The global “medical tourism” industry has been estimated to worth some US$60 billion per year, with 20% annual growth. This is a clear sign that an economic quantification can indeed be made to a hitherto less commercialised sector called healthcare.

In today’s globalised world, scientific advancement and medical progress led to a proliferation of healthcare facilities in Asia, Europe, US and everywhere. Even remote places like Cuba, India and Russia increasingly started to brand their unique clinical specialties with a price tag often considered a huge bargain for many more expensive countries. From the periscope of an “ideal world with an ideal health system”, this is a clear sign yet of an imbalance between supply of such capabilities and services vs. demands for them. Such phenomenon is further accentuated by the better communications in the form of ubiquitous information through cyberspace and affordable transportation through cheaper airlines etc.

More recently, medical tourism has evolved as a phenomenon wherein patients from industrialized nations seek healthcare at advanced medical facilities in less developed countries, bypassing services offered in their domestic capabilities and infra strcuture. News of the next revolution of healthcare delivery system will present another epoch in our history when proposal by some EU countries to allow their citizens treated overseas and have their bills reimbursed nationally. This must be quite unthinkable as a news for a start, let alone to feel comfortable with for many; but frankly and profoundly speaking, instead of competing to build local facilities and capabilities; while the level of service decline by the days, leading to the public healthcare system regressing into bureaucratic decline, and most certainly the votes in the next election heading into some alternative voice purported to have a panacea for all the healthcare woes; this may well be a model to explore seriously.

On the one hand, healthcare is a basic right for every citizen who contributes to any economy through any direct or indirect means; and there are incomprehensive emotive values attached to the patient and their loved ones. On the other hand, healthcare is an economic hot potato to every government who tries to appease or make the best out of their promise when ballot boxes are being counted.

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The government’s job to build and provide the right level of resources will always have a limit; and there is always somewhere else in the world where something is better than ours. The best indicator to such disparities is to watch behavioural changes in the pattern of health travel. People travel to receive services, people travels to offer services; products travel through vast space to where the demands are generated, so can demands be translocated to rendezvous the supplies. Often medico-legal landscape will determine the extent of such “transactions”, but certainly can’t decide the continuity of such activities. The recent two cases of “kidney on demand” provide a prelude to what’s to come in the future both to the complexity and perplexity of legislations and ethics.

In the end, healthcare doesn’t really differ very much from other “trade or services”, there is a distinctive economic dimension to it albeit both the economic and emotive components are a lot harder to quantify, but economist certainly did try. Welcome to the new era of medical tourism with an ever enlarging global footprint…!

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Ng Cheng Tiang
Pharmaceutical Society of Singapore.

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