Medical Tourism and Healing in India

Policy Update
Khushboo Dandona

India’s healthcare system is a diverse and complex network of public and private sectors. It offers a wide range of medical services. India’s medical system follows pluralistic principles, as there is the Ayush system of medicine. AYUSH is an acronym for Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa Rigpa, and homeopathy. Over the decade healthcare became the largest sector of the Indian economy, both in terms of employment and revenue. Several factors contributed to the growth of healthcare facilities such as the aging population, increase in lifestyle diseases, increase in FDI inflow, etc.

According to WHO, health is a state of complete physical, mental, and social well-being and not merely the absence of disease. India’s healthcare industry comprises hospitals, health insurance, telemedicine, medical tourism, etc. Among these, medical tourism is a growing sector in India. Thanks to globalization and progressive liberalization that leads to disparity and inequality among different regions. Medical tourism is when an individual is experiencing an ailment and is compelled to get better treatment at a lower payment. It primarily includes biomedical procedures.

In mid-2020, India’s medical tourism sector was estimated to be worth USD 5-6 Billion. India has been ranked 10th in the Medical Tourism Index (MTI) for 2020-2021 out of 46 destinations of the world by the Medical Tourism Association. There are several factors like cost-effectiveness, the presence of world-class hospitals, superior quality healthcare, alternative systems of medicine and rejuvenation therapies, etc. Apart from curing the disease, there is healing, a holistic process involving the patient and placing his/her interests at the center.

Healing tourism, according to Kim et.al (as cited in Hong, V. L., & Hsu, L. (2022). Healing tourism as the “New Normal” in the tourism industry: Through expert’s perspective.) is a piece of health tourism. A method to handle or cope with extreme physical and mental pressure and revive the sensations of energy to manage this. People may get back to their everyday lives with an improved feeling of health and wellness. Some researchers have shown that healing tourism is a product of post-COVID-19 and will be a growing trend in the future.

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Figure- Number of Foreign Tourist Arrivals in India on Medical Visa
Source: Investment Opportunities in India’s Healthcare Sector (P-24)

Emergence of Medical tourism in India

In comparison to first-world countries like the USA and the UK, third-world countries like India spend one-eighth to one-tenth. Medical tourism is increasing by 25-30% each year. After independence, the national government made promises to provide medical health care to all its citizens regardless of their paying capacity. In the 1980s, under the sixth five-year plan, there was an increase in the private sector and the government also shifted to the corporate sector by providing subsidies, cheaper lands, etc. The eighth and ninth plans focused on the underprivileged and the importance of involving the private sector in medical care. T

he ninth plan opens the way for the business interests of those other than professional providers. The pressure of liberalization and privatisation made acceptance of the new economic policy, which led to reform in the health sector. There was a major cutback in public sector investment and commodification of health. This policy leads to the separation of services for the poor and rich on the one hand, and the liberated public sector makes its profit through medical tourism.

In 2003, Finance Minister Jaswant Singh in the annual budget speech announced the government policy of merging medical expenditure and tourism. He called the India to become a global health destination and glamorized the complex technologies offered at relatively cheaper rates, the potential hi-tech, etc. This led to creating the chains of such institutes and medi-cities.

India has comparatively better tertiary care as compared to neighbors like Pakistan, Bangladesh, etc. In an interview with Hindustan Times, Dr Rajeev Agarwal, an IVF specialist mentions that many foreign people preferred due to advanced infrastructure, skilled medical professionals, the availability of advanced treatment, and cost-effectiveness (see below Table 1). He mentioned that Kolkata has become the IVF landscape, with several state-of-the-art fertility clinics offering comprehensive services to both domestic and international patients.

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Table 1 – cost comparison of different countries
Source of image- Investment Opportunities in India’s Healthcare Sector,(p 23)

SWOT analysis of Medical travel

The Indian medical value of travel has various strengths, weaknesses, opportunities, and threats. These are important to strategize the development in these fields. The major strengths include fast-track appointments, financial savings, traditional healthcare therapies-AYUSH, etc. These attract the large population, however, there is a uniform pricing policy, a lack of government regulation, no campaign, perception of India as an unhygienic country which hinders its full potential.

While there are various opportunities for the growth of medical tourism as there is demand in countries with aging populations, wellness and alternate cures, post COVID-19 rise in healing tourism, high cost, etc contribute to its expansion. Apart from these, there are threats such as ignoring the native’s health, exploitation by middlemen as medical value tourism is unorganized, and many unprofessional agents exploiting the traveler.

Proponents of this claim that it helps in the growth of the economy and has development impacts on the destination countries. Opponents raise concerns about patient safety, ethics, and the growth of the private market in developing countries at the expense of adequate staff and resourced public systems. One of the major benefits is the reverse migration of medical professionals from developed countries. The Apollo group claims that more than 123 expatriate medical professionals return by offering competitive salaries and the opportunity to live and work in their own country.

Some of the challenges faced by the wellness industry is the recruitment and retention of skilled manpower. The wellness industry does not have a regulatory framework which leads to a lack of adequate regulation and often results in lower barriers to entry, making it quite easy for small and unprofessional players to enter the market. These players lack hygiene and quality, transparent pricing, and pro-customer behavior. Additionally, there is a dearth of good training institutes. The vocational training programs often impart theoretical knowledge with little hands-on experience. Limited pool of skilled professionals available in the country where the demand is huge.

National Strategy and Roadmap for Medical and Wellness Tourism

Over the decade, India has become a premier and attractive destination for travelers from across the globe seeking best-in-class clinical treatment. To improve medical tourism in the country and recognize the opportunities and challenges in the sector, the Indian government has taken proactive steps to enhance the sector. One such initiative is the National Strategy and Roadmap for Medical and Wellness Tourism, introduced by the Ministry of Tourism in 2022.  The vision of this policy is to position India as a sustainable and responsible medical and wellness tourism. The government identified the following pillars:-

  1. Develop a brand for India as a wellness destination
  2. Strengthen the ecosystem for medical and wellness tourism
  3. Enable digitalization by setting up an Online Medical Value Tourism (MVT) Portal
  4. Enhancement of accessibility for MVT
  5. Promoting Wellness Tourism
  6. Governance and Institutional Framework

India is currently promoted as a destination under the umbrella of “Incredible India”, with individual hospitals marketing themselves but there is no campaign for the country as a destination for medical and wellness tourism. Not only a high level of expertise, India has AYUSH.

As there is an increase in lifestyle diseases like depression, diabetes, etc. there is now a focus on the ancient science of Ayurveda as these diseases show the linkages between the mind and body. These traditional systems of medicine help in holistic healing.  India will be marketed as a medical and wellness tourism destination under the “Heal in India” brand. Under this, they will integrate a communication strategy to promote the brand. To increase wellness tourism government support for wellness tourism companies, healthy hotels to go mainstream, encouraging partnerships between airports, airlines, and wellness businesses.

There is a need to strengthen the ecosystem which includes facilities of commercial agencies such as hotels, airlines, etc, and regulatory agencies of government. The government is also enabling digitalization by setting up of online MVT portal. This portal helps in assisting in better stringent regulations in the industry. Apart from digitalization, the government is enhancing the accessibility for medical travel by providing a liberalized VISA policy, better air connectivity, a helpdesk, and an MVT lounge at the airport.

This is not only policy developed by the government but there are various others to improve this like the E-Medical Visa’ introduced for 166 countries, the National Medical & Wellness Tourism Board constituted to promote Medical/Wellness Tourism, AYUSH, increased funding to improve healthcare infrastructure, tax incentives for hospitals catering to international patients, establishing 200 cancer daycare centers across the country, etc. These initiatives pave the way for international patients to receive quality care in India. 

The Road Ahead

More than 6,00,000 international patients are seeking medical care and 36 life-saving drugs which make the advanced treatments accessible and make India a leading global healthcare destination. However, there is still room for support. The 2025 annual budget strengthens India’s position as a top medical tourism destination by providing cheaper medicines, expanded infrastructure, increasing seats in medical colleges, faster visa approvals, etc. This helps in increased revenue which is often used in reinvestment into healthcare infrastructure, research, and training programs.

References

About the Contributor: Khushboo Dandona, a research intern at IMPRI India and a postgraduate student of Gender Studies at the Dr BR Ambedkar University, Delhi.

Disclaimer: All views expressed in the article belong solely to the author and not necessarily to the organisation.

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