A Jones Lang LaSalle Hotels research study entitled FocusOn Medical Travel said the medical travel sector has the potential to develop into a lucrative niche market for hotel operators and investors.
Thailand, Singapore, Malaysia and India are developing first-class facilities. International tourists are attracted by the high-quality and relatively low-cost healthcare offered. With destinations such as Eastern Europe, Turkey and Dubai getting in on the act, this market is poised for rapid expansion in the future. As travellers become more discriminating, they will continue to seek out hotels and resorts that offer a complete array of amenities. Medical spas, medical travel and rehabilitation at desirable destinations will play a large role in the new generation of spa resorts. In Dubai alone, there are at least 120 spas, health clubs and clinics offering wellness services. By 2015, the United Arab Emirates could be amongst the top spa destinations in the world with an estimated 200 hotels offering world-class facilities, said Mark Wynne Smith at Jones Lang LaSalle Hotels.
The report emphasised that all involved must ensure that the medical travel industry offers accessible, affordable and high-quality care to cement the reputation of this fledgling sector and allow the travelling public to make informed choices about their medical care. There is enormous potential for partnerships between hotel chains, property developers, airlines, insurance companies and financial institutions.
These partnerships are vital as medical travellers need the security and peace of mind provided by purchasing an all-inclusive package for their trip. Medical Tourism has the potential to become a significant tourism segment with investment opportunities ranging from large scale hotel developments adjacent to city hospitals or specialist offerings with some minor modifications to existing product. In either scenario, the amount of incremental capital expenditure will depend on the size and opportunity within the market and should be a key consideration for any investor, added Smith.

An increasing number of visitors to Vietnam are combining tourism with the advantages of natural medicine.
Vietnam has abundant natural resources to provide natural medicine for the health tourism industry, especially hot springs and mineral water sites. Naturopathy tourism is still a new industry in Vietnam. The country’s health facilities and services are as not as modern as other countries, but it is known worldwide for its traditional herbal medicine.
Some of Vietnam’s most popular tourist sites offer added health benefits. The Thap Ba Hot Springs in the central coastal city of Nha Trang, the Kim Boi Mineral Waters in the north-western province of Hoa Binh and the National Institute of Acupuncture in Hanoi are all places where visitors can enjoy traditional therapies.
Nha Trang offers a mud bath at the Thap Ba Hot Spring Centre. The director of the Thap Ba Hot Spring Centre, Hoang Quang, said that despite the fact that natural medicinal tourism is new to the country, his centre has received 400,000 travellers this year, including 31,000 foreign tourists.
Meanwhile, the National Institute of Acupuncture in Hanoi is world-renowned for its technique of using acupuncture anaesthetic instead of general or local anaesthetic for surgery. Hanoi is a centre for health tourism for herbal treatments, particularly acupuncture.
Vietnam’s tourism sector is anticipating an average of 7 to 8 million foreign visitors a year for the next 10 years, but is still struggling to create an image that will increase those figures. One solution is to enhance advertising in key markets and give priority to building a brand name for national tourism.
Vietnam is in need of a clear message to convey its attractions to potential tourists. The development strategy of the Vietnam National Administration of Tourism (VNAT) aims to turn the country into one of the world’s top destinations by 2010. VNAT plans to advertise on international television networks as well as in newspapers in Singapore, Malaysia, Thailand and Cambodia. But it has yet to identify strategic tourism products in its advertising campaigns. The cultural and eco-tourism aspects of current advertising campaign have appeared vague and are not memorable to visitors.

Market Image, a team of healthcare professionals and internet-savvy marketers, is extending its marketing services to medical tourism facilities around the world.

Founded a decade ago, it originally just worked with Canadian healthcare providers. It has developed websites for the international pharmaceutical industry, medical clinics, and pharmacies. The company restricts its clients to those in the global healthcare industry. It offers a variety of marketing services including web site design, internet marketing, search engine optimization, PR services and a Canadian based call centre service.
The company now wants to expand to provide services for hospitals, surgeries and agencies worldwide.
Medical tourism is big business. The patients are there. The doctors and hospitals are there. We use our real-world marketing experience and knowledge of the healthcare industry to inform patients, insurance companies, employers and government market segments about these international facilities. We make sure prospects know that these medical professionals understand the unique needs of foreign patients and they are open for business, says Market Image marketing manager Victor Tiongco.
The company offers packaged services like its Seahorse service, which includes 12 press releases per year, call centre services, 1-800-number on website for North American patients, and two blog entries per month.

South Africa can accommodate up a million medical tourists every year and is ideally placed to the become a destination of choice for medical and cosmetic surgical procedures, says Cawe Mahlati, organiser of the inaugural South African Health Tourism Congress (SAHTC) in Gauteng. Mahlati says a strong health sector could bring down the cost of healthcare in the country, at a time the country is seriously considering restructuring what the public and private healthcare sectors offer internally.
More than 300 delegates representing medical tourism agencies, hospitals and healthcare providers, dentists and doctors, government representatives and insurers attended the congress. The aim is to create a health tourism cluster, getting all parties to work together to market South Africa as a cost-effective, quality provider of medical and cosmetic procedures. In the last few years politicians and government bodies have offered no support or shown any intent to assist medical tourism. This will change as the congress has received the support of the government with both Deputy Health Minister Thokozile Xasa and Deputy Tourism Minister Molefi Sefularo speaking at the event. Xasa said that the government aims to complete a national strategy and implementation plan by the end of this year to develop the country as a destination for international medical tourism.
He also said that out of 9.5 million foreign tourist arrivals in the country last year, 410 000 were medical tourists, but organiser Mahlati is wary of trusting those figures. Trade estimates in recent years have consistently used a figure of only 20,000. She suggests that the creation of a health visa would make it easier to calculate real numbers. Xasa admitted that the country’s service offering in medical tourism is sporadic, The industry in its innate state is fragmented and consequently inefficient."A pioneer in medical tourism, South Africa has long established itself as a destination for health tourists, with thousands of foreign patients electing to have cosmetic or medical procedures in local hospitals. But more organized rivals have overtaken it as marketing has mainly been left to agencies, with few hospitals prepared to promote their services.
The congress aims to stimulate the inbound health tourism market in South Africa. Deputy Minister of Health Molefi Sefularo said, Although the private sector is the main beneficiary of health tourism, there is a slow stream of patients who are price sensitive and have seen the opportunity of using the public sector hospitals. There is much scope for collaboration between the medical, tourism, hospital and travel industries. It is therefore important for the public sector to utilize this opportunity in a co-ordinated manner, without negatively affecting access to the South African patients.South Africa has to position itself therefore as a destination of choice for medical healthcare ahead the 2010 FIFA World Cup."
South African Medical Association regulations prohibit commercial brokers from recommending patients to doctors, and restrict doctors from marketing their services directly or indirectly to the public.
The authorities sudden interest in medical tourism is due to an acceptance that leisure tourism in South Africa has reached saturation point, giving an impetus to new strategies that target medical and health tourism for high spending visitors.

South Florida is becoming an international destination for health care, and various new initiatives, often led by the medical tourism programme for the Greater Miami Chamber of Commerce, are increasing the inbound flow. But substantial unpaid fees mean that Miami hospitals will no longer accept patients from Turks and Caicos.
Bahamas based The Bank of the Bahamas, with a branch in Florida, has a new Visa card that allows Bahamians discounts of between 30 % and 60% at seven South Florida hospitals. South Florida facilities accepting the card are Mercy Hospital, Baptist Hospital, Cleveland Clinic Florida, Jackson Memorial, Broward General, Miami Children’s and UM Health Systems. The bank argues that it is not promoting medical tourism, simply accepting the fact that as Bahamian residents do travel to Florida for healthcare, they are helping them afford treatment. Many hospitals offer international patients discounts off the gross charges, but foreigners generally still pay more than Americans with private insurance, which generally negotiates rates of discounts of 50 percent to 70 percent off gross rates. Four Miami-Dade hospitals have enlisted in a joint-marketing program through the Greater Miami Convention and Visitors Bureau to market the region.
One issue is whether hospitals are getting paid for international patients. Several South Florida hospitals are owed $20 million for treating patients, but there are differing accounts as to whether the money is owed by medical tourism agency Southern Health Network, or the government of the Turks and Caicos Islands. In April, the Turks and Caicos Islands Government decided not to renew its contract with Southern Health Network, the third party company that had been handling the country’s overseas medical referrals for the past two years.
The Turks and Caicos, eight inhabited islands, has been in financial and political turmoil for months. A premier known for extravagant spending resigned in March after a commission of enquiry proved corruption accusations, and a commissioner appointed by the United Kingdom has been trying to sort things out. The UK government has taken over responsibility for the country, as it is a British Overseas Territory.
According to documents filed with the Miami-Dade County Circuit Court, two Miami businesses are suing Southern Health Network for failing to pay for services provided to Turks and Caicos residents who travelled to the US for care. Several other hospitals claim they have not been reimbursed for money owing back to 2006. Baptist Health is owed money, as is Miami Children’s Hospital. The two providers suing Southern Health Network are plastic surgeon John Grossman, owed $50000, and SkyeMed Pharmacy and Infusion Services, owed $76,000. Southern Health Network has filed a lawsuit against the Turks and Caicos government for fees of $16 million.
What complicates matters is that according to a transcript from a Turks and Caicos government corruption inquiry held earlier this year, in 2006 island officials contracted with Southern Health Network to secure and coordinate U.S.-based healthcare for residents who needed treatment beyond what they could obtain through the islands’ healthcare system. But several years into the contract, investigators said that the medical travel program grew from $4 million a year to tens of millions of dollars annually under Southern Health Network’s management. Investigators found that Southern Health Network is owned Delroy Howell, a business associate of former Turks and Caicos finance minister Floyd Hall. According to Hall’s inquiry testimony, the agreement called for Southern Health Network to negotiate the provider contracts and pay for the provided treatment upfront. They would then receive reimbursement, which would include a fee based upon a previously negotiated discount-rate formula, from the Turks and Caicos government. But government officials cancelled the programme in April largely because of costs and questions over the contract-award process.
In 2006 Hall brought a proposal to the Cabinet that Southern Health Network, a Miami company set up for the purpose, be awarded the health care management contract at 50 percent of the savings they achieved. Prior to April 2006, a Canadian company, Canadian Medical Network (CMN), had been providing overseas health care management to the Turks and Caicos Islands government and in CMN’s last year of operation they had dealt with health care provision totaling $4.2 million and received fees of some $443,519, calculated on the basis of 25 percent of the discounts on real or inflated prices for medical services that they were able to negotiate on behalf of the TCI government.

Although the Kingdom of Saudi Arabia has an expanding and up to date health system with world-class hospitals containing state-of-the-art facilities, it has yet to make its mark in the booming medical tourism industry. Many of its own citizens look overseas for medical help and treatment.
Dr. Sami Badawood of Jeddah Health Affairs says that fewer Saudis are going overseas, while there is an increase in the number of medical tourists from Gulf countries. The number of people going abroad for medical treatment has decreased by around 20 to 30 percent over the last three years. This is because of two reasons, the global economic downturn, and that better medical services are now available in the Kingdom itself.
Dr. Badawood admits that there has not been enough marketing overseas for the Kingdom’s heath sector, but there are strategic plans afoot and that special attention is being given to build a brand for medical tourism in Jeddah, The strategic five-year plans seek to develop medical cities in Jeddah that will have concentrated medical services, similar to those in other countries, and this will attract people, but more private sector investment and cooperation with specialized companies is required. 
Jeddah’s summer festivals also attract tourists from different regions, and medical tourism is at a peak at this time of the year with a dramatic increase in the number of patients seeking appointments. Jeddah has 40 hospitals and an increasing number of private clinics.
The Ministry of Health and the Jeddah Governorate are to hold a workshop on how best to develop the plans to boost medical tourism in Jeddah. Formal conclusions from this will be sent to the Saudi Commission for Tourism and Antiquities (SCTA). SCTA is responsible for promoting tourism, and is working with private and public sectors on implementing marketing programmes to attract medical tourists and boost the capacity and resources of private hospitals.
Saudi Arabia does have competition from other Middle Eastern countries; particularly Jordan and the UAE.Korea, Malaysia, Thailand, India, the Philippines and Eastern European countries are attracting substantial numbers of medical tourists from the Middle East.
Dr. Badawood admits that tourism and medical tourism work separately, and says that the most popular medical services for which people come to the Kingdom are paediatric and obesity treatments and eye surgery. Cosmetic surgery is increasingly popular but cosmetic treatment is much more expensive than in India, Egypt and Lebanon. Surgery costs are lower than the US, but higher than many Asian countries. The kingdom has expertise in stem-cell treatment and infertility treatment.
The government and private sectors are not yet working in unison. Where to position itself on cost and expertise, is an unsolved puzzle. The bottom line is that while thousands of Saudis go overseas, it is difficult to get substantial numbers of inbound medical tourists.

Japan plans to attract Asian and Russian medical tourists as a way of boosting healthcare income to help the country cope with rising costs of its aging society, says a report from the Ministry of Economy, Trade and Industry.
Japan plans to begin a pilot project in September with ten of the country’s biggest hospitals, including the National Cancer Center and Keio University Hospital in Tokyo, while travel and translation companies will help coordinate tour packages. As healthcare in Japan is not cheap, it cannot promote cost savings. The plan is to offer added value that is not widely available elsewhere, such as gene diagnosis and regenerative therapies to restore lost or damaged cells and tissues. The project includes package tours combining medical checkups with sightseeing at cultural, historical and sports venues.
Promoting Japan to medical tourists could make hospitals less dependent on patients’ payments to cover their costs, but the volume of visitors needed to make any real impact is huge. As Singapore has found, promoting quality over cost saving is not an easy path, and prices in Japan are a lot higher than Asian medical tourist destinations.
The ministry project is a one to two year pilot to get feedback on the feasibility of medical tourism for the longer term, and the ministry is reluctant to give away any detail of how it will attract travelers. For months, a panel of experts has been meeting at the Ministry of Economy, Trade and Industry (METI) behind closed doors to discuss the merits of attracting wealthy patients from Asia and Russia to Japan for top of the range medical treatment.
Countries such as India, Singapore and Thailand are a popular destination for Asians, Russians, Americans, Europeans and even Japanese who don’t want to pay the high costs at home. Japan cannot compete on price, e.g. a heart procedure costs $100,000 in the USA or Japan, but as little as $20,000 at top private hospitals in Asia. The cost of drugs in Japan is one of the highest in the world.
The ministry is hoping the idea will boost the finances of the nation’s hospitals. Many hospitals that rely on national health insurance payouts from the government are struggling to make ends meet. Currently about 80% of Japan’s annual medical costs are paid for by the state. Japan’s national insurance system is hard up for money too. With the population graying, the number of workers paying for insurance has dwindled, to the point where the payments no longer cover the annual costs.
There are problems, even with the pilot. The country has few doctors who are bilingual. No hospitals in Japan have JCI or similarly accepted international accreditation. Japanese hospitals are not allowed to advertise and are not interested in international accreditation, partly due to accreditors refusing to translate essential documents into Japanese. Japan even has a shortage of doctors with fewer doctors per head than most other major countries. The only good news is that the quality of care in the 8000 private hospitals is excellent. The pilot is well intentioned, but achieving results will be an uphill struggle.

Indian research group Koncept Analytics has published a new short 49-page report on medical tourism, Medical Tourism Report 2009. This report gives an overview of the medical tourism industry with a focus on Asia. It discusses the major medical tourist destinations of Singapore, Thailand, Malaysia, India, Philippines, Taiwan and South Korea and their respective competitive advantages. The major healthcare organizations in Asia are also profiled.
Author Vikas Gupta argues that, More than thirty countries in Asia, Africa and Eastern Europe are serving millions of medical tourists annually. Thailand, Singapore, Malaysia, India and Philippines are the major destinations in the Asian medical tourism market. 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. Global economic downturn has resulted in decline in visitor numbers in Singapore and the same holds true for medical tourists also. The decline is most among Indonesian patients, but is being compensated by patients from other places such as Vietnam and the Middle East. The private healthcare market in Singapore could witness a period of slower growth due to declining medical tourists. The healthcare industry in Thailand has seen rapid growth in recent years, ahead of the country’s GDP. In Thailand, medical costs are lower than in Singapore and also, it is a much more popular tourist destination. The cost of healthcare in Thailand is about five times lesser than it is in the US. The Malaysian government is aggressively 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. India is one of the lowest cost and highest quality of all medical tourism destinations. It offers low-cost cardiovascular and orthopedic procedures, at about one-tenth the cost of similar surgeries in the US. Taiwan provides high-quality healthcare at very competitive prices but is a slow starter. A liver transplant costs half as much in Taiwan as in Singapore. China is a key target market for Taiwanese hospitals. The Korean government is promoting the nation’s growing medical tourism industry and has set a target of 100,000 foreign patients by 2012. However, Korea is considered to be a latecomer in medical tourism.
The report includes:
1. Medical tourism overview2. Market overview2.1 Singapore2.2 Thailand2.3 Malaysia2.4 India2.5 Philippines2.6 Taiwan2.7 South Korea3. US – outbound medical tourism4. Rise of medical tourism in Africa & Middle-East4.1 Uganda4.2 Tunisia4.3 Jordan4.4 UAE5. Profiles of hospitals5.1 Bumrungrad Hospital5.2 Parkway5.3 Bangkok Dusit Medical Services5.4 Raffles Medical Group5.5 Thomson Medical5.6 KPJ Healthcare5.7 Apollo Hospitals
There are many tables including-

Patient demand US Outbound Tourism (2007-12E)

Comparative cost of major medical procedures by country

Worldwide medical tourism market (2006/12E)

Russia and medical tourism are often linked, with Russians seen as key target markets for South Korea, Taiwan, The Philippines, Japan and small Eastern European countries. But there are signs that inbound trade is developing, and, remembering the size of the country, internal domestic dental tourism. Medical tourists leave Russia because it is problematic to receive some kinds of treatment back home.
But for those seeking specialist medical attention or medical spas, Russia is becoming a popular destination, particularly for Germans, at a fraction of the cost of many Western hospitals or medical spas. Russia offers competitive competence and quality to patients, in addition to luxurious and therapeutic accommodations.  For those traveling to Russia, especially to St. Petersburg, for medical treatment or procedures, many facilities have the same quality, integrity and credentials as Western doctors and hospitals, often offering services for 40-80% less. Cardiology, neurosurgery, and ophthalmology are some of the areas where Russian doctors are highly qualified professionals.
Russia offers numerous benefits to medical tourists, including rehabilitation at the Rehabilitation Clinic of Dr. Vorobiev in Moscow, for people suffering from every addiction imaginable, from drugs, to alcohol, to gambling, benzodiazepines and barbiturates. Patients can also be treated for neuroses, depression and sexual disorder. The AVA-Peter Clinic in St.Petersburg, is a specialist fertility clinic
Although they have the facilities, hospitals and clinics are mostly poor at promotion. A handful of medical tourism agencies are emerging. Russian Medical Tourism (RMT) is one of the first medical tourism agencies in Russia. It can suggest medical institutions and doctors. RMT cooperates only with a select few Russian clinics and hospitals
Dental tourism grows more and more popular in Moscow due to the economic crisis. It is twice as cheap to have your teeth fixed in the regions and countries near to Moscow, than in Moscow. Dentistry went up 40-50% in price at the beginning of the summer in Russia. In Moscow one filling can cost 4,500 rubles ($145), while in a province it costs about 2,000 rubles ($64). The number of people willing to go outside Moscow to enjoy healthy teeth has been growing recently. Travel companies, which organize such tours, have had a tenfold increase in their clientele.
Medical tourism agency Health Vacations Inc. of St. Petersburg, targets Americans and Canadians by offering high- quality, low-cost medical care in St. Petersburg at 40-80% lower than the cost of the same procedures in the United States. It also offers new technology that has not yet been approved in the US, including hyperthermia treatment for cancer and the prosthetic disc nucleus for degenerative disc disease.