Medical tourism in the Caribbean: a cure for economies in crisis?

A new paper argues that local claims of the potential for medical tourism in Jamaica and other Caribbean islands are unrealistic due to the limited health resources and skills available.

Professor John Connell of the University of Sydney, Australia, has written a paper ‘Medical Tourism in the Caribbean Islands: A Cure for Economies in Crisis? ‘, published by The University of Prince Edward Island.

”Small island states have increasingly sought new means of economic diversification. Several Caribbean states have begun to develop medical tourism, partly building on existing tourist-oriented economies. Medical tourism has boomed in this century in several states in Asia and in Central America. The Bahamas, Barbados and the Cayman Islands exemplify different strategies for medical tourism, in order to generate foreign exchange and new employment, and reduce costs from overseas referrals. Most medical tourism projects have been developed by overseas corporations and are oriented to a US market. Business principles rather than healthcare dominate development strategies, notably of emerging transnational medical corporations, and raise ethical issues. Success will be difficult to achieve in a crowded and competitive market.”

Connell is critical of the strategies of Caribbean countries. He suggests that some can develop a limited medical tourism industry if they focus on nationals who have gone to live overseas and/or offer limited niche offerings for overseas Jamaicans when they visit; only if they can attract skilled doctors and nurses back from overseas.

Most Caribbean islands have some potential for medical tourism as:
• They are familiar to tourists from North America and Latin America.
• They are easily accessible by the target Americas markets.
• They have tourism oriented economies and infrastructure.
• English is the main language and Spanish is spoken too.
• Most island states have modern healthcare systems.
• Diasporic tourism (locals and their descendents who live abroad) is significant.

But they all have common problems-
• Healthcare systems are adequate but not as complete or up to date as many of the countries they are targeting.
• There are concerns over quality of care and aftercare.
• Where quality of care is essential, it is hard for small states to market or prove this.
• They face strong regional competition from Mexico, Cuba, Panama, Costa Rica and others where travel costs and care costs are lower.

The number of island states seeking to develop medical tourism continues to grow, despite the problems, and the challenges of breaking into an overcrowded and competitive global market where price matters and experience is critical. Some are being misled by outside consultants who make implausible claims and promises.

Success is possible for some, but others have little hope of breaking in. Offering specialisms that are not readily available in the US, Canada or local countries is the most likely route to limited success; but numbers will always be small compared to elsewhere.

Potential winners include-
• Antigua addiction therapy
• Barbados fertility tourism
• Bahamas prostrate cancer and spinal surgery

The small-scale success of the Barbados fertility centre contrasts with the huge projected numbers in the Cayman Islands. A new 140-bed Barbados hospital would need 10,000 patients a year to give investors any profit. A 2000 bed Cayman hospital would need 150,000 clients a year to make money. Most medical tourists go with a companion or family, placing enormous pressure on local resources. Estimates of potential numbers are probably inflated. Not all new projects will succeed, or even launch, as there are suggestions that some potential investors in announced proposed ventures are having second thoughts as to whether they would ever get their money back.

Those countries who could have some success are where the country and healthcare offerings are sophisticated. But the region suffers from relatively high costs compared to established regional competitors. Developing sophisticated and expensive facilities with no guarantee of success in a sensitive industry with boom and bust cycles is risky at best. There is a lack of skilled health workers. The new US insurance regimes exclude medical tourism outside the USA.Medical tourists tend to go offshore for simpler low risk procedures rather than complex surgery or long-term cancer treatment.