FIFTEENTH CONGRESS
First Regular Session

Introduced by HONORABLE JUAN EDGARDO “SONNY” M. ANGARA

EXPLANATORY NOTE

Medical tourism can be broadly defined as the provision of cost effective medical care in
collaboration with the tourism industry for patients needing surgical and other forms of
specialized treatment. The term was initially coined by travel agencies and the media as a
catch-all phrase to describe a rapcly growing industry where people travel to other countries to
obtain medical care while at the same time touring, vacationing and enjoying the attractions of
the countries which they are visiting. Medical tourism has become a common form of
vacationing and covers a broad spectrum of medical services. It mixes leisure, fun and
relaxation together with wellness and healthcare.

‘A combination of many factors has lead fo the recent increase in popularity of medical
tourism. Exorbitant cost of healthcare and medical facilities in advanced countries, ease and
affordability of international travel, favorable currency exchange rates in the global economy,
rapidly improving technology and high standards of medical care in the developing countries
has all contributed their share to this rapid development of medical tourism, Some countries that
operate from a public health-care system are so taxed that it can take a considerable amount of
time, sometimes even years, to get needed medical care. The time spent waiting for a
procedure, such as a hip replacement, can be a year or more in Britain and Canada. However,
in Bangkok or Bangalore, a patient could feasibly have an operation the day after their arrival.

Medical tourists are generally residents of the industrialized nations of the world. The
countries to which they travel are typically less developed and have a lower cost of medical
care. Ten years ago, medical tourism was hardly large enough to be noticed. Today, more than
250,000 patients per year visit Singapore alone--nearly half of them from the Middle East. This
year, approximately half a million foreign patients will travel to India for medical care, whereas in
2002, the number was only 150,000. In monetary terms, experts estimate that medical tourism
could bring India as much as $2.2 billion per year by 2012, Argentina, Costa Rica, Cuba,
Jamaica, South Africa, Jordan, Malaysia, Hungary, Latvia and Estonia all have broken into this
lucrative market as well, or are trying to do so, and more countries join the list every year.

Some important trends guarantee that the market for medical tourism will continue to
expand in the years ahead. By 2015, the health of the vast Baby Boom generation will have
begun its slow, final decline, ard, with more than 220 million Boomers in the United States,
Canada, Europe, Australia aid New Zealand, this represents a significant market for
inexpensive, high-quality medical care.

Studies indicate that the cost of surgery in Argentina, India, Bolivia, Thailand or South
Africa can be one-tenth of what it is in the United States or Western Europe, and sometimes
even less. A heart-valve replacement that would cost US$200,000 or more in the US., for
example, goes for $10,000 in India-and that includes round-trip airfare and a brief accion
package. Similarly, a metal-free dental bridge worth $5,500 in the US. costs $500 in India, a


cost $20,000 in the U.S. runs about $1,250 in South Africa.

India is a relative newcomer to medical tourism, but is quickly catching up with Thailand,
and recent estimates indicate that the number of foreign patients is growing there by 30 percent
each year. It is known in particular for heart surgery and hip resurfacing, areas of advanced
medicine in which India is generally considered a global leader. Probably no country has been
in the news for medical tourism than India in 2005 - 2006, and the government and private
hospital groups both seem committed to a goal of making the subcontinent a world leader in the
industry. Indian medical industry's main appeal is low-cost treatment. Most estimates claim

treatment costs in India start at around a tenth of the price of comparable treatment in America
or Britain.

Medical tourism is also a growing segment of Thailand's tourism and health-care
sectors. In 2005, one Bangkok hospital took in 150,000 treatment seekers from abroad. In 2006,
medical tourism was estimated to earn the country 36.4 billion baht. One patient who received a
coronary artery bypass surgery ai Bumrungrad Hospital in Bangkok said the operation cost him
US$12,000, as opposed to the $100,000 he estimated the operation would have cost him at
home in the US. Today many Thai physicians hold US professional certification. Thailand has
long been known as a preferred destination for medical tourists. Over one million people per
year travel there for everything from cosmetic surgery to cutting edge
cardiac treatment.

Singapore has made international news for providing complex neurosurgical procedures

Currently Singapore boasts the largest number of US Joint Commission accredited hospitals in
the region.

Malaysia, which drew 100,000 patients in the first half of 2005, expects its medical
tourism receipts to reach 590 million dollars in five years' time.

Medical tourism is a multi-billion dollar industry and the Philippines needs to compete for
this market in order to uplift the economic state of its country. The Philippines has many things
to promote in its medical tourism package. It has many world-class hospitals like St, Luke's
Medical Center, Makati Medical Center, Asian Hospital, Medical City and Metropolitan Hospital.
The Philippines has thousands of world-class doctors, nurses and other health care
professionals who can give foreign patients not only expert service but also the sincere, caring
attention that Filipinos are known for. Filipinos are fluent in English; some are multi-lingual and
most of them can pick up and learn a foreign language easily. Medical tourists will have no
problem communicating with their Filipino doctors, nurses and caregivers. Furthermore, the
Philippines is an ultimate tropical paradise of 7,107 islands and warm, gentle breezes, with a
coastline twice the length of that of the United States. For those looking for a total experience of
relaxation, restoration and rejuvenation, our country can provide a complete array of choices for
a patient's total care.

in thai v dical tourism industry.
It is in this framework thai we need to proactively promote our me
It is hoped that this proposed measure will be an attractive strategy to reverse the eins
outward migration of our professionals, prompt new doctors fo stay and lure back our heal
workers who had international training.

In view of the foregoing, the passage of this measure is earnestly sought.

JUAN EDGARDO“SONNY” M. ANGARA
Representative

Lone District, Province of Aurora


Ae gy
H.B.No.__ 7%

Introduced by Honorable JUAN EDGARDO “SONNY” M. ANGARA

AN ACT
INSTITUTING A COMPREHENSIVE AND HOLISTIC MECHANISM FOR THE
PROMOTION OF MEDICAL TOURISM IN THE COUNTRY AND FOR OTHER
PURPOSES

Be it enacted by the Senate and House of Representatives of the Philippines. in
Congress assembled:

SECTION 1. Short Title. This Act shall be known as the “Medical Tourism Act
of 2010”.

SEC. 2. Declaration of Policy. \t is hereby declared the policy of the State to
promote the right to health and the delivery of quality health care service to patients. In
the pursuit of such policy, the State shall institutionalize a medical tourism program that
is comprehensive and holistic. As such, the State will facilitate the collaboration among
government and private health service providers at the national and local levels in order
to promote quality medical tourism in the country.

Towards this end, the State shall provide the mechanisms to maintain, update,
and improve the scientific knowledge, technical skill, competence, and patient
relationship of every health provider that is involved in the provision of medical tourism
packages in the Philippines thereby promoting the medical tourism industry in the

country.

SEC. 3. National Accreditation Procedures for Hospitals, Medical Centers
and Health Service Providers. - \n order to ensure the delivery of low cost medical
treatment, high quality medical care and short waiting time for critical treatments to
foreign and local patients, the Department of Health (DOH) is hereby mandated to

conduct a national accreditation and affiliation program that will assess the


medical centers and health service facilities sacking to provide medical tourisrn to
joreign patients.

Towards this end, the DOH shall issue the appropriate standards, guidelines and
procedures for the accreditation process and monitoring of hospitals, medical centare

and health service providers seeking to provide medica! touriem services to local and
foreign clients

Existing hospitals, medical centers and health service facilities who want to avail
of the benefits provided herein may request for an accraditation with the Department of
Health (DOH) with respect to the evaiuation of quality of health services and the

Department of Tourism (DOT) with sespect to the tourism aspect of tha facility or
services,

SEC. 4, National Task Foree on Medical Tourism. + There is hereby
established and instlutionalized @ National Task Force on Medical Tourism (NTFMT),
herein referred to as the “Task Force” which shall serve as an inter-agency and multi-

sectoral mechanism taeked to promote the implementation of the National Medical
Tourism Plan of the government.

BEC. 5. Composition of the Hational Task Forse on Medical Touriam.
The Task Force shall be composed of the Secretayies of the Depariment of Health
(DOH) and Depariment of Tourism (DOT) which shall serve as the co-chair of the Task
Force. The Task Force shall be composed on the following members;

a) The Secretary of the Department of Trade and Industry (DT});

b) The Secretary of the Department of Foreign Affairs (DFA);

©) —- The Secretary of the Department of Justice (DOJ);

a) ‘The Secretary of the Department of Interior and Local Government
{(DILG),

°) ‘One (1) representative from the duly accredited travel and tours
organizations;

‘Ons (1) representative from the duly accredited association of hotel
operators and travel accommodation facilities; ,

9) ‘Ona (1) representative from the duly accredited hospital aseociation in the
country; ;

h) One (1) representative from the duly accredited association of medical
doctors and practitioners.

3) One (1) representative fram the non-gavernmentsl organizations (NGOs)
involved in the medical tourlam advocacy;


travel and tours organization, association of note! operatore and travel accommodation
facilities, hospital association, medical doctors and medical practitioners and non-
goverment organizations shell be appointed by the President of the Philippines, from a
list of three {3) nominees from each sector, who shall serve for a term of three (3) years,
and renewable for another term: Provided, That the person appointed shaill be of good
moral character, of unquestidnable integrity, and with expertise and experience of a
least six (6) years in medical tourism and tts various related fielde:: Provided, further,
‘That in the event of a vacancy, the successor appointed io fill the sema shall serve only
‘the unexpired portion of the term of the member he/shs succeeds to.

‘The mambers of the National Task Force on Medica! Tourism irom the
government agencies and institutions may deeignate their permanent representatives

who shail have a rank not lower than an assistant secretary or its equivalent to attend
meetings.

Ail members of the Task Force shal! receive emoluments as may be determined

by the Task Force, in accordance with existing budget and accounting rules and
regulations.

SEC. 8 Meetings. ~ The National Task Force on Medical Tourism shail
meat at least once a month upon a three-day notice signed by the two (2) Chairpersons

or as oftan as necessary upon the written request signed by two-thirds (2/3) of its
mernbers.

‘The presence of a majority of the members of the Task Force shall constitute a
quorum in order for it to conduct its business.

SEC. 7 The Powers and Functions of the National Task Force on
Medica’ Tourism. — The Task Force ehall have the following powers and functions:

(@) To promote the enforcement of this Act, as well ae the other applicable
national legislations, rules, regulations and standarde on medical practice standards
and ethics;

(b) To esiabfish, initiate and coordinate multi-sectoral medical tourisrn action
plans at the ragional and focal government unit fevel to respond to the advocacy of
promoting quality medical tourism in the country;

(c) To coordinate the implementation and dissemination of information in the
Medical Tourism Website, as created under this Act, 80 that the medical tourism
programs of the government will be made accessible to the various parts of the world;

(8) ‘To institutionalize and coordinate the establishment of a legal eupport
meachanism in order to ensure that foreign medical tourism patients are given legal


the medical touriem program of the country;

(©) ‘To receive donations and grants from intemational donor institutions,
foundations, and multilateral and bilateral foreign doner agencies involved in the
promotion and advocacy of madical tourism all over the world;

() To establish guidelines and procedures in the prosecution of those service
providers and medical practitioners who have deen found to exploit medical tourism
patients and those in viclation of the provieions of this Act;

(9) To catalyze and provide the avenue for exchange of information,
exchange programe and sharing of best practices on Issues relating to medical tourism;

‘(n) To provide gender sensitive medical tourism prograrns and projects that
‘will inform the general public, policy makes in the LGU lavel and medical practitioners
‘on the various issues concarning medical tourism;

() To establish a databank which will provide detailed information on the
quality and state of medical touriem in the country;

0) Te establish a mechanier for the legal protection of medical tourism
patients who come to avail of the medical tourism program of the goverment, aa
provided for in this Ack;

(k) To issue certificates of accreditation and sffiliation to qualified health
service institutions and facilities for the delivery of medical tourism services; and

() To hire and avait of the services of technical exparts, consultants and staff
in the fle of medical tourism and other relevant fieids of disciplines for the effective
Implementation of its mandated duties and functions.

SEC. 8. The National Task Force on Msdical Tourlsm Secretariat, - The
National Task Fores on Medical Tourism shall establish a Task Force Secretariat which
shall serve a6 the technical support staff to effectively implement the provisions of thie
Act. Towards this end, the National Task Force on Medical Tourism shail submit to the
Civil Service Commission (CSC) the staffing complements of the Task Force Secretariat
to effectively Implement the provisions of this Act.

SEC. 9. Creation of a National Website for Mesical Tourism. ~ The
National Task Force on Medical Touriem, in coordination with the various stakeholders
in the medical tourism industry, is hereby mandated to establish a national website on
Philippine Medical Tourism. The Website shail highlight the various medical tourism
packages being offered in the country and provide the fist of accredited medical tourism
providers so that prospective patients/clients can register at the website and select
madical packages bundled with hotel accommodation, car traneier service, a tour guide


procedures available in the Philippines.

‘The Medical Tourisrn Website shall also incorporate a market inforrnation system
which shall be inetalled for the use and benefit of all the stakeholders in the medical
tourism industry in the country.

SEC. 10, Marketing of Medical Tourlem. - The Taek Force is hereby
faked to establish a National’Marketing Program in order to ensure the generation of
‘the highest possible income for all the stakeholders in the medical tourism industry in
the country by matching supply and demand in both domestic and foraign medical
tourism markets,

As such, within six (8) months frorn the date of effectivity of this Act, the National
‘Task Force on Medical Tourism le hereby tasked to formulate a strategic marketing plan
which highlight the marketing strategies, business plan and operational plan that will be
adopted by our government so that our heath services, medical tourism packages,
hotels, treatment and post-operative vacation packages wifl be competitive and
comparable as compared to that being offered by other countries,

SEC. 11.  Jesuance of VISA Yor Foreign Medica! Tourists, - Within ex (8)
months from the dats of effectivity of this Act, the Department of Foreign Affairs (OFA),
Jn coneultation with the DOT, DOH and DT} shail formulate the necessary implementing
rules and regulations for the issuance of visas for foreign medical tourists who will seek
to visit the Philippines and avail of our country’s verious medical tourism packeges.

‘SEC. 12. Medical Yourlsm Modernization Credit Facility and Loan
Package. ~The Land Bank of the Philippines (LBP) is hereby mandated to formulate a
Medical Tourism Credit Facility and Loan Package Window which ehall provide a low
interest leans for medical institutions and health service providers seoking to Improve
and modernize thelr health faollities, equipment and services in order to participate In
the medical tourlem program being implemented by the government,

‘Within six (8) months from the date of effectivity of this Act, the Land Bank of the
Philippines is mandated to formulate the necessary guidelines, procedures and
requirements for the various stakeholders to avail of the Medical Tourism Credit Facility
and Loan Package, as mandated under this Section.

SEC. 13. Annual Conference on Trends in Medical Tourism. ~ The
National Taek Force on Medical Tourism, in coordination with the various stakeholders
in the medical tourism industry, is hereby mandated to conduct an Annual Medical


tourism business, including hotel operators, medical practitioners, tours and travel
providars, marketing and sales agents, government regulators, policy makers, health
facilities suppliers and providers and various ancillary cervice providers involved in the
delivery of a comprehensive medical tourism package to chente/patients,

The Annual Medical Tourism Conference is envisioned to be an avenue where
various players in the medical tourism industry will share their knowledge on the issues

and business trende relating to the medium and iong term prospecis of the medical
tourism business.

‘The national conference will discuss and review the various demand and supply
data of the varlous countries in order to provide the stakeholders with the information
needed for them to be competitive in the medical tourism business.

The proceedings of the National Conference on Medical Tourism will be
published and be made available to the public.

SEC, 14, Monitoring the State of Medical Tourism in the Country, ~ The
National Yask Fores on Medica! Tourism is hereby tasked to condust a comprehensive
‘study on the state of medicel tourism In the country, taking into account the quality of
health service delivery being provided by existing health providers, the supply of health
service providers, the global demand and market for medical tourism and the
competitiveness of the Philippine medical tourism packages in comparison with the
madical tourism packages being provided by other countries. The comprehensive study
on the state of medical tourism in the Philippines shall include the following aepacts,
namely:

(1) The socio-economic, demographic and academic training characteristics
‘of the haalth providers in the country;

(2) The extent with which the clients/patients for the medical touriem
packages are satisfied with the services being provided in our country in comparison
‘with the satisfaction rates of other clients in other countries;

(3) A market demand analysis on the various medical procsdures and
operations being demancied by various patients all over the world; and

(4) ‘The medium-term and long-term supply and demand prospects of medical
tourism industry.

Furthermore, the National Task Fores on Medical Tourism shall conduct a
comprehensive study on the viability and efficiency in coordinating and integrating the
various medical services being offered by the six (8) government-run hospitals, namely:


‘Transplant Institute, Philippine Children and Medical Center and the East Avenue
Medical Center, with the end in view of making the medical tourism package in the
Philippines competitive with that of our foreign competitors.

Finally, the National Task Force on Medical Touriem shall also conduct a
comprehensive study on the viability, efficiency and effectiveness of incorporating into
the National Medical Tourism Program of the government the provisions and programs
of Republic Act No. 8424, otherwise known as the Traditional and Alternative Medicine
Act of 1997. 7

‘Within two {2) years from the date of effectivity of this Act, the Task Force shall
make @ report to both Houses of Congress on the results of the studles conducted by
‘the Task Fores for policy implication, in ald of legislation, in order to furthar promote the
development of the medical tourism industry in the country.

SEC. 18, Appropriation. ~ The amount necessary to implement the
provisions of this act shall be included and Incorporated in the annua) general
appropriations of the various agencies of the government involved in the implementation
of the National Task Force on Medical Tourism and in the various provisions of this Act,

SEC. 18. International Accreditation of our Hospitels and Health Serview
Facllities, ~ The Department of Trade and industry (DT!) is hereby mandated to assist
the various hospitals and health service delivery points to acquire the required
accreditation from foreign countries so that our hospitals and heaith service facilities can
serve foreign tourist patients. Towards this end, the DTI shall conduct intensive
consultation with foreign health service accreditation agencies in order to facilitate the
accreditation of our hospitals, medical practitioners and health service delivery facilities
to serve their foreign patients,

‘Within six (8) months from the date of effectivity of this Act, the Department of
‘Trade and Industry (DTI), in consultation with the Department of Foreign Affaire (DFA),
shall promulgate necassary implementing guidelines and accreditation proveduyes for
‘our hospital to seek accreditation for them to serve foreign patients from foreign
countries,

SEC, 17. JAR on Litigation of Medical Malpractice, — Within six (6) months
from the date of effectivity of this Act, the Department of Justica (DOU), in consultation
with the Department of Health (DOH), shail promulgate necessary implementing rules
and regulations and guidelines in the prosecution of erring heaith service providers and


medical health services to medical tourism patiente/elients.

SEG. 18. Evempiions From Filling Fees and Other Expenses. —~ When
the victim of medical malpractice abuse and exploitation institutes a criminal and civil
action for the recovery of damages, he/she shall be exempt from payment of filling fees,
and other fees ae required.

SEC, 19. Implementing Rules and Regulations (IRR). ~ Within etx (8)
months from the date of effectivity of this Act, ihe Department of Tourism (DOT) shall
promulgate necessary implementing rules and regulations In the accreditation of travel,
tours and tourism facilities and equipment that will seek to implement medical tourism
packages: and programs for foreign medical patients.

SEC. 20. Repealing Clause. - Ai) Laws, decrees, executive orders, rules and
regulations or parts thereof not consistent with the provisions of this Act are hereby
repealed of modified accordingly.

SEC, 21. Separablilty Clause, - Hf any provision or pert of this Act, or the
application thereof toany person or circumstance, is held unconstitutional or invalid, the
remainder of this Act shall not be affected thereby.

SEC, 22,  Efffectivity Clause. - This Act shall take effect fifteen (15) days
from the date of its complete publication in the Official Gazette or in at least two (2)
newspapers of general circulation.

Approvetl,