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International medical zones: bane or boon for Taiwan?

April 29, 2011

Medical tourism is rapidly growing in Asia, with the number of people seeking treatment in the region standing at around 1.32 million per year. The sector’s predicted net worth for 2012 has been put at US$4 billion.

Taiwan's medical resources are on par with those found in Europe and the U.S., but it lags behind leading regional medical tourism destinations. Some 85,000 tourists visited the country last year for treatment, far less than the 665,000 who opted for Singapore and the 1 million who traveled to Thailand.

Although Taiwan has been seeking to expand its presence in this lucrative industry since 2004, a lack of funding meant that large-scale overseas promotion of the nation’s medical tourism facilities did not begin until 2007. After taking office in May 2008, the Ma Ying-jeou administration initiated steps to internationalize this sector, designating it as one of six emerging industries targeted for promotion.

The launch of direct cross-strait flights, along with the opening of Taiwan to more mainland Chinese tourists, has seen more visitors from across the strait use local medical facilities. They come because of the nation’s advanced health care system, one of the best in Asia, but the real draw is cheap travel costs and a similar language and culture.

Although only 15,000 mainland Chinese will travel to Taiwan as medical tourists in 2012, the central government believes this number is set to eventually hit 75,000, or 5 percent of total visitor numbers from the other side of the strait.

Taiwan is in an enviable position in which it could create an unrivaled niche market for the new middle-class of mainland Chinese looking for treatment overseas. Yet, while ever increasing numbers of these tourists is certainly good for the economy, it could harm the country’s national health care system.

Many of Taiwan’s larger hospitals are the facilities of choice for over 90 percent of patients covered by the national healthcare program. These same facilities are also becoming the preferred option for mainland Chinese tourists. As more of these visitors arrive in Taiwan for treatment, such facilities could face ever-widening nurse-to-patient ratios and serious staff shortages.

The government plans to head this problem off at the pass by establishing special international medical zones. It is currently seeking some NT$4 billion (US$138.5 million) in private investment for the planned aerotropolis project at Taiwan Taoyuan International Airport. An estimated 40,000 medical tourists are expected to visit the zone per year, generating revenue of US$350 million—a figure dwarfing the industry’s current US$73 million.

Taiwan has at least three other such zones in the pipeline. But for these to go head to head with international competitors, the government must amend or at least liberalize the Medical Care Act under which hospitals and healthcare centers are banned from soliciting patients. It also needs to review laws covering the employment of foreign doctors.

In reviewing these laws, the government must ensure there is no sudden commercialization of Taiwan's medical services. The employment of foreign doctors and allowing of hospitals to openly vie for patients will, no doubt, lead to heated legislative and medical community debate.

While the government claims these special zones will help retain medical talent, they could have a reverse effect. Private and foreign-owned hospitals may offer higher wages than their government and locally run counterparts. This could be disastrous at a time when Taiwan’s medical sector is already suffering from brain drain.

The exodus of the country’s top health professionals abroad is being spurred by higher wages. Competitive salaries could stem this tide, but there is no guarantee these individuals will not spurn the public system for higher pay on offer at private facilities.

The government has yet to say whether foreign-owned hospitals will be allowed to operate in the planned special international medical zones, but such a system has worked in Vietnam. The FV Hospital in Ho Chi Minh City—an internationally accredited medical tourism facility—is 100-percent French owned and employs 20 foreign doctors from countries such as Belgium, France, South Korea and the U.S.

Regardless of how the government tackles its plans to cash in on the Asian medical tourism boom, it will have to ensure the continual high quality of public health care.

One option is pumping a percentage of tax revenues generated by hospitals operating within the special medical zones back into the national health system. But if the public system is allowed to wither on the vine as a result of this initiative, the government will be guilty of putting financial reward above its obligation to provide citizens with the best state-funded medical care.

Gavin Phipps is a Taipei-based journalist. These views are the author’s and not necessarily those of Taiwan Today. Copyright © 2011 by Gavin Phipps

Write to Taiwan Today at ttonline@mail.gio.gov.tw

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