The spread of health tourism

For the last few years, Spanish politicians have criticised the arrangement that they say lets British citizens take advantage of their superior health system.

This year, Spain’s Union of Doctors in the Public Health Service (SiMAP) complained that up to 20% of patients in Alicante (a Spanish province popular with British expats) are non-Spanish nationals.

The doctors say the Spanish health system is under enough pressure as it is, and any Britons who wish to be treated under the Spanish system should register their residency status and pay taxes.

But for many, the increasing opportunity to receive fast and cheap medical treatment all over the world is proving to be a much better alternative to healthcare at home.

How does it work?

In Spain’s case, anyone domiciled in Britain (that is, anyone who says they live there) gets free or subsidised health treatment under the British National Health Service (NHS).

But, like many public health services, the NHS is often overloaded, and potential patients can face waits of months or years.

In Spain, anyone with a European Health Insurance Card is eligible for emergency treatment (subject to certain conditions).

And anyone who is covered by a government social security system in any EU country (like the NHS in Britain) is eligible for that card.

But the doctors say that too many British people are freeloading and using the Card when the treatment isn’t necessarily an emergency.

Even though it’s up to the doctor involved to decide whether or not a complaint requires emergency treatment, SiMAP says potential patients are still exploiting the system.

To counteract the pressure, the Spanish regions have moved to tighten the system.

Those foreigners under 65 who are now resident in Spain are no longer eligible for free healthcare, and France made the same changes in 2007.

But for those non-residents holding a European Health Insurance Card, “emergency” treatment remains available.

Globalised healthcare

Spain is certainly not the only country to feel the effects of globalised healthcare.

Websites such as discovermedicaltourism.com and treatmentabroad.com list countries that actively promote medical tourism, such as India, Singapore, Mexico, Costa Rica and Hungary.

These countries provide essential treatment such as hip replacement surgeries, but also elective treatment like cosmetic and dental procedures.

And information about which country specialises in which treatment is easily available on the web.

Thailand, for example, is cited as a “world leader” in medical tourism, and recommended for its LASIK eye surgery, heart bypass surgery and cosmetic surgery.

And treatmentabroad.com lets browsers apply for quotes for everything from cancer treatment to dental care, anywhere from Norway (apparently good for CT scans and infertility treatment) to Tunisia (specialists in cosmetic surgery, particularly breast reductions or augmentations).

The main attraction is that many such operations and procedures are a fraction of the price of private care at home and don’t have the long waits in public care.

Furthermore, the quality of care is sometimes as good as, if not better than a lot of the care in the West.

For these countries, medical tourism is a welcome and booming industry. Government studies suggest that medical tourism in India could be a billion dollar industry by 2012.

This year, 6 million Americans will travel to developing countries like India for medical treatment, up from 750,000 in 2007.

Additionally, a prominent Indian doctor is opening up a 2,000-bed hospital in the Cayman Islands – a short flight from Miami – to offer surgery at half the price charged by American hospitals.

The problems with healthcare holidays

But while medical tourism undoubtedly creates profit for developing economies, some argue that the practice makes healthcare inaccessible to locals.

And the increased demand for services makes it more expensive for public healthcare providers to retain staff (as in Spain).

For patients, the main concern is the lack of follow up care.

While many medical tourism packages combine the treatment with a rest and relaxation period, once a patient returns home it is difficult for the medical provider to ensure they get the follow up treatment required.

In addition, many of the countries where medical tourism is most popular have lax medical malpractice rules, so patients have little or no legal options if things go wrong.

Nevertheless, while government-provided healthcare systems continue to be blocked and patients sit on waiting lists, medical tourism remains a viable and cost-effective alternative, with the added bonus of going on holiday.

By Natalya King