Make Money On Medical Tourism

[LaoPo]

Mods: this thread is about 'Money & Investing but Medical & Tourism' as well....so I posted it in General Topics, if you don't mind of course.

Make Money On Medical Tourism

Last year, more than 500,000 U.S. citizens traveled abroad for health care. They went to Thailand to get heart bypass surgeries for $11,000 instead of the $130,000 it would cost in the U.S. Or they went to India for spinal fusion at $5,500 a pop, well below the $62,000 sticker price in the states.

The trend of more people traveling abroad to get medical treatment shouldn't take Americans by surprise. As our population grows older and health care costs keep rising, more people want cheaper ways to get hip replacements and liposuction. Web sites like MedRetreat.com facilitate medical tourism and allow potential patients to comb through vacation-like packages for procedures and destinations as if they were going on a honeymoon.

This is getting everyone's attention. Consulting firm Mercer is developing programs for companies to allow them to outsource elective surgeries. The West Virginia state legislature is considering a plan to cover state employees for foreign treatment, including first-class flights for the patient and a companion, plus recovery in a four-star hotel and other incentives like bonuses and sick leave.

So how can investors cash in on this boom? By buying stock in countries' medical infrastructure, like hospitals, airports and medical record management companies.

David A. Semple, director of international equity at Van Eck Global, manages the firm's emerging-market fund, which includes medical tourism plays. The fund, with a 1.95% expense ratio, is up 38% in 2007, besting its benchmark by 13%.

One play he recommends is Thailand's Bumrungrad International Hospital in Bangkok. "It's certainly better than any hospital I've ever been to in the U.S. or the U.K.," says Semple, noting the hospital has a doorman and is home to a Starbucks. "This is a far cut above the rest."

Bumrungrad had 66,000 American patients last year and is seeing tremendous demand from the Middle East. In 2005, 70,000 patients came to the hospital, 13 times as many just five years earlier.

With a price-to-earnings ratio of 27, Bumrungrad is not cheap. Nor are many of the other picks that Semple recommends.

Very interesting read continues here:

http://www.forbes.com/2007/12/07/medical-t...ting_newsletter

http://www.forbes.com/2007/12/07/medical-t...mp;boxes=custom In Pictures: Top Hospitals for Medical Tourists

LaoPo

[Prakanong]

Interesting - how many beds does Bumrungrad have?

I wonder if Americans are the most numerous of the foreign patients there?

In my time there the most numerous group I saw apart from Tha'is would have been Arabs from whatever country they were from.

How do they count patients - I was probably there 10 times last year for tests and after an accident (Run over by a tuk tuk - really ) - I wonder if i was counted as 10 UK patients or just 1 as the hospital number is the same?

[onomataho]

~~~

I always choose my hospital by the type of coffee shop they have in the lobby!

~~~

[LaoPo]

Interesting - how many beds does Bumrungrad have?

I wonder if Americans are the most numerous of the foreign patients there?

In my time there the most numerous group I saw apart from Tha'is would have been Arabs from whatever country they were from.

How do they count patients - I was probably there 10 times last year for tests and after an accident (Run over by a tuk tuk - really ) - I wonder if i was counted as 10 UK patients or just 1 as the hospital number is the same?

"Both hospitals treat approximately the same total number of patients – about 1 million a year – however Bumrungrad began courting foreign patients much earlier than BMC and now draws 400,000 foreign patients a year to BMC’s 150,000-250,000." BMC=Bangkok Hospital Medical Centre.

From:

http://www.business-in-asia.com/asia/thail...dical_tour.html

PS: the counting is probably PER VISIT rather than PER PATIENT, but that's just IMHO.

And, if you Google 'Medical tourism Thailand' you get an enormous feedback and the #'s will vary I suppose.

"Bumrungrad serves over a million patients annually. Over 400,000 are internationals. They include thousands of expatriates who live in Bangkok and nearby countries, plus visitors from 190 countries around the world who come here for treatment. English is widely spoken. The hospital has a medical coordination office staffed by doctors, nurses, and interpreters who serve the special needs of international patients."

From Bumrungrad Hospital:

http://www.bumrungrad.com/overseas-medical...s/overview.aspx

LaoPo

[LaoPo]

Interesting - how many beds does Bumrungrad have?

* 554 Inpatient Beds

* 500 Medical/Surgical/OB/Pediatrics beds

* 26 Adult Intensive Care beds

* 14 Cardiac Care (CCU) beds

* 9 Pediatric Intensive Care beds

* 5 Level III Neonatal Intensive Care beds

* 57 Deluxe rooms, 21 VIP Suites and 2 Royal suites

From Bumrungrad website.

LaoPo

[Tinkelbell]

~~~

I always choose my hospital by the type of coffee shop they have in the lobby!

~~~

.....and the way the hospital doorman saluts.

[Jingthing]

They went to Thailand to get heart bypass surgeries for $11,000 instead of the $130,000 it would cost in the U.S.

Is that really that cheap there? I thought that would easily be up to at least 30K USD by now ...

[GuestHouse]

And while people here on TV were sticking it into 'Big Tipping Tourists' because they are jacking local prices up - It is this issue of Medical Tourism that is creating a huge increase in the price of medical treatment in Thailand.

Every hospital manager in Thailand believes he too can milk the international medical treatment market - and when the medical tourists don't turn up in Nakhon Nowhere, its the local expats that become the source of increased profits.

[Jingthing]

And while people here on TV were sticking it into 'Big Tipping Tourists' because they are jacking local prices up - It is this issue of Medical Tourism that is creating a huge increase in the price of medical treatment in Thailand.

Every hospital manager in Thailand believes he too can milk the international medical treatment market - and when the medical tourists don't turn up in Nakhon Nowhere, its the local expats that become the source of increased profits.

A very good and very depressing point.

[Heng]

The stock gurus might be able to give more detail, but I recall from an old ajarn in my MBA days (specifically that Money Talk guy from the local Money Channel): investing in Bamrumrad Hospital, also exposes you to all kinds of other market risk in unrelated businesses that the controlling shareholders are involved in. I recall that it's used as a debt vehicle (not that it isn't a super profitable one), the way the folks at Central use Robinson's as a debt vehicle. It isn't as simple a decision as "wow, they are charging super high margins, they must be swimming in cash." Last I heard they were swimming in red ink, with much cash flow funnelled elsewhere (and certainly not paid out as dividends to minority shareholders).

[Prakanong]

And while people here on TV were sticking it into 'Big Tipping Tourists' because they are jacking local prices up - It is this issue of Medical Tourism that is creating a huge increase in the price of medical treatment in Thailand.

Every hospital manager in Thailand believes he too can milk the international medical treatment market - and when the medical tourists don't turn up in Nakhon Nowhere, its the local expats that become the source of increased profits.

Is there not a differecne betwen public and private hospitals though.

The market should sort out the problem of the private hospitals - hmm I forgot where I am talking about TiT

[LaoPo]

The stock gurus might be able to give more detail, but I recall from an old ajarn in my MBA days (specifically that Money Talk guy from the local Money Channel): investing in Bamrumrad Hospital, also exposes you to all kinds of other market risk in unrelated businesses that the controlling shareholders are involved in. I recall that it's used as a debt vehicle (not that it isn't a super profitable one), the way the folks at Central use Robinson's as a debt vehicle. It isn't as simple a decision as "wow, they are charging super high margins, they must be swimming in cash."

Last I heard they were swimming in red ink, with much cash flow funnelled elsewhere (and certainly not paid out as dividends to minority shareholders).

I don't know Heng; before I go to bed I just wanted to give you this to study:

http://www.bumrungrad.com/investor/investor.html

Let me know what you think because I'm too tired now.

LaoPo

[bonviveur]

60 minutes which is a TV show here in the state had a show about american going to Thailand for bypass surgery. If you don't have any medical coverage here you are in big trouble.

The guy they feature in the story came to Thailand for the surgery, he had two choices sell his business get the bypass and be poor or go Thailand which he did, now he goes back every year for follow up.

Another story I saw was an hospital in Los Angeles use to drop their poor patients, if they did not have medical coverage, on the street as soon as they walk on their own sometime in their hospital clothes.

[stevemiddie]

The figures for the hospital don,t make sense to me.

1,000,000 a year? 2,740 every day? 181 Americans every day?

They deal with a patient EVERY 30 seconds?

[Prakanong]

The figures for the hospital don,t make sense to me.

1,000,000 a year? 2,740 every day? 181 Americans every day?

They deal with a patient EVERY 30 seconds?

Is 2,740 a lot of patients in one day?

Its been bloody busy when I have been there from early morning to after work evening - my one time in ER there was no-one there and the Dr was less than useless - quite the opposite from experiences during the day (mostly).

[PeaceBlondie]

As GuestHouse mentioned, this isn't just about Bumrungrad, but all the fancier hospitals in Thailand that cater to expatriates. I like the fancy clinic at the best govt. hospital in the north, Maharaj, because they have a mix of middle class Thais (such as teachers on the good health plan) as well as long term expatriates. I've not noticed medical tourists, though Chiang Mai Ram probably has a fair number of those at its private hospital.

Still, I think when I send in my insurance claims to the processors at the USA, Sally jokes to Betty Lou, "Look how cheaply PeaceBlondie got shoulder surgery in Thailand! I'm going to pay it in full after the deductible and copay, without the usual shenanigans we play against claims here in the States!"

[samran]

one of the exciting things about BH is that they are courting and are starting to get US insurers on board.

As for prices going up, don't get me started. I did a couple of units on Heath Economics for my masters. Interesting and depressing.

Medical inflation is a problem, and is likely to happen in markets where medical prices are unregulated. Remember, doctors are essentially monopolists, able to charge whatever the heck they want. Doctors don't live in a competitive market. At the end of the day - from a consumers perspective - the industry needs prices to be regulated, in much the same way that electricty, water and other utilties prices are regulated in the west.

This is the reason (and I'm not trying to knock it here) medical costs in the US are much higher elsewhere - a mainly private system will mean that medical inflation remains unchecked. Compare this to say Australia, Canada, or the UK, where the national health systems there ultimately act as a check on price rises, and where the negotiating power of the state means that patients get better deals on medicins and equipment.

The pharmacutical companies and doctors hate it, but patients ulimately can get affordable treatment.

[Prakanong]

one of the exciting things about BH is that they are courting and are starting to get US insurers on board.

As for prices going up, don't get me started. I did a couple of units on Heath Economics for my masters. Interesting and depressing.

Medical inflation is a problem, and is likely to happen in markets where medical prices are unregulated. Remember, doctors are essentially monopolists, able to charge whatever the heck they want. Doctors don't live in a competitive market. At the end of the day - from a consumers perspective - the industry needs prices to be regulated, in much the same way that electricty, water and other utilties prices are regulated in the west.

This is the reason (and I'm not trying to knock it here) medical costs in the US are much higher elsewhere - a mainly private system will mean that medical inflation remains unchecked. Compare this to say Australia, Canada, or the UK, where the national health systems there ultimately act as a check on price rises, and where the negotiating power of the state means that patients get better deals on medicins and equipment.

The pharmacutical companies and doctors hate it, but patients ulimately can get affordable treatment.

Health economics - a very interesting subject.

Big Pharma (where I work) is coming to terms with the fact that prices will be controlled in most of the world and new business models are emerging - those that do not adapt might not survive.

PPP's, non-government organisations like the Bill And Melinda Gates Foundation, International Finance Facility for Immunisation (IFFIm) , and a biggie Advance Market Commitments (AMC)

[stateman]

They went to Thailand to get heart bypass surgeries for $11,000 instead of the $130,000 it would cost in the U.S.

Is that really that cheap there? I thought that would easily be up to at least 30K USD by now ...

My wife's Thai friend had a quad bypass in 2006 at Bangkok Hospital, which specialized in hearts. She went in as a Thai person, naturally. She worked in one of the government's entity. The total bill was B100,000 ~ USD3000.

I am sure it would have cost several hundred thousands of dollars in the US.

What impressed me the most when my wife and I visited her at the hospital, was the way a quad bypass was suggested so casually. This was what the hospital do all the time. It definitely sounded so routine - like production line work. Just scheduled it and bingo! Done.

A day or two later she had the quad bypass done. Afterward, she said on the phone that she was fine and soon left the hospital! This was so trivial like having a hemorrhoid surgery!

[LaoPo]

They went to Thailand to get heart bypass surgeries for $11,000 instead of the $130,000 it would cost in the U.S.

Is that really that cheap there? I thought that would easily be up to at least 30K USD by now ...

My wife's Thai friend had a quad bypass in 2006 at Bangkok Hospital, which specialized in hearts. She went in as a Thai person, naturally. She worked in one of the government's entity. The total bill was B100,000 ~ USD3000.

I am sure it would have cost several hundred thousands of dollars in the US.

What impressed me the most when my wife and I visited her at the hospital, was the way a quad bypass was suggested so casually. This was what the hospital do all the time. It definitely sounded so routine - like production line work. Just scheduled it and bingo! Done.

A day or two later she had the quad bypass done. Afterward, she said on the phone that she was fine and soon left the hospital! This was so trivial like having a hemorrhoid surgery!

That's unbelievably cheap in comparison with the west but 'several hundreds of thousands of dollars in the US' sounds a bit overdone IMHO

LaoPo