Ian Youngman revisits the figures of medical tourism

As someone who has been collecting, analyzing and publishing facts and figures on medical tourism, I am getting increasingly frustrated and annoyed about the continual use of figures that have often already been discredited.

It suits politicians, conference organizers and some consultants to continually circulate these figures as it exaggerates the importance of some countries or potential. It also has the reverse effect of damaging realistic figures and estimates from other countries, and downplays real achievements.

Market potential

In 2007 and 2008 several reputable organizations published estimates of medical tourism figures, particularly of how many Americans went overseas or would go overseas. You may have noticed the global economic crisis since then. To give these organizations credit, they have since revised and downsized the numbers and potential numbers. But some people and organizations still publicly quote the 2007 and 2008 figures as if they were true, and some even compound it by suggesting that if this was correct in 2007, then by 2012 with a ‘growth of 30% a year’ look how great the figures are now.

The recent Ipsos poll suggesting that almost one in two people would consider medical tourism is already being seized on by those wanting to promote an over optimistic view of medical tourism. The problem was that the survey wrongly assumed that the only reason for going overseas is to save money… which is far from true.

The other problem with Ipsos and any other “what would you buy” surveys is that they are simplistic.

If you asked people: “Would you like a return space trip to the moon?”, you might get 90% saying YES.

If you then asked: “Would you take that one hour $1 million trip if you had to sell your house, car, pension, savings and business?”, the numbers saying YES would drop to 0.000000009%.

All ‘what would you buy’ surveys are risky. Ask the makers of Betamax machines, the failed alternative to VHS video recorders; who told the world how many millions would like to buy their product!

Numbers of medical tourists

This is a huge subject. The usual problem is that many countries and organizations have an incentive to over claim numbers.

An international medical tourist is one who goes from where they live to another country solely for the purpose of healthcare or health treatment. Many make the mistake of equating “international patients” with “medical tourists”.

The usual trick is to include some or all of the following in the counting of medical tourists:

• Holidaymakers
• Diplomats
• Military personnel
• Business travellers
• Non-nationals who are residents but not citizens of the country
• Temporary expatriates
• Long term expatriates
• Overseas students
• Health/spa tourists

Medical tourism numbers by country

Many country figures are nothing more than an estimate made up by a conference speaker or politician, based on no actual figures at all. The problem is that these numbers go “viral”…. The figure becomes an “internet fact” endlessly repeated forever.

My favourite is the now disgraced politician who claimed “My country has had 600,000 medical tourists in the last 6 months. This shows how well my campaign worked”. Sadly for her, there were only 400,000 visitors of all types to that country in those six months!

Academic studies

Some academic studies are very good. But you have to remember that academics rarely have much money to spend so rely heavily on literature searches, existing sources or very small samples. Taking a sample of 500 people of whom 3 have been medical tourists or may consider medical tourism in the future, and then converting that to a huge number as a percentage of the population is hugely risky and rarely accurate.

My favorite here is one recently claimed by a medical tourism magazine to be a “new study”. It had actually been published four years ago and was based on 2001 data (that is not a misprint). It claimed that a million Californians go to Mexico every year for medical treatment. If true, would mean Mexico now gets something like 4 million medical tourists a year. The survey methodology had many problems, and the likelihood of the figures being true is close to zero.

Price comparisons in medical tourism

We have all seen the “Come to my country and save 70% to 80% on what you pay in Europe or the USA”.

But the price they quote rarely includes all hospital extras, travel and accommodation for patient and companion and other sundry expenses that may double or triple the actual cost.

The price is compared against an incorrect overseas price or the highest they can find.

The big problem on European prices is that most urgent surgery and many other treatments are not actually paid for by the patient, but by some form of universal healthcare and/or insurance.

In the US there are now several price comparison sites where patients can compare prices or get quotes – much cheaper than the “US price” quoted by these overseas hospital or countries.

The other problem is that they say the same thing to insurers and employers – forgetting that a big insurer or employer will usually pay only 50% of the list price. And in these tough times big health insurers can hammer cheaper deals with desperate private hospitals, some only paying a third of list price.

Medical tourism leaders

You see this every time a country begins a medical tourism initiative. Somebody, a bought in consultant, a conference organizer, will claim that “Country x has the potential to be a global medical tourism leader”.

Now… after the first 200 countries or so, I stopped counting these claims. Think of it as an election, a race or a football tournament, you can only have one winner. In a Formula One race, you often have “the leaders”, the first three or four cars; the rest (usually the same teams) are trailing many laps behind; and in medical tourism you have the real leaders and the rest of the pack; you would not describe the last racing car as “a leader”.

The good news!

The good news is that more countries and organizations are producing reliable figures on prices and actual numbers of medical tourists.

We no longer need the spin and lies about actual or potential numbers. This is a growth industry; we do not need to con customers or potential investors by exaggerating the potential.