There are some basic criteria for the conditions of taking part in health tourism and the sustainability of the success to be achieved. It should not be forgotten that a significant part of the people involved in health tourism come from a relatively better economic region than us, and in order for them to prefer the service in us, they demand at least a service of the quality of health care provided in their region at a lower cost. There are many factors that develop medical tourism around the world. It is possible to examine these factors simply as follows;
- Increasing out-of-pocket expenditures: In developed western countries such as the USA and Canada, health expenditures have affected the country’s economy due to the decrease in the share of the public in the provision of health services and their transfer to the private sector. Health insurance policy providers, who found a wide area for themselves with the public’s exit from the system, soon realized that it was difficult to meet the fees demanded by the hospitals with the collected insurance figures. As a result, many transactions have been removed from the refund system. Medical service focused policies have been replaced by wholesale health services policies. This has led to the exclusion of many diseases. As a result, as out-of-pocket payments increased, cheaper treatment methods began to be researched and treatment options abroad came to the fore.
- Price differences: One of the most fundamental factors in the development of health tourism in general and medical tourism in particular is price differences between countries. There are very important price differences in specific surgical interventions such as coronary surgeries, hip/knee prosthesis, oncological surgeries. For example, coronary bypass, which costs 70,000 dollars in the USA, is completed around 12,500 dollars in Turkey. When all travel expenses are added, the same treatment can be obtained in Turkey with the same quality and safety, for a figure of around $ 17.000. This situation affects the preferences of individuals making out-of-pocket payments and seems to be an attractive option for reimbursement institutions. It is inevitable that the coming years will lead to a period in which reimbursement institutions and countries or hospital groups will make massive agreements.
- Waiting lists: Long waiting lists in Western countries force people with a life-threatening or distressing illness to look for other options, especially. For example, in a developed western country, 6 months can be expected for prostate cancer surgery and 15 months for hip replacement. Whereas, this waiting period is at most 10 days in India, and at most 3 days, including the pre-operational examination and evaluation period, in Thailand and Turkey. The long-term use of assisted reproductive treatments in western countries has led to the formation of a new group called “infertility tourists” in the tourism world.
- Accreditation: Looking at the success stories in health tourism, it is seen that facilities with international standards, certifications and accreditations, as well as prices and waiting times, have a significant advantage. International standards, certifications and accreditations Its application to health facilities that aspire to medical tourism service may also be an indication of international quality assurance in the relevant facilities. It should not be overlooked that one of the most important components of quality is safety. It is almost a necessity for the facilities that want to make progress in health tourism to apply international quality systems, especially up-to-date occupational certification and accreditations for health. Accreditation systems such as JCI, TEMOS or ACHSI have paved the way for insurance reimbursement institutions to facilitate travel for treatment purposes. The accreditation of health institutions by the countries that aspire to the provision of health services or their encouragement for accreditation has been an accelerating factor in the development of this sector. For example, “JCI – Joint Commission International” in the USA has accredited more than 300 foreign healthcare facilities, most of which are located in the USA, Turkey, Thailand, India, Dubai and the United Arab Emirates.
- Intermediary institutions: With the introduction of intermediary institutions in medical tourism, intermediary institutions (facilitators) for this purpose have started to enable patients to travel more easily. As a matter of fact, the US Travel industry saw this important opportunity in the market and intermediary institutions arranged health tourism packages that included flight tickets, accommodation and surgery costs, claiming to save up to 80% compared to the costs in the USA. A good example is the all-inclusive treatment of a $250,000 cardiovascular surgery in the USA, through intermediary institutions, for $50,000 in Thailand. In this context, a process management will be provided by intermediary institutions, where patients are taken from their homes, all procedures are followed, and then left to their homes. In this way, hidden costs will be protected as patients or insurance institutions will make package payments.
- Out-of-scope treatment: The fact that cosmetic, dental surgeries and aesthetic operations are excluded from the scope of health insurance in most western countries, and the presence of people who need this type of health service has led to the search for cheap treatment in foreign countries. When the health tourism potential is evaluated individually in terms of the procedures performed on all patients, it will be seen that visits to other countries for dental treatment constitute the largest share of the health tourism sector numerically. With the fee to be paid for a dental implant to be made in developed countries, a one-week vacation for a family of three is possible in Turkey besides the implant.
- International agreements: Medical tourism has become an important area of outsourcing around the world. Instead of providing nursing homes and gerontology services for retirees within the country, as in the example of Japan, it is preferred to send people to countries where these services are provided at lower prices. In this way, both a cost-effective solution is produced and its own employee power can be used in more strategic areas. In England, the NHS has outsourcing with India for the provision of medical services. The best example of outsourcing services in the field of tourism is given from Japan. In addition, the agreements made by the private insurance companies in the states of the USA at JCI accredited international hospitals are increasing day by day.
- Elderly population: Today, the population over the age of 65 in developed countries has reached 20 percent and it is estimated that the proportion of the elderly population will reach 50 percent in 2050. In addition, the necessity of employing the productive population, which should be employed to serve the elderly at this rate, mostly in the finance and technology sectors, emerges as an important problem. The necessity of providing elderly health care in countries that provide service standards set across borders emerges. This creates an important market for health tourism.
- Healthy life: In addition to the aging population, young people also attach more importance to their physical and mental health, and accordingly, adopting a healthy lifestyle; It has led to an increase in demand for formations such as cosmetic surgery, thermal health facilities, fitness centers, mental rehabilitation clinics.
- Pension funds: A different and rapidly developing type of medical tourism is the new lifestyle that can be considered as “cross-border retirement” life. Health care centers for the elderly in other countries attract this category of people. In Turkey, there are regions such as Alanya, Kuşadası and Marmaris that appeal to retirees from Germany, Russia, England and Northern European countries in this category. In some countries such as Germany, the implementation of the “Care Insurance” system since 1995 is an important source of financing for health services for the elderly and disabled. In this application, it is necessary to provide accommodation permits for retirees for at least 6 months and to provide opportunities for banking activities (such as withdrawing salary, making payments from the account). This group is the group of “old people with chronic diseases” that are known as diabetes, hypertension and asthma and need regular care.
