Health tourism
or travel for health consists of two different segments. One segment consists
of people who travel to other countries for rejuvenation purposes, and the
other segment consists of people who travel for curative care that is not
available in their countries. While the former is a luxury segment, the latter
is economy. Majority of the market that travels for curative care is extremely
price sensitive and hence it plays an important role in deciding their
destination for medical assistance (Natarajan, 2015). With both, rising of
disposable income and healthcare awareness, health tourism is becoming a more
and more popular across the world. The global wellness tourism industry, with a
growth rate of 9 per cent per year, is said to be growing at a 50 per cent
faster rate than other tourism sectors (Natarajan, 2015). Figure X shows the
range of health products and facilities which have emerged in the past years.

 

Figure X:
Health Continuum

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Source: Global
Wellness Institute

 

Health tourism
has been widely studied and therefore has many interpretations. There is no
commonly used definition to express this term, however, the IUOTO in 1973
emphasized that health tourism is “… the provision of health facilities
utilizing the natural resources of the country, in particular mineral water and
climate” (p. 7). Mueller and Kaufmann (2001) further defined health tourism as
“the sum of all the relationships and phenomena resulting from a change in
location and residence by people in order to promote, stabilize and, as
appropriate, restore physical, mental and social well-being while using health
services and for whom the place where they are staying in neither their
principal nor permanent place of residence or work”. Which means that people
travel to a destination in order to either get a medical treatment or to
maintain and improve their health. Therefore, health tourism can be generally
seen as an umbrella term for wellness tourism and medical tourism as shown in figure X. Medical paradigm is represented on the
poor health continuum, which focuses on treating and curing illness and it is
reactive. Connell (2006, p. 1094) defines medical tourism as tourism
“deliberately linked to direct medical intervention, and outcomes are expected
to be substantial and long term”. 
Natarajan (2015) adds up that those travelling can include complex
surgeries, specialized treatments for chronic diseases, and other methods of
focused care.

 

In contrast, wellness paradigm is best understood on
a continuum ranging from poor health to the state of optimal well-being,
focusing on maintaining and improving health and is proactive. According to Begum
(2013) wellness tourism is a field of healthcare focused on improving everyday
health and state of wellbeing, rather than treating a disease or curing
illness. Global Wellness Institute (2017, p. 11) provides more expansive
definition of wellness tourism, namely, “travel associated with the pursuit of
maintaining or enhancing one’s personal wellbeing”. It includes two types of
wellness travelers, those who travel entirely for wellness purposes (primary
wellness tourists), and those who may engage in wellness activities during
their trip (secondary wellness tourists). In 2015 wellness sectors, which
encompasses 10 diverse sectors, shown in Figure
X below represented $3.7 trillion of economy including both international
wellness tourism receipts and domestic wellness tourism expenditures (Global
Wellness Institute, 2017).

 

Figure X: Global Wellness
Economy: $3.7 trillion in 2015

Source: Global Wellness
Institute

 

According to
the latest data from Global Wellness Institute (2017) the wellness economy
currently represents 5% of global economic output and covers almost half of the
global health expenditures, which was $7.6 trillion in 2014. Wellness economy
is growing enormously, especially southeast Asian countries are the
fastest-growing wellness travel destinations, with a projected 22 percent
annual growth rate (Gregoire, 2013).

Health Tourism in India

 

Medical tourism can be measured in
different ways, however in this paper we will focus only on Medical Tourism
Index (MTI). MTI “measures the attractiveness of a country as a medical tourism
destination in terms of overall country image and environment; healthcare and
tourism attractiveness and infrastructure; and availability and quality of
medical facilities and services” (“MTI Construct – Medical Tourism
Index”, 2017). It is based on opinion survey and it consists of three main
dimension or groups with 34 underlying indicators among 41 countries worldwide.
The first one is “Destination Environment” and relates to overall country
environment (economy, safety, image and culture). The second one is “Medical
Tourism Industry” which consists of two parts, the attractiveness of county as
a tourism destination and costs associated with medical tourism. And the third
is “Facility and Services” that includes factors related to the quality and
availability of the medical facilities and services.  According to Medical Tourism Index (MTI)
2016, India is placed on the fifth place, after Canada, UK, Israel and
Singapore on overall ranking, showing the
Figure X below. Looking over three dimensions, in 2016 India has become
the leading country in “Medical Tourism Industry”, the third one in “Quality of
Facilities & Services” and twelfth on “Destination Environment” dimension.

 

Figure X: Top five destinations
according to Medical Tourism Index 2016

Source: Medical Tourism Index

 

As stated in
The Economic Times article India among
fastest growing medical tourism destinations: Official (2017), India is one
of the “fastest growing medical tourism destinations in Asia” and it
is estimated that medical tourism in the country can become $9 billion industry
by 2020, from about $3 billion currently, according to a white paper by CII and
consulting firm Grant Thornton India (Reddy, 2016). Ayurveda, yoga and wellness
industry are the strongest competitive advantages of India and set country
apart from the other medical tourism destinations in the world. 

 

In wellness tourism
rankings India in not placed that high as in the medical tourism rankings.
However, it’s position is still among the top twenty countries worldwide,
according to Global Wellness Economy Monitor made by Global Wellness Institute
in January 2017. As shown in the Figure X below, India is positioned on the 12th
place on the ranking of “top twenty wellness tourism markets, 2015”. India’s
wellness tourism expenditures in 2015 were US$11.8 billions, they received 38.6
million wellness tourism trips, which contributed to 5.32 million direct
employments.   

 

Figure X: Top
Twenty Wellness Tourism Markets, 2015

Source: Global
Wellness Institute

What is even
more surprising, according to Global Wellness Institute (2017), India is facing
a robust growth in wellness tourism, which can be seen in the Figure X below.
It is positioned on the 4th place after China, US and Germany, with
the 6 million wellness trips added and 8.8% average annual growth rate from
2013-2015. This drastic constant growth could be a consequence of the “Incredible
India” tourism ad campaign launched in 2002, suggests Gregoire (2013). 

 

Figure X:  Leading Growth Markets for Wellness Tourism
Trips, 2013-2015

Source: Global
Wellness Institute

 

India wellness supply is quite broad and they have a lot to offer. Susie
Ellis, Chairman and CEO of the Global Spa & Wellness Summit, emphasizes
that “India’s wellness offerings are very understandable — they have yoga,
meditation and ayurveda, … Right now, those are things that are really
resonating with people… the kind of things that people want and need are the
things that India is offering.” (Gregoire, 2013).