FACULTY ECONOMY AND MANAGEMENT MGM 3304 MARKETING MANAGEMENT

GROUP PROJECT: THE FACTOR THAT ATTRACTING FOREIGNER TO GET MEDICAL TREATMENT IN MALAYSIA 2010/2011

GROUP 1

Contents

1.0 Introduction 1.1 1.2 Globalization and trade in health care Issues

1 2 2-3 3-5 5-6 6-7 7 8-9

2.0 The market for medical tourism 3.0 Introduction- Ethical 3.1 Illegal Organ donation and transplantation 3.2 Is Embryonic Stem Cell Research Ethical?

4.0 legal issues 5.0 Why do people come to get the medical treatment in Malaysia? 5.1 Advance in technology 5.2 Healthcare 5.3 Medical services 5.4 Lower cost 6.0 Recommendations 6.1 Recommendations in our opinions

10 11-12 12-13 13-15 16-17 17-18

Conclusion

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References List of Figure: Figure 1: Number of International Patients and Revenue Figure 2: market services provided in Malaysia Figure 3: News about Malaysia in top 5 for medical tourism Figure 4: Example of illegal donation organ Figure 5: CT Scanner by GE: Kuala Lumpur Malaysia health Figure 6: Medical staff in Malaysia Figure 7: cost comparison with the UK

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2 3 4 6 10 13 14-15

Medical Tourism In Malaysia

1.0

Introduction

Medical tourism refers to the many patients that are currently traveling overseas for immediate and affordable treatment. Caballero-Danell and Mugomba (2007) defines medical tourism as the pursuit of medical care abroad and simultaneously engage in more conventional forms of tourism. It is an emerging phenomenon in the health care industry. In addition, tourism is different from the traditional form of international medical care where patients typically journey from less developed nations to major medical centers in highly developed countries for advanced medical treatment. This means even patients from a highly developed country such as The United States, United Kingdom or France can go to those developing countries such as Malaysia and its neighbors for medical treatment. In short, medical tourism is the attempt by patients to seek for a qualified and high quality medical health care at foreign countries at an affordable price or cheaper price. It does not limit to traveling to modern countries to seek for better service but most important is the affordable price with the same quality of service. This combination of surgery and tourism is a relatively new type of nonexclusive niche tourism that promises to have significant growth over the next few years. Experts found as health care costs have increased tremendously, patients in the developed world are looking overseas for medical treatment and patients in developed countries always suffer from long waiting time. They have to take turns to wait for the medical treatment. Thus, consumers commit to travel overseas for their medical treatment. Often, consumer will also take the opportunity to be a tourist in the visiting country and enjoy what it has to offer. Therefore, consumers may combine their holiday and medical care into one venture. Besides that, medical tourists seek for medical tourism because those foreign countries offer a better price with the same service provided. Patients also travel to medical tourism destinations for procedures that are not available in their own countries such as stem cell therapy for heart failure. Other reasons for medical tourism are the natural attractiveness in the foreign countries, the medical expertise and the medical quality. All of these are interrelated and needed to be developed in order to become a competitive medical tourism. 1.1 care Globalization and trade in health

Medical tourism in Asia is relatively new. Medical tourism was brought on in the 3

aftermath of the Asian Financial Crisis that led private hospitals to seek alternative revenue sources. Malaysia started to be actively participating in medical tourism since 1998 with the setting up of the National Committee for The Promotion of Medical and Health Tourism. In Malaysia, the medical solutions range from traditional medicine to telemedicine. Under Malaysias health tourism promotion drive, there are 35 private hospitals in Malaysia which have been chosen to promote Malaysia as a health tourist destination. These 35 private hospitals are members of the Association of Private Hospitals of Malaysia (APHM). Besides that, these hospitals have been awarded the certification for internationally recognized standards for example MS 9002 or accreditation by the Malaysian Society for Quality in Health and ISO 9001 Gupta (2005). Malaysia achieved some success in establishing as a regional hub for good health care and its ability in providing state-of-the-art medical facilities and services for medical tourists (Ministry of Health). Malaysia became a centre of medical excellence because of its high quality medical facilities and services plus its highly trained and qualified medical specialists and staffs. Malaysias natural attractiveness and most importantly the competitive medical fees provide additional attractions to enrapture medical tourists to Malaysia.

1.2

Issues

Globalization has caused many countries to re-evaluate their economical strengths and weaknesses, as well as re-assess what products or services in which nations can benefit. Nowadays, medical tourism has grown tremendously in many countries such as Thailand and India. In 1990s, many Asian countries became the victims in Asian economic crisis. Thus, they need to find economic diversification and solutions to settle this crisis. Malaysia is one of those countries. As a result, those Asian countries started to involve in medical tourism. In table below there are some statistics which shows the number of medical tourists who came to Malaysia has been increasing from year to year.

(Source from APHM) Figure 1: Number of International Patients and Revenue Through this statistical data, we understand that Malaysia has experienced an increasing number of medical tourists over the years. However, Malaysia is still experiencing a smaller scale of medical tourists compared to its neighbour countries such as Thailand and Singapore. Statistics also show that in the year 2006: Singapore attracted an estimated 410,000 medical tourists. Number of international Year patients Revenue [(RM) 'million] 2001 75.210 44.3 2002 84.585 35.8 2003 102.946 58.9 2004 174.189 104.9 2005 232.161 150.9 2006 296.687 203.7 2007 341.288 253.84 Malaysia attracted an estimated 300,000 medical tourists. Thailand attracted an estimated 1,200,000 medical tourists. While in the year of 2007, India attracted an estimated 450,000 medical tourists. The 4

data stated above reveals Malaysia is the country that has least medical tourists. This small amount of medical tourists indirectly reflects the quality and the reputation of Malaysias medical tourism.

2.0

The market for medical tourism

Figure 2: market services provided in Malaysia The Malaysia Tourism Promotion Board (MTPB, Tourism Malaysia) is embarking on a three-year project to collect market data on health tourism, as the country seeks to increase the number of people visiting the country for medical treatment. According to analyses, healthcare expenditure in Malaysia is driven by increased privatization within the healthcare service provision. The market for healthcare services has also received a positive impetus from health tourism. Malaysia healthcare tourism grew at a rate of 25.3 percent a year since 1998, while revenues posted a growth of 37.9 percent during the same period. By 2010, medical tourism revenue per patient is estimated to reach 90. This signifies the growth of foreign confidence in more advanced medical care services in Malaysia. Most international patients come from neighboring countries with less developed medical infrastructure (mainly Indonesia), and other developed countries from the West. Malaysia is also a preferred destination for these international patients due to the higher foreign exchange rate in Singapore and unstable political scene in Thailand.

Figure 3: News about Malaysia in top 5 for medical tourism According to Frost & Sullivans Dr. Pawel Suwinski, in 2006, the bulk of foreign patients came from Indonesia (65-70 percent), followed by Japan (5-6 percent), Europe (5 percent) and India (3 percent). There are an increasing number of patients from Middle Eastern countries (particularly U.A.E., Qatar and Saudi Arabia). The Malaysian government has set up several referral gateways to assist medical tourists. One of them is the health tourism website that assists medical tourists globally. Private hospital groups and major private hospital providers have set up departments to deal with international patients. Gleneagles Intan Medical Centre and Hospitals Pantai are among those that have set up international customer departments specifically for the admission and support of international patients. KPJ Medical Group, Mahkota Hospital and Subang Jaya Medical Center have established tie-ups with several travel agencies and hotels to provide comprehensive tourism packages in conjunction with healthcare services, as well as setting up representative or referral offices. Healthcare in Malaysia is mainly dominated by private hospitals. 62 percent of the total hospitals in Malaysia are privately owned. The number of private hospitals increased dramatically from 50 in 1980 to an estimated of 223 private hospital last year. The government has built 10 public hospitals in the past 4 years to increase the number to 140. The Malaysian government is promoting medical tourism. It has extended the visa period for health tourists from one month to six months. Major hospitals in Malaysia are targeting new markets such as Vietnam and Cambodia. Africans are now coming to Malaysia because it is cheaper to do so rather than go to Europe where they used to go previously. Malaysian Prime Minister Najib Razak recently said. Medical tourism is a high priority to position Malaysia as a world-class healthcare services provider. The government will invest in education and technology. The key is to make sure Malaysias regulatory environment is ready to support investment.

From marketing materials (both newspapers and web-based sites) it is apparent that the range of the treatments available overseas include: Cosmetic surgery (breast, face, liposuction) Dentistry (cosmetic, reonstruction) Cardiology/cardiac surgery (by-pass, valve replacement) Orthopaedic surgery (hip replacement, resurfacing, knee replacement, joint surgery) Bariatric surgery (gastric by-pass, gastric banding) IVF/reproductive system (IVF, gender ressignment) Organ and tissue replacement (organ transplantation; stem cell) Eye surgery Diagnostics and checkups.

3.0

Introduction- Ethical

Medical tourism is one of the most lucrative industries in the world today. Countries like India, Malaysia, Brazil, Argentina, Hong Kong and China earn huge revenue yearly from treatment from citizens of other countries. Countries are not at the same level in terms of 6

their infrastructural and health care developments. Citizens from countries with poor infrastructural and health facilities will always seek for medical relief abroad. There are different conditions which may warrant one seeking for medical treatment abroad. The medical tourism phenomenon is growing. However it leads legal and ethical issues contribute to the increase of medical tourism cases too. Next, this article will explain five major ethical issues in medical tourism, but will discuss two issues that warm in Malaysia. Five Ethical Issues in Medical Tourism 1. Illegal organ and tissue Tissue is often taken from corpses which have not signed their organs away or illegal purchase of organs and tissues for transplantation. The organ may not be up to professional standards, and can cause damage. 2. Inequality between the classes. Have argued that in countries that are in the class system is still unclear, the possibility of the Medical Tourism creates further divide between the classes is not possible. 3. Exploitation. In any other situation, tourists are exploited and taken for all their worth. Apparently, the same can be said for medical tourists. Occasionally doctors will commit to medical procedures which have not been proven as a means of securing clients. The naivet of a patient unfamiliar with the hospitals past may fall victim to this. 4. Stem Tissue Countries which use stem cells or partake in stem cell research are more likely to get clients because of the many advances stem cells can bring about. However the issue over whether stem cells are ethical is still a hot topic. 5. Tourists overtaking homeland rights. It has been argued that the medical tourists flocking abroad have diminished the amount of care doctors can provide the people actually living within the country.

3.1

Illegal organ donation and transplantation

Organ transplant tourism is not a fad nor a fashion, but a serious 21st century problem for health service providers and governments. Numerous ethical questions have been raised regarding tissue and organ transplantation procedures. This include whether human beings have the right to give away a part of their body such as the kidney or a portion of their liver, whether it is all right to harvest body parts of a cadaver and how available parts are assigned to those who are in need of them. Nowadays in rich countries, patients are willing to pay high prices to purchase the organ, whereas in poor countries, people are willing to sell their organs in order to gain money to support your family. Although these transactions (between buyer and seller) often seem to be a win-win situation, however it lead legal and ethical issues contribute to the increase of medical tourism cases too. 7

Moreover, some countries provide "transplant tourism package. China, Colombia, India, Pakistan, Malaysia and the Philippines also involve in offers organ transplants for patients under the international circumstances. This can see like patients are buying a kidney during travelling abroad. That also means a desperately poor person is putting their health to earn money for survive in world. This issue was a huge ethical for considerations.

Figure 4: Example of illegal donation organ Malaysia had cases about a patient willing to pay RM50000 for a kidney. According to Sunday Star, Nov 2007, an extraordinary advertisement put up at the busy Pudu area. The content show that a kidney patient willing to pay RM 50,000 for a kidney and provide a contact number for interest seller to reach the buyer. When Sunday Star reporter contacted, a man who picked up the phone told that his cousin was a kidney patient, he need a kidney transplant from Chinese donor. The man also told Sunday Star reported about they were looking for a Chinese donor only. There is no chance for some other race or religion.

3.2

Is Embryonic Stem Cell Research Ethical?

What is embryonic? Embryonic stem cells are derived from a four- or five-day-old human embryo that is in the blast cyst phase of development. The embryos are usually extras that have been created in IVF (in vitro fertilization) clinics where several eggs are fertilized in a test tube, but only one is implanted into a woman. Innovative research and new technologies for the stem cells was raise ethical and policy concerns. This is particularly so in any biomedical application, such as stem cell research, where ethical issues are often raised. The main reason argument claims that using embryonic stem cells for research is murder. This camp believes life begins at conception (the fertilization of the embryo), and that using embryos in research is the same as murdering babies. Although many people do not agree to do stem cell research, but the Government is showing more support for stem cell research. According to New Straits Times, May 28, 2008: Malaysia Government's support for stem cell research with the agreed allocation of RM32 million to develop and strengthen the stem cell and cord blood banking activities in the country. Health Minister Datuk Liow Tiong Lai told, however stem cell research and treatment need to be in the ethical guidelines that have been agreed. He also said that the clinical use of embryonic stem cells are not allowed, while all forms of experimental stem cell therapy for 8

myocardial infarction, spinal injury, Down syndrome and cerebral palsy need to be approved by the Research and Ethics Committee.

4.0

Legal issues

The healthcare system hospitals in Malaysia majority offering services to medical tourists are privately owned institutions following internationally recognized standards in healthcare. Currently, there are at least 35 hospitals in Malaysia that are being geared towards medical tourism. All are accredited locally by the Malaysian Medical Society for Quality of Health (MSQH) and are licensed by the Malaysian Ministry of Health. Most of these hospitals are accredited by international bodies including the International Organization for Standardization (ISO) and the Joint Commissions International (JCI) among others. Healthcare and medical tourism have become a matter of global concern today. Healthcare has become a global concern. In a competitive global market where information is shared instantly, consumers have all the knowledge and choices at their disposal. The internet enables the patients to seek out the best service providers, to make comparisons by themselves or to find out brokers and specialists services provider in host country. There are many legal issues associated which should be taken into consideration before traveling on a medical trip. The idea of legal recourse is something all medical tourists need to consider before travelling. Most medical facilities catering to foreign patients have international accreditations and affiliations with esteemed to establish a high level of quality. However, physicians are still likely to make errors, in which case a patient should be able to receive retribution in the form of medical malpractice. Legal or law is the rule to be followed by all parties and legal is one thing that has been designated by the government, because the law is very important for every country. This law depends on a place because the law is not the same for all states in Malaysia and Overseas. Tourism can help to rebuild a damaged city due to natural disaster. Receiving medical care abroad may subject tourists to unfamiliar legal issues. What type of medical has related to medical treatments is associated with certain difficulties such as arranging the paperwork for example visa, insurance and others. Whatever documents had been prepared it is required to check accuracy and completeness as well as all needed details such as photos, signatures, seals, and others. Some papers will have to be translated into a foreign language and oftentimes legalized to be valid in a foreign country. These issues are frequently delegated to lawyers. A number of questions naturally arise in regards to trip arrangement and primarily concern establishing legal relationship with the service provider by the agency, insurance company, clinic, and others. For example contractual relations should without fail be upheld by means of entering of civil contract in writing. The contract may be concluded directly with medical or rehabilitation institutions or through an intermediary agency, insurance company, or others. Before signing a contract it is strongly recommended to consider properly the details of the parties and authority of persons entering the contract. Legal person introduced without the power of attorney should be represented by its head officer as opposed to the manager. In case if reading a copy contract and dont understand of how correctly the contents regulates the legal relationship and guarantees protection. The most important thing must do is to 9

avoid signing the not real or not genuine the contents of document agreements. The contents of agreements is very important to understanding because of the world country provide medical services must have legal procedure to give a treatment for parties. All the parties must follow what type of legal in medical tourism. In most cases it is associated with reproductive IVF programmers with surrogacy or donation, stem cell application, organ transplantation, induced abortions and others, because to avoid legal conflicts in both the destination of choice for medical interventions and consequently in the home country, it is recommended to consult a competent lawyer in advance. In this issues of legal medical tourism have several questions and related to legal in medical treatment. For example the questions is what if I decide not to do my surgery, will I be able to get my money back? In the perspective legal contents in medical tourism is its depends on the policy of the hospital have chosen, as well as when cancel the procedure. The procedure in medical is very important to know, because if dont know the policy of medical tourism will give an implications such as when do the surgery and something happen we dont know how to solve the problem. When we do the treatments at hospital we must follow the policy of medical. Any things before to do the treatment, surgery or others at hospitals must have an agreement from the parties either agree to do the medical treatment or not. Especially foreign come to Malaysia because want to get a medical treatment, they must know the procedure of medical in this country because the legal medical tourism in Malaysia not same with their country depends on the policy of the country. The issues became an illegal because one of the doctors sale the organ of human to other people without the permission from their family or signing the agreement. The important legal in medical is to protect, support and safeguard the character and interests of legally qualified health care practitioners. The main of build hospitals in our country is to help people or give a treatment for their health, because in life not all people will not sick but have sentences people need medical checkup for their health. In the world we must follow the law or legal because all things have a legal and law. Legal or law also very important because to help solve the problem, or to punish who had done malpractice. Foreign people also must follow the rules when enter to Malaysia for a treatment or medical, because the rules at their country is very different not all country must same rules but its depends on the country especially in medical tourism.

5.0 5.1

Why do people come to get the medical treatment in Malaysia? Advance in technology

Technology Medical tourism in Malaysia is increasingly using technology as a means to improve productivity, competitiveness and customer service while also cutting cost. Malaysia hospitals always provide new medical technology to help specialist do their job very easily. For example if the doctor want do the minor surgery for their patients, they dont need knife to make operation because they just using laser technology. This technology can make the operation more effective and efficient because technologies laser speedy recovery and no surgical wounds. As we all know, with the technology advance all hospital can fulfill the customers need. Here we can see with the demand for medical technology to increase in Malaysia by 15% per annum in line with both public and private hospital expansion plans the timing of Asia Medical will be perfect for suppliers to use the event as a key platform for driving future business growth. 10

Today we can see a lot of technology did develop in Malaysia to fulfill the customers need. With a Government initiative to upgrade and expand existing facilities for the local population and the ever increasing medical tourism market, the stage is set for a premier international medical technology exhibition to make its debut here in Kuala Lumpur. Examples of advanced technologies used in medicine include medications such as targeted therapies for cancer, antidepressants, medical and surgical procedures, medical devices such as magnetic resonance imaging (MRI) and computed tomography (CT) scans, screening tests such as fecal occult blood test for colorectal cancer, electronic support systems such as telemedicine, and electronic medical records. Beside that the applications of medical technologies include diagnosis of diseases (X-ray), treatment of diseases (chemotherapy for cancer), prevention of diseases (immunization), screening for diseases (mammography), rehabilitation (physical therapy), automation and reducing errors (computerized order physician entry) and improving quality of life of patients (artificial legs and arms). With this technology not possible if we say technology in Malaysia standing with oversea technology.

Figure 5: CT Scanner by GE: Kuala Lumpur Malaysia health

5.2

Healthcare

Health care is the diagnosis, treatment and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy and allied health. The exact configuration of health care systems varies from country to country, but in all cases requires a robust financing mechanism; a well-trained and adequately paid workforce; reliable information on which to base decisions and policies; and well maintained facilities and logistics to deliver quality medicines and technologies. Malaysia Healthcare is home to world class facilities in cardiac care driven by doctors who have been trained and experienced in some of the noteworthy institutions of the West. Our success rates and practice methodology are comparable with the best hospitals in the world. Our latest offering is the much talked about and highly acknowledged robotic heart surgery that uses a computer enhanced system to perform highly complicated cardiac surgeries with extreme accuracy and precision. Malaysias health care industry offers a full range of elective and non-elective 11

medical procedures at rates radically lower than those of most Western countries. The exchange rate of the Malaysian Ringgit allows visitors to avail themselves of services which would be prohibitively expensive at home. Beside that for the smile that lasts forever, healthcare medical tourism provides you with Malaysias best dental practices. Our range of treatments caters to aesthetic as well as general dental practices with prices that are a true steal. They are provided in highly equipped facilities with exceptional standards of sterilization procedures. Malaysia also offers dental packages which are the perfect combination of your holiday and treatment requirements. Alternatively, you may also customize your holiday cum treatment plans using our services. Moreover Malaysia healthcare provides comprehensive tertiary eye care service as well as treatment for complex eye problems, which is made possible by its state-of-the-art technical facilities for diagnostic testing and treatment of eye disease and vision problems. Also recreate an aesthetic look and revive your precious youth through the multiple and effective solutions of cosmetic surgery Malaysia healthcare can offer. We ensure that you receive the maximum benefits out of your treatment in Malaysia by ensuring quality treatment under maximum confidentiality. Healthcare tourism in Malaysia always make sure their customers can get the good service and the important things is the costumers can take care their health and avoid or safe them from any dangerous dieses. So to achieve this mission, a lot of health care did develop in Malaysia to give service not just for local people but for abroad customers also. Moreover majority of hospitals offering services to medical tourists are privately owned institutions following internationally recognized standards in healthcare.

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Healthcare in Malaysia involved healthcare facilities. Most hospitals in Malaysia offer a wide range of accommodation from comfortable to luxurious, including private rooms and connected rooms. Meals included and the cost of hospital stays is based on the level of services required as there are medical centers that provide private servers and full-time nurses. Overnight facilities are also available for couples or friends of patients. In addition, the low-cost services and high living standards here, a long-term visit to an attractive option for foreign visitors. However, the most interesting things for visitors to receive medical treatment in Malaysia are a period of rest and recuperation is spent here. Patients have the opportunity to enjoy the sightseeing and tourist activities while they wait for the recovery period. A visit to the beach can be arranged, even more so because there are several medical centers located here near the beach or popular tourist areas. 5.3 Medical services

Firstly about quality of medical staff, many doctor in Malaysia study abroad for example UK, USA and Australia. After complete their study, they can use knowledge and skill that their learned at abroad to give high quality service for their costumers not only to local people but their provide service for international patients also. In addition, Doctors and staff practicing at Malaysian international hospitals are English-speaking and internationally trained. Over 90 percent of these doctors were trained in the UK, USA or Australia, and in some cases are involved in international medical research. Beside that almost doctors in Malaysia have a lot of experience same with international doctors and they can speak English very well. This factor gives advantage for them to give good service for patients and communicate very fluent with their patients, so this can make the international patients not feel doubtful and feel comfortable to get medical service in Malaysia.

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Medical service in Malaysia also involved service from nurse. Nurse in Malaysia have training for higher courses after learning four year basic about medical education. Nurses that have skill in medical can help doctor to give faster service for their patients and when patients feel satisfaction with service that a given, as a result this can make a long term relationship between patients and doctors in Malaysia. Moreover this can encourage costumers to come back in Malaysia to get the other service because they convince and feel happy with service that provided before this. Beside that medical service tourism focuses on hospitality for their patients because this is important thing that Malaysia has. The hospitality means the quality or disposition of receiving and treating guests and strangers in a warm, friendly, generous way. So all doctors and nurse in Malaysia must have hospitality attitude to make sure the patients that come from abroad will feel familiar with Malaysia environment and make they not feel like a patients but as a friends. The effect from this attitude is encourage many people from abroad came to Malaysia and this give opportunity for Malaysia to become popular or famous not only in medical service but also famous in hospitality.

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Figure 6: Medical staff in Malaysia 5.4 Lower cost

Lower cost is one of the most important factors in medical tourism. This factor is a one reason why year by year total patients that come from abroad increase in the high quantity and this not become surprising. According to the Association of Private Hospitals of Malaysia (APHM), the majority of Malaysia's medical tourists come from Indonesia mainly due to the superior quality of healthcare that Malaysia offers. The same reason draws health travelers from other Asian countries like Bangladesh and Pakistan. Patients from richer Asian countries like Singapore and Japan, (which are the second and third highest origins of medical travelers respectively), visit Malaysia due to the lower prices of medical procedures. Australians and people from the European Union are attracted to the lower cost of medical procedures in Malaysia, whilst Middle Eastern medical travelers visit Malaysia for both the price and the quality of healthcare provided. One research has been conducted and found competitiveness in cost structure of medical treatments is a unique and driving factor for the Malaysian medical tourism sector. The country offers some of the complex medical treatments and services at considerable low prices compared to the developed world. For instance, the cost of knee replacement in Malaysia is US$ 8,000 compared to US$ 40,000 in the US for the same treatment.

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Cost comparison with the UK General and Cosmetic Dentistry

Procedure Face Lift (rhytidectomy)

UK Hospitals

Malaysia

Average Savings 70% - 77%

$11,000 - $12,000 $2,500 - $3,500

Breast Augmentation (Mammoplasty) $7,000 - $8,000

$3,000 - $4,000

50% - 57%

Breast Reduction Breast Lift

$8,000 - $9,000 $2,000 - $3,000

$3,000 - $4,000 $900 - $1,000

55% - 63% 55% - 67%

Tummy Tuck

$6,000 - $7,000

$2,000 - $2,500

64% - 67%

Liposuction (lipoplasty)

$5,000 - $6,000

$2,000 - $3.000

50% - 60%

Nose Surgery (Rhinoplasty)

$5,500 - $6,500

$2,000 - $2,500

61% - 64%

Plastic and Reconstructive Surgery

Procedure Porcelain Bonded Crowns Root Canal (per canal)

UK Hospitals $950 - $1,000 $300 - $400

Malaysia $150 - $200 $200 - $250

Average Savings 80% - 84% 33% - 38%

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Cost comparison with the USA

Medical Procedures

Procedure Angioplasty Heart Bypass Heart-valve Replacement Hip Replacement Hysterectomy Knee Replacement

US Hospitals Malaysia $55,000 - $57,000 $7,500 - $8,500 $120,000 $11,500 - $12,500 $130,000 $150,000 $14,500 - $15,500 $160,000 $41,000 - $43,000 $9,500 - $10,500 $18,000 - $20,000 $3,500 - $4,500 $38,000 - $40,000 $7,500 - $8,500

Average Savings 80% - 86% 90% - 91% 90% - 91% 75% - 77% 77% - 81% 78% - 80%

Plastic and Reconstructive Surgery Procedure Face Lift (rhytidectomy) Breast Augmentation (Mammoplasty) Breast Reduction Complete Liposuction (lipoplasty) Nose Surgery (Rhinoplasty) US Hospitals $7,000 - $9,000 $5,000 - $8,000 $4,000 - $6,000 $4,000 - $6,500 $5,500 - $6,500 Malaysia $2,500 - $3,500 $3,000 - $4,000 $3,000 - $4,000 $2,000 - $3.000 $2,000 - $2,500 Average Savings 61% - 64% 40% - 50% 25% - 33% 50% - 53% 61% - 63%

General and Cosmetic Dentistry Procedure Root Canal Porcelain Crown US Hospitals $600 - $1,000 $600 - $1,000 Malaysia $200 - $250 $150 - $200 Average Savings 67% - 75% 75% - 80%

Figure 7: cost comparison with the UK The report Malaysia Medical Tourism Outlook 2012 covers all the key aspects of the Malaysian medical tourism sector, and analyzes current market trends and their impact on the future performance. It also analyzes the cost structure of different treatments and makes comparisons among Malaysia and the other leading countries of the world. Moreover, the report provides a prudent analysis on the revenue patterns regarding the medical tourism sector in Malaysia. 6.0 Recommendations Malaysia's got big potential for medical tourism. The hospitals are very good, spoken English is better than in many countries and a lot of Malaysian doctors trained in the UK and Australia. Pantai Medical Centre, Kuala Lumpur 17

Posh patients can enjoy deluxe accommodation at Pantai's Royal and Premier Suites. This includes the services of a bow-tied butler, satellite TV and digs more Regent Hotel than recovery room. Some even have a one-way mirror for your personal security guard to check up on you. Mahkota Medical Centre, Melaka This 356-bed hospital offers homely hostel rooms in the same block for visiting family members. The center's specialties include affordable caesarean delivery and open-heart surgery. Outpatients might want to consider Mahkota's three-day/two-night health-screening packages, which include tours of the historic town and even transportation to a local golf course. Beautiful Holidays, Penang Marketed to Europeans through the Internet, Beautiful Holidays (beautiful-holidays.com) is a tour company providing plastic-surgery packages in conjunction with the Loh Guan Lye Centre, a 25-year-old private hospital in Penang. The most popularly requested operations: liposuction and tummy tucks. "Our customers enjoy the anonymity," says Marloes Giezenaar, Beautiful Holidays' managing director. "They fly in, recuperate around the pool, and fly out again without anyone noticing they've been under the knife." The company can also arrange post surgery tours of Penang. Country Heights Medical Tourism (CHMT), Kuala Lumpur The country's only medical screening center within a five-star resort, CHMT offers patients a battery of diagnostic tests (including fluoroscopy and abdominal ultrasounds) and the results five hours later. Pass the time by taking a water taxi to the neighboring Mines Shopping Fair for a bout of retail therapy.

Gleneagles, Pantai Medical Centre in KL and Loh Guan Lye Specialist Centre and Island Hospital in Penang Packages cover a full spectrum of health problems, and prices range from basic health screening (RM450) to angioplasty (RM15,000), cataract surgery (RM27,000), total knee replacement (RM15,000, inclusive of five days ward stay and meals), liposuction(RM5,000) and abdominoplasty (RM7000). Whether one seeks critical or not-so-urgent medical treatment like preventive procedures, cosmetic surgery or corrective dental work, Malaysia has a lot to offer with highly trained and experienced doctors, surgeons and paramedics, latest healthcare facilities and medical procedures, five-star hotel accommodation, affordable apartments and a warm tropical paradise for post-operative recuperation. Moreover, English is widely used, especially in urban areas. Combine this with her unbeatable offering of Asian and international cuisine and her warm and hospitable people and you get a great package. For further information, log on to www.hospitals-malaysia.org 18

6.1 Recommendations In Our Opinions

Malaysia is a one country that provides the good service for the medical or health care tourism. Although this country develop in this sector but Malaysia must do something better or make value added for service that provide. Since Malaysia still no laws to prohibit the selling or buying of an organ, although it was frowned upon. Here Malaysia should legislate a law to against people purchase or selling organs. This is because to make sure someone not take benefit or advantage from freedom that a given in purchase organ. So with the law if something happen, the action will be taken. Besides that, government and private hospital would not go ahead with organ transplants if they knew that a living donor was not related to the patient. This is to make sure the donor organ before this not have any problem with their health and not give the other problem after this for the patient that accept the organ. In the several cases the organ transplant is not limited from race or religion. This is because if the patients found suitable organ, they should be glad, because it is hard to get a match organ and hard to found someone that very kind to donor their organ. If the government and private hospital still keep the organ, this can make someone that really need the organ and have change to life can not to save. This can make the patient family feel disappointed and lost hope to get service anymore at the hospital. In medical technology should be enhanced to ensure that all types of services for patients can be conducted in Malaysia. We can use new technology from overseas to enhance our technology in line with the country beyond. It is necessary to increase the number of tourists to Malaysia. Due to the increasing number of tourists to earn extra income while dispelling the Malaysian economy. In addition, doctor and nursing services should be enhanced to achieve the most good. Doctor and nurse service is very important to attract health medical tourism came to Malaysia. They should be given higher education and training a lot to improve the quality of service. If the patient is satisfied with the services provided they would believe our country with quality service. This could increase the country's name as a country that is appropriate for health medical tourism. When their staff and nurse has an experiences in medical this situations can prevent the staff give a wrong medicines for patient. If this situation occurs in hospitals this can impact the names of hospitals and the foreign people will not go to hospitals to get a treatment. Beside that the medical or healthcare tourism in Malaysia must do the aggressive promotion to attract more costumers not like usually to come and get service in Malaysia. In the promotion we must give more attention to price, technology, environment and something that other country did not have. For example although the price that Malaysia give is a low but the service that promise is high quality and the patients can get the other package that interesting also. In my opinion, the government should think the safety of people who take the treatment or medical checkup in the hospitals. The safety of patient is very important 19

because people are assets for our country. The government must determine the rules in medical to prevent complications when give a treatment to patients. The good service was provided for patient and the patients will satisfied with the services. When a complication occurs the patients will get their insurance with the agreements before do the treatment especially for foreign people who come to Malaysia for get treatment. All medical services performance must be determined in accordance procedure. Its necessary to avoid a mishap occur, that will give an effect for healthcare medical tourism in Malaysia.

Conclusion Medical Tourism is a very old concept dating back to thousands of years, is where people who live in one country travel to another country to receive medical, dental and surgical care at a significant savings while at the same time receiving equal to or greater care than they would have in their own country. Medical travel is becoming more popular, as more people realize its benefits. The main benefits of medical tourism or health tourism include getting the opportunity to travel to fantastic and alluring destination, top quality health services to local and international patients and reaping potentially big monetary saving. Several factors that influence in medical tourism is related with technology, healthcare, medical service and cost. Medical tourism has been helping individuals, corporations, and insurers save time also, on the cost of healthcare through its vast network of high caliber and professional overseas surgeons and hospitals. Today a large number of individuals in the western countries are taking advantage of this popular alternative for their health care needs. However, there are challenges, which require immediate attention of industry stakeholders. Malaysia has become one of the top health tourism destinations in the world presenting most attractive opportunities for medical tourists in cost effective treatments. The total number of medical tourist arrivals in the country reached to the mark of 425,500 in 2009, backed by factors, such as availability of good healthcare infrastructure, government support through promotional programs, and well-skilled medical professionals. According to Malaysia Medical Tourism Outlook 2012 report, the total medical tourist arrivals in the country will reach 689,000 by 2012 end, which represents a CAGR growth of around 17% since 2009, says our latest report. References http://findarticles.com/p/articles/mi_qn6207/is_20040101/ai_n24907111/ http://thestaronline.com/news/story.asp?file=/2010/9/19/nation/7041441&sec=nation http://www.myhealthcare.gov.my/en/index.asp http://www.health-tourism.com/medical-tourism/statistics/ http://www.intmedtourism.com/en/legal-issues-in-medical-tourism/ http://en.wikipedia.org/wiki/medical_tourism#Description

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