Constantine Constantinides speaks on the role of government in medical travel


In a recent press release, the Indian Ministry of Tourism announced that medical tourism will be included under the government financed Marketing Development Assistance Scheme. The Ministry of Tourism has sanctioned Rs.12,47,966.00 as Marketing Development Assistance to ten medical tourism service providers this year. The Indian Government (through various governmental organizations) is also subsidizing or funding medical tourism “expeditions” to Africa to attract African patients to Indian hospitals, targeting countries such as Kenya, Uganda and Nigeria.

This is just one of the medical tourism-related “incentive schemes” that has appeared as medical tourism has developed across the world..

Asia (including India, Thailand, Singapore, Malaysia, Korea) is leading this trend which is by no means a new one; it is a long established practice. “Incentives and subsidies” are amongst my pet hates (which includes import tariffs) because they distort the economy and the market and run counter to the spirit of “fair competition”.

But incentives and subsidies are (and are likely to remain) a fact of life in medical tourism.

As a destination, if you are prepared to look at this issue in a purely amoralistic context, why not exploit the concept yourself? If you still find the practice distasteful, sweeten the pill by reciting the adage “if you can’t beat them join them”!

My feeling is that if every medical tourism destination body plays the incentives and subsidies game, it will cease being “unfair competition” because just as with “bottom prices – top quality”, the floor and ceiling will be reached, and then we will all be on a level playing field.

Even the USA is at it…

Alongside the newer destinations, such venerable US institutions as the Mayo Clinic and Cleveland Clinic are renewing their efforts to attract patients from abroad. Perhaps it is just a matter of time before the US-based (inbound) medical tourism Industry applies for a piece of the “stimulus package” pie. Perhaps as a precursor to this, we should note the recent award by the U.S. Department of Commerce. The Department awarded $500,000 as part of a three-year Cooperative Agreement to the (Illinois-based) University HealthSystem Consortium. The award is part of the US National Export Initiative, announced in June 2010 which aims to double medical care "exports" by 2015.

It’s interesting that the project will focus on both “counting” and attracting foreign patients to the USA. According to the project head, "Our goal is first to define and measure medical exports coming to the U.S. and quantify their impact on our healthcare economy. Subsequently we will develop strategies to stimulate growth in the number of international patients choosing U.S. healthcare providers."

And being Greek, based in Greece with some interest in developing Greece into a Health Tourism Destination, if you read on, you can read the “Greek Example”, with regards to Incentives for Investment and Development.

Are these “incentives schemes” in fact a euphemism for “dumping”? Of course they are.

Dumping refers to "predatory pricing" (such as selling goods or services abroad at a price below cost or real market price), the idea being to drive competitors out of the market, or create barriers to entry for potential new competitors.

“Shovel ready” projects

The sweetest sounding phrase to many American ears today is “economic stimulus spending” (purportedly to help stimulate the flagging economy by providing “incentives” in the form of subsidies, or even “no strings attached grants” to companies and for “projects”.

And the projects which are most likely to be selected under the “economic stimulus spending” scheme are those known as “shovel ready”. Shovel ready projects are those which are complete and ready for immediate implementation.

Implementation of these projects - and their deliverables - have a more immediate impact on the economy than money spent on a project on which a great deal of time must elapse for architecture, zoning, legal considerations or other such factors before it can be initiated / implemented.

The EU perspective

According to EU regulations, government-funded incentive schemes (e.g., subsidies and grants) are “nominally” illegal but, ironically, the EU is itself openly and unashamedly guilty of “subsidizing” production and projects and thus of “protectionism”.

And of course, we are seeing a plethora of “Projects” (many in my opinion, worthless) being subsidized by the individual governments of EU Member countries.

For many years, newly inducted countries into the EU prided themselves on their fantastic economic growth and development (but did not overly publicize the fact that this was fueled by EU subsidies and grants). Ireland’s current woes can perhaps be tracked back to its EU stimulated boom in construction and development.

And being Greek, based in Greece with some interest in developing Greece into a health tourism destination, let me provide an insight into a Greek example, with regards to incentives for investment and development.

A Greek example

Initiatives and actions aimed at creating enabling conditions and a favorable environment for investment and development are the responsibility of the government.

To its credit, the Greek government, through a “catch all” development law, does provide incentives for investment (including in health tourism-related projects), although the “strings attached” and bureaucratic hurdles and absurdities has led many to call them disincentives.

Many potential investors are holding off investment and development until the regulatory environment becomes clearer. They need to consider laws, rules and regulations issued by at least four separate ministries, those of Health, Tourism Development, Development and Environment.

These “regulators” determine where one can develop, what to develop and even how many months a year they will be obliged to operate (the pressure on investors is to establish facilities that will operate throughout the year - the seasonality factor).

What seems to be holding back those with medical tourism ideas and plans is the fact that a draft law on medical tourism which would define the rules and spell out the “incentives” is stagnating, whilst the Ministry of Health deals with other more pressing priorities.

A specific law already exists providing incentives for investment and development in spa tourism, both the conventional and contemporary variety. But although it has been in effect for a number of years, investors and developers do not seem to be overly enthusiastic about exploiting the “incentives”. The reason? Once again, due to bureaucracy, ambiguity and absurd regulatory conditions!


Amateur to professional

Articles, 01 August, 2018

Medical tourism clusters are not in the right league

“Fragmentistan Syndrome”

Articles, 01 March, 2017

The “Fragmentistan Syndrome” in medical tourism

Industry Representative Bodies

Articles, 31 January, 2017

The raison d'être of Health Tourism Industry Representative Bodies

Health tourism improvements

Articles, 21 September, 2016

Making health tourism “truly” sustainable and resilient – for all

The rise of domestic medical tourism

Articles, 10 December, 2015

Why more and more medical tourism business is becoming “domestic”

Insurance funded treatment abroad

Articles, 15 October, 2015

The future of “Health-Plan-Funded” treatment abroad

A fortune in pyramids

Articles, 12 June, 2015

Is there a fortune at the bottom of the medical tourism pyramid?

Saying NO

Articles, 24 November, 2014

Why some countries are turning their back on medical tourism.

"Buyers" at events

Articles, 07 August, 2014

Hosted "Buyers" fail to live up to expectations

Who leads "Health Tourism Destinations"?

Articles, 22 May, 2014

Are there leaders, or does he who pays, speaks?

The Russian Patient

Articles, 22 April, 2014

Russia is the new focus for medical tourist companies.

Why "Google Health" failed

Articles, 09 January, 2014

Examining the electronic health record "Death Trap"

Greece as a destination

Articles, 29 November, 2013

Times are changing as Greece tries to become a major destination.

Luxury and Medicine

Articles, 07 October, 2013

If medical tourism is all about cost, why so many luxury destinations?

Conventional bankruptcy

Articles, 27 August, 2013

The old models have failed, but what replaces them?

State and Government

Articles, 17 June, 2013

The role of governments in developing health tourism

Haves and wants

Articles, 12 April, 2013

How have to travel is being replaced by wanting to travel

Changing motivations

Articles, 01 February, 2013

Is medical tourism experiencing a shift from 'have to' to 'want to'

Discovering medical tourism

Articles, 22 October, 2012

Despite the recession, there's still growth in medical tourism

Tourism "free zones"

Articles, 01 June, 2012

What are the goals and benefits?

International medical children

Articles, 18 May, 2012

How the EU directive may stimulate an increase in child care

On ice?

Articles, 23 April, 2012

Dr Constantine Constantinides talks on the EU directive on Cross Border Healthcare

Short/long term

Articles, 06 March, 2012

Which should we focus on in medical tourism

Survivor bias

Articles, 23 January, 2012

Past success is no predictor of future eminence

Healthcare standards

Articles, 21 October, 2011

Do standards need to have a regional flavour?

Is it enough?

Articles, 28 September, 2011

Can medical tourism on its own be sustainable?

Understanding the market

Articles, 03 June, 2011

Why would you want to get into the medical tourism market?

Exploring the health tourism market

Articles, 28 January, 2011

Constantine Constantinides provides advice as to understanding the health tourism market


Articles, 26 August, 2010

Constantine Constantinides talks on why medical tourism businesses fail

Should accreditation be sold

Articles, 29 July, 2010

Constantine Constantinides talks on how should handle Destination Marketing

Blowing their own trumpet

Articles, 26 February, 2010

Is there any noise from the market, or is it all in the industry?

Brightest Africa

Articles, 20 January, 2010

Is Africa always a exporter, or can it be a healthcare destination?

Cross-border opposition

Articles, 10 December, 2009

Spain and other nations blocked the draft proposal, we ask the experts why

The resentment factor

Articles, 15 October, 2009

Health tourism is often resented by countries, but can it have positive effects?

Free and open debate

Articles, 22 September, 2009

Constantine Constantinides voices concern over the expression of opinions in the industry

Medical tourism in denial

Articles, 30 July, 2009

Supply is exceeding demand in medical tourism, but the industry is in denial



Do you have an article that you’d like to share with the medical travel industry?

Publish for FREE on IMTJ.


Related Articles

USA healthcare reforms: why it matters to medical tourism

09 January, 2020

Targeting outbound US patients? Understand American healthcare first

Medical travel: Bold predictions for the future

19 December, 2019

Perspectives from the IMTJ Medical Travel Summit 2019

Dental tourism to Costa Rica

20 November, 2019

Cost and quality drive medical travel to Costa Rica

China boosts inbound medical tourism offer

06 November, 2019

New policies push China's Hainan pilot zone

Setting up a medical travel business

23 October, 2019

Lessons from the front line