Does medical tourism contribute to shortages in hospitals?
There have been numerous discussions on the possible impact of medical care on a country’s public medical services. Of particular concern to some people is the possibility that the residents of poor countries could face shortages of doctors and hospital beds due to “rich” foreign patients utlizing them. The presumed mechanism is that the lucractive medical tourism trade will draw doctors and nurses to private hospitals, leaving public hospitals understaffed. Detractors are not yet certain if the extra revenue foreign patients bring into a country helps or hurts public medicine – the funds flows are hard to analyze but certainly there are increased tax revenues. Those increased tax funds could be used to boost public health care systems but could also be spent on further promoting medical tourism to a country so the benefits can accrue in either area.
But it isn’t just poor countries that may face issues exacerbated by medical tourist inflows. Singapore, for example, has been experiencing some shortages of hospital beds at public medical facilities. According to an article in the Straits Times on Februay 18, 70% of foreign patients utilize private hospitals in Singapore while the other 30% go to public hospitals. If there is already overcrowding at public facilities then this is certainly contributing to the problem. What I don’t know is if the foreign patients, who are presumably paying out of pocket since they would not be covered by national health insurance, are getting priority treatment and negatively impacting the locals.
I am wondering if the public hospitals in Singapore have something similar to the “private clinic hours” like Thailand public hospitals. Siriraj Hospital, Thailand’s national hospital and the country’s oldest and largest, has these private clinic hours at many of it’s specialty centers. These are usually evening hours for patients who pay out of pocket. During the day the clinics receive Thais who are covered under the national health plan. The cost is nearly nil so the demand is naturally large and therefore the crowds huge and wait times are long. During the private clinic hours the crowds and wait times are smaller. The staff is also different, at least in the clinic’s I have visited. The doctors and nurses from the day shift leave and a new team comes in for the evening. The question would be if medical tourists use these private clinic hours and if that detracts from the public’s health care. Based on what I saw the answer is no – other than myself there were no other foreigners any of the times I visited.
Singapore may be quite different. The language barrier keeps non-Thai speakers away from the public hospitals in Thailand. The staff don’t speak much English. Even learning about the availability of the special clinic hours is unlikely since the hospital don’t advertise it in English. Public hospitals in Singapore are probably much more accessible to English speakers so that alone makes a big difference.