Why does a medical tourist pick one destination over another? Assuming perfect information and holding price constant, the following factors will infl uence an individual in favor of one country and away from another: cultural affi nity, distance from home, medical specializations, and reputation. Clearly other factors are relevant, such as portability of insurance that determines where one can receive care (this is a large component of Chile’s attraction for Bolivians).
Medical tourism in India began with demand from the Indian diaspora, especially the twenty or so million fi rst- and second-generation patients who have ties to their homeland. Patients from the diaspora feel comfortable at home as their cultural affi nity to facilities, personnel, and interpersonal relations is strong. When they engage in VFF (visiting friends and family) tourism, they take care of routine health care on their trip. To the extent that they are concerned with cutting their costs, they undoubtedly save money not only because medical services are cheaper than in their host countries, but also because they can pass themselves off as locals and pay even lower fees (this is popular, for example, among nonresident Indians with dual passports).
To the extent that patients from the diaspora are inclined towards traditional medicine, they are likely to purchase such services while on VFF travel (Houyuan claimed this is one of the reason Chinese outside of China visit their homeland). Other patients from the diaspora go home for medical care because they feel more comfortable with culturally determpatient-doctor relations (Teh and Chu note the importance of cultural differences in medical care especially among the Japanese and Koreans who, for example, do not challenge their doctor’s opinion).
A sense of cultural affi nity also comes from shared language. Being able to communicate with medical staff in one’s native tongue is reassuring and, as a result, patients are drawn to countries where their language is spoken and past colonial ties still beckon. Indeed, the British go to India, Americans to the Philippines, Spaniards to Cuba, and Saudi Arabians to Jordan.
Religion is sometimes a factor in determining cultural affi nity. International patients may choose a destination according to its dominant religion. In this way, Jordan attracts Muslims from the Middle East, and lately Malaysia has stepped up its efforts to attract patients from Islamic countries. These efforts include assurances that patients will receive sensitive treatment with respect to their religious observances such as prayers and food. Incidentally, religion may also be a deterrent for some international patients who worry it might dominate their medical tourism experience. Medical establishments often reassure potential patients that they are embracing of all religions (for example, the Christian Medical College and Hospital in Vellore, India, promotes its 1,700 bed complex as an interdenominational community that is tolerant of diversity).
Some international patients feel cultural affi nity for a region even if they have no roots there and do not speak the language. Perhaps they have traveled there in the past and are comfortable in that environment. When there is no cultural affi nity, promoters of medical tourism will try to create it. Bumrungrad Hospital in Thailand for example, has built a culturally compatible wing for Middle East patients to make them feel comfortable. They hired additional Arabic interpreters, they built a new kitchen to offer religiously acceptable food, and they purchased many Muslim prayer rugs. Malaysia has developed the Feel At Home Program for West Asian tourists that includes Arabic and Middle Eastern food, songs, and dances. Similarly, the International Medical Centre in Bangkok provides Japanese patients with a special wing, paying particular attention to religious, cultural, and dietary restrictions of its clientele.
Demand for Medical Tourism in General
