When a VVIP (Very Very Important Person) in India needs medical care of a serious nature, they head off quietly to London, New York City, or Singapore. This is rather ironic considering that India’s medical services are superb.

But there is a catch! There always is.

You should have enough money to pay for the treatment.

This kind of travel to get medical treatment is called medical tourism. This is an area of great interest to geographers. Of course it is. It’s about places, movement of people, disparities in economies among places, etc. You name a phenomenon, and we geographers are interested in it!

International scale

At the international scale, India receives a large number of medical tourists (this includes patients and accompanying care-givers). This industry is worth more than US$3 billion in India.

As always with human movement, there are many factors involved.

In many “rich” countries, health care, even if it is affordable, is not available on an urgent basis. For example, in the National Health Service (NHS) in the UK, the waiting times are reportedly very long. The services themselves are said to be affordable because of the universal health care policy in the UK.

In the USA, costs of medical treatment are astronomical (meaning it costs lots and lots of money). This is even if you have insurance that will pay for your expenses. (Insurance premiums are very high in the USA and many companies do not provide the coverage that a person needs, though the person has paid vast sums of money as premiums.) Health care in the USA continues to be a matter of fierce debate in American society for decades.

Therefore, medical care can be so expensive even in the so-called ‘developed’ countries that patients have to find alternatives abroad.

One of their choices is India.

Why India?

I found a list of advantages for patients that India’s health care system offers to potential medical tourists. Among them:

  • Affordability – Example: The cost of heart bypass surgery in US is $144,000 while in India it is $8,500.
  • Low waiting period ­– In India, the patients have immediate access to consult a specialist and get their treatment done.
  • Medical experts – Highly qualified individuals
  • Advanced equipment – Latest medical technologies are available.
  • Superior health care – Medical experts and hospitals are certified by reputable national and international organizations.
  • No or low insurance coverage – Even patients without insurance coverage can get the treatment that they cannot get in their own countries.

Some popular treatments medical tourists seek in India:

  • Ophthalmology
  • Cardiac Bypass Surgery
  • Bone Marrow Transplantation
  • Hip and Knee Replacement
  • Fertility Treatments
  • Neurological Treatments
  • Oncology Treatments
  • Genitourinary Care
  • Alternative Treatments

The Government of India is actively promoting medical tourism to India. In a paper in the Indian Journal of Medical Ethics, author Amit Sen Gupta says:

The National Health Policy, 2002, makes it clear that government policy supports medical tourism: “To capitalize on the comparative cost advantage enjoyed by domestic health facilities in the secondary and tertiary sector, the policy will encourage the supply of services to patients of foreign origin on payment. The rendering of such services on payment in foreign exchange will be treated as ‘deemed exports’ and will be made eligible for all fiscal incentives extended to export earnings.”

Check out this source for very interesting information on medical tourism to India.

Medical treatments in various countries and the percentage savings on costs of the same treatments in the USA.
Source: https://goo.gl/nXkBZA [Last accessed on 11 August 2018] Click on the image to see a larger version.

And this interesting graphic about the regional characteristics of treatments in various parts of India:

Regional characteristics of medical treatments in various parts of India.
Source: https://goo.gl/nXkBZA [Last accessed on 11 August 2018] Click on the image to see a larger version.

Identify geographic concepts

In what I’ve shared above, identify the two sets of important factors (push factors and pull factors) that promote movement of people. Medical tourism is a temporary migration. Push factors are those in the place of origin that push people to go elsewhere. Pull factors are those in the destination that attract or pull people.

Unequal geographies

Even in ‘wealthy’ countries such as the USA and UK, there is considerable gap between the rich and poor. Your typical National Geographic or other documentaries will not show you about poverty in the ‘wealthy’ countries. If the documentary is about India, Pakistan, Bangladesh, etc. poverty will be ‘front and centre’ in it. So, medical tourism abroad is not affordable to everyone even in ‘wealthy’ countries.

Within India also, there is a huge divide between the rich and the poor. This is reflected on the landscapes that we all move about every day going about our lives. These landscapes are part of our activity space. We don’t always necessarily engage with this; we take it in our stride.

The kind of treatment that moneyed foreign patients can avail in India because it is affordable is still unaffordable to a vast majority of Indians. So, the high-tech, super-speciality hospitals that cater to foreign medical tourists are usually out of reach for most Indian patients.

These unequal geographies are addressed in three ways.

  1. Super-speciality hospitals make sure to use some part of their profits from medical tourism to treat poorer patients in India. There are several such hospitals.
  2. Some of the super-speciality hospitals do not do this. They are violating Central Government rules that require them to put some of their profits into providing the same care for poor patients in India also.
  3. A third alternative is very interesting. Private hospitals funded by religious charities have set up hospitals to provide to medical care for everyone free of cost. The super-speciality Sathya Sai hospital in Bengaluru and in Puttaparthi (Andhra Pradesh) are 100% free no matter the patient’s socio-economic status.

Service motivation

Medical tourism of a different kind also happens, especially in the religious charities-funded super-speciality hospitals. The medical experts who work there come from many different countries and serve at these hospitals for free, motivated by a sense of service.

Featured image: JCI Gold Seal, an example of international hospital standard accreditation.
Source: https://goo.gl/yWbZPo [Last accessed on 11 August 2018]

An earlier version of this article appeared in the Deccan Herald Student Edition on 8 August 2018.


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