ASEAN: Regional Trends in Economic Integration, Export ... - USITC

Singapore’s largest export markets are Indonesia and Malaysia, 53 although Singapore has
entered into bilateral agreements with certain Middle Eastern countries, such as the
United Arab Emirates and Bahrain, to diversify its export base. 54 The ASEAN market
accounts for 85 to 90 percent of Malaysia’s exports of healthcare services, as patients
from Indonesia, Vietnam, and Cambodia travel to Malaysia for care, while the Middle
East and developed countries account for the remainder. 55
The market for healthcare services exports within the ASEAN region has become more
competitive in recent years; regional healthcare groups have sought to differentiate their
services by adopting marketing strategies based on cost and perceived quality. 56
Malaysia, Singapore, and Thailand all have low labor costs relative to developed
countries, which allow them to specialize in healthcare services exports. 57 Each has found
a way to differentiate its services within the ASEAN market based on a combination of
cost and quality. Thailand has positioned its healthcare exports as low-cost, high-quality
care in a luxury setting, targeted at the extra-ASEAN market, 58 while Malaysia has
focused largely on price-sensitive patients seeking quality care within the ASEAN
region. 59 By contrast, Singapore has focused on exporting specialty care, such as cancer
and heart treatment; this focus allows Singapore’s medical professionals to maintain
expertise in specific specialties and address excess capacity in Singapore’s healthcare
infrastructure, such as available hospital beds and underutilization of advanced medical
technology. 60 Additionally, by creating a niche market, Singapore’s exports command
premium prices, as the country’s industry has positioned itself to compete more on
quality than on price, avoiding direct price competition with other regional providers. 61
Malaysia’s rise as a destination for low-cost healthcare exports has provided the largest
challenge to Singapore, particularly as the two countries are neighbors. 62 Patients from
Indonesia, Vietnam, and Cambodia travel to Malaysia seeking more developed healthcare
services infrastructure, while Singaporeans travel to Malaysia seeking lower prices. 63
ASEAN member governments have aided their domestic exporters of healthcare services
by implementing marketing campaigns and other initiatives to promote the industry
(box 6.1). For example, the governments of Singapore, Malaysia, Thailand, and the
Philippines have established programs, most often in conjunction with tourism
authorities, which market directly to potential patients through online marketing
53 UN, ESCAP, “Medical Travel in Asia and the Pacific,” 2009, 12; Chee, “Medical Tourism in
Malaysia,” January 2007, 19; industry representatives, interview by USITC staff, Bangkok, Thailand, March
16 and 17, 2010.
54 Chee, “Medical Tourism in Malaysia,” January 2007, 20; eTurboNews, “Health Travel Magazine
Launched in Thailand,” August 27, 2009.
55 Industry representative, interview by USITC staff, Singapore, March 8, 2010; Malaysian-German
Chamber of Commerce and Industry, “Market Watch 2009—the Healthcare Sector,” 7.
56 Socio-Economic and Environmental Research Institute, “Medical Tourism,” April 2009, 13.
57 Davis and Erixon, “The Health of Nations,” 2008, 10.
58 Industry representative, interview by USITC staff, Bangkok, Thailand, March 16, 2010.
59 Industry representative, interview by USITC staff, Singapore, March 9, 2010.
60 Industry representative, interview by USITC staff, Singapore, March 8, 2010; Chee, “Medical Tourism
in Malaysia,” 2007, 20.
61 Industry representative, interview by USITC staff, Singapore, March 9, 2010.
62 Ibid.
63 Singaporeans account for 10 percent of foreign patients treated in Malaysia. Industry representative,
interview by USITC staff, Singapore, March 8, 2010; International Medical Travel Journal, “Malaysia
Promoting Health Tourism from Brunei and Singapore,” March 25, 2010; Malaysian-German Chamber of
Commerce and Industry, “Market Watch 2009,” 6.
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