The healthcare sector accounts for approximately 10% of world’s GDP. This
has been rising on average by 5.2% a year between 2014 - 2018 and is expected
to reach USD9.3 trillion. Spending is driven by a growing ageing population,
rising affluence, longer life expectancy and lifestyle related diseases.
ASEAN’s overall healthcare expenditure has lagged behind that of
developed countries. Japan and the U.K. spend twice as much per capita on
healthcare compared to Malaysia, Singapore, Thailand and Indonesia (“ASEAN
four”). Income levels and spending on healthcare are fairly closely related. So
there is every chance of more spending in the ASEAN four.
The industry has the following key characteristics:
(i) Resilience in a downward
cycle – not unduly impacted by a recession;
(ii) Low-price sensitivity –
the higher end market is not price sensitive;
(iii) Structural demand –
continued steady growth expected with rising urbanisation;
(iv) Increasing private healthcare
investment meeting future needs;
(v) Low insurance coverage, especially in
ASEAN four – possibility for insurers to be involved; and
(vi) Usually regulated
operations by authorities.
There are also risks involved which are similar to other sectors:
·
Competition from local players and overseas centres;
· Operating
efficiency and management;
· Size and
scale of operations – the larger the operations, better is the access to
finance;
· Geographic
location;
· Service
coverage – operations that cover more procedures reduces vulnerabilities of
revenue stream; and
·
Clientele – as a service industry, consumer
satisfaction is important
In the midst of this, is the growing niche on medical tourism. The
expansion of which is largely attributed to affordability, treatment options
and access to air travel. The revenue that medical tourism generates is
substantial, for example Thailand earned more than USD3 billion in medical
tourism in 2015. There are hospitals in Thailand with over 50% of its revenue
coming from foreign patients.
Cost
comparison of selected medical procedures
(USD)
|
USA
|
Singapore
|
Thailand
|
Malaysia
|
India
|
Coronary artery bypass graft
|
88,000
|
54,500
|
23,000
|
20,800
|
14,400
|
Valve replacement with bypass
|
85,000
|
49,000
|
22,000
|
18,500
|
11,900
|
Hip replacement
|
33,000
|
21,400
|
16,500
|
12,500
|
8,000
|
Knee replacement
|
34,000
|
19,200
|
11,500
|
12,500
|
7,500
|
Spinal fusion
|
41,000
|
27,800
|
16,000
|
17,900
|
9,500
|
Gastric bypass
|
18,000
|
13,500
|
12,000
|
8,200
|
6,800
|
Source:
Patients Beyond Border, 3rd Edition by Josef Woodman
On every procedure listed above, India has the lowest cost. Thailand is
lower than us (Malaysia) for knee replacement and spinal fusion. We are more
competitive than Singapore and the U.S. According to Malaysia’s Healthcare
Travel Council (MHTC), healthcare travellers to Malaysia increased from about
0.64 million in 2011 to 1.05 million in 2017. MHTC was established to
facilitate the strategic development of Malaysia’s healthcare travel industry
and raise the country’s profile as a globally-preferred destination for
world-class healthcare services.
With a little bit of imagination, we could market our procedures based on
quality, speed and accessibility. There is need for a broad masterplan on this
with coordinated steps by MHTC to harness our medical advantages.
Source: Various reports, including RAM (April 2016)