Medical tourism in Asia shows promise

Market Scope

Julie Munro, founder of Cosmetic Surgery Travel, believes she has hitched her wagon to a growing trend – Americans going to Asia to find inexpensive surgery, including Lasik. “These are people who want to take care of themselves,” says Munro, whose year-old business, based in Philadelphia and Bangkok , arranges Lasik as well as cosmetic surgery in Thailand and escorts patients when they arrive.

These “medical tourists” are willing to fly for 15 to 24 hours to Asian countries with teeming, dusty streets because they want exotic travel, accept that outcomes will be good and, perhaps most of all, like the low price. Munro says Thai Lasik costs $1,500 for both eyes, one-half to one-third of the normal charge in the United States . A round-trip plane ticket to Bangkok costs $750 and a stay in a good hotel is about $100 a night. Clients stay a week or longer, have multiple operations and take in some tourism, she says.

Authorities in Thailand , Singapore , Malaysia and India report that the numbers of medical tourists are swelling by the year. Thailand , which already has an estimated 10 million tourists a year, counts 100,000 of those as medical tourists . Malaysian authorities report 85,000 medical tourists a year. Many of the patients are from nearby countries or are U.S. and European diplomats or expatriates. But a growing number travel from the United States , fleeing skyrocketing medical prices, and from Europe and Canada , avoiding long waiting lists for procedures. In addition to Lasik, they come for low-cost cataract removals, MRI scans, heart surgery and even sex-change operations. Facilities have English-speaking staff.

Asian governments view medical tourism as a potentially huge source of revenue and are encouraging growth. Malaysia is working with private institutions to make the country “ Asia 's health tourism hub.” In 2003, Singapore launched an initiative specifically to attract medical tourists. Thailand is focusing efforts on medical tourists over age 50. And India deems medical tourism an export that is eligible for tax breaks. The Indian state where Bombay is located recently started a “Medical Tourism Council .”

Singapore , until recently, offered the highest priced Lasik surgery in the region and was losing business to its neighbors. Then last summer, the National Eye Centre, Singapore 's largest eye clinic, cut Lasik by up to 30 percent, to $1,320 for both eyes. That price puts the island nation lower than neighboring countries, but still higher than India , where the rate is as low as $850 for both eyes.

The price might be right, but how about the quality? Lee R. Duffner, M.D., an ophthalmologist at Eye Surgery Associates in Hollywood , Fla. says he does not discourage his patients from seeking treatment in some foreign countries, despite drawbacks such as lack of continuity of care. Dr. Duffner, an inveterate traveler, has personally visited several Asian eye surgery centers. While Singapore clinics “at the cutting edge” in expertise and technology, “the Indian facilities that I saw were adequate but not as up-to-date as what I've seen in Singapore ,” he said, but added: “Never put anything past the Indians. They are incredibly resourceful.”

Adam Hickenbotham, O.D., a U.S. optometrist who had Lasik done at TRSC International LASIK Center in Bangkok , has studied outcomes of 15,000 TRSC patients. He found that more than 99 percent met the standard for driving without glasses and 88 percent were seeing 20/20. But the foreign clinics still strive hard to prove their quality to Westerners. Joint Commission International, a branch of the Joint Commission on Accreditation of Healthcare Organizations that accredits U.S. hospitals, has accredited Thailand and Singapore hospitals and has received applications from two Indian hospitals. And the Singapore Health Ministry plans to release outcomes data on medical facilities, starting with Lasik, cataract surgery and obstetrics.

Ronald Yeoh, MD, a Singapore eye surgeon, told the local Straits Times that Singapore 's quality stands out. While some eye centers in other countries use the same blade for about 10 eyes, he says he uses just one per eye. Ang Chong Lye, the director of the Singapore National Eye Centre, added that with its price cut, “we believe we can chalk up even more volume that will only mean better economies of scale...without compromise to quality, safety and standards.”

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