Rising health costs boost medical tourism – Far East becoming popular destination


The global growth in the flow of patients and health professionals as well as medical technology, capital funding and regulatory regimes across national borders has given rise to new patterns of consumption and production of health care services over recent decades.

A significant new element of a growing trade in health care has involved the movement of patients across borders in the pursuit of medical treatment and health; a phenomenon commonly termed medical tourism.’ Medical tourism occurs when consumers opt to travel across international borders with the intention of receiving some form of medical treatment. This treatment may span the full range of medical services, but most commonly includes dental care, cosmetic surgery, elective surgery, and fertility treatment. There has been a shift towards patients from richer, more developed nations travelling to less developed countries to access health services, largely driven by the low cost treatments available in the latter and helped by cheap flights and Internet sources of information.

Looking back through history, medical tourism is often thought of as a recent phenomenon. The truth, however, is that people have been traveling long distances to better their health for thousands of years. Granted, it’s hard to picture a swarthy chieftain traipsing across the desert on his camel to barter for a nicer set of pearly whites. Were clinics and hospitals even around that long ago, thousands of years ago?

Archaeological evidence from the third millennium BC suggests that ancient Mesopotamians traveled to the temple of a healing god or goddess at Tell Brak, Syria, in search of a cure for eye disorders. A few thousand years later the Greeks and Romans would travel by foot or ship to spas and cult centers all around the Mediterranean. The Asclepia Temples, dedicated in honor of the Greek god of medicine, were some of the world’s first health centers. Pilgrims would sometimes spend several nights in the temple, hoping Asclepios would appear in a dream and suggest a diagnosis or treatment.

Later in the 16th and 17th centuries, spa towns such as St Moritz and Bath became prime destinations for the European upper classes looking to soothe their ills. What kind of “procedures” were the ancients seeking? No butt lifts or hip and knee replacements, that’s for sure. Many were looking for “healing” waters or the benevolence of the gods to cure common ailments of the time such as rheumatism, syphilis, gonorrhea, blindness and paralysis.

Modern medical tourism as we know it today has largely been the result of several factors including the high cost of medical care in first world nations, ease of long distance travel, and advances in information technology.

ACE Health Tourism CEO Hisham Huneidi, who has over 25 years of experience in the medical tourism, in this interview tackles the medical tourism industry in Kuwait in particular and the GCC countries in general as he sheds light on its various aspects, offerings to patients, issues and concerns as well as the challenges being faced by the industry.

Question: What is medical tourism?
Answer: Medical tourism generally refers to people traveling to other countries for medical treatment and care. Once associated with cheap cosmetic surgery and fringe medical therapies, medical tourism (also known as health travel, medical travel, or global health care) is now rapidly gaining acceptance by both the public and the medical community at large (the latter if somewhat reluctantly), as a real solution to the high cost of health care. So what is medical tourism and why does this catchy term seem to be popping up in the media so often these days? First off it may be helpful to define what medical tourism is not. It is not a vacation package sold to doctors, nor is it a pastime for folks who like to tour hospitals. It is also not strictly tourism per se, although many aspects of tourism are engaged to some degree or another.

Simply put, medical tourism can be defined as the act of traveling outside one’s own area of residence for health care. This can take the form of a two-hundred mile drive to your parent’s birthplace, or it can mean flying half way around the globe to an exotic culture you know nothing about. For people without insurance or those needing medical procedures that insurance won’t cover, medical tourism offers an attractive alternative to rising healthcare costs.

Q: How did the medical tourism thrive?
A: Traditionally medical tourism has been associated with elective procedures (procedures not seen as strictly necessary) such as cosmetic dental and plastic surgery. Destinations such as Brazil, Costa Rica and Mexico have long catered to North American body worshippers in need of a nip or a tuck. Over the last few years however, non-elective procedures such as knee and hip replacements, cardiac procedures and neurosurgery have rapidly been gaining ground and are soon expected to overtake seemingly “trivial” pursuits such as searching for the perfect smile.

Asian nations such as India, Thailand and Singapore have taken the lead in marketing their hospitals and countries to this new wave of medical tourists, most of whom are baby boomers hailing from countries in North America, Europe and the Middle East. Not to be left behind, other countries in Asia, Latin America, and Europe are now catching up and have begun to successfully attract many of these same markets with enticing offers of cheaper prices, shorter flights and cutting edge technology.

Q: How did medical tourism become popular in Kuwait and the Middle East?
A: Medical tourism came to the consciousness of the people about 10 to 15 years back when patients from Kuwait or other countries in the GCC started travelling outside their country to seek medical treatment overseas and people accompanying these patients like their husband, wife or relatives see touristic attractions in the place where they travel too. Most of the people from the GCC travel to two popular destinations — the US and the UK from the ’80s to mid ’80s and Germany in the late ’80s. In 1992-1993, according to some statistics, people from Kuwait and the GCC traveled to Germany and Germany has taken 40% of the share of medical tourism across the globe. In 2000-2001, Czech Republic and France were popular destinations then it shifted to the Far East recently.

Q: What are the different kinds/categories of medical tourism?
A: Medical tourism comes in different types but can be grouped primarily under the following four branches:

  1. Medical Tourism For “Major” Medical Procedures

Also referred to as non-elective or critical procedures, these tend to be relatively complex surgeries that, due to their urgent nature, must be procured in a relatively short time period. They include but are not limited to orthopedic procedures such as knee and hip replacements, cardiac surgery, neurosurgery, gynecology procedures and general procedures such as hernia repairs and gallbladder removals.

  1. Medical Tourism for Plastic Surgery or Cosmetic Surgery Procedures

From breast lifts to tummy tucks and buttock augmentations, these are the glamorous procedures most commonly associated with the term medical tourism. They are known as elective procedures as you elect or choose to have them done usually based on non life threatening considerations such as bettering your appearance. These procedures are normally not covered by insurance and its adherents are usually between the ages of 35 and 65. We find a growing number of patients from Kuwait and the GCC going for this.

  1. Dental Tourism a Form of Medical Tourism

As the heading suggests, this is the side of medical tourism that focuses on fixing your smile. The truth of the matter is that for many people, going abroad is the only way that they can afford to take care of sometimes complex dental problems. Popular treatments and procedures include teeth whitening and veneers all the way up to implants, crowns and complex cases such as maxillofacial surgery (correcting injuries and defects in the head, neck, face and jaw).

  1. Health Tourism for Wellness & Alternative Treatments

This is a rapidly growing sub-niche of medical tourism that has been around for many years. It is technically two sub-niches (though they do overlap) as we must differentiate between travel for alternative treatments and wellness tourism. These “interventions” include but are not limited to certain cancer therapies, homeopathy, chiropractic, naturopathy, mega-vitamin therapy, herbalism, acupuncture, massage, and new age healing. Wellness tourism, on the other hand, is characterized by generally healthy people seeking to preserve or promote their health through preventative care treatments such as medical check-ups, mega-vitamin therapy, yoga and meditation.

Q: How much budget should one set aside  for medical tourism trip?
A: This is case-to-case basis and based on my experience, I don’t offer a ready-made package but I tailor each to suit the patient’s needs. Your particular lifestyle, the medical tourism destination, and the type of medical tourism procedure you will be undergoing will dictate, to a large degree, how much money you will be spending. In general, the farther away your medical tourism destination the more you will pay for airfare. So, for example, expect to pay more if you are flying from Kuwait to the US or the UK than you would for a flight to Bangkok, Thailand or Kuala Lumpur, Malaysia. At the same time you also need to take into account that some medical tourism destinations are more expensive than others. So even if a particular country is cheaper to travel to, you will need to factor in the relative cost of “living”, in comparison to another medical tourism destination. What about your lifestyle preferences? Do you plan to stay at a five star hotel or are you comfortable “roughing” it at a local bed and breakfast? Some adventurous souls prefer to immerse themselves in the local culture and will literally live on a shoestring budget. Most everyone else though will tend to fall somewhere in between.

The type of medical tourism procedure or medical tourism treatment you are undergoing will also play a large part in your decision of where to stay and what you will do. A medical tourism patient undergoing open heart surgery or a knee replacement will require extra care and very comfortable conditions after leaving the hospital. Not the case for someone coming for a dental bridge or an eyelid lift. Wherever you decide to stay, make sure it serves your needs as a medical tourism patient. Many of the expenses of a medical tourism trip will be the same as those of a “normal” trip or vacation. At the very minimum you will need to budget for airfare, hotel accommodations, transportation requirements and meals. Sightseeing tours and souvenirs are also a real possibility, particularly if you are traveling with a companion.

Q: What are the advantages of using a medical tourism facilitator?
A: First, it’s one-stop medical tourism shopping. The convenience of being able to choose and access information about a variety of destinations, hospitals, procedures, and services. Users can come to a medical tourism facilitator’s website and request a price estimate for a particular procedure from several different hospitals or clinics, and then choose which provider better serves their needs and budget. In addition, once you have made a decision on where to travel, the medical tourism facilitator can usually take care of all your travel logistics such as flights, lodging, and transportation.

Second, it has established relationships with international providers — Medical Tourism Facilitators, at least in theory, have already done the groundwork to make sure your chosen hospital and doctor are accredited and safe to work with. The best case scenario is that they have visited your chosen hospital and already have a system in place to make your medical tourism trip process a smooth one.

Thirdly, convenient transfer of medical information — Most medical tourism facilitators have a mechanism in place for quickly transferring your medical information including large files such as CTs and MRIs.

Finally, language and culture barriers are usually not an issue — Contacting some international hospitals can be challenging due to time zone differences, language barriers, and cultural differences. As shown above, medical tourism facilitators already have the right contacts and a medical tourism trip/medical tourism process in place with your international hospital. Additionally, as most medical tourism facilitators are located in North America, you will be dealing with people who speak your language and have a better understanding of the obstacles you face in order to get you from point A to point B.

Q: What is the difference between a travel agent and a medical tourism facilitator?
A: Medical tourism facilitators have played an important role in promoting the growth of medical tourism, and for many medical tourism patients, represent their first face to face contact with the concept of medical tourism. Over the years, thousands of these companies have popped up, most sporting names synonymous with health and travel. They function much like a travel agency, requesting and obtaining passports, booking flights, and arranging a medical tourism patient’s lodging, transportation and tours. The key difference, of course, is that they also serve as the liaison or mediator between you and the international hospital and doctor. In effect, it is the facilitator’s job to repackage the medical provider’s service offering, make it more appealing, and then guide you along the medical tourism process. For those trying to decide whether or not to use a facilitator, it is important to weigh both the advantages and disadvantages they provide.

Q: What are the forces and drivers behind medical tourism?
A: Over the last ten years, several factors have contributed to the increasing popularity of medical tourism. Chief among these are rising health costs.

Q: How would you describe the medical tourism industry in Kuwait? Is it booming?
A: Medical tourism has been doing good so far. In fact, it wasn’t affected by the economic crunch. However, the presence of representative offices established by the Kuwait Ministry of Health has in a way affected the business operation slightly as part of the government’s way of cutting cost of citizens availing medical treatment abroad but of course, medical tourism facilitators or companies usually make things easier for the patients and those accompanying them, hence, we’re still very much in the picture.

Q: How do you see the future prospects of medical tourism in the region and across the globe?
A: There is a bright future ahead for medical tourism as everyone is gearing toward achieving a holistic approach to health and wellness. We are now looking at the Far East as countries there like Thailand, Malaysia, Taiwan are becoming popular medical tourism destinations as well as the Philippines.

Hisham Huneidi 
In 2000 — 2003 — He is the Director of Shorouq — for health and tours company and Agent of  Marburg University Hospital of Germany in Kuwait. They started expanding their medical services to new destinations like France — Czech Republic – UK — and started their strong relations with the medical service department in charge of sending patients for treatment abroad at the Ministry of Defense in Kuwait. In March 2004 — September 2008, he worked at Alshamel Travel and Tourism as Health & Spa Director. He is also the exclusive agent and representative in Kuwait and GCC of a major American stem cell treatment center in Asia and in Thailand. In 2009, he has been appointed to be the exclusive agent representative of THTDC ( Turkish Healthcare Tourism Development Council ) in all GCC countries which include Kuwait — UAE — Saudi Arabia — Qatar — Bahrain — Oman. THTDC is an official non profitable council created through Turkish tourism authorities and he had the chance to meet Turkish President Abdullah Gul in Kuwait during his official visit to Kuwait on Dec 22, 2009.

In 2014 to date, he has been appointed as an exclusive agent in Kuwait for CGMH Chang Gung Memorial Hospital of Taiwan.