Health, Wellness and Tourism: healthy tourists, healthy business ...

scheme, although this theoretically increases individuals’ access to healthcare and provides the
same quality health services as offered by other health schemes, it can lead to healthcare
service and provision not being equally accessible to many local people with the same quality
standards (Sreshthaputra and Indaratna, 2001). Unlike the developed countries, their public
healthcare can not only reach everyone for free, but also with good quality and standard of
care. Pachanee and Wibulpolprasert (2006) argue that the UC scheme, the incoherent health
policy implemented by the Thai government, hinders the promotion of international trade in
health services. The UC scheme has large impact on healthcare system in Thailand including
financing system, quality of care, manpower, etc. Although the UC scheme increases people’s
health security and decreases people’s healthcare expenditure (Ngosurachet and
Sornlertlamvanich, 2004), some middle- and upper-classes eligible for it decide not to use the
service because of long queues, and non-confidence in the quality and standard of care
(Sreshthaputra and Indaratna, 2001; NaRanong, 2005). Therefore, they rather visit private
hospitals. As any individual claiming for this health insurance benefit can mainly receive the
service at public hospitals, the promotion of healthcare services to medical tourists in public
medical providers is unlikely due to the existing high demand of the local people, and the
contribution of major affordable resources to firstly serve most local people. Consequently,
medical tourism business in Thailand is focused on private hospitals 3 which provide good
images of hotel-like atmosphere in medical settings and create positive attitudes towards Thai
healthcare services and medical expertise for medical tourists.
Medical tourism
Medical tourism is an emergence of a new and distinct niche market in terms of the deliberate
articulation of the healthcare and tourism industry where patients travelling overseas for
medical care – involving specific medical intervention – treatments and operations in hospital
context combined with a vacation (Cornell, 2006a; 2006b). However, medical tourism is not
considered as a new concept in terms of travelling for healthcare as evidenced since the Greek
and Roman periods. While Caballero-Danell and Mugomba (2007) agree with Connell by
shedding light on tourism experience gained from leisure activities after medical treatment,
others emphasise the cost effective medical care provision (Awadzi and Panda, 2006).
In this research, the term ‘medical tourism’ will be used to denote foreign patients travelling to
seek medical treatments and operations from the healthcare services in Thailand. However, the
participation in tourism either before or after treatment and the degree of participation is not
yet defined in the term as this can be highly diverse and really depends on the types of
treatments medical tourists have. This is yet to be investigated in the research if medical
tourism in Thailand is about tourism. Although medical tourism covers a wide range of
products and services (elective and non-elective treatments), cosmetic surgery, such as
Security Scheme (SSS) – covering employees in private companies, and the universal coverage scheme (UC or
30 baht scheme) – covering the rest who is not eligible for the first two schemes, since October 2001
(Ngosurachet and Sornlertlamvanich, 2004). Each scheme has different types of payment: fee for service on
CSMBS; capitation on both SSS and UC. With the UC scheme, the beneficiaries have to register to particular
health facilities and pay only 30 baht per hospital visit for most of diseases in public hospitals which are the
main providers. Therefore this leads to a huge workload but low pay to doctors in public providers, and to an
increasing internal brain drain of doctors to private hospitals which provide better incentives. 30 baht is about
£0.58 (51.52 baht equivalent to £1, rated on 2 August 2010).
3 Private hospitals, accredited by Thailand’s Ministry of Public Health (MoPH), deliver not only expertise in
healthcare but also excellent service. Private hospitals sometimes cooperate and liaise with ‘medical travel
agencies’, which work just like traditional travel agencies except that they specialise in medical travel services
and can help consumers make medical appointments, make arrangements for travel-related needs (e.g., flight and
accommodation bookings), and also include leisure and sightseeing activities in customer itinerary.