HONG KONG - In Thailand, the months-long occupation of the prime minister's
office, climaxed by an eight-day closure of Bangkok's Suvarnabhumi
International Airport has ended with Western-educated Prime Minister Abhisit
Vejjajiva heading a new government.
But Thailand's latest political tonic won't cure all ills. There will be a
lasting impact on a US$1 billion segment of the Thai economy once poised for
dramatic growth: medical travel, the phenomenon of people journeying overseas
for better and less expensive healthcare.
Medical travel - also known as medical tourism - stood up relatively well this
year despite facing what Bangkok Hospital
Medical Center (BMC) international patient coordinator Dr Michael Moreton
called "the triple whammy" of perceived political turmoil - "reality, it seems,
is whatever CNN says it is" - high air fares, and the global slump.
Phyathai Hospital, for example, weathered the rough times through its focus on
Persian Gulf customers. "Political issues are no problem," Phyathai Middle East
and Africa regional marketing manager Sirirat Thongdonphum said before the
airport closure. "I'm worried about the economy, even in the Middle East now as
oil prices go down."
Hospitals and medical travel agencies focused on economic, not political,
tumult. "A lot of our customers come from places where demonstrations happen
all the time," Saint Louis Hospital international patient manager Koreah
Sama-ae said.
I was in Bangkok for my annual medical check up in mid-November and went about
my business undisturbed by escalating political tensions, flying out of the
country on the morning of November 18, ahead of the airport shutdown.
Extended stay
Even after the airport closing, Thailand's medical travel industry saw little
fallout. "There was no impact on my business," Pete Mills, founder of
Thailand4Healthcare, reported. Mills said several clients of his patient
assistance agency were in the country for treatment during the airport
occupation. "Most were happy at the prospect of a few extra days in Thailand."
The height of the political standoff in Thailand coincided with terrorist
attacks in India, another leading medical travel destination. Bangkok endured a
non-violent - except occasionally between rival factions - airport occupation,
while Mumbai had gunmen attacking foreigners in luxury hotels that left nearly
200 dead.
"Demand has not abated as a result of the one-two punch of Bangkok and Mumbai,"
said Rudy Rupak, president of Planet Hospital, which arranges travel for
medical purposes to countries in South America, Europe as well as in Asia. In
addition to assisting patients during the crises, Planet Hospital offered
patients heading to India and Thailand within 90 days the opportunity to
postpone or change destinations: none did.
Mumbai's violence might actually help Thailand attract business in the short
run. Rival medical destinations are also hoping to cash in. For example,
Singapore promotes its PEST advantages - political, economic, social,
technological - that make it a stable, first-world health care destination.
Some medical travelers may process the situation differently, however. "India's
unrest was especially bloody and therefore much more impactful on medical
tourism from the US and probably Canada," SenseTrak.com global trends analyst
David Amdal said. Amdal spoke at last year's UltraFutureWorld conference in
Hong Kong on opportunities for lower-cost Asia related to high US healthcare
costs.
Next big thing
Medical travel from North America and Europe has been the next big thing for
more than a decade, and it still is. Western travelers - as opposed to
expatriates living in Asia - remain a tiny fraction of Thailand's healthcare
market. That may be partially attributable to a side effect of the 2006 coup
and its chaotic democratic aftermath: like most central government agencies,
the Tourism Authority of Thailand has ceased to function effectively.
Currently, Westerners account for 5% of overseas patients at Samitivej
Hospital, according to its chief executive Raymond Chong. "Medical tourism will
be driven by Third World countries seeking better medical care," Chong said.
His point doesn't only apply to Thailand. Singapore's Parkway Health Group has
three representative offices in North America and 17 in Indonesia. Parkway
rival National Healthcare Group (NHG) executive director Tyrone Goh said:
"Jakarta is a one-hour flight [to Singapore] versus 20 hours from the US."
Those numbers also underscore the competitive medical travel landscape. Trying
to convince individual patients to come to your hospital is a highly
competitive business, servicing patients or agencies that are constantly
looking for a better deal. In Bangkok, buyers are spoiled for choice, with more
than a dozen hospitals competing in this space.
"About half the business in medical travel is cosmetic, which is elective,"
US-based Global Medical Referrals owner Joe Bender said. "With the global
economy in a tailspin, people are not doing elective surgeries right now.
Cosmetic surgeons are offering deep cuts in fees."
Taking medical travel to the next level focuses on the West - particularly the
US - but under a new model. Instead of medical tourism, it's called medical
outsourcing; rather than attracting individual patients, hospitals contract to
treat patients sent by overseas insurers, care providers, or self-insured
businesses. Britain's National Health Service does it using hospitals in Spain,
and US health maintenance organizations do it using dermatology clinics across
town.
Carolina blues
Some Bangkok hospitals already have contracts with Gulf state governments and
deals with insurers to treat expatriate employees of multinationals. Bumrungrad
Hospital, Thailand's medical tourism pioneer, signed a groundbreaking
outsourcing deal last year for US insurer BlueCross BlueShield of South
Carolina to send its subscribers to Bangkok as patients.
"It's inevitable," Bumrungrad group marketing director Ruben Toral said of
medical outsourcing at the signing. "Corporations and insurers alike are
looking for new solutions to drive down the cost of healthcare, and we are part
of the solution." Singapore's Parkway Health also participates in the program.
"There's a lot of buzz about it," Singapore Tourism Board director of
healthcare services Jason Yap said of outsourcing. "Three years ago when I
started, there was no interest. Now they're approaching us: insurers,
corporates and intended intermediaries for corporates."
There's just one problem with outsourcing so far - insured US patients aren't
interested. In its first 14 months of operation, only one of the South Carolina
Blues 1.3 million subscribers chose care in Asia. Fresh headlines about
Bangkok's airport closure and terror attacks in India are unlikely to generate
a more enthusiastic response.
"The unrest is a problem, big time," Amdal said. "With the Bangkok unrest
overlapping Mumbai, it's enough to put the whole region off the map of
possibilities for many, especially those less well-traveled."
The aftermath also includes government warnings that rule out travel insurance.
This is a must for clients of US companies, which in the absence of insurance
cover would face liability in the event something did go wrong. After the
bombings in Bali, individual tourists came back much faster than overseas
groups and corporate junketeers, because of the travel insurance issue.
Amdal said, "I think Bangkok will eventually lose much of its US market to
Central and South America, where Panama already has negotiations underway to
allow Medicare reimbursement for procedures at approved hospitals. Costa Rica
will move strongly now, and Brazil already has a lead in the region."
Former broadcast news producer Muhammad Cohen told America's story to the
world as a US diplomat and is author of Hong Kong On Air (www.hongkongonair.com),
a novel set during the 1997 handover about television news, love, betrayal,
high finance and cheap lingerie.
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