Medical Tourism in the Philippines - Philippine Institute for ...

dermatology, 6.8 weeks; and cardiology, 5.2 weeks; most other specialties record average waiting timesin excess of 2-3 weeks (Alten, Singal, and Kara, n.d.).The U.S., with a largely private system of funding, performs better. Only 8 percent of surveyedAmerican patients in the 2007 Commonwealth Fund study of 6 OECD countries (cited by Doherty, 2010)reported a waiting time of four months or more for elective surgery, compared to 33 percent in Canadaand 41 percent in the U.K. However, the U.S. had the largest percentage of patients (61 percent) whosaid that getting care on nights, weekends, or holidays without going to the emergency room was verydifficult or somewhat difficult.Waiting time has high opportunity costs in industrial countries because of the higher salariesand standards of living. In contrast, in the Philippines, one hospital reported no queue time, i.e., thepatient is cared for immediately, while another hospital reported a queue time of only 3 days to 1 weekdepending on the procedure to be done (BOI TWG, 2012).The size of the uninsured and underinsured populations also accounts for some of the medicaltourists’ surging number. Prior to Obamacare 14 , it was estimated that 47 million American residents(including illegal aliens) were uninsured. In Western Europe where the immigrant population is alsogrowing, the proportion of uninsured population may also be growing. For this population segment,out-of-pocket spending is the only recourse to health care financing, forcing uninsured people to becost-conscious and to seek less expensive providers outside their residences.Under-insurance can also drive patients to medical tourism. Elective surgery is not usuallycovered by basic health insurance. Cosmetic surgery and some dental procedures are not coveredeither. These procedures have to be paid for through out-of-pocket means, and the patient needs toseek inexpensive providers to economize.Interestingly, health reforms are being cited as a key driver of medical tourism. In a survey doneby ExHealth and reported by Stephano (2011), 31 percent of the key informants interviewed said thatthe U.S. health care reform will greatly increase outbound patients, while 21 percent opined that theE.U. directive on health care reforms will see increased movement of patients outside the EuropeanUnion.Teh and Chu (2005) noted that the tightening of immigration rules and security checks in theU.S. contributes to increasing medical tourism in emerging economies. According to them, “the U.S. hasseen a decline in the number of foreign patient visits. More patients especially those in the Middle Eastare moving to other alternatives,” initially to Europe and lately to Asia and other Middle Easterncountries.The changing dynamics of demand and greater consumer role in health care decisions is anunder-appreciated factor driving medical tourism, which used to be limited to the wealthy. Today, themiddle classes in advanced and emerging economies also travel for care as airfare has become moreaffordable, and as less expensive medical care of comparable quality became available in middle-incomecountries. Because of this trend, consumers now have a greater say in health care decisions than theywere in the past. In a survey of Americans done by Deloitte (n.d.), almost 39 percent said they would go14 The U.S. health insurance reform initiated by U.S. President Barack Obama mandating all Americans to obtainhealth insurance coverage.9