from various countries that consume health care services such as cosmetic, dental, laservision, orthopedic, and even cardiac surgery abroad (see Table 2).<sup>15</sup> _Table 2. Medical tourism in the developing world_

|_Country_|_Estimated_<br>_number of_<br>_foreign_<br>_patients_<br>_(’02-’03)_|_Estimated number_<br>_of foreigners_<br>_visiting specifically_<br>_for health care_<br>_(’02-’03)_|_Countries of origin of_<br>_foreign visitors_|_Treatments sought by foreign visitors_|
|---|---|---|---|---|
|Thailand|632,000|126,000|South and South East<br>Asia, Europe, and the US|Cardiac surgery, post-op care,<br>cosmetic surgery, dentistry, cataracts,<br>bone-related procedures|
|Singapore|200,000|20,400|South and South East<br>Asia, Korea, Japan,<br>Australia, the UK and the<br>US|General surgery, Cardiac surgery,<br>ophthalmology, Orthopedics,<br>Gynecology & Urology|
|Malaysia|103,000|75,000|Indonesia, India, Middle<br>East, and the UK|Cardiology, hematology,<br>gastroenterology, neurology &<br>cosmetic surgery|
|India|150,000|62,000|Bangladesh, Middle east,<br>the UK, Europe, and the<br>US|Cardiac surgery, joint replacements,<br>ophthalmology & alternative<br>medicine.|
|Jordan|N/a|70,000|Yemen, Sudan, Libya,<br>Algeria, Tunisia, and Iraq|Cardiac surgery, correction of spinal<br>injuries, cornea transplants &<br>alternativemedicine|
|Cuba|N/a|3,500|Central and Latin<br>America, and the UK|Cosmetic surgery, Vitiligo<br>treatments, ophthalmology, joint<br>replacements &neurology.|

_Sources_ : Tourism Authority of Thailand, Singapore Ministry of Health, Khoo (2004), Malaysian Department of Statistics, Confederation of Indian Industry, South Asia Network of Economic Research Institutes (SANEI), the Jordan Times, and Cuba Travel USA. “N/a” indicates that data was not available.

We have presented estimates for destinations in developing countries because our interest is in trade motivated by differences in costs, but the numbers in Table 2 also include consumers from other developing countries who travel because the required care is not available in their own countries. Medical tourists from industrial countries include both consumers without health insurance as well as those who are insured at home, but opt to have the surgery overseas anyway, either because of long waiting lists at home, or due to prohibitively high out-of-pocket costs. For example, in the UK, as of 2004, over 41,000 people were expected to experience a waiting time of six months or longer to have various surgeries under the National Health Service (NHS) scheme.<sup>16</sup> The NHS has responded by flying patients to neighboring countries such as France, Spain and Germany for orthopedic procedures, eye surgery, and otolaryngological procedures (UK Department of Health).<sup>17</sup> 15 Relying only on their website and magazine write-ups, the Mediscapes company in South Africa reports getting about 50-80 bookings a month from parties in the US interested in procedures such as dental whitening, botox treatments, health check ups, and elective surgery (both cosmetic and other).

> 16  Source: U.K. Department of health.  See <u>http://www.performance.doh.gov.uk</u> for detailed figures.

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