How helpful are the new WTTC medical tourism statistics?

 

The WTTC  Medical Tourism: A Prescription for a Healthier Economy is a new 11-page report on global medical tourism.  It looks at the economic contribution of medical tourism in 115 countries, and showcases some of the best policies and initiatives from selected countries whose governments have actively supported the development of this sector. 

The good news is that this is the first time this major global travel organisation has looked seriously at medical tourism.

The bad news is that in general, the travel figures that the WTTC issues are frequently then taken as endorsed “fact” by countries and organisations that are keen to promote themselves in the sector. Only a small number of countries actually issue medical tourism numbers, and these are rarely comparable.  People new to researching medical tourism run the risk of taking figures for fact, when they may be “spin”.

So, when some of its conclusions are disputed, this can cause a credibility problem.  How useful, then, is this new WTTC medical travel report?

An unrealistic comparison?

An 11-page report cannot obviously cover the same detail as either the IMTJ 100-page market overview, or the almost 1,000-page page IMTJ Country Profile analysis of over 180 countries. 

In addition, the danger of using the past to predict the future is a warning often used by investment companies that also applies to medical tourism.  The WTTC looks at several years up to 2017 (IMTJ includes information on 2018 and 2019).  Using historic figures can be very misleading, since a leading destination in 2012 may be almost out of the medical tourism sector by 2019. 

For example, in the last three years a number of Middle Eastern countries, including Oman and Egypt have either introduced or plan to introduce compulsory health insurance for citizens and resident expatriates.  Future outbound numbers from these countries may well reduce, as the insurance is often twinned with significant investment in new local health facilities. 

Comparing WTTC and IMTJ: key highlights 

Global market value

  • WTTC: International spending on medical tourism products and services grew by 358% in nominal terms between 2000 and 2017, increasing from US$2.4 billion to US$11 billion. This growth resulted in spending on medical tourism reaching 1.2% of international visitor spending in 2017 compared to 0.6% in 2000. 
  • IMTJ: Every country defines medical tourism differently, so the process of getting to a global figure is always difficult. Some countries only count medical spending, others include food and travel and accommodation and those travelling with medical tourists. However, as a ballpark market figure for 2017 and now, the WTTC estimate is reasonable and roughly in line with IMTJ analysis. 

Key inbound medical travel destinations

  • WTTC: The USA is the largest destination market for inbound medical tourists, with spending reaching almost US$4bn in 2017 and representing nearly 36% of global medical tourism spending. Turkey, Thailand, Jordan, Costa Rica and Mexico are some of the leading emerging economies in terms of inbound medical tourism spending. 
  • IMTJ: Realistic revenue numbers on actual medical travel spend are far more debatable than patient numbers (see above). USCIPP estimates of inbound patient numbers to the USA are a good indicator.  However, reliable US inbound revenue figures still don’t exist. On patient numbers, Malaysia, India and Thailand get significantly more medical tourists than the USA, and South Korea, Dubai, and Iran are all far bigger markets than Jordan.  While Costa Rica is promoting itself heavily, it is only a minor destination in terms of revenue. 

Is the USA the leading source of outbound patients?

  • WTTC: The United States is also the world’s leading outbound medical tourism market, representing 20% of the market, with US citizens spending around US$2.3bn in 2017 on medical tourism services abroad. 
  • IMTJ:  The USA does not account for 20% of the market by revenue or numbers; there are more Chinese and Indonesian medical tourists than American travellers. 

Are Kuwait and Nigeria significant source markets?

  • WTTC: Kuwait is the second largest source market for outbound medical tourism, largely due to its government policy of supporting and financing medical procedures abroad. Nigeria is the third largest source market. 
  • IMTJ:  WTTC is using 2015 figures for Kuwait and, while the country is still sending patients abroad for complex healthcare needs, it has had a policy of not sending citizens overseas unless it can be avoided. Even adding private payers to government spending gives a best estimate of 15,000 to 30,000 outbound medical tourists from the country, a small number  compared to China and Indonesia. Plans for compulsory medical insurance in Kuwait will reduce future numbers.  The IMTJ estimate of approximately 100,000 outbound Nigerian patients place it at number 12 in the outbound market, well below European countries that are often forgotten including France, Germany and Italy.

Excluding China, Germany, Japan and others

  • WTTC: There are no inbound medical tourism figures for China, Germany and Japan, and others, so these countries have been excluded from the comparative tables.
  • IMTJ: The lack of medical travel data is why, when comparing medical tourism destinations, you must also use patient numbers when comparing countries.  It is misleading, we believe, to compare countries and exclude China, the country with, possibly, the most outbound medical tourists.  Chinese sources do provide reputable outbound numbers and revenue, Germany has reputable inbound revenue figures from a local university.

In conclusion: stick with IMTJ

It is encouraging that WTTC is at last showing genuine interest in medical tourism, however, it’s worth bearing in mind that some of their numbers are disputed and should not be taken as “fact”.  Their report findings reinforce our long-held view that countries need to calculate and produce validated medical tourism figures and revenue estimates, explain the basis of their calculations, and continue to publish this data even when the market turns against them.

For an independent and and most up to date view on medical tourism:

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