MEDICAL TOURISM IN THE PHILIPPINES

Introduction

The Philippines has been growing as a tourist destination of choice for

health and vacation because of our world class physicians, modern technology,
and our uniquely Filipino brand of caring and compassion at great values for
money with only a fraction of the cost in developed countries. As a Filipino
citizen, we can prove that we are home to some of the best hospitals and stand-
alone specialty clinics in the world, offering world-class expertise, state-of-the-
art facilities, topped with the distinct warmth of the famous Filipino hospitality.

Discussion

Medical tourism is the term commonly used to describe people traveling

outside their home country for medical treatment. Patients may pursue
medical care abroad for a variety of reasons, such as decreased cost, a
preference for care from providers from a similar culture, or to receive a
procedure or therapy not available in their country of residence. In the United
States, medical tourism generally refers to people traveling to less-developed
countries for medical care. Medical tourism is a worldwide, multibillion-dollar
phenomenon that is expected to grow substantially in the next 510 years.
Studies have estimated that hundreds of thousands of medical tourists travel
from the United States annually. Little reliable epidemiologic data on medical
tourism exist, but ongoing reports of disease outbreaks serve as a reminder
that medical tourism is not without risks.

Most medical tourists pay for their care out of pocket and rely on private
companies or medical concierge services to identify foreign health care
facilities. These companies may not require accreditation of foreign providers,
track patient outcome data, or maintain formal medical record security
policies. Some insurers and large employers have formed alliances with
overseas hospitals to control health care costs, and several major medical
schools in the United States have developed joint initiatives with overseas
providers, such as the Harvard Medical School Dubai Center, the Johns
Hopkins Singapore International Medical Center, and the Duke-National
University of Singapore.

According to De Vera, et. al (2008), the Philippines is able to provide

quality health care to medical tourist at a right price. De Vera compared that
Philippines is much cheaper health care than U.S. De Vera stated that the
advent of medical tourism in the Philippines was known as the destination for
catholic faith healing, which attracts thousands of visitors from America and
Europe in year 1960s.

During Marcos regime in year 1975, the Philippine government

established different hospitals like Philippine Heart Center (PHC), National
Lung Center (NLC) and National Kidney and Transplant Institute (NKTI) in
order to build the country into a hub of medical expertise in East Asia.

According to the Philippine Institute for Development Studies, cataract

surgery costs $950 in Thailand, $1,424 in the Philippines, and $1,014 in
Malaysia. Liposuction in the Philippines costs $1,400. Patients in Thailand
have to spend $1,365 only for the same procedure. Total knee replacement
surgery is more expensive in the Philippines at $5,639, compared to $5,500 in
Thailand and $4,342 in Malaysia. India boasts that its medical rates are 40%
to 60% lower than the rates in the US and UK.

In year 2004, Philippine President Gloria Macapagal created a joint

partnership task-force between the Filipino private and public sectors to
develop a program to specifically promote medical tourism within the country.
Called the Philippines Medical Tourism Program, or PMTP, the program draws
together government hospitals and medical centers as well as private practices,
hospitals and businesses to create one of the most attractive medical
communities anywhere in the world.

Department of Health made Philippine Medical Tourism Program with a

vision of the global leader in providing quality health care for all through
universal health care. Philippine Medical Tourism Program consist of four
domains: full hospital care and treatment; specialty clinics (e.g., eye, dental,
and cosmetic services); wellness and spa centers; and retirement and long-term
care for the elderly. The Philippines Medical Tourism Program closely monitors
all health care providers in the country to ensure they comply with some of the
most stringent medical standards on the planet, guaranteeing that visitors to
the Philippines receive world-class treatment and care. Several Filipino
hospitals have even received the coveted accreditation of the Joint Commission
International, a private organization that ensures hospitals and healthcare
facilities worldwide comply with strict international standards in patient care.

Under the Philippines Medical Tourism Program, medical facilities

throughout the country have invested heavily in the latest medical technology
for their practices to be able to offer their overseas patients the very latest
treatment with the most up-to-date technology available. But of course,
technology and treatment are just one aspect of the medical experience, and
the legendary kindness and compassion of nursing staff is just another
attraction that keeps patients returning to this country, which is described by
many as the heart of Asia.

The Philippines medical system is also free of many of the problems that
have driven up the cost of medical treatment in western countries.
Infrastructure costs, real estate, construction and labor costs are all
significantly lower. Medical practitioners are not hampered by the same
bureaucracy or red tape which affects their western counterparts, and
government taxes and inflated medical insurance costs are also kept to a
minimum.
Advantage

Philippine medical professionals are also fluent in English, which

reduces the possibility of error and misunderstanding between doctor and
foreign patient. Medical professionals in the country, particularly the nurses,
are known for their hospitality, skills, and excellent patient care, which makes
them in demand in foreign hospitals abroad.

Pacific prime 202, discussed different advantages in medical tourism.

Costs as the biggest benefit to seeking medical treatment abroad. The
significant savings can made. Travelling to Thailand, for example, for a range of
surgeries and medical procedures can result in savings of between 65 and 90
per cent on equivalent costs in the United States. Reduced costs of up to 80
per cent are possible in Malaysia. Open heart surgery in the United States can
cost up to $324,000 yet it can cost as little as $8,000 in India.

By choosing to have treatment abroad, typically at a private medical

facility, the treatment or procedure can be arranged for a mutually suitable
time. This means that there is no need to join a waiting list, as might be the
case in the United States or other European countries. Not being required to
wait for treatment is obviously beneficial to those suffering from serious
illnesses or medical conditions for which urgent treatment will help.

Reduced paperwork in hospital. One of the benefits of medical tourism is

the ease with which a procedure or course of treatment can be arranged. As
the hospital or clinic requires payment in cash, there is very little paperwork to
be completed. There is also no need for complex insurance forms or other
administrative work to be submitted before or after the procedure. Depending
on the destination, in many cases the most time consuming aspect of the
journey may be arranging the necessary travel documents or visa. This
reduction in paperwork can help a patient plan their trip in a relatively short
space of time, again benefiting those with serious illnesses.

Medical tourism or a medical vacation gives patients a chance to explore

a new destination and a new culture. In fact, medical tourism agencies offer
well-rounded health vacation packages that let medical tourists receive first-
class medical care while sightseeing tourist hotspots or relaxing on the beach
in the destination. Destinations such as Philippines, Thailand, India and
Singapore offer patients world-class medical and recreational facilities, which
is important to help recovery. Medical treatment abroad is usually purchased
as a package, meaning that in some cases it can act like a mini-vacation.
Bringing a partner, spouse or family members along too will help keep morale
high, and also provide an opportunity for everyone to enjoy the climate, food
and other attractions the destination country has to offer.

Why do patients go abroad? Jagyasi gave 5 major factors involved in

decision making: affordable, accessible, available, acceptable and additional.
Affordable is probably the major reason and this is particularly true for
patients from the well-off, developed countries like America and UK, where
private health care is expensive, and some surgeries are not covered by their
insurance. Available is often because the medical treatment they need is not
available in their local areas or not trusted by the patients, as is often the case
with Omani patients. Accessible applies more particularly to patients from
countries where the waiting list is long, particularly to National Health Service
patients in the UK and in Canada. In the UK, private health care may be
available locally, but is expensive. Acceptable applies to services, which may be
affordable, available, and accessible, but they are not acceptable in the
patients own country for religious, political reasons or other social reasons.
Additional refers to the availability of better care, perhaps better technology, or
a better specialist, or simply better service and personalized care abroad
compared to care in the home country.

Disadvantage

Lamsk discussed that there are other risks which medical tourism poses
to patients. For example, patients may not tolerate travel very well, or may not
have inherent resistance to some of the diseases in the host countries. We
therefore need to have better scientific studies on the impact of medical
tourism on the health care services of the source and destination countries as
well as on the patients themselves. We need more statistics on the rate of
complications. The article in this issue of this journal reported a 15%
complication rate;1 granted we do not know how severe those complications
were, but that is what needs to be studied. A survey was carried out by the
British Association of Plastic, Reconstructive and Aesthetic Surgery. They
received responses from 203 out of 325 members. A total of 37% of them had
seen a patient in the National Health Service with complications arising from
overseas cosmetic surgery. In another survey in the UK, 60% of complications
were of emergency nature requiring inpatient admission. Americans and
Europeans now realize that they need to analyze the impact of medical tourism
beneficent or maleficenton the patients and the countrys health care
system.

According to Lamsk, health insurance companies may be disadvantage,

who may refuse to cover a patient going abroad for legitimate reasons, or may
actually encourage patients to go abroad if the treatment is cheaper, but then
not cover the airfare and other expenses. The other side of the coin is that
there is now pressure on insurance companies to cover the cost of all overseas
treatment and this may mean raising premiums yet another negative side to
medical tourism for some patients.
 According to Neeraj, Medical Malpractice Suits may be an issue in
medical tourism. Although most medical tourism facilities (hospitals, dental
clinics, etc.) will have medical malpractice insurance to cover any unforeseen
events, seeking damages can sometimes be difficult in cases of negligence,
misdiagnoses, or incompetence. This is not to say that medical tourists have
absolutely no legal recourse, but if you're looking for large cash settlements,
you should probably stay in your home country. The laws of your country
might not be any easier to decipher, but you will probably enjoy greater access
to more transparent guidelines and regulations.

Conclusion

Medical tourism is a growing phenomenon with policy implications for health

systems, particularly of destination countries. The Philippines is actively
contending for Asias medical tourism customers, and the country has many
advantages. Americans are a major portion of Asias customers due to the
U.S.s high health care costs, and the Philippines and the U.S. have a history of
strong relations. Many Filipinos have lived in the U.S., and extensive travel
exists between the two countries. This provides a pool of Filipino doctors that
have been trained in the U.S. who find it attractive to return home to be near
their extended families. It makes it more likely that naturalized Filipinos (and
their offspring) who are now American citizens will consider having procedures
in the Philippines. The Philippines is a beautiful tropical country, which adds
value to the tourism part of its value proposition. It has been famous for
many years for tourism, as a tropical paradise. Costs are very low, and the
quality of the facilities and medical staff is high. Many hospitals have the latest
medical technology. Private hospital rooms are similar to five star hotels. The
staff has excellent English language skills. The concept of medical tourism is
appealing to anyone who is interested in high quality and affordable
healthcare. The medical tourism phenomenon is gaining popularity and the
number of people going abroad for treatment increases rapidly every year.

With many medical tourism benefits, advancements in technology and

improvements in healthcare standards within developing countries, it is likely
that the advantages of medical tourism will provide a striking economical
solution to many healthcare problems.

Medical tourism can bring economic benefits to countries, including additional

resources for investment in healthcare. However, unless properly managed and
regulated on the policy side, the financial benefits of medical tourism for health
systems may come at the expense of access to and use of health services by
local consumers. Governments and industry players would do well to
remember that health is wealth for both foreign and local populations.