To an American, medical tourism might sound like a trip to Mexico for a BBL or Costa Rica for a rhinoplasty. But America has its own corner of the medical tourism market which, in 2021, was valued at $4 billion and is expected to increase substantially over the next few years. Between 2022 and 2030, America’s medical tourism sector is projected to increase nearly 33%.
And the money doesn’t just come in from treatments alone. Foreign patients need to consider additional costs that include airfare, housing, food, outpatient care, exchange rates, and more, all which funnel into the operating city’s economy. One of America’s most popular cities for medical tourists? Houston, Texas. Houston is an international healthcare destination for patients looking to undergo a variety of procedures ranging from cosmetic to life-saving cancer care.
Houston is an international healthcare destination for patients looking to undergo a variety of procedures ranging from cosmetic to life-saving cancer care and is home to one of the largest medical districts in the world, We went to Texas to understand how medical tourism impacts a city's economy with help from in-state experts who know the system inside and out, including Dr. Vequest, founder of the Center for Medical Tourism Research.
And the money doesn’t just come in from treatments alone. Foreign patients need to consider additional costs that include airfare, housing, food, outpatient care, exchange rates, and more, all which funnel into the operating city’s economy. One of America’s most popular cities for medical tourists? Houston, Texas. Houston is an international healthcare destination for patients looking to undergo a variety of procedures ranging from cosmetic to life-saving cancer care.
Houston is an international healthcare destination for patients looking to undergo a variety of procedures ranging from cosmetic to life-saving cancer care and is home to one of the largest medical districts in the world, We went to Texas to understand how medical tourism impacts a city's economy with help from in-state experts who know the system inside and out, including Dr. Vequest, founder of the Center for Medical Tourism Research.
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00:00 [MUSIC]
00:03 So in American, medical tourism might sound like a trip to Mexico for
00:07 a BBL or Costa Rica for rhinoplasty.
00:10 Well, America has its own corner of the medical tourism market,
00:14 which in 2021 was valued at $4 billion and
00:17 is expected to increase substantially over the next few years.
00:22 So much so that between 2022 and 2030, America's medical tourism
00:27 sector is projected to increase nearly 33%.
00:30 And the money doesn't just come in from treatments alone.
00:33 Foreign patients need to consider additional costs that include airfare,
00:38 housing, food, outpatient care, exchange rates, and more.
00:42 All which funnels to the operating systems economy.
00:45 One of America's most popular cities for medical tourists, Houston, Texas.
00:50 Houston is an international healthcare destination for
00:53 patients looking to undergo a variety of procedures.
00:56 Ranging from cosmetic to life saving cancer care.
00:59 And it's home to one of the largest medical districts in the world.
01:02 We went to Texas to understand how medical tourism impacts the city's economy.
01:06 With help from in-state experts who know the system inside and out.
01:10 Including Dr. Bequist, founder and
01:12 director of the Center for Medical Tourism Research.
01:16 >> Medical tourism is basically health seeking behaviors that go
01:21 beyond traditional boundaries and borders.
01:24 This could be people that are traveling outside of their city, county, or
01:29 even state.
01:30 Or potentially even outside of the country to get access to care that they
01:35 want at the price they want, at the time they want,
01:39 at the location they want, and at the quality they want.
01:42 Medical tourism, the nomenclature of medical tourism is an interesting term.
01:48 But it turns out it's very appropriate.
01:52 The reason I say that is that when people are traveling for
01:56 health care, particularly over a border,
02:00 whether that's a domestic or an international border, they tend to engage
02:05 in tourism.
02:06 So for example, here in Houston, the Texas Medical Center is
02:11 the largest medical center in the world, receives a lot of international patients
02:15 from all over the world, primarily places like Asia, Latin America, and
02:20 the Middle East.
02:22 And when people come to Houston, they engage in tourism.
02:26 Our studies find that about 70% of the medical tourists,
02:31 as we like to call them, that come in for various types of care,
02:36 will also engage in some tourism in terms of going to a local festival or concert.
02:43 [MUSIC]
02:46 My path into medical tourism and researching medical tourism is that when
02:51 I dropped out of industry, I was a hospital executive for
02:55 one of the largest publicly traded hospital chains in the world.
02:59 And I came over to academia.
03:02 There was really nobody else studying medical tourism at the time
03:06 that had a focus on it.
03:07 And so I was really interested in it because the whole idea of
03:13 patient consumerization, people taking control and responsibility for
03:18 their healthcare, and then going out and finding the healthcare that they want.
03:22 And in fact, being able to find alternatives from the traditional models
03:27 of healthcare that they were being offered in the United States and
03:31 around the world was very intriguing to me.
03:35 >> I started reporting on medical tourism because of that story back in,
03:39 I think it was March, of those four Americans who went down to Mexico.
03:44 And they were kidnapped and two of them were murdered.
03:48 And so they went down because one of them wanted a tummy tuck.
03:51 And my journalist brain was going off,
03:52 why are we going to Mexico for a tummy tuck when there's doctors here in the US?
03:58 And so that's kind of how I found out about medical tourism.
04:01 I think medical tourism is getting popular just for a couple reasons.
04:06 For one, it's the cost effectiveness.
04:08 A lot of people travel down to different countries like Mexico,
04:12 because procedures there can sometimes be less expensive than they are here in
04:16 the States.
04:17 And then of course, there's less restrictions in certain countries.
04:22 So some doctors here in the States might tell someone, you're too old or
04:26 your BMI may be too high for a certain procedure.
04:29 But a foreign doctor might take them and be able to perform the procedure.
04:35 And then, especially with the overturning of Roe here recently,
04:40 and a lot of states are making abortions illegal.
04:45 A lot of people are traveling outside of the country to get procedures like
04:49 abortions done in countries where they're still legal.
04:53 [MUSIC]
04:56 >> Cosmetic surgeries, interestingly, make up only about 13% of the total
05:01 surgeries that we find that people are traveling for.
05:05 So it's far less than overall, all the surgeries,
05:10 general surgeries about 30%, and much less than dental, which is probably about 50%.
05:16 Pharmaceutical, we don't have a good understanding of that.
05:19 But here recently with the supply of Ozympic being restrained in the United
05:24 States, there was a study that showed among Canadian pharmacies that about 10%
05:29 of their total prescriptions for Ozympic were going to American citizens.
05:36 That really depends on the type of people they're traveling, their needs, and
05:40 also, again, the core competence that exists in that specific location.
05:45 Interestingly, Americans have an interesting view
05:52 in regards to international healthcare, and that they tend to be fairly provincial.
05:57 And they tend to not believe that there's good healthcare outside of
06:01 the United States compared to what's here in the United States.
06:05 And in some cases, there may be some truth to that, but
06:08 there are many places around the world that are providing extraordinarily good
06:12 care, usually at lower prices than not only
06:17 what a cash price would be in the United States.
06:20 But in some cases, the price is lower than what you would pay for
06:25 your deductible, meaning though even though you're insured,
06:29 whether you have a healthcare product from the exchange or
06:35 private insurance, you may be paying thousands of dollars out of pocket for
06:38 your deductible.
06:40 And it's actually cost less than that to get a procedure internationally.
06:45 And so when you combine that with a trip, you may actually end up with a vacation
06:49 and healthcare for much less than you would expect.
06:53 >> People coming inbound, foreign patients,
06:57 international patients coming into the United States, tend to be affluent.
07:01 >> It's actually really interesting just because you wouldn't think that this
07:08 city in Texas, especially because I'm from Texas, I had no clue that this
07:13 is where a lot of foreigners were coming to get procedures done.
07:16 >> Houston has a world class medical center.
07:19 Houston is known for two things.
07:21 One of them is energy and oil and gas and the other is healthcare.
07:24 And so Houston has the largest medical center on earth.
07:27 It is a massive accumulation of very specialized facilities.
07:33 It's called the Texas Medical Center.
07:35 [MUSIC]
07:39 >> One of the things that Houston is doing in particular is the integration.
07:44 The Houston and the Texas Medical Center,
07:47 which is the largest medical center on the face of the earth,
07:49 has a cluster approach.
07:51 >> In layman's terms, the Texas Medical Center is a very defined piece of
07:55 geography.
07:56 And within that piece of geography are massive hospitals.
08:00 Texas Methodist Hospital, Memorial Hermann Hospital.
08:03 And so the hospitals and practices that are there in the grounds of
08:07 the Texas Medical Center proper are part of those bigger hospital systems.
08:12 >> And they use what's called the International Patient Advisory Council
08:16 to get together a variety of organizations from throughout Houston,
08:21 including the Chambers of Commerce, the airports, the local,
08:26 city, county, state, and federal government.
08:30 The restaurants, the hotels, the hospitals, they all get together.
08:36 And what they do is they coordinate and talk about things, for
08:41 example, transportation.
08:43 If you're an Arab patient coming into Houston,
08:46 you're gonna want to know that not only can you come here and be safe and secure,
08:51 and then you have a good place to stay for you and your entourage.
08:55 But you also need to know that you're gonna be able to access halal food.
08:58 >> A lot of procedures require patients to stay in close proximity
09:04 to their hospitals.
09:06 Like this is kind of an extreme example, but
09:09 like the people on My 600-lb Life, for example.
09:12 They oftentimes travel to Houston to get their procedures done,
09:18 their gastric sleeve, their gastric bypass.
09:20 And so they have to stay close to their hospitals or
09:24 even stay in the hospitals to get the post-op work done.
09:29 And so sometimes they have to literally uplift their families so
09:32 that they can come stay with them for months or weeks or however long it takes.
09:37 And so that's one reason.
09:39 And then other procedures like BBLs, for example, and
09:43 other cosmetic procedures like the first week or
09:46 even a couple of days can be a little brutal in terms of recovery.
09:51 Especially with lymphatic drains, and they have to sleep or even sit a certain way.
09:57 And so I can imagine that going through that recovery phase
10:02 can be much more beneficial or even convenient in a place like a house or
10:07 an apartment rather than like a hotel, for example.
10:11 Especially because you have to pay for a hotel by the night, whereas a rental,
10:15 you can oftentimes pay by the week or by the month.
10:19 [MUSIC]
10:22 >> I'm Michelle Neeland with Corporate Retreats International, and
10:26 we're based out of Houston, Texas.
10:29 We're a corporate housing company, but
10:31 we specialize in furnished apartments in the Texas Medical Center area.
10:36 People seeking medical treatment find us a number of ways,
10:40 word of mouth, maybe from a friend who came here.
10:42 Joe's House is a resource that we get a lot of calls from.
10:47 It's a website and or a list that's a resource for
10:52 specifically people seeking cancer treatment.
10:56 So it offers a number of housing options for
10:58 people who are receiving cancer treatment.
11:01 We also get calls.
11:04 People are referred by the different hospitals,
11:06 by the social workers or agencies at the hospitals.
11:09 They'll get a list of housing options.
11:13 And people also just drive around and look for something that they like.
11:17 They'll walk into a lobby and they'll be referred to us that way as well.
11:21 I would say it's on average between 20 and
11:24 30% at any given time of our residents are here from outside the US.
11:30 And they travel here usually with a lot of family members.
11:35 So it's more common that they would be looking for a two or
11:38 three bedroom apartment than a one bedroom.
11:41 But we see people from all over the world.
11:46 >> The people that we typically see that travel great distances to come see us are
11:51 people that have usually had a failed surgery somewhere else.
11:53 And these people are in desperate shape.
11:57 So desperate that they'll travel thousands and thousands of miles to try to find
12:01 the right practice or doctor or both to help them.
12:05 Some of the simple things that it's just easy to overlook.
12:07 So for instance, if somebody has a big revision spine surgery and
12:10 they need home health, well, home health won't respond to a hotel, right?
12:15 So to hook them into the services that they're likely to need,
12:19 where you can put them into more of a home situation with a physical address so
12:24 that they can receive that care that they're going to need after a big
12:26 complicated surgery.
12:28 >> I would say in the 80 to 85% range of our revenue would come from
12:35 people who are here for medical treatment of some kind.
12:37 And probably in the 25% range would be international.
12:44 And that of course changes all the time because we have people move in and
12:46 move out every single day.
12:48 So it's in flux.
12:52 Some people stay with us for six weeks, two months, six months, a year.
12:56 So those international numbers kind of change all the time.
13:00 But that's probably a pretty accurate representation of our clientele.
13:07 >> In places like Houston,
13:09 we typically have international patients that will come in.
13:12 They spend a very large amount of money.
13:15 It's typically about ten times as much as what a tourist would pay in Houston.
13:23 So in other words, a normal tourist coming to Houston,
13:26 doing most types of tourism activities.
13:30 They would spend, say, in the nature of maybe $3,000,
13:35 $4,000 at the most, probably in the hundreds of dollars is more average.
13:41 And for medical tourism, the total amount could be tens of thousands of dollars.
13:48 At least thousands, potentially tens of thousands of dollars.
13:51 So the economic impact of foreign tourists coming into a place like Houston is
13:57 tremendous.
13:58 [MUSIC]
14:01 >> About 600,000 visitors in Houston came from foreign countries in 2022 alone.
14:06 And out of that 600,000, over 20,000 of them came for medical purposes.
14:11 And the average amount of money being spent by patients in Houston is $3,400.
14:16 And that's not including things like hotel, travel, food, and
14:20 other miscellaneous costs.
14:21 That's just strictly focusing on inpatient and outpatient care.
14:25 >> So interestingly, what we've seen around the world is an increase in
14:29 affluence.
14:31 Many people have heard about in the business literature the idea of the BRICS,
14:35 which was Brazil, Russia, India, China.
14:38 Those have expanded greatly to include many countries that are seeing
14:42 increases in affluence, meaning that the people that are in those countries
14:46 have more money than ever before.
14:48 >> One of the first things that people do when they have more money, and
14:53 also interestingly, one of the things that most immigrants are traveling for
14:58 is they're looking for better education for their children.
15:02 So therefore, you see educational tourism, as it's sometimes called.
15:07 If you go to most top tier business schools around the world,
15:11 you're gonna find that a very large percentage of them are from overseas.
15:15 And the reason they travel into the country is to get access to better
15:19 education.
15:20 Another thing that people do as soon as they have more money is they want to
15:25 travel and they want to eat better.
15:27 And so we see that in terms of the tourism aspects.
15:30 And then the fourth, if you will, leg of the stool or the chair is healthcare.
15:36 When people get more money, one of the first things they wanna do is they want
15:39 to have better health for themselves and their family.
15:43 >> So international tourists coming to the US for medical tourism,
15:48 they're more affluent and they have more money and
15:52 more resources to travel for medical purposes,
15:56 especially after the COVID-19 pandemic.
15:59 [MUSIC]
16:01 >> The pandemic made basically the entire world sicker.
16:07 The more people are sick, more people are ill,
16:10 more people have put off healthcare for too long, for years during the pandemic.
16:18 There's estimates that upwards of 40% of Americans alone
16:22 gained on an average about 15 pounds during the pandemic.
16:27 There's estimates that 10% of British
16:32 people put off seeking cancer care during the pandemic.
16:36 All of these issues are leading to the world being a much sicker place.
16:41 Plus, many people were sedentary and sat around and watched Netflix way too much
16:46 and snacked on food while during the pandemic.
16:50 All of this has led to people needing more healthcare and
16:54 more invasive and higher acuity levels of healthcare.
16:59 The American Medical Association is saying that just in the US hospitals alone,
17:04 just domestic patients are seeing overall bills about 10%
17:09 higher than they were before the pandemic, not due to inflation, but
17:13 due to the acuity or their level of sickness when they present.
17:18 So more people are presenting with stage two cancer when they should have presented
17:23 with stage one if they had engaged in primary care and
17:26 preventative services, obviously during the pandemic.
17:30 >> I think that our recent experience with the coronavirus pandemic has really
17:34 put international healthcare on its ear.
17:37 Obviously, there's been a tremendous amount of regulations and
17:41 rules about travel visas and this and that.
17:44 Historically, Houston is a natural place for international patients to come,
17:48 not only because of our medical center and just our expertise in healthcare in
17:53 general, but also geographically Central America, South America.
17:57 We see a lot of people from the Middle East because of our ties with oil and gas.
18:02 And so historically, we see a large number of patients within our practice
18:07 every year.
18:07 We have departments of individuals that are geared towards helping those people
18:13 with some of the unique challenges that they face as they seek healthcare.
18:18 Yeah, I mean, most of it is just logistical.
18:20 The care of the international patient is challenging for a lot of reasons.
18:25 As a surgeon, the biggest reason that I come into grips with
18:28 is the support system for the person.
18:31 And so for instance, if I was to operate on you and you were from Houston and
18:34 the surrounding area, that once we got done with you and we were to send you home,
18:38 you'd have the support of your family and all those types of things.
18:41 And so our biggest emphasis on caring for international folks is understanding
18:45 the fact that they don't have that support system around there.
18:48 And people with very simple problems rarely travel 1,000 or
18:53 more miles to get that simple problem cared for.
18:55 And so our entire focus is that of just helping the individual
19:01 with some type of support structure.
19:03 >> So people, when they first call us, are usually extremely under a lot of stress.
19:09 Sometimes they just found out they have this diagnosis, or
19:12 their family member does.
19:13 And they're gonna be traveling from across the world or
19:17 across the country, some long distance.
19:20 They've not been to Houston maybe, and
19:22 they really have no idea that this is all very stressful and very unknown.
19:29 So what's really amazing is when I do get the chance to tour someone, or
19:35 even just really get to narrow down what they want,
19:37 even over the phone, and help them find what's a good fit.
19:41 You can just hear relief in their voice, see it on their face.
19:45 It's such an important thing for people to say, okay,
19:49 I know where I'm gonna stay when I'm here, and I like that at least.
19:54 I know I'm gonna be going through a really tough time, and
19:56 I don't know what that's gonna look like for me.
19:58 But at least I'm gonna be in a comfortable place where I'm gonna feel safe,
20:03 where I can relax and rest and recover.
20:06 It is really tough because it's not like what we do is just lease apartments,
20:10 just rent apartments to people.
20:12 I mean, it's very personal.
20:14 People call you crying.
20:17 There's really good stories, there's really good success stories,
20:22 a lot of happy endings, and
20:23 then there's some really tough things that happen as well.
20:26 So it's hard because we aren't a non-profit, we're running a business,
20:33 but we have to have empathy for all of our customers.
20:37 [MUSIC]
20:42 >> I'll give you some evidence to show how big medical tourism is into
20:46 the United States.
20:48 Back in the Obama administration, I think it was the end of their first term,
20:55 they decided to give a grant for establishing a group.
21:02 It's called USKIP, and it's a group of the best,
21:06 what most well-known academic medical centers in the United States, so
21:10 that they could get together and promote themselves and
21:14 promote healthcare in the United States.
21:16 So it was identified, again, under the Obama administration,
21:20 as being one of the up and coming revenue streams for the United States.
21:28 In terms of how large it is, just here in Houston alone,
21:33 we know it's hundreds of millions of dollars.
21:36 So across the United States, there is estimates to say
21:42 that potentially with all the people coming in and all the locations,
21:47 it may potentially reach upwards of a billion dollars in
21:52 total revenue coming from foreign patients.
21:55 Now, there's some distinctions in that.
21:58 Is that all healthcare revenue?
22:00 Probably not.
22:01 That probably includes both flights, hotels, transportation, food, tourism.
22:07 There's a variety of aspects that go into medical tourism.
22:11 But overall, we know that it's a significant driver of
22:15 revenue in several places throughout the United States.
22:19 So this is leading to, again, unhealthy populations,
22:25 greater utilization, put off healthcare for a long time.
22:29 It's kind of like, if you will, a perfect storm for medical tourism.
22:33 And so locations like Houston,
22:35 which already see a large number of foreign nationals, it's going to be a boom for
22:40 them. And don't forget, we're also seeing increasing population growth
22:46 in places like Latin America, one of the number one locations for
22:50 foreign nationals coming into Houston.
22:52 We're seeing population growth in places like Asia, which was sending
22:57 a lot of medical tourists into the United States prior to the pandemic.
23:03 So there's a lot of, if you will, upward pressures on or
23:09 upward opportunities for medical tourism to grow.
23:15 And my belief is it's gonna grow at at least a double digit rate going forward.
23:21 Historically, both into and out of the United States,
23:25 we've seen about 10, 15% growth rates.
23:29 I expect that to continue in the near future.
23:31 [MUSIC]
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