reprinted courtesy Maui News 2/4/07

reprinted courtesy Economist magazine 3/10/07

Sun, sand and scalpels

BANGKOK

Soaring health-care costs in the rich world offer Asian firms an opportunity

America's soaring health-care costs, already $2 trillion a year, are predicted to double in the coming decade. Dissatisfaction

with the rocketing price of care will only get worse as demanding and healthconscious "baby-boomers" hit retirement

and start to suffer the costly ailments of old age. In countries like Britain and Canada, with supposedly universal coverage, state

spending is not keeping up with growing demand, so patients face long and agonising waits for operations. And in the

prosperous bits of Asia and the Middle East growing numbers of people are rich enough to demand high-quality medical

care that they cannot get locally. All this presents a fantastic business opportunity for those Asian countries,

principally Thailand, Singapore and India, which have excellent private hospitals that are used to treating foreigners and where

costs are a fraction of those in rich countries. "Medical tourism" is booming as patients look abroad for cheap, fast treatment,

often combined with a holiday afterwards. Josef Woodman, the author of "Patients Beyond Borders", anew guide for

those seeking surgery abroad, reckons that 150,000 Americans did so last year, and predicts the numbers will double this year.

Booming demand is encouraging rapid expansion at big stockmarket-listed hospital operators such as Thailand's Bumrungrad

and Bangkok Dusit, Singapore's Parkway and Pacific Healthcare and India's Apollo Hospitals. This week PacificHealthcare

said it would build seven medical centres across Asia. Bumrungrad, which treated 430,000 non-Thais last year, has

just expanded its Bangkok hospital and is setting up in the Philippines and Dubai. Singapore is more expensive than Thailand,

but still far cheaper than America. Goh Jin Hian, the head of Parkway's Gleneagles Hospital, says Singapore should

try to compete for the most complex treatments, leaving cosmetic surgery and other price-sensitive operations to lower-cost rivals

such as Thailand. Nevertheless, like the Thai hospital operators, he is sure the medical-travel boom will provide plenty

of foreign patients for them all. Mr Woodman reckons that today's boom is just the start. So far, most medical

tourists pay their own way. But the Asian hospital operators are now courting American health insurers and employers desperate

to rein in soaring costs. Bumrungrad's marketing chief, Ruben Toral, who was in America this week for talks with

insurers and big employers, says they were very keen. BlueCross BlueShield of South Carolina already offers Bumrungrad's cutprice

treatments to members whose policies do not cover the surgery they need. To reassure foreign patients, many hospitals

are seeking accreditation from the Joint Commission International (TCI),the international arm of the body that accredits

American hospitals. Thailand's Bumrungrad and nine Singaporean hospitals already have ]CI certificates. Raymond

Chong, the boss of Bangkok Dusit's Samitivej Hospital, reckons it will be only a year or two before big American insurers and

employers routinely offer patients lower premiums if they are prepared to travel to a foreign]cI-accredited hospital for surgery.

For patients, employers and insurers the benefits are clear. But the hospital operators are bracing themselves for a backlash

from the rich countries' medical vested interests whose jobs are, in effect, being outsourced. Expect much shroud-waving

from doctors' associations and health-care unions as they highlight the few cases of foreign surgery that go wrong-as though

such a thing never happens back home.

reprinted courtesy Economist magazine 3/10/07

original story at: www. economist.com

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Peter Gelsey R (PB)

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