Thailand has long been the undisputed leader in medical tourism. Companies such as Bumrungrad, Samitivej Hospitals and the Bangkok Hospital have leveraged the country’s prominence as a tourism destination into a lucrative industry supplying the likes of heart by-passes, hip replacements, cosmetic enhancement and bariatric surgery for obesity.

Today its position is being challenged by newcomers to the market: India, Korea, Taiwan and Singapore have all made concerted efforts to attract patients and their medical dollars. But at a time of rising costs and fierce debate on access to healthcare – particularly in the US, where President Barack Obama is trying to drive through healthcare reform – medical tourism is increasing and Thailand is well placed to benefit.

The country’s medical sector is holding its own in the face of the global economic slowdown and increased competition. “We are down about 10 per cent in volume but up about 6 per cent in revenue,” says Kenneth Mays, marketing director at Bumrungrad.

The downturn has had mixed results for the industry. The number of what Mr Mays terms “accidental medical tourists” – those needing care after an accident, who made up about 40 per cent of the hospital’s non-Thailand-resident patients last year – has declined as tourism to the country falls.

However, the problems facing Americans may prove a boon for healthcare providers elsewhere. “Many people now in the [uS] are being squeezed so they are having to look at international options in a way they didn’t before,” says Reuben Toral, president of the International Medical Travel Association.

The figures are compelling. A heart bypass operation that would cost some $130,000 (€91,000, £79,000) in the US costs $24,600 at Bumrungrad, and even when air fares and a two-week holiday/recuperation period are factored in it is still almost 80 per cent cheaper.

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These hospitals keep putting prices and are now charging up to three times what they did 10 years ago, They are losing thier ex-pat clientele in Thailand many of whom are going to government hospitals. Bangkok General Hospital charged me 3 times what I used to pay. It appears to have adopted the dual pricing policy. since it charged me double what my wife paid to see the same doctor. I complained and was told it was a mistake!! Having used Bungrumrod and BGH for ten years we now use government hospitals, which apart from long waiting times, offer good care.