specialties and procedures at 30 to 70% savings over US prices, coupled with easy access from North America, it is no surprise to us that Monterrey is quickly becoming the choice of many looking for quality, affordable healthcare." Monterrey will be the first in a new series- Patients Beyond Borders City Edition –where a group of medical facilities within a closely knit geographical area, usually close to a major international airport, can focus industry and consumer attention on the unique attributes of its medical infrastructure, leading facilities, and educational and research offerings. PBB City Editions are distributed digitally throughout the world, as well as to selected regions. Medical Traveler Yucatan (MTY) has teamed with Dr. Elena Solis, cardiologist and a pioneer in performing the new Liberation procedure for Multiple Sclerosis patients in Merida, Yucatan. While still controversial in Canada and the USA, the procedure has apparently proven successful for most MS patients who are now travelling to countries that embrace the treatment. MTY works with Dr. Solis and Star Medica Hospital of Merida, Yucatan in making both medical and travel arrangements for American and Canadian MS patients. Alan Graham of MTY says, “It is vital for MS patients in Canada and the USA to have access to this procedure. While their home countries are still debating, patients who have undergone Liberation treatment are reporting immediate and sustained improvement. Patients from Canada who are leaving Merida are reporting amazing results - movement and mobility where none existed before the procedure. This is a sound alternative solution.” Liberation treatment was first undertaken by Dr. Paolo Zamboni of the University of Ferrara, Italy whose wife has multiple sclerosis. Zamboni discovered the role of blocked veins in causing the debilitation in MS patients. His research and subsequent treatment showed that MS afflictions could be lessened with a relatively simple - and low risk - angioplasty procedure. MTY is now offering new specially priced all-inclusive packages for Canadians and Americans to Merida, Yucatan for this procedure. The special packages include all medical and non-medical arrangements, excluding airfare, and range between $9200 and $9500.

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SINGAPORE: Singapore sees rise in medical tourism

Thu, 26 Aug 2010 11:22:14 GMT

Singapore has seen an average annual 20% increase in medical tourists from the Middle East since 2006, according to figures collated by Singapore Tourism Board (STB). Common procedures and treatments undertaken by the Middle Eastern visitors include live donor liver transplants, in-vitro fertilisation, heart procedures, stem cell transplantations and cancer treatments. Jason Ong of STB says,” Middle East populations are realising the benefits of travelling to Singapore for a wide range of medical procedures, which has resulted in year-on-year double-digit growth in the number of regional healthcare tourists. Middle East patients can be certain that they will receive the highest quality of treatment and follow-up care in Singapore, which has repeatedly shown to be on par with the best in the world. They can also be certain that their cultural and religious needs are attended to with Arabic-speaking service personnel, Halal food and even Arabic TV channels, during their hospital stay.” Once selling on quality rather than price, with fierce competition vying for medical tourists’ money, prices in Singapore have been depressed to one of the region’s lowest. This competitive pricing strategy the health-care companies are quietly taking is the only way the government’s targets of million foreign patients annually could be met. Singapore is viewed favorably by medical tourists from South-East Asia and China due to the better quality of health-care service, and now low prices too. Parkway is Singapore’s premier healthcare provider, and although it is now Southeast Asia’s largest private healthcare group and has ventured into India and China, Singapore itself is still Parkway’s key market. Parkway operates hospitals, specialist and general practitioner clinics, health screening and professional radiology and laboratory services in Singapore. The Mount Elizabeth, Gleneagles and East Shore hospitals have 1008 beds in total. Singaporeans make up the majority of the patients of these hospitals, but 35% of patients of Parkway’s Singapore hospitals are foreigners. Of this, about 65% are Indonesians, followed by Malaysians at 25%. Parkway Novena Hospital may open next year or by 2012.It is designed as a luxurious hospital and the first private hospital to offer only single beds. It will have 333 beds. Fortis Healthcare chairman Malvinder Mohan Singh says his plan to use Singapore to build a pan-Asian healthcare empire remains unchanged though he lost a bid to take over hospital operator Parkway Holdings. The quality of medical education and the public health care system, which produces doctors, nurses and other talent for the industry, makes the city-state an ideal hub, "All of these capabilities are available in Singapore, and they are available to anybody who wishes to leverage on it. I want to be in a position to be able to leverage on those skill sets, capabilities and talent, and to build on them." The recent struggle between Fortis Healthcare and Khazanah Nasional for control of Parkway Holdings has thrown the spotlight on the local health-care industry, with new investors now looking at the potential. Healthway Medical has a wide range of specialist clinics, making it the largest private medical service provider in Singapore in terms of clinic network with 4000 patients everyday, It is opening specialist clinics and screening centres, catering to the increasing number of people who are more health conscious – choosing prevention at an earlier stage through screening, rather than paying out more for a cure later on in life. Plans are underway to add six more clinics in China to its current two by end 2010, all of which are wholly owned and managed by the company. All eight Healthway China clinics will be in Shanghai, and are for expatriates as well as local Chinese. Viewing Shanghai as its strategic foothold into China, the company is set to expand into smaller cities nationwide. In Singapore, with over 100 clinics, it is increasingly targeting medical tourists.

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PHILIPPINES: New health accreditation program introduced in The Philippines

Thu, 26 Aug 2010 11:19:46 GMT

An international group has launched an accreditation programme for hospitals, clinics, and wellness centres in The Philippines to improve healthcare services and promote medical tourism in the country. The National Accreditation Board for Hospitals and Healthcare Providers (NABH) and its Philippine representative HealthCORE, has launched a global programme that accredits hospitals, clinics, blood banks, medical laboratories, dental clinics, spas, fitness centers, and cosmetic and skin care centers. The NABH standards aim to raise the quality of healthcare facilities and the level of professionals’ skills to meet international standards. The Department of Health (DOH) and the Department of Tourism have been promoting the country as a medical tourism destination. But hospitals and clinics have yet to compete with leading medical tourism destinations in Asia such as Singapore, Hong Kong and India. One perceived problem is the lack of international accreditation. The Philippines has its own accreditation standards through the Philippine Health Insurance Corporation (PhilHealth). However, PhilHealth is limited by what the law prescribes for it to do. PhilHealth is a national body for accrediting health care services, focused on financing issues and accreditation of hospitals, maternity clinics and other medical clinics. The government wants to make PhilHealth an internationally recognized accrediting body, but as this could take several years, NABH International has been welcomed by the Department of Health. NABH International is a subsidiary of NABH in India, where the program was developed. NABH is accredited by the International Society for Quality in Healthcare (ISQua), an international body that approves healthcare accreditation programs around the world. Dr. Sanjiv Malik of NABH, says that international accreditation is the practical solution to quality and safety assurance, two important factors in medical tourism, ’’International accreditation provides assurance to patients that they are in a hospital that follows protocols. It builds credibility and confidence, which generates recognition among foreign patients. This is the first time that NABH is taking its services outside of India. We have chosen the Philippines to be our first international venture because we believe that the Philippines faces similar healthcare challenges with India. In the first two years of NABH implementation, the quality of healthcare delivery in India has vastly improved, which helped us become one of the leading providers of healthcare in the world. We would like to carry out the same mission in the Philippines." The leading laser and aesthetic center in Japan has opened in the Philippines, targeting the fast-growing market for medical tourism. The Shinagawa Lasik and Aesthetics Center (Philippines) in Makati is owned by the Shinagawa Clinic Group. Shingawa says it is the first-ever Japanese medical technology in the Philippines and seeks to boost medical tourism in the country by attracting foreign clients to try their laser eye service that uses the most advanced and safest facilities. Medical Tour Experts, Inc. (MTE) is a new Filipino-American company engaged exclusively in the promotion of medical tourism in the Philippines. MTE believes that the Filipino’s caring attitude and warm personality will make for a strong selling pitch in this fast-developing business. It is the only Filipino-owned healthcare company in the USA promoting the interest of the Philippines in the medical tourism business. In the US, a simple cosmetic surgery like breast augmentation could cost $12,000. In the Philippines, such surgery is routine and it costs only around $3500. But it’s not all that easy because there’s also the question in clients’ minds: are these doctors and facilities abroad as reliable as they claim they are? Are they as competent as doctors in America? MTE allows patients in the US to talk via video phone to specialist doctors in the Philippines. The agency is promoting cosmetic and dental surgery, bariatric treatment, neuro surgery, laparoscopic surgery, heart bypass, knee and hip replacement, kidney transplant, hair transplant, and more.

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BAHAMAS: Medical travel opportunities in the Bahamas

Thu, 26 Aug 2010 11:15:36 GMT

Medical travel is a central feature of the Bahamas’ future tourism expansion strategy. Bahamas Law Chambers has successfully obtained approval from the Bahamas Investment Authority for a multinational company to operate a medical facility in the Bahamas. The company will service clients traveling to the Bahamas for medical treatment. There are several reasons a company would consider opening a hospital in the Bahamas. Many companies offering medical tourism facilities are currently operating and servicing American clients out of Mexico. The Bahamas seeks to redirect the international clientele to its shores by informing the world it is open for business in the global medical tourism market. A big advantage the country has over competing jurisdictions in the Caribbean is its proximity to the United States. Any company wanting to set up on the islands needs to incorporate a Bahamian company and then register trademarks with the industrial properties unit of the Registrar General’s Department, in order to protect the multinational company’s intellectual property rights in names and logos associated with the offered treatment. Bahamas Law Chambers specializes in trademark applications and advises its corporate clients to register trademarks in their names and logos and the names and logos of their products to prevent competing companies and competing products from stealing market share. The final step is to submit the application to the Bahamas Investment Authority. The application must include a business plan and letter from a financial institution evidencing sufficient funds to finance the project. An integral document is the project proposal form, which requires the applicant to report on, amongst other things: land requirements, proposed start-up-date, management/personnel requirements, capital investment and employment projection. The applicant must show that the project will benefit The Bahamas, usually by way of employing Bahamians, and that it has extensive capital resources. On the submission of a medical tourism application to the Bahamas Investment Authority, approval is subsequently sought from the Ministry of Health and its National Research Ethics Committee. Only with the Ministry of Health’s blessing can the project progress to be reviewed and decided by the Bahamas Investment Authority. Obtaining approval from the Bahamas Investment Authority is not an overnight process. The application may be delayed while being reviewed by the Ministry of Health and its National Research Ethics Committee. Bahamas Law Chambers received approval in a moderate amount of time and was very satisfied by the outcome and process as a whole. Once approval from the Bahamas Investment Authority is granted, the multinational’s Bahamian company must obtain exchange control approval from the Central Bank of The Bahamas, obtain a business license and open a bank account in a local banking institution. Their attorney must also apply for work permits for any non-Bahamian medical experts and personnel and apply for a healthcare facility licence. Bahamas Law Chambers anticipates a very bright future for the medical tourism industry in The Bahamas and has revealed the name of the business as Ibocure.The Bahamas Investment Authority (BIA) has given Miami based Ibocure a green light to operate in the Bahamas, with the Ministry of Tourism and the Ministry of Health also welcoming the idea. The Ministry of Tourism will help with promoting the business in the context of the destination itself. A second medical tourism firm is currently being vetted that is close to approval and other interested parties in the pipeline. Ibocure, will service clients travelling to the Bahamas for medical treatment. As long as the company can raise funds quickly, Ibocure ’s addiction rehabilitation centre could open up in western New Providence as early as February 2011. Ibocure is offering a revolutionary drug called Ibogaine that is said to eradicate substance abuse in less time than other addiction treatments. While the drug has not been approved by the Federal Drug Administration (FDA) in the US, the company will be allowed to administer the drug in the Bahamas. The company chose the Bahamas for its addiction rehabilitation centre because of its proximity to the US and its ability to meld the healing process with a relaxing atmosphere. The company is considering a location only feet from the beach in an area just east of Sandyport. Ibocure’s Bonnie Levengood says, "We want people to feel relaxed. We are attracting very high-end people and it will be expensive to go, so we want to create an idyllic location by the ocean so they feel like they can relax and attract their friends and family. It takes a stressful situation and makes it relaxed and therapeutic. We will take a very Zen-like approach to the development of the centre which will be a spa-like world class facility.” Investors have already raised $2million for the start-up of the centre that will be able to house at least 15 patients at a time.

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UAE: Are the UAE's medical tourism claims credible?

Thu, 26 Aug 2010 11:10:42 GMT

Reported across the Arab press was the news that more than 4.3m medical tourists will visit the UAE this year, with the value of the industry projected to jump by 7% in comparison to 2009, according to data released by the government. The UAE is the Middle East’s biggest market for medical tourism. The local sector will be worth $1.7bn in 2010, with the second half alone seeing 13 % growth over the same period last year. Local experts have put these results down to better infrastructure, state-of-the-art medical centres, and modern technology. But are these figures in any way believable? An analysis of these claims puts these figures in perspective. 4.3 million medical tourists would mean UAE attracts a million medical tourists than the combined numbers going to Thailand, India, Singapore, Malaysia, United Kingdom, USA, Poland and Hungary! The volume of medical tourism traffic worldwide is estimated at between 38 and 40 million people. This would give the UAE a global market share of 10%. There would be nearly as many medical tourists as locals, as the population of all seven states is only 4.6 million (UN, 2009) The organization running DHCC says that in 2009 it had 220,000 patients of which 10% were from outside the UAE - and that 10% includes expats and business travelers. So…..the total number of medical tourists is at best 20,000 a year. Where are they and their companions staying? According to a review of key cities in the Middle East by research firm STR Global and Deloitte & Touche Middle East, for June 2010; Abu Dhabi hotels notched up the biggest falls in revenue in the region with occupancy levels at 56.9 % and Dubai hotels at 73.1%. Where are locals being treated? There is a massive hospital building programme across the region that is struggling to cope with the health needs of a local population. In the UAE, two of Abu Dhabi’s biggest projects include the complete refurbishment of both Al Ain and Al Mafraq hospitals, whilst in Dubai, a report by the Chamber of Commerce and Industry anticipates as many as 17 new hospitals providing 2,325 beds will be built in 2010 alone. The increase in demand, expected to hit a massive 165,000 beds by 2025, is partly due to a growing prevalence of Type 2 diabetes and obesity throughout the region, as well as increasing populations and a fresh influx of expatriates. According to the World Health Organisation, on 2007 figures there are18.6 hospital beds in the UAE for every 10,000 residents. Even assuming the number of beds has more than doubled since 2007, this would give the country a total of 20,000 hospital beds. Even if we said every hospital bed is occupied by a medical tourist with an average stay of only one day there are only 3.6 million bed days….not enough beds. If the average hospital stay for a medical tourist is five days, then there are a few million beds short. Using Dubai’s figures that only one in ten hospital guests are from overseas, and assuming 3.6 million hospital bed days, and an estimated five day stay, this would mean the number of hospital bed days occupied by medical tourists is only 72,000. Put simply, for the figures to be true, medical travellers would be stacked six to a bed. Although widely reported in the Arab press, no government department has either admitted to being the source of the figures or been able to say how they arrived at them. The number of tourists to the UAE in 2009 fell slightly because of the economic slowdown, and is only slowly recovering in 2010, say reports by financial analysts Business Monitor International (BMI). But even they cannot check exact figures for Dubai as the authorities refuse to release any tourist arrival figures for 2009 or 2010. According to the Department of Tourism and Commerce Marketing (DTCM) Dubai attracted seven million tourists in 2008. Dubai is the main attraction for the UAE, and as figures are stable, these figures would mean that more than one in two tourists to the UAE is a medical traveller. Comparing the number of medical tourists with the number of hospital beds is hard, as the Ministry of Health has published no statistics of any kind since 2007. Sadly, our conclusion has to be that ’ 4.3 million ’ is a figment of someone’s promotional imagination. Promoting overblown figures does damage, not just to the credibility of medical tourism in the UAE, but across the world. The ability for the UAE to compete on price is a matter of concern, as the average cost of heart bypass surgery in the UAE amounts to $44,000. This compares with an average cost of $18,500 in Singapore, $11,000 in Thailand, $10,000 in India and $9,000 in Malaysia. Although the UAE is developing its medical tourism industry region, Asian destinations such as Singapore, India and Thailand are the market leaders for providing medical treatment to foreign patients. Further competition will be forthcoming from other countries seeking to exploit the medical tourism industry such the Philippines, Taiwan and Latin American nations.

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AFRICA: Private healthcare sector growing in Africa

Thu, 26 Aug 2010 11:07:48 GMT

Africa’s healthcare needs are huge and increasing, with most governments struggling to provide healthcare to their people. The private sector, with foreign and domestic investors, is becoming increasingly important. Estimates suggest that private healthcare now accounts for 60% of all African health care. The reason is Africa’s growing middle classes. The tiny country of Lesotho has its first new hospital for many years. The 425-bed National Referral Hospital in the capital Maseru will replace the aged Queen Elizabeth II with eight well-equipped operating theatres, an intensive care unit and a laboratory when it opens next March. The building is a public-private partnership between South Africa’s biggest private healthcare operator, Netcare, the Development Bank of South Africa and the Lesotho government, overseen by the World Bank’s private sector arm, the International Finance Corporation. Governments cannot afford to build and open hospitals from their own resources, so private finance holds the key to improving the continent’s cash-starved and chaotic healthcare sector. While some private clinics are opening, most African governments prefer the public-private partnership model as it allows treatment for millions who cannot afford healthcare, with hospitals financed by companies who will mainly make their money from private healthcare for the increasing number of Africans who can afford private care, either from their own resources or health insurances. Netcare’s model is one it plans to roll out in Swaziland, Zimbabwe, Central African Republic, Ghana and Zambia and the DR Congo. Under Netcare’s structure, the Lesotho government will buy back the hospital over 18 years. Citizens get access to quality care in a hospital designed and operated by the private sector and the new hospital will offer better salaries and help retain Lesotho’s health professionals. At the end of the concession, the government gets a modern, well-equipped and maintained hospital. The returns on investment may be lower than an entirely private venture but the partnership model avoids problems in unstable nations, where a change of regime could instantly take over a private hospital without compensation, or refuse to allow profits to be repatriated to the investor country. Over the long term, it puts those companies on good terms with governments across Africa. Although much of the attention on health care in 45 sub-Saharan African countries centres on government activity, the private sector plays a surprisingly significant and growing role in meeting the region’s health care needs. Research by the International Finance Corporation (IFC) found that the increasing demand for health care due to improved economic growth across much of the region could translate into $20 billion of additional investment in the region’s private-sector health care infrastructure in the coming decade. Governor Babangida Aliyu of Niger State has condemned the widespread practice of public office-holders going abroad to seek treatment. Speaking at the opening of the Umaru Musa Yar’Adua Hospital in Sabon Wase, Niger State, he called it a national disgrace and asked the Federal Government to end the practice. While some medical cases are taken abroad because the facilities for handling them do not exist within the country, many trips are not necessary. Medical check-ups can be carried out in Nigeria; while for other ailments there is effective treatment in private hospitals, if not in their public counterparts. There is a mood to make it harder for public office-holders and senior civil servants to embark on medical trips overseas, and increasing the capacity of local medical services to offer viable alternatives to going abroad. This will require commitment on the part of federal, state and local governments. Increasing the effectiveness of medical services within Nigeria is a longer-term project.

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SOUTH KOREA: Korean medical tourism growing despite problems

Fri, 20 Aug 2010 13:18:25 GMT

The Organization for Economic Cooperation and Development has issued a report calling for health care reforms in Korea. The report advises the government to license for-profit health care companies. It received a mixed response from the government. The Strategy and Finance Ministry liked the idea of regarding health care as an industry, while the Health and Welfare Ministry wants to keep it in the realm of social welfare. The previous administration had wanted to allow investment in hospitals and medical care facilities in order to expand the health care industry. But the policy hit a roadblock due to a dispute between the two ministries. As the OECD pointed out, investment in hospitals and medical companies is a global trend, but the absence of an advanced infrastructure limited Korea’s medical tourism to just 60,000 patients to the country in 2009.There is a potential for Korea to move beyond the original base of cosmetic surgery to more expensive medical treatments for cancer, cardiac disease and neurological problems. With additional investment, the health care industry, and specifically the medical tourism industry, has the potential to become more lucrative. Last year, the government included the healthcare industry as one of 17 sources for new economic growth and launched a Medical Korea marketing campaign. But medical tourism has difficulty competing in a tough market when hospitals and clinics are restricted by many restrictions and regulations. One area that the country hopes will attract medical travellers, particularly from the USA, is a new proton therapy center within Korea’s National Cancer Center. Charm Lee of the Korea Tourism Organization says, "Korea is on the forefront of medical technology. Patients spend two months of proton treatment and have an interesting, inspiring, refreshing, and regenerating experience." Korea believes that the U.S., with its high prevalence of prostate cancer (less common among Asian men), is a perfect fit for a package that costs a patient $48,000 and includes airfare, accommodation, and daily transport to and from the hospital. This advanced form of radiation therapy is available at just seven U.S. hospitals. The National Cancer Institute estimates there will be nearly 218,000 new cases of prostate cancer in the U.S. in 2010 and more than 32,000 deaths. Korea’s efforts to create the right image for its medical tourism program will be wasted if it does not first address issues such as the international accreditation of hospitals and language barriers, according to Geoff Moss of American medical tourism agency Planet Hospital speaking to The Korea Times, "Medical tourism isn’t just about marketing an image, their hospitals need to meet certain requirements. Certain agencies in Korea are too focused on selling an image and brand for Korea. A patient does not get influenced by a brand or image. They get influenced by service, innovation and the price. A lot of hospitals in Korea think they can just put up a sign that says ’welcome medical tourists’ and people from all over the world will show up. It is important that each hospital gets internationally accredited to assure the hospitals are up to international standards." The company is looking at Korean hospitals to add to its network. Moss feels Korea is on the right track to implement a successful medical tourism programme, but some aspects need to be addressed. Planet Hospital took 18 patients to Korea but encountered some setbacks. Geoff Moss explains, "We ran into problems such as languages issues, lack of follow-up care by the doctors, and nurses having no power to administer medication to sick patients. We have since fixed that problem by working with KMI International which handles all ground logistics for us and also provides full English speaking concierge services." Moss believes Korea’s attempts to get U.S. insurance companies to send their patients to Korean hospitals are pointless, "Insurance companies are not sending patients abroad in any large numbers. So no matter how hard Korea lobbies them, the insurers will not be persuaded because they are not ready." Moss says Korea should try to focus on companies who pay for their employees’ health care, since they are the ones who are ready to send their workers abroad for treatment. Global Korean companies such as Hyundai, Kia, Samsung and LG could also be given incentives to send their employees working in overseas offices to Korea for medical care. The agency does like the fact that Korean prices are much less than American ones, and sees potential in specialist areas such as proton therapy.

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SPAIN: New offerings in medical travel to Spain from SimpleCare World Health

Fri, 20 Aug 2010 13:16:38 GMT

SimpleCare World Health-with offices in Miami, Florida and Malaga, Spain –is a new medical tourism agency offering international medical travelers high quality affordable treatment in a first world country-Spain. Non-acute operations and medical procedures (such as orthopedic surgery, hip and knee replacements, cardiac surgery including coronary artery bypass and heart valve replacement, bariatric surgery) are available for significantly less than what they would cost in other first world countries, especially the agency’s main target , the United States. Spain is a world leader in medical tourism, offering state of the art facilities and the newest technology. Even with the travel costs involved the total amount spent on treatment for cancer care, cardiovascular disease and hip & knee replacements, amongst other procedures, still saves money for those who are willing to travel. SimpleCare offers English speaking medical specialists in hospitals in Spain, at prices 40-70% less than US costs. The package includes- Flights to and from Spain. Airport pick-up and drop-off. Cell Phone with $50.00 prepaid to stay in touch with family back home. Consultation with the appropriate specialist. Booking into a hospital for the operation. Accommodation for patient and companion. Concierge service for patient and companion. Arrangements for aftercare while in Spain. The medical specialists are all highly qualified, board certified doctors who have received some or all of their specialty training in the US or the United Kingdom as well as Spain. All speak English as their second or third language. Simple Care will partner with the patient’s own doctors in his or her home country. The agency has a network of 2500 specialists in 13 Hospitals throughout Spain. Included in the network are-Hospital Quiron with hospitals in Madrid, Barcelona and Valencia; Santa Elena Hospital, a private multidisciplinary hospital; USP Hospital in Marbella, that has an international patient services department; and Hospital Parque San Antonio, which is staffed by multilingual professionals. The hospitals are inspected regularly by the agency.

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GLOBAL: Global dental implants market growing

Fri, 20 Aug 2010 13:14:13 GMT

Dental implants already hold a substantial 18% share of the global dental device market, and are also expected to have one of the highest growth rates amongst all dental device submarkets. This is primarily because dental implants offer an effective treatment for edentulism and because of the rising demand for cosmetic dentistry worldwide across all age groups. The global dental implants market is expected to grow from $3.2 billion in 2010 to $4.2 billion in 2015 at an annual rate of 6% from 2010 to 2015. Europe currently forms the world’s largest market for dental implants with a 42% market share, and is also expected to have the highest annual increase, 7%, from 2010 to 2015. While the lack of consumer awareness in developing economies may hinder market growth, industry players still have immense growth opportunities as merely 2% to 3% of the global edentulous population has already received dental implant treatment so far. The aging baby-boomer population in developed nations offers an especially high-growth opportunity, as this consumer segment is characterized by high disposable income, and also by an increased need for dental care due to longer life expectancy. The MarketsandMarkets report on the global dental implants market analyzes the market dynamics exclusively from the industry point of view. It aims at providing a two-dimensional picture of the market by focusing on all aspects of the dental implants market by reporting the key trends, which are further analyzed at the micro market levels, with market tables, drivers, restraints and opportunities along with the key players and competitive landscape. The report also provides more than 35 market tables for various geographic regions covering the sub-segments and micro-markets. Dental implant technology has made great strides in recent years, providing patients with unparalleled levels of effectiveness, convenience, and affordability. This is one of the main reasons why so many dentists recommend dental implants as their preferred method to replace missing teeth. Dental implants can offer many benefits. Because they eventually fuse with the jawbone, they are more stable than dentures. People with dental implants may be able to talk and eat more easily because they don’t face the risk of their dentures slipping. Dentures require replacement when the gum tissue shrinks and changes the fit; implants are not affected by this problem. They don’t wiggle or slip, as dentures can, and they are healthier for the gums and bone. Most patients find implants easier to maintain than dentures. There is a problem. An implant to replace a single tooth can cost $3000 to $4500 in the USA. Implants to replace a full or partial set of teeth can run from $20,000 to as much as $45,000.Implants typically involve the work of both a surgeon and a dentist. Several office visits may be needed to put in the screws and to add the prosthetic teeth. The high costs of dental implants and the demand for cosmetic dentistry are seen as driving the growth in dental tourism. People are increasingly seeking treatment at a fraction of the cost abroad as the reputation of highly skilled dentists and state of the art technologies are reported. Americans tend to go mostly to South American countries while Western Europeans go to Eastern European countries such as Hungary, and Asia. Dr. Pero Šutalo of Dental Implants Croatia, in Dubrovnik, Croatia comments on dental implants, "When it comes to dental treatment, let’s be realistic. We cannot offer an implant for 400 Euros becaus