Speaker 1: Pretend this is a surgery.

Speaker 2: Okay. This is Chris Pochiba, a YouTuber and influencer from the U.S., having his pupils thoroughly examined ahead of a laser eye surgery halfway across the globe in South Korea.

Speaker 1: You may actually have to like turn your head a little bit because you have a higher nose bridge. Like turn, yeah.

Speaker 2: Oh, I see. Chris is a classic example of a medical tourism patient. In October 2022, the Tennessee resident, accompanied by wife Sarah, opted to seek treatment on foreign shores for financial reasons.

Speaker 3: I had glasses my entire life and I have always wanted to have LASIK on my eyes. Being here in the States, it was a little pricey for what I was willing to pay, especially, you know, I could pay a hundred bucks for glasses and they would last me until I broke them. So we started looking into medical tourism and looking at different places around the world that we could get surgery done and it turned out to be like a fantastic choice.

Speaker 2: The medical tourism industry was already booming before the COVID-19 pandemic, worth more than $70 billion. Millions of patients were spending on medically related costs, cross-border and local transport, inpatient stay and accommodations. So what's behind such rapid growth in the sector and are there pitfalls individuals considering this route should be wary of?

Speaker 4: The earliest origins of medical tourism actually came at the emergence of civilization itself.

Speaker 2: David Viquist is a professor at the University of the Incarnate Words Center for Medical Tourism, a private Catholic institute in Texas.

Speaker 4: We have records of travelers, for example, from Roman times going into what's now known as Turkey and places like Switzerland for baleenotherapy or being able to access the hot volcanic waters that they would find in those locations. The modern equivalent has been driven primarily through access to information through the internet about various health care procedures, some of which may not be available in your local area or some which may be at, say, a lower cost or a higher quality somewhere else. This is allowing people to travel not just within their own countries, but outside of their countries.

Speaker 3: Actually, we started looking at Google reviews and different options online. We actually had some friends that had family that lived in Seoul and we asked their recommendations as well.

Speaker 4: About 70 percent of all medical tourists, health tourists, wellness tourists tend to also travel for the tourism. People choose places like Thailand not only based on the fact that Thailand has very good hospitals, but they also choose it because Thailand has beautiful beaches.

Speaker 5: More than picking a destination for the surgery, we sort of put the surgery into the destination, really because a lot of countries around the world have the same technology. I mean, LASIK's pretty basic at this point, but Korea is known for being very tech, it's very clean, very hygienic, very professional.

Speaker 2: As demand for medical tourism rises, an industry supporting the journey has cropped up, including health care and insurance providers, websites and brokers. Paul McTaggart is the CEO and founder at Medical Departures, a medical travel agency based in the Thai capital of Bangkok.

Speaker 6: I think the key thing that we offer is trust. We actually go and we visit these clinics. We actually go and we verify the doctor's credentials with the local regulatory body. We walk with the patient hand in hand and give them the who, what, where, why and how of going abroad for health care.

Speaker 2: While trust and clinical reputation are indeed key determining factors, the final decision for many patients comes down to affordability.

Speaker 3: The actual surgery itself cost around US$2,000, give or take. And here in the States, it goes from around US$1,700 to US$2,500 per eye.

Speaker 5: All in, we only spent a couple thousand dollars in Korea and that was with tours and food and everything. So it was very affordable. So pretty much the amount of money we saved on the LASIK largely funded the entire trip to justify having three weeks in Korea.

Speaker 2: According to a pre-pandemic report published by global medical tourism guide Patients Beyond Borders, health care and prescription costs in the U.S. eat into nearly 30% of retirement and pre-retirement incomes. It is no wonder then that Americans are traveling abroad to the likes of Mexico, Costa Rica, India and Thailand, where their average cost savings on treatments like heart operations, joint replacements and cosmetic procedures are in the range of 45 to 90%.

Speaker 6: There's really three markets. There's what I call the flight to value, i.e. you're going from your home country to another country to get less expensive dental or medical care. Then there's the flight to quality. A good example is Indonesians going to Singapore. And then finally, it's a flight to speed. My home country, UK, if you want to get an orthopedic procedure, you're waiting up to two years. So you can go to Singapore, get that particular treatment in less than a couple of days.

Speaker 2: One destination considered a hotspot for medical tourism is right here in Singapore. With state-of-the-art technology, highly trained doctors and ample government support, the city-state ticks all the right boxes for traveling patients. Those that do end up on these shores, however, tend to come from more affluent backgrounds. Some high-profile patients to the country include Zimbabwe's former president Robert Mugabe and Brunei's royal family. Syed Munir Iqbal is executive director of MediConnect Singapore, a medical concierge service he runs alongside his wife, Dr Sabah Iqbal. The business links patients in South Asia and the Gulf with public and private health care providers in Singapore.

Speaker 7: Our target audience changed from one where we were trying to get anyone who wanted a second opinion to one which was a high-net-worth individual. So we started targeting the banks because that's where we felt that our market lay.

Speaker 2: According to a survey of more than 3,000 Americans, Singapore ranked second, marginally behind Canada, out of 46 medical tourism destinations. The findings were based on the respondents' assessments of 41 criteria rating destination attractiveness, safety and quality of care.

Speaker 7: We just feel that Singapore has that strength. One of organ transplant as the key area that we want to focus on. Oncology is the other one because there are centres of excellence here. Third area is orthopaedics, knee surgeries, spine surgeries. Cardiology is the other one. Singapore is really a hub when it comes to private banking and wealth management and that's where the premium value at parity price came in.

Speaker 2: While the medical tourism industry has been thriving, it's also encountered some serious obstacles. The biggest impediment to the sector's growth came with the arrival of the pandemic, which ground international travel and by extension patient inflows to a halt.

Speaker 7: For three years, we could not manage to get even a single patient into Singapore. So anything that was elective would need to be put on a back burner for a while. But now that it is opening up, we are starting to see some inquiries coming in again, which gives us the comfort that we can bounce back strongly.

Speaker 6: The only market that saved us, that stayed open during all of COVID, you obviously know the dramatic lockdowns that were in Singapore. Those didn't exist in Mexico. Americans wanted to travel and Mexicans were willing to let them come regardless of whether they had masks or vaccinations. A third to a good 40% of our competitors and clinics, doctors and dentists that focused on international patients just disappeared and they went and pivoted to focusing on domestic patients.

Speaker 2: And Medical Departures too was forced to streamline its operations.

Speaker 6: We actually came back with less people, made more revenue than 2019. As you're seeing the inflation at the pump, at the grocery store, you're also seeing at the hospital. You're seeing the cost of healthcare in these markets like Australia, Europe, the Americas go up faster. The price of medicine and dental care has gone up and we've been a benefactor of that.

Speaker 2: At the height of the pandemic, many healthcare systems around the world found themselves overwhelmed and ill-equipped to handle an unprecedented volume of COVID-19 patients, resulting in delays for non-essential surgeries. In the UK, a record 7.1 million people were waiting to begin treatment at public hospitals at the end of September 2022, prompting many Britons to seek routine medical care abroad.

Speaker 4: The geopolitical issues and the incredible malaise that is affecting the world in terms of the economy, when you combine all these together, it is a positive trend for medical tourism and health tourism globally.

Speaker 2: Medical procedures overseas can be tricky, even for the wealthy. In 2011, a Singapore surgeon was accused of overcharging the sister of the Queen of Brunei a hefty $20 million for medical services provided over 110 days. Oftentimes, medical tourists have no or limited legal recourse if there are surgical complications.

Speaker 4: Medical tourism around the world is kind of what we call in the United States a wild, wild west. There's very few regulations that cover international travel.

Speaker 2: Despite its shortcomings, however, medical tourism remains a viable alternative for individuals who are underinsured, looking to save money, access better quality care, and experience shorter waiting times.

Speaker 3: The mere fact that I had to keep my eyes open while they were operating on me and watching them do that kind of freaked me out. But honestly, the clinic was so helpful in making sure I was calm. And then, you know, 10 minutes later it was done. It was very painless.

Speaker 8: Could you read any alphabets?

Speaker 3: I think that's E-V-O-T-V.

Speaker 8: So right now your current vision itself is 20 over 16. Okay. Even better than 20 over 20.

Speaker 5: The office didn't feel like a typical hospital in the States. It actually felt more like a spa. So they had trees in the office and I think they had like a waterfall sound machine or something. They did, yeah.

Speaker 3: And it just was very peaceful. Getting something done out of the States can be a little daunting and scary. And it's really just a mind game. I would do it again in a heartbeat. I would do it again in a heartbeat.