Global Medical Tourism

The wealthy citizens of developing countries have frequently traveled to the U.S. and Western Europe to seek the expertise and gain access to advanced technology available at leading medical centers. Recently, a trend categorized as “medical tourism” has emerged, wherein citizens of highly-developed countries choose to bypass care offered in their own communities and travel to developed areas of the world to receive a wide variety of medical services in order to save money. Medical tourism is fundamentally different from the traditional model of international “medical travel,” where patients generally journey from less-developed nations to major medical centers in highly-developed countries for medical treatment that is unavailable in their own communities. This TriMark Publications report focuses on the medical tourism trend that will have an increasing impact on the healthcare landscape in industrialized and developing countries around the world. The term “medical tourism” does not accurately reflect the reality of the patient’s situation or the advanced medical care provided in these destinations. Nevertheless, it provides an unambiguous way of differentiating the recent phenomenon of medical tourism from the traditional model of international medical travel. This phenomenon is driven by marketplace forces and occurs outside of the purview and control of the organized healthcare system. Medical tourism presents important concerns and challenges as well as potential opportunities. This analysis will examine the international locales that are experiencing a dramatic increase in medical tourism, with particular emphasis on Asia, Eastern Europe and Latin America.
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1. Introduction 12
1.1 Executive Summary 12
1.2 Medical Tourism: An Overview 13
1.3 Scope 14
1.4 Methodology 15
1.5 Key Drivers of Medical Tourism 16
1.6 Medical Tourism: Advantages 17
1.7 Medical Tourism: Disadvantages 19
1.8 Medical Tourism: A Fine Line Between Pleasure and Pain 19
1.9 Medical Tourism: Its Increasing Popularity 21
1.10 Medical Tourism: The Preferred Destinations 22
1.11 The Global Healthcare Marketplace 24
1.12 Quality and Safety in Medical Tourism 25
1.13 The Response to Medical Tourism 26
1.14 The Continuing Evolution of Medical Tourism 26
1.15 Medical Tourism: Evaluating Trend, 2007 27
1.16 Medical Tourism: Emerging Trends, 2008 27
1.17 Medical Tourism: The Leading Players 28
1.18 Hosts Who Lead the Race 28
1.19 Hosts Excelling in Medical Technologies and Procedures 29
1.20 Medical Tourism and the Morality of Organ Sales 29
1.21 Trends in Organ Transplantation 30
1.22 India Offers World-Class Facilities for Organ Transplantation Procedures 31
1.22.1 Kidney Transplants in India 31
1.22.2 Liver Transplants in India 31

2. American Patients on a Shopping Spree for Global Medical Care 32
2.1 Savings for the American Shopper can be Significant 32
2.2 Forecast of U.S. Out-Bound Medical Tourism Spending 34
2.3 Non-U.S. Based International Providers 37
2.4 American Medical Association Guidelines for Medical Tourism 38
2.5 A Few Tips for Would-Be Travelers 38
2.6 Why Do U.S. Patients Travel Abroad for Medical Care? 39
2.6.1 Not Available at Home 39
2.6.2 Less Expensive 39
2.6.3 Cost for Procedures in the U.S. vs. Abroad 39
2.6.4 Faster to Obtain 40
2.6.5 Access to Medical Staff 40

3. Record Number of British Patients Flying Abroad 42
3.1 Fact Sheet by Infertility Network, U.K. 43
3.1.1 Regulations and Inspections 43
3.1.2 Patients Conducting Research 43
3.1.3 The Journey 43
3.1.4 Language Difficulties and Follow-Up Care 43
3.1.5 Finances 44
3.1.6 Embryo Transfer 44
3.1.7 Donor Gametes 44
3.1.8 Counseling 45
3.1.9 Support 45
3.2 Infertile Couples Head Overseas for Treatments 45
3.3 E.U. Directive on Cross-Border Healthcare 45
3.4 Exodus of Medical Tourists from the U.K. 46

4. Which is the Best Shopping Center for Medical Surgeries and Medical Travel? 47
4.1 The Twelve Steps for an Enjoyable Medical Tour 47
4.1.1 Step 1: Get Educated and Learn From Others 47
4.1.2 Step 2: Determine Whether Medical Tourism is the Right Option 48
4.1.3 Step 3: Consider the Healthcare Options 48
4.1.4 Step 4: Decide What Kind of Trip is Required 48
4.1.5 Step 5: Choose a Provider or Broker 49
4.1.6 Step 6: Research the Destination 49
4.1.7 Step 7: Calculate the Finances 50
4.1.8 Step 8: Determine Dates of Travel 51
4.1.9 Step 9: Secure Passports and Visas 51
4.1.10 Step 10: Prepare Records and Paperwork 52
4.1.11 Step 11: Plan for Post-Operative or Post-Treatment Recovery and Assistance 52
4.1.12 Step 12: Take the Trip 52

5. International Healthcare Accreditation 53
5.1 Joint Commission International (JCI) 53
5.2 Trent Accreditation Scheme (TAS) 53
5.3 Society for International Healthcare Accreditation (SOFIHA) 54
5.4 Healthcare Tourism International (HTI) 55

6. Global Players in Medical Tourism 56

7. Medical Tourism in Latin America 58
7.1 Mexico: The Nearest Host for U.S. Patients 58
7.1.1 U.S. Patients Turn to Mexico for Medical Care 58
7.1.2 Mexico: Accommodating Foreigners 59
7.1.3 Insurers Consider Mexico 59
7.1.4 U.S. Patient Interest Growing Towards Mexico 60
7.1.5 Planned Projects in Mexico 60
7.1.6 Tips for Americans Seeking Healthcare in Mexico 60
7.1.7 Hospital Angeles 61
7.1.8 Hospital Angeles, Lomas 62
7.1.9 Hospital Angeles, Queretaro 63
7.1.10 Hospital Angeles, Mocel 63
7.1.11 Christus Muguerza Alta Especialidad Hospital 64
7.1.12 Aesthetic Plastic Surgery Institute 64
7.1.12.1 Plastic Surgery for the Body 64
7.1.12.2 Plastic Surgery After Weight Loss 64
7.1.12.3 Plastic Surgery for the Face 65
7.1.13 Baja Oral Center 65
7.1.14 Clinica Dental Estrella 65
7.1.15 Codet Aris Vision Institute 65
7.1.16 Cosmed Clinic 65
7.1.17 Pacific Dental 66
7.1.18 Rio Dental 66
7.1.19 Mexican Dental Vacation 66
7.1.20 Miguelangelo Plastic Surgery Clinic 66
7.1.21 Angel's Touch Dental Clinic 66
7.1.22 Mexico Plastic Surgery Clinic 67
7.1.23 Tourism in Mexico 67
7.1.24 Sample Tour Package from Caravan 69
7.2 Medical Tourism in Antigua and Barbados 70
7.2.1 Crossroads Center 70
7.2.2 Barbados Fertility Center 70
7.2.2.1 Treatment Options in the Center 70
7.2.2.2 What to Expect from the Center? 71
7.2.2.3 Typical Treatment Cycles 71
7.2.2.4 Causes of Male Infertility 72
7.2.2.5 Causes of Female Infertility 73
7.2.3 Tourism in West Indies 75
7.3 Medical Tourism in Argentina 76
7.3.1 Xetica Argentina 76
7.3.1.1 Procedures Offered in Xetica Argentina 76
7.3.1.2 Xetica's Medical Tourism Services in Seven Steps 77
7.3.2 Austral University Hospital 77
7.3.2.1 Services from Austral 78
7.3.3 Tourism in Argentina 78
7.3.4 Argentina Discovery Tour Package from Tico Travel 78
7.4 Medical Tourism in Brazil 79
7.4.1 Hospital do Coração 81
7.4.2 Albert Einstein Jewish Hospital 81
7.4.2.1 Services for International Patients by Albert Einstein Jewish Hospital 82
7.4.3 Hospital Samaritano 82
7.4.4 Hospital Revitalise 83
7.4.5 Tourism in Brazil 84
7.4.6 Brazil Tour Package by Brazilian Waves Tours and Travel 84
7.5 Medical Tourism in Costa Rica 85
7.5.1 Centre Internacional de Medicina (CIMA) Hospital 85
7.5.2 Rosenstock-Lieberman Center for Cosmetic Surgery 86
7.5.3 Hospital Clinica Biblica 87
7.5.3.1 Clinica Biblica Medical Specialties 87
7.5.3.2 Clinica Biblica Services for International Patients 88
7.5.3.3 Clinica Biblica Maternity Plans 89
7.5.4 Meza Dental Care 90
7.5.5 DentaVac Dental Clinic 90
7.5.6 Prisma Dental Clinic 91
7.5.7 Tourism in Costa Rica 96
7.5.8 Sample Tour Package from Costa Rica Green Forest 96
7.6 Medical Tourism in Panama 97
7.6.1 Pana-Health 97
7.6.2 Hospital Punta Pacifica 99
7.6.3 Tourism in Panama 100
7.6.3.1 Panama Sample Tour Package 100
7.7 Medical Tourism in Cuba 101
7.7.1 Havana Hospital 102
7.7.1.1 Services Available in Havana Hospital 102
7.7.2 Tourism in Cuba 103
7.7.3 Sample Tour Package from Floridita.com 103

8. Medical Tourism in Europe 105
8.1 Medical Tourism in the Czech Republic 105
8.1.1 Esthesia Dental Center 105
8.1.2 Cosmetic Surgery in the Czech Republic: Travel and Accommodation 108
8.1.3 Tourism in the Czech Republic 108
8.1.4 Sample Package Tour by Cedok Travel Corporation 109
8.2 Medical Tourism in Hungary 109
8.2.1 The Aesthetica International Medical Center 110
8.2.2 The Sopron Elizabeth Hospital 110
8.2.3 Tourism in Hungary 112
8.2.4 A Sample Hungarian Tour Package from Adventures Abroad Group 113
8.3 Medical Tourism in Belgium 115
8.3.1 Antwerp University Hospital 115
8.3.2 Weight Loss Surgery Group (WLS) 115
8.3.3 BeuCare 115
8.3.4 Eye Surgery Belgium 116
8.3.5 Brussels Neurosurgery Center 117
8.3.6 Tourism in Belgium 117
8.4 Medical Tourism in Poland 117
8.4.1 Poland: Paradise of Low Prices in European Medical Tourism 118
8.4.2 Spa w Raju, Medical Spa and Beauty Farm in Naleczow 118
8.4.3 Damian Medical Center 119
8.4.4 Tourism in Poland 120
8.4.5 Sample of Package Tours from Karakus Tourist and MICE Bureau 120
8.5 Medical Tourism in Turkey 120
8.5.1 Memorial Health Group, Turkey 121
8.5.1.1 Diagnosis and Treatment Methods Performed 121
8.5.2 JineMed Hospital 122
8.5.3 Baskent University, Alanya Hospital 123
8.5.3.1 Alanya Hospital's International Patient Department Call Center Services 124
8.5.4 Acibadem International 124
8.5.4.1 Acibadem's Cancer Center 124
8.5.4.2 Acibadem's Neurosurgery Center 125
8.5.4.3 Acibadem's Cardiac Care 126
8.5.4.4 Acibadem's Cardiac Surgery 126
8.5.4.5 Acibadem's In Vitro Fertilization Center 127
8.5.4.6 Acibadem's Neurology 127
8.5.4.7 Acibadem's Orthopedics 128
8.5.4.8 Acibadem Healthcare Group's Aesthetic, Plastic and Reconstructive Surgery Departments 129
8.5.4.9 Acibadem Healthcare Group's Oral and Dental Health Clinic 129
8.5.4.10 Acibadem's Ophthalmology Center 130
8.5.4.11 Acibadem's International Patient Center 130
8.5.5 Yeditepe University Eye Hospital 130
8.5.5.1 Eye Disorder Treatments 130
8.5.5.2 Yeditepe University Hospital's International Patient Services 131
8.5.6 Tourism in Turkey 131
8.5.7 Sample Package Tour in Turkey 132
8.6 Medical Tourism in Germany 133

9. Asia: The Rise of Medical Tourism 135
9.1 Medical Tourists Heading Towards Asia: Economical Rationale 136
9.2 India: The Emerging Giant in Medical Tourism 138
9.2.1 India: Healthcare Market Overview 138
9.2.2 India: Spreading the Net 138
9.2.3 India: The Importance of Geography 138
9.2.4 India: Diagnostics and Screenings, the New Niches 139
9.2.5 India: The Technology Edge 139
9.2.6 India: The Growing Credibility 139
9.2.7 India: Advancing Efforts 139
9.2.8 India: The Policy Thrust 139
9.2.9 India to Invest $6.5 billion in Medical Tourism 140
9.2.10 India: Healthcare Market Growth Perspective 143
9.2.11 India: Healthcare Growth Perspective 143
9.2.12 India's Advantage in Medical Education and Manpower 143
9.2.13 India's Healthcare Perspective Budget, 2007-2008 143
9.2.14 India: Shift to Lifestyle Related Diseases 144
9.2.15 International Accreditation Bodies Present in India 144
9.2.16 JCI-Accredited Hospitals in India 144
9.2.17 National Accreditation Board for Hospitals & Healthcare Providers (NABH) Accredited Hospitals in India 144
9.2.18 Evolving Concept of Healthcare in India 144
9.2.19 Indraprastha Apollo Hospital, New Delhi 145
9.2.19.1 Apollo Group Medical Highlights 157
9.2.19.2 Medical Treatments Available at Apollo Hospitals 158
9.2.19.3 Apollo International Patients Facilities 163
9.2.19.4 Apollo Insurance Facts for International Patients 164
9.2.19.5 Apollo International Patients Speak 165
9.2.20 Wockhardt Hospitals 165
9.2.20.1 Wockhardt Hospitals Treatments and Procedures 166
9.2.20.2 Wockhardt: Expatriates Can Obtain Cashless Treatment 168
9.2.21 Escorts Heart Institute 168
9.2.22 Max Heart & Vascular Institute, Saket 170
9.2.22.1 Max Super-Specialty Hospital, Saket 170
9.2.22.2 Max Balaji Hospital, Patparganj; Max Hospital, Pitampura; Max Hospital, Noida & Max Hospital, Gurgaon 170
9.2.22.3 Max MedCenter and Max Specialty Clinic (Eye Care and Dental Care), Panchsheel Park 170
9.2.22.4 Max Healthcare's International Patient Services 171
9.2.22.5 Max Healthcare's Super-Services 172
9.2.23 Artemis Health Institute 173
9.2.23.1 Artemis Cardiovascular Institute 174
9.2.23.2 Artemis Cancer Institute 174
9.2.23.3 Artemis Orthopedics Institute 175
9.2.23.4 Artemis International Patient Service 175
9.2.24 Fortis Healthcare 176
9.2.24.1 Fortis Network 176
9.2.24.2 Fortis Hospital, Mohali 176
9.2.24.3 Fortis Hospital, Amritsar 177
9.2.24.4 Fortis Hospital, Noida 178
9.2.24.5 Fortis Jessa Ram Hospital, New Delhi 178
9.2.24.6 Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj, New Delhi 178
9.2.24.7 Escorts Heart Institute and Research Center Ltd., New Delhi 178
9.2.24.8 Fortis Escorts Hospital, Faridabad 178
9.2.24.9 Fortis Escorts Hospital, Amritsar 179
9.2.24.10 Fortis Escorts Hospital, Raipur 179
9.2.24.11 Fortis La Femme, New Delhi 179
9.2.24.12 Fortis Escorts Hospital, Jaipur 179
9.2.24.13 Fortis Malar Hospital, Chennai 180
9.2.24.14 Fortis Healthcare International Patients Service Center 180
9.2.25 Kerala Institute of Medical Sciences 181
9.2.26 B.M. Birla Heart Research Center 185
9.2.26.1 BMBHRC's International Patient Services 185
9.2.27 Tourism in India 185
9.2.28 A Sample Tour Package: The Golden Triangle Package with Tiger Safari by Travelmasti.com 186
9.2.29 Ayurveda Treatment in Indian Medical Tourism 187
9.2.29.1 Benefits of Ayurveda 187
9.2.30 Arya Vaidya Sala, Kottakkal 187
9.2.31 Amrutha Ayurveda Center 188
9.2.32 Nagarjuna Ayurvedic Center 188
9.2.32.1 Yoga and Meditation in Nagarjuna 188
9.2.33 Tourism in Kerala 189
9.2.34 Sample Kerala Tour Package for $245 (Per Two Persons) 189
9.3 Medical Tourism in Thailand 190
9.3.1 Bumrungrad International Hospital 190
9.3.1.1 Bumrungrad: Accreditations, Awards and Recognition 192
9.3.1.2 Bumrungrad: Medical Centers 193
9.3.1.3 Bumrungrad: Facilities 193
9.3.1.4 Bumrungrad: Plan Your Visit 194
9.3.2 Bangkok Hospital Medical Center (BMC) 195
9.3.2.1 Bangkok Hospital Medical Center (BMC): Awards and Accreditation 195
9.3.3 Samitivej Hospitals 196
9.3.4 Samitivej Sukhumvit Hospital 196
9.3.5 Samitivej Srinakarin Hospital 197
9.3.6 Samitivej Srinakarin Children's Hospital 197
9.3.7 Samitivej Sriracha 198
9.3.8 Yanhee Hospital 198
9.3.9 Tourism in Thailand 200
9.3.10 Sample Thailand Tour with Spa Package 201
9.4 Medical Tourism in Philippines 202
9.4.1 St. Luke's Medical Center 202
9.4.1.1 International Patient's Service at St. Luke's Medical Center (SLMC) 203
9.4.2 The Medical City 203
9.4.3 Tourism in the Philippines 204
9.4.4 Sample Tour Package from Hotel Philippines 204
9.5 Medical Tourism in China 204
9.5.1 Medical Tourism China, Inc. 204
9.5.2 Medical Tourism Package 204
9.6 Medical Tourism in the United Arab Emirates (U.A.E.) 205
9.6.1 Dubai Healthcare City Free Zone (DHCC FZ) 206
9.6.2 University Medical Complex 207
9.6.3 The Medical Cluster 207
9.6.4 The Wellness Cluster 207
9.6.5 Healthcare Support 207
9.6.6 Cosmetic Surgery in United Arab Emirates (U.A.E.) 208
9.7 Medical Tourism in Saudi Arabia 208
9.7.1 Al Imam Abdulrahman Bin Faisal Hospital, Dammam 209
9.7.2 Almana General Hospitals 209
9.7.3 Dr. Soliman Fakeeh Hospital 209
9.7.3.1 Specialty Units & Centers 210
9.7.4 International Medical Center, Jeddah 210
9.7.5 King Abdulaziz Medical City-Riyadh 211
9.7.6 King Faisal Specialist Hospital and Research Center-Jeddah 212
9.7.7 King Khaled Eye Specialist Hospital 212
9.7.8 Al Mouwasat Hospital, Dammam 213
9.7.9 Saudi Aramco Medical Services Organization, Dhahran 213
9.8 Medical Tourism in Jordan 214
9.8.1 Jordan Hospital and Medical Center 214
9.9 Medical Tourism in Singapore 214
9.9.1 Singapore: Technology and Touch Points 215
9.9.2 Singapore: Customized Experience 215
9.9.3 Parkway Health 215
9.9.3.1 Parkway Health's Mount Elizabeth Hospital 216
9.9.3.2 Parkway Health's Gleneagle Hospital 216
9.9.3.3 Parkway Health's East Shore Hospital 216
9.9.3.4 Parkway Healthcare Services 216
9.9.3.5 Parkway's International Patient Assistance Center 217
9.9.4 Raffles Hospital 217
9.9.4.1 Raffles International Patients Center 218
9.9.5 Alexandra Hospital 218
9.9.6 Changi General Hospital 218
9.9.7 National University Hospital 219
9.9.7.1 National University Hospital (NUH): Awards and Achievements 219
9.9.7.2 National University Hospital (NUH) Specialties 219
9.9.7.3 National University Hospital (NUH) International Patient Liaison Center 220
9.9.8 National Cancer Center 220
9.9.9 eMenders 221
9.9.10 Tourism in Singapore 221
9.9.11 Sample Package Tour by Pearls Tours & Travels 222
9.10 Medical Tourism in Malaysia 222
9.10.1 Medical Tourism in Malaysia: Advantages at a Glance 222
9.10.2 Institute Jantung Negara (IJN) National Heart Institute 223
9.10.3 Mahkota Medical Center 223
9.10.4 Specialist Centers in Mahkota 224
9.10.5 Ampang Puteri Specialist Hospital 224
9.10.6 Gleneagles Intan Medical Center 224
9.10.7 Tourism in Malaysia 225
9.10.8 A Package Tour of Malaysia and Singapore by International Travel Tours.com 225

10. Medical Tourism in New Zealand 227
10.1 Tourism in New Zealand 227
10.2 Sample Package Tour of New Zealand 227

11. Medical Tourism in South Africa 229
11.1 Bay View Private Hospital 229
11.2 Christiaan Barnard Memorial Hospital 229
11.3 Cape Town Medi-Clinic 235
11.4 Carter Gordon Clinics 236
11.5 Kingsbury Hospital 237
11.6 Netcare Olivedale Hospital 237
11.7 General Information for International Patients Traveling to South Africa 238
11.8 Tourism in South Africa 242
11.9 A Sample Package Tour of South Africa by S.A.-Venues.com 243

APPENDIX
Appendix 1: Medical Tourism and the Demand for Hospital Accreditation Overseas 244
Appendix 2: JCI Accreditation 245
Appendix 2.1: JCI is Different from JC Accreditation in the U.S. 245
Appendix 2.2: How JCI Accreditation Works 246
Appendix 3: ISO Certification 246
Appendix 4: Cost Comparison for Medical Treatments Abroad 251
Appendix 5: A Select List of Global Medical Tour Operators 254
Appendix 5.1: Medical Tourism Corporation 254
Appendix 5.2: MedRetreat 254
Appendix 5.3: MediTravels 255
Appendix 5.4: MedicalIndia.in 255
Appendix 5.5: Plentias 255
Appendix 5.6: Waves India 255
Appendix 5.7: Medical Discounts International, Inc. 256
Appendix 5.8: Royal Medical Tourism 264
Appendix 5.9: Health Options International 265
Appendix 5.10: Healthbase 265
Appendix 5.11: Maryland Insurance Outlet 265
Appendix 5.12: Sahara Global 265
Appendix 5.13: StatMedica.com 266
Appendix 5.14: Cosmetic Surgery Travel LLC 266
Appendix 5.15: Cosmetic Vacations, LLC 267
Appendix 5.16: Medical Tourism Association (MTA): An International Nonprofit Organization 267
Appendix 5.16.1: Medical Tourism Association (MTA): Transparency 267
Appendix 5.16.2: Medical Tourism Association (MTA): Communication 267
Appendix 5.16.3: Medical Tourism Association (MTA): Education 268
Appendix 5.16.4: Medical Tourism Association (MTA): Mission 268
Appendix 5.17: Surgical Bliss, South Africa 268
Appendix 5:18: Destination Beauty 269
Appendix 6: Travel Medicine: Helping Patients Prepare for Trips Abroad 269
Appendix 6.1: Assessment Before Traveling Abroad 270
Appendix 6.2: General Issues 270
Appendix 6.3: Common Travel-Related Conditions 272
Appendix 6.3.1: Travelers' Diarrhea 272
Appendix 6.3.2: Protection Against Insects 273
Appendix 6.3.3: Transportation Risks 273
Appendix 6.3.4: Sexually Transmitted Diseases 273
Appendix 6.3.5: Immunizations and Chemoprophylaxis 273
Appendix 6.3.6: Measles Vaccine 275
Appendix 6.3.7: Rubella Vaccine 275
Appendix 6.3.8: Poliovirus Vaccine 275
Appendix 6.3.9: Tetanus-Diphtheria Vaccine 275
Appendix 6.3.10: Varicella Vaccine 275
Appendix 6.3.11: Influenza and Pneumococcal Vaccines 275
Appendix 6.3.12: Hepatitis A Vaccine and Immune Globulin 276
Appendix 6.3.13: Typhoid Vaccine 277
Appendix 6.3.14: Yellow Fever Vaccine 278
Appendix 6.3.15: Japanese B Encephalitis Vaccine 278
Appendix 6.3.16: Meningococcal Vaccine 279
Appendix 6.3.17: Malaria Chemoprophylaxis 279
Appendix 6.3.18: Hepatitis B 280
Appendix 7: A Guide for U.K. Patients Considering Medical Tourism 281
Appendix 7.1: What to Consider? 281
Appendix 7.2: Decide Where To Go 282
Appendix 7.3: Compare the Costs 283
Appendix 7.4: Investigating the Surgeon and Dentist 283
Appendix 7.5: Investigating the Clinic / Hospital 284
Appendix 7.6: Questions to Ask the Surgeon / Dentist Overseas 284
Appendix 7.7: What Guarantees Should Be Expected? 284
Appendix 7.8: What to Check in the Document 285
Appendix 7.9: How to Compare Different Providers 285
Appendix 7.10: What Not To Do 286
Appendix 7.11: The Practicalities of Going Abroad for Treatment 286
Appendix 7.12: What To Do If Something Goes Wrong 286
Appendix 8: World Tourism Statistics and Ranking 287
Appendix 9: Medical Tourism: Additional Facilitators 289
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Table 1.1: An Overview of Medical Tourism, 2006 14
Table 1.2: Countries and Their Specialties in Medical Tourism 14
Table 1.3: Insured and Uninsured Breakdown in the U.S., 2001-2005 17
Table 1.4: Percentage of Population Without Health Insurance in the U.S., 2007 17
Table 1.5: International Health System Features: A Snapshot 18
Table 1.6: Medical Tourism: Destinations 22
Table 1.7: Procedures Sought by Medical Tourists 23
Table 1.8: Cost Comparison for Surgery: International 23
Table 1.9: Revenue Earnings from Medical Tourism by Host Country 24
Table 1.10: Countries Promoting Medical Tourism with Active Government Support 25
Table 1.11: Evolution of Medical Tourism 27
Table 1.12: Competing Countries and Specializations 28
Table 1.13: Cost Comparison Between the Two Asian Rivals 28
Table 1.14: Cost Comparison Between Thailand, Singapore and India 29
Table 1.15: U.S. Charges per Transplant, 2005 30
Table 1.16: Surgery Costs for Transplantations in India 31
Table 2.1: Cost Comparison of U.S. vs. Foreign Surgical Procedures 34
Table 2.2: Cost Estimate for Spending by Out-Bound Medical Tourists, 2008-2017 34
Table 2.3: Lost Domestic Spending in U.S. by Out-Bound Medical Tourists, 2008-2017 35
Table 2.4: Leading U.S.-Based Partnerships for Out-Bound Medical Tourism 36
Table 2.5: Major Medical Procedures and Costs in Western-Level Hospitals 38
Table 2.6: Companies Based in the U.S. Facilitating Medical Tourism 40
Table 2.7: Comparison Between U.S. and Indian Prices 41
Table 3.1: U.K. Patients Flying Abroad, 2004-2010 46
Table 3.2: Value of the U.K. Medical Tourism Market 46
Table 5.1: Low-Cost World-Class Hospitals Abroad with JCI-Accreditation 54
Table 6.1: Countries Promoting Medical Tourism 57
Table 7.1: Average Dental Cost Comparison of U.S. vs. Mexico 67
Table 7.2: Cosmetic Surgery Cost in Mexico 68
Table 7.3: Mexican General Price List 68
Table 7.4: Argentina's Price List 80
Table 7.5: Typical Cost of Cosmetic Surgery in Brazil 84
Table 7.6: Estimated Prices at Centre Internacional de Medicina (CIMA) (Physician fee not included) 86
Table 7.7: Procedures Available at CIMA Hospital 86
Table 7.8: Procedures Available at Rosenstock-Lieberman Center for Cosmetic Surgery 87
Table 7.9: Rosenstock-Lieberman Center for Cosmetic Surgery Price List 87
Table 7.10: DentaVac Price List 91
Table 7.11: Certified Dentists in Costa Rica 92
Table 7.12: Average Prices in Costa Rica for Medical Tourists 93
Table 7.13: Price List from Pana-Health 98
Table 7.14: Havana Hospital's Price List 102
Table 8.1: Average Cost of Surgical Procedures in the Czech Republic 106
Table 8.2: Price List from Hospitals in Hungary 111
Table 8.3: Treatment Prices in Budapest Compared with Prices in the U.K. 111
Table 8.4: Weight Loss Surgery Group's Price List 116
Table 8.5: BeuCare's Price List 116
Table 8.6: JineMed Hospital's Price List 123
Table 8.7: Acibadem's Price List for Cosmetic Surgery 130
Table 8.8: Foreign Tourist Arrivals in Turkey, 1998-2007 133
Table 9.1: U.K. Prices and Waiting Periods 141
Table 9.2: U.S. Prices 141
Table 9.3: Cost Difference: Coronary Bypass Surgery 141
Table 9.4: Cost of Infertility Treatment in India 142
Table 9.5: Price Comparison Between U.S. and India 142
Table 9.6: India: How the Healthcare Pie Will Evolve, 2006 and 2012 142
Table 9.7: Snapshot of Healthcare Market, 2006 142
Table 9.8: India: Public Healthcare Infrastructure, 2006 145
Table 9.9: Upcoming Health Cities in India 146
Table 9.10: Key Healthcare Players in India 146
Table 9.11: New Entrants in Indian Healthcare 146
Table 9.12: Price List for JCI-Accredited Hospitals in India, 2008 147
Table 9.13: Leading Indian Players in Medical Tourism 157
Table 9.14: Apollo Treatment Costs 158
Table 9.15: Apollo Price Comparison 163
Table 9.16: Apollo Health Check-Up Tariff for International Patients 163
Table 9.17: Wockhardt: Cost Comparison 168
Table 9.18: Escorts: Comparative Price 170
Table 9.19: Escorts: Treatment Costs 171
Table 9.20: Fortis Treatments Cost of Packages 180
Table 9.21: KIMS Packages for International Medical Tourists 182
Table 9.22: Nagarjuna's Curative Treatments 189
Table 9.23: Thailand: Cost of Treatments 191
Table 9.24: Medical Tourists in Thailand, 2001-2005 191
Table 9.25: Foreign Patients Treated in Thailand Hospitals, 2002-2005 192
Table 9.26: Number of Certified Spa Operators, 2005 192
Table 9.27: Spa Operators by Region, 2005 192
Table 9.28: Thailand: Revenue from Medical Tourism, 2004-2008 192
Table 9.29: Bangkok Hospital Medical Center (BMC): Cost of Surgical Packages 196
Table 9.30: Yanhee Prices for Cosmetic Surgery 199
Table 9.31: Almana General Hospitals: Size of Establishments 209
Table 11.1: Botox Injection for Frown Lines and Crow's Feet 231
Table 11.2: Augmentation Mammaplasty (Breast Enlargements / Implants) 231
Table 11.3: Breast Reduction and Breast Lift 231
Table 11.4: Forehead Lift and Eyebrow Lift 232
Table 11.5: Cosmetic Laser Resurfacing 232
Table 11.6: Blepharoplasty (Eyelid Lift Surgery) 232
Table 11.7: Rhytidectomy (Face Lift) 233
Table 11.8: Mouth and Chin Surgery 233
Table 11.9: Liposuction 233
Table 11.10: Rhinoplasty (Nose Surgery) 234
Table 11.11: Otoplasty (Prominent Ears) 234
Table 11.12: Removal of Moles and Skin Lesions 234
Table 11.13: Abdominoplasty (Tummy Tuck) 235
Table 11.14: International Airlines in South Africa 242
Table 11.15: South Africa Domestic Airlines 242


INDEX OF TABLE APPENDIX

Table App 2.1: Hospitals Accredited by JCI 247
Table App 4.1: Cost Comparison for Arthroscopy (Price all inclusive) 251
Table App 4.2: Cost Comparison for Carpal Tunnel Release 251
Table App 4.3: Cost Comparison for Cataract Removal 252
Table App 4.4: Cost Comparison for Colonoscopy 252
Table App 4.5: Cost Comparison for Coronary Angioplasty 253
Table App 4.6: Cost Comparison for Hip Replacement 253
Table App 5.1: Medical Discounts International's Offer of Indian Procedures with Highest Savings for U.S. Patients 257
Table App 5.2: Medical Discounts International's India Price List, 2008 257
Table App 6.1: Resources on Travel Medicine 271
Table App 6.2: Drugs for Prophylaxis and Treatment of Travelers' Diarrhea in Adults 272
Table App 6.3: Routine Vaccination Updates for Travelers Abroad 274
Table App 6.4: Routine Travel Vaccination for Hepatitis A 276
Table App 6.5: Immune Globulin for Protection Against Hepatitis A in Travelers Abroad 276
Table App 6.6: Routine Travel Vaccination for Typhoid 277
Table App 6.7: Yellow Fever Vaccine: Recommended for Travel to Endemic Areas 278
Table App 6.8: Japanese B Encephalitis Vaccine: Recommended for Travel to Endemic Areas 278
Table App 6.9: Meningococcal Vaccine: Recommended for Travel to Endemic Areas 279
Table App 6.10: Drugs Used in the Prophylaxis of Malaria 279
Table App 6.11: Hepatitis B Vaccination for Travelers Who Visit Endemic Areas for Six Months or Longer and for All Healthcare Workers 280
Table App 8.1: World Tourism Ranking, 2006-2007 287
Table App 8.2: International Tourism Top Spenders, 2006-2007 287
Table App 8.3: Most Visited Tourist Attractions by Domestic and International Tourists in 2007 288
Table App 8.4: Most Visited Cities by International Tourists in 2006 288

Figure 1.1: Number Uninsured and Uninsured Rate in the U.S., 1987-2006 16
Figure 2.1: Total Spending on Healthcare in the U.S., 1960-2007 32
Figure 2.2: International per Capita Healthcare Spending by Country, 2006 33
Figure 2.3: U.S. Out-Bound Patient Flow Forecast, 2007-2017 33
Figure 2.4: Forecast of U.S. Patients Spending Abroad, 2008-2017 35
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