The first in a series of articles on the US medical tourism market.
How many Americans actually go abroad for treatment? In recent years, there have been wild variations in estimates of the extent to which the US has adopted medical tourism. Where do all of these figures come from? Does anyone actually know? Should you be targeting a massively growing US market or is it an industry generated myth? IMTJ looks behind the medical tourism hype and provides an assessment of what to believe and what not to believe.
This article is written by Ian Youngman, a specialist researcher and publisher of detailed research reports on insurance and medical tourism.
Medical tourism statistics are quoted at every conference, in every article, every television and radio report, and every book on medical tourism. The speakers or writers must know their facts, you think? Unfortunately no one knows the number of Americans leaving the country for medical, dental or cosmetic treatment. Many medical tourism "experts" pick the estimate they think suits their argument best, or make up their own. Those seeking to sell their services to overseas hospitals and government bodies have a vested interest in using the largest figure possible. The US government neither knows nor wants to know the answer. Although the US demands to know why people from overseas travel there, the authorities argue that it would be a breach of liberty to ask the same of Americans going overseas. So there are no national US figures on medical tourism, and security prevents sample exit polls at airports. The fact is that we simply do not know.
Amazingly, hardly anybody who quotes these figures names a source....so let us look at the various estimates. To be fair, the US is not the only country where there are wildly varying claims on medical tourism statistics. Last year, one tourism body for a Middle Eastern state repeatedly claimed a figure for probable inbound medical tourists by 2012 that was so high it was double the current estimated world total. The scarcity of believable figures means people can make up their own in the knowledge that there are rarely actual figures to contradict them.
The range of estimates on US medical tourism
In the last two years the ‘factual’ figures used have been:
These are all conveniently big, and nicely rounded up numbers.
On the one hand we have McKinsey saying that fewer than 50,000 Americans go overseas; but they don’t count people going to Mexico, Canada, Cuba or anywhere else that has a border with the USA. At the other extreme we have a 2008 report from Deloitte estimating the number to grow to six million by 2010,10 million by 2012 and 15.75 million in 2017.Two recent quotes from industry figures claimed respectively that 17 million and 23 million Americans will travel overseas for treatment by 2017. All these estimates are as scientific as a fortune teller.
The 2008 Deloitte report is also the source of the estimate of 750,000 going overseas in 2007. However, Deloitte’s follow up report in 2009 said less than 1% of Americans had ever gone overseas for treatment, let alone in the last year. Translating such vague figures to the adult US population of 250 million is statistically worthless, which is why Deloitte did not try to recalculate their mind-blowing estimates of 2008.
Is it 150,000?
For at least three years, one ‘factual’ figure used was 150,000. The only reason that changed for 2008 and 2009 is that some commentators and conference speakers may have thought that an audience may not believe the same figure, if it is used five years running. One commentator solved the problem by upping it to 180,000. IMTJ has tracked the original source of the 150,000 back through a series of newspaper and magazine sources (often wrongly quoted as the original source) to the original which shows it is no more than a guess back in 2003 of the total number of outbound US, Canadian and European medical tourists combined!
Is it 500,000?
One of the most commonly quoted figures in 20008 was “an estimated 500,000 US residents travelled abroad for care last year”.
The year was not in fact 2007, but 2005. The source is a 2007 study by the right-wing think tank National Center for Policy Analysis in Dallas. According to the study, an estimated 500,000 Americans crossed the border for treatment in 2005. The report “Medical tourism: Global Competition in Health care” identifies their source, a November 2006 newspaper article ‘Employers increasingly tapping medical tourism for cost savings’ by "citizen journalist",
Jessica Fraser, for a small online health news site, (http://www.naturalnews.com/020999.html). Her source was the National Coalition on Health Care.The figures were at best a rough estimate and the NCHC itself no longer believes them, as it does not use the figure in any of the range of excellent healthcare statistics that it produces.
Is it 250,000.....is it one million?
The other regularly repeated statement is “250,000 Americans travelled abroad for medical treatment last year’’. Last year is never pinned down to a specific year. The original version dates back at least to 2005. ‘Over a million’ is a more recent figure. No source is ever quoted, it just sounds great at conferences or in press releases!
With no factual outbound figures, we could create an estimate by using figures from countries Americans go to. Here we hit another snag; few countries have reliable figures on inbound medical, dental or cosmetic travelers. Even those that do often only have very rough estimates. Some figures are reliable, others are fevered fantasies from politicians either promoting medical travel or crowing how well their country is doing. No more than a handful of countries try to calculate total numbers and work out where they are from. Once outside the American continent, Americans figure in very small numbers – if at all. Even then, there is a tendency for countries to include expatriates, business and holiday travellers, US armed forces, and diplomats who are treated in international patient centres; none of whom are medical travellers in the sense we mean.
And the latest "guesstimate"?
Newly released research throws up another number. UCLA researchers say that in 2001 nearly a million Americans went to Mexico for treatment. Half of these were Mexican settlers going home. Since 2001, more Mexicans have settled in the US and a cross-border medical tourism industry has grown. If the 2001 figures are accurate, it would be reasonable to assume that more than a million now cross the border each year. If correct....it consigns McKinsey's figures to the rubbish bin.
The recently launched Center for Medical Tourism Research at the University of the Incarnate Word (UIW) in Texas is pursuing data, but at present there are no accurate figures of how many Americans go overseas.
So the truthful answer?....Nobody knows!
Ian Youngman is a writer and researcher specialising in insurance and health. He writes regularly for a variety of magazines, newsletters, and on-line services. He also publishes a range of insurance reports and undertakes research for companies. An ACII, with an honours degree in Economics from the University of Liverpool, Ian was a co-founder of The General Insurance Market Research Association. He also has widespread experience within the insurance industry at management level, working for brokers, a bank and an insurance company.