By Anchana NaRanong* and Viroj NaRanong
*Professor of Graduate School of Public Administration (GSPA NIDA)
Objective To explore both positive and negative impacts of medical tourism on the Thai economy, human resources, and medical costs for Thais.
Methods The estimates on the impacts of medical tourism on the economy are partly based on the data collected or estimated by the Ministry of Commerce, with some modifications and extrapolations based on various scenarios and assumptions. The analysis on the impact of medical tourism on human resources employs data from a survey of 4,755 foreign and Thai outpatient samples in two private hospitals. Changes in the relative prices of five representative medical services, namely, Caesarean Section, appendectomy, hernia repair operation, gallbladder surgery, and knee replacement, over time in five private hospitals, were collected. Focus groups and in-depth interviews with hospital directors and/or administrators (including those in a teaching hospital) and key informants from various government agencies and the private sector were undertaken to gain deeper understanding of the motivations and practices of various stakeholders on these issues and to gain information on medical tourists.
Findings For the country’s economy, medical tourism generates the value added that is equivalent to 0.4% of GDP. However, the surge of medical tourists has exacerbated the shortage of medical personnel (especially of physicians, dentists, and nurses). The higher purchasing power of foreigners has drawn more medical personnel, especially specialists, from both the private and the public sector (including professors in medical schools) to foreigner-oriented hospitals, and this brain-drain will potentially affect the availability and quality of medical training in the future. This personnel shortage has raised medical costs in the private hospitals substantially and is likely to drive up the costs of the public hospitals and the publicly-provided Universal Coverage Health Insurance (including the Social Security Scheme and the Civil Servant Medical Benefit Scheme) which covers most of the Thai population.
Conclusion Medical tourism has both positive and negative impacts on the country. To reduce negative impact, proposed recommendations include lifting the regulation that has prevented importing qualified foreign physicians and imposing specific taxes/fees on medical tourists whose purpose of visit is solely for medical treatment and to use this revenue to expand training of physicians and retain professors in public medical schools.