The modern healthcare industry revolves around accessibility and affordability. In countries like the United States of America, healthcare services are quite expensive especially when it comes to detailed procedures like bypass surgery or transplants. Besides cost, long waiting lists and limited treatment options are major hindrances in most western countries. Whereas in developing or least developed countries, factors like domestic policy reform, political instability, travel restrictions, availability of modern healthcare infrastructure, and medical personnel all contribute to the demand for affordable healthcare. This is where medical tourism as a niche has emerged.
Medical tourism, not only provides growth opportunities for the medical sector of the host country but also helps in tourism development. According to a recent market research report on medical tourism, “global medical tourism market was valued at approximately USD 15.5 billion in 2017 and is expected to generate revenue of around USD 28.0 billion by the end of 2024, growing at a CAGR of around 8.8% between 2018 and 2024”. Emerging economies with medical expertise and facilities with tourism resources are pushing for medical tourism. Hence, some of the popular destinations for medical tourism are emerging economies like India, Mexico, Malaysia, and Turkey among others.
Historically, India has always been famous for its spiritual and natural healing image, which has brought people in search of tranquillity to our country. But for the past decade, international tourists are coming to India for modern medical procedures. The Indian healthcare sector, particularly the private entities, boast state-of-the-art infrastructure along with well-qualified practitioners. This has led to foreign tourists coming in for affordable treatment, while eventually allowing for tourism at other sites of the country. India’s medical facilities are famous for fertility, oncology, heart bypass surgery, orthopaedic and spine treatment. The number of foreign tourists coming to India for medical treatments has increased considerably in the past few years. The estimated number of Foreign Tourist Arrivals (FTAs) in India for the medical purpose was Rs 2.34 lakh in 2015 which almost doubled to Rs 4.27 lakh in 2016.
According to the Ministry of Tourism, the provisional estimates of total Foreign Exchange Earnings (FEE) through medical tourism during 2015, 2016 and 2017 were INR 1,35,193 crore, INR 1,54,146 crore, and INR 1,77,874 crore, respectively. Furthermore, NITI Aayog in its report has identified medical value travel (MVT) as a major source of FEE. India currently has around 18 per cent of the global medical tourism market. It has been estimated that by 2020, India’s medical tourism industry could be worth USD 9 billion, and account for 20% of the global market share. Based on these projections, the Indian government has taken considerable steps to boost the medical tourism niche.
Accessibility has been made easier through the Medical and Medical attendant visa which is processed within 72 hours. Medical tourism facilitation centres have been set up along with separate counters at major airports of Delhi, Mumbai, Chennai, Kolkata, Hyderabad and Bengaluru for tourists arriving on Medical Visas. For better promotion and dissemination of medical tourism for potential patients/tourists, the Department of Commerce along with Services Export Promotion Council (SEPC) has set up an online platform listing the top healthcare institutions in the country with comprehensive supplementary information on each. For better outreach and making the process comprehensive for the tourists, the portal is in four different languages.
For better accountability, and efficacy of the medical tourism sector, a National Medical and Wellness Tourism Board has been constituted. The role of the board is not only to provide a dedicated institutional framework of the medical tourism sector but also promote other forms of Indian medicine and wellness practices like Ayurveda, Yoga and Homeopathy among others. The Ministry of Tourism has also taken up the responsibility of providing financial and technical support for individuals or organisations through marketing development and assistance programs as well as through workshop/events/seminars. The future of medical tourism looks solid, and India may yet emerge as an important medical tourism destination.
Yet, there is an ethical aspect that just cannot be ignored. Approximately 22% of the Indian population lives below the poverty line, and many do not have access to healthcare services. Despite being a fundamental right under Article 21, primary healthcare remains in shambles. The under-investment in the primary healthcare sector is evident from the fact that public health expenditure from 2008 – 2015 was approximately 1.3 % of GDP whereas, in 2016-17, it was approximately 1.4 %. This is way below the world average of 6%.
Furthermore, healthcare in India is considered the most affordable across the globe, yet for most Indians it is expensive. Additionally, the rate of Indian’s out-of-pocket spending on healthcare is one the world’s highest since the health insurance penetration rate in India is approximately only 20%[5]. World Banks’s 2017 report on ‘Tracking Universal Health Coverage’ also points out the “catastrophic spending on health” by Indians, illustrating that out-of-pocket medical expenditure exceeds “10 and 25% of household total income or consumption”. These are only some of the problems in the Indian healthcare system.
To conclude, the government has taken some major steps in resuscitating the healthcare sector. In 2018-19 approximately INR 56,600 Crore has been allocated to the Ministry of Health and Family Welfare which is a 2% increase from 2017-18. Moreover, the National Health Mission (NHM) received its highest allocation of INR 30,130 Crore which is roughly 55% of total allocation. More concrete reforms and policies are required for making healthcare more affordable for Indians. It would be a shame to see India thrive as a medical tourism destination, while Indians cannot afford primary healthcare services.