While credit markets enable individuals to travel now and pay later, and airline mileage programs make distant, expensive locations more accessible, discretionary income is still necessary for medical tourism. As people have more income, they tend to buy more wellness and preventive medicine. High-income individuals tend to be healthier because they are more educated about disease and preventive health, they know more about healthy lifestyles, and as they age, they pursue even healthier lifestyles.
Smoking rates have gone down among adults, especially high-income adults. They avoid exposure to second hand smoke, and bars and restaurants are responding to their taste. People stay out of the sun and they exercise. In the United States there are 80 million baby boomers who are aging and, given their dispositions, will go to great lengths to retain their health. People with discretionary income living in MDCs have the necessary prerequisite to demand medical tourism. This demand is likely to grow since the cohort will grow. The population of the more developed countries is living longer as life expectancies are steadily inching upwards. People live in retirement for longer and barring any policy changes in the retirement age, they are likely to continue to do so. When longevity and retirement are crossed, the result is more travel, more medical care, and more medical tourism.
The positive relationship between income and tourism extends also to the tourist’s country of origin. Quantity of travel and income per capita are positively correlated with GNP (although not perfectly, because the propensity to travel depends also on other factors) because travel requires income in excess of subsistence, a condition more prevalent in high-income countries (indeed, more than 90 percent of world tourism originates in MDCs). This has implications for medical tourism. The most affl uent in Western countries still pay for their treatments close to home or travel to the United States, Canada, and the UK; the most affl uent in developing countries are still willing to pay a lot and travel to the United States and UK, or even Australia and Singapore. It is the second tier of wealthy patients that travels to destination LDCs with superior health care. Luxury medicine is also purchased by middle-income populations from LDCs who can’t afford to go to the West and have no medical care in their own countries.
In order to travel abroad for medical services, whether bypass surgery or traditional healing, one has to like to travel. Some people simply do not like fl ying, or disrupting their routine, or living out of a suitcase. Despite what they have heard and read, they distrust LDC doctors and facilities. They want to be close to friends and family when hospitalized. By contrast, others are attracted to the exotic and they have an inclination to travel, clear ideas as to where they want to go, and what they want to do once they get there. From the study of travel patterns and modes of traveling by geographers and psychologists, and from economic analyses of tourist motivations, it is clear that variations in taste make travel very complex. People want to consume medical tourism because their taste makes them so inclined. Several aspects of taste are relevant in this discussion.
Some consumers desire privacy, and having medical treatment abroad satisfi es this need. They are not tracked in any way and if they choose to have a secret procedure, they are confi dent it will remain so. Such a consumer can go on a two-week holiday and return with no proof that she underwent rhinoplasty Others desire immediate gratifi cation and instant happiness. If they are low on the National Health Service waiting list, or if they still need years to accumulate savings for a procedure, medical tourism enables them to achieve satisfaction sooner.
For most consumers, it is their concern with health and wellness that defines their taste for medical tourism. They are seeking longevity and so they are controlling their weight and following low carb diets. In addition, the antismoking movement that decreased the number of smokers in the United States from 30 percent (1983) to 21 percent (2000) is spreading into Western Europe. This emphasis on healthy lifestyles and preventive medicine increases the demand for spas that feature wellness. For this reason, spa, health, and fitness tourism is booming (in the United States, the number of spas grew by 52 percent between 1997 and 1999, and spa visits rose 70 percent during that time). In addition to fi tness, North Americans and West Europeans are fascinated by alternative therapies (in 1997, 42 percent of Americans spent $21 billion on nontraditional medical therapies and products). With their longer life spans, international patients have more time to consume products and services associated with health and wellness.
Globalization as the Main Context of Medical Tourism
