Healthcare in Costa RicaCosta Rica is a Central American country located between Nicaragua and Panama. It has a population of more than five million people. Healthcare in Costa Rica ranks among the best systems in Latin America. The level of medical quality matches even that of more-developed countries, such as the United States. In a 2000 survey by the World Health Organization (WHO), Costa Rica was ranked No. 36 for the best healthcare system in the world, placing it one spot above the U.S. at the time. Other statistics from the WHO show that Costa Rica has a high life expectancy — 77 for men and 82 for women. For comparison, the United States’ life expectancy is 76 for men and 81 for women. There are two Costa Rican healthcare systems — the government-run system and the private system. Both of these healthcare systems are constantly improving, with developments in equipment, clinics and staff training.

Public Healthcare

Costa Rica’s government-run public healthcare system, Caja Costarricense de Seguro Social (CCSS), often called “Caja,” has 30 hospitals and over 250 clinics throughout the country. Though the public sector can have waiting lists, like any other healthcare system, it offers citizens and permanent residents full coverage for all medical procedures and prescription drugs. A small percentage of one’s income funds Caja. It is relatively inexpensive, especially in comparison to the costs of treatments in the United States.

Private Healthcare

Private healthcare in Costa Rica is more expensive than public healthcare, but it is of considerable quality. Doctors in private healthcare facilities generally speak English and have received professional training in the United States, Europe or Canada. CIMA hospital in Escazu, Clínica Bíblica in San Jose and Hospital La Católica in Guadalupe (San Jose) are the three most well-known private hospitals in Costa Rica and they are also internationally accredited.

Medical Tourism

The beautiful scenery and relatively low costs of healthcare in Costa Rica have turned the country into a popular spot for “medical tourism.” Medical tourism is defined by the Centers for Disease Control and Prevention (CDC) as “traveling to another country for medical care.” Each year, more than 40,000 Americans travel to Costa Rica annually to seek healthcare. In 2016, Costa Rica welcomed 70,000 medical tourists according to the Costa Rican Health Chamber, PROMED. The primary procedures for medical tourists in Costa Rica are dentistry and cosmetic surgery.

Both citizens and medical tourists can attest that healthcare in Costa Rica is of great quality and is low-cost in comparison to other systems. With the constant improvements to the universal and private health sectors, Costa Rica rightfully deserves its ranking as one of the best healthcare systems in Latin America.

Emma Benson
Photo: Southcom

tourism in Thailand
Thailand is a unique country that attracts over 32 million tourists each year. Tourism made up 20.6 percent of Thailand’s GDP in 2016 and supported about 6.1 percent of jobs. Bangkok, Thailand’s capital, was the most visited city in 2017. It is clear the tourism in Thailand is impacting the country.

Thailand’s 2004 Tsunami Recovery

Tourism both aided and hindered Thailand in its post-tsunami state. With a high need for jobs and funds, many luxury hotels were able to reopen within months. Unfortunately, some groups such as migrant workers had a difficult time receiving aid, if they even received any at all.

The event was also a catalyst for the marginalization of those in a lower socioeconomic status as many were barred from returning to their homes in popular tourist areas such as the beach. It is estimated that upwards of 10,000 were either prevented from returning or an attempt was made to prevent them from returning.

The Marginalized in Thailand

The country’s social bias against migrant workers, immigrants and refugees is one of Thailand’s biggest criticisms. People in these marginalized groups are at a legal disadvantage compared to Thai citizens. Migrant workers are at the will of their employer, needing a “termination and employer transfer form” (in other words, permission from their current employer) in order to switch jobs. Research by the International Labor Organization (ILO) in 2010 found 33 to 50 percent of employers in the fishing, domestic and manufacturing sector used this law to their advantage to prevent losing migrant workers as employees.

There are also multiple reports of migrant workers being punished by law in what seem like uncertain situations. One example is the fourteen migrant workers who filed a complaint against their employer for exploitation, thus damaging the company’s reputation. This resulted in the employer filing a lawsuit against the workers with potential consequences being imprisonment and fines. 

Another unfortunate example occurred in 2015 when two migrant workers from Myanmar were sentenced to death for the murder of two tourists; the case was marred by police misconduct such as the mishandling of evidence and the alleged torture of the workers. While it is difficult to find an exact number of migrant workers convicted of a crime in Thailand, it is becoming increasingly clear to the world that this is a human rights issue that needs to be addressed.

Sex Tourism in Thailand

Prostitution was outlawed in the 1960s, but Thailand still has a growing trade revolving around paid sex. There is no way to get a real number on those traveling for sex tourism in Thailand, but NGOs estimated 70 percent of male travelers were visiting specifically for the sex industry in 2013. Prostitution does not have a social stigma in Thailand like in other countries and many Thais have accepted it as part of the culture, creating growth in the industry despite questionable legalities.

Medical Tourism in Thailand

Many tourists travel to Thailand because of the low-cost medical treatment. In 2006, about 200,000 tourists traveled to Thailand explicitly for medical treatment. By 2011, that number rose to half a million.

According to insurance company Thai Expat Club, Thailand was third in the world as the most likely destination for health tourism in 2016. Many medical tourists are saving at least half of what they would pay in the US. Add on recovery by the beach or in a resort and it is no wonder Thailand has become the medical hub of Asia.

Tourism’s Impact on the Environment

With tourism in Thailand increasing, trash increases as well. Unfortunately, Thailand’s infrastructure has been unable to keep up. A common assessment has been waste left over from beach parties. It is estimated that Ko Phangan Full Moon beach parties leave about 12 tons of debris per day behind which mostly goes into landfills or the ocean.

Many groups are currently trying to highlight this issue which will hopefully create a springboard for biodegradable materials and other environmentally conscious decisions. Some of the organizations partnering with Thailand to address the waste issues are the U.S. Environmental Protection Agency, which collaborates with Thailand to protect environmental laws, and the International Union for Conservation of Nature, which works on conservation within the country.

Tourism in Thailand is drawing in great opportunities such as growing jobs, a developing medical field and cultural awareness. However, there are some points of contention with prostitution, the waste problem and an increasing awareness of the marginalized in Thai society. Curbing environmental problems and working toward a more equal society will create a stronger Thailand and, ultimately, a stronger world.

– Natasha Komen
Photo: Flickr

Medical TourismTourism has been around for many years, in the past it was mainly used for research purposes for young scholars, but over time it has evolved to become its own individual industry. Medical tourism is an arising type of tourism whereby a tourist leaves their home country to receive medical attention in another. Countries visited through medical tourism are usually less developed countries, and the effects of medical tourism have been beneficial to both sides.

According to Orbis Research, in 2016 the global medical tourism market was worth $19.7 billion, and by 2021 it could reach $46.6 billion. In fact, for some developing countries, medical tourism is one of the biggest industries. India, for example is renowned for its success in the medical tourism space; in 2002 alone, the industry earned at least $2 billion in revenue for the country, and this number has gradually grown.

The effects of medical tourism have proven beneficial to less developed nations. According to a study on Thailand, “most developing country governments see medical tourism as an opportunity to generate more national income”.

Medical tourism has become a common method of seeking out cheaper medical treatment for individuals in developed countries. According to the study, “Medical Tourism: A Look at How Medical Outsourcing Can Reshape Health Care,” the examination of Howard Staab’s case in 2004 illustrates the benefits for medical tourists. In Staab’s case, the patient needed a mitral heart valve replacement surgery that had to be done within a year.

The original cost for the operation was $200,000. Staab could not negotiate with the hospital nor the insurance within the one-year policy, therefore Staab decided to travel to India for the surgery. There, the surgery came to cost $6,700 and Staab was able to save approximately $193,300. Since 2004, medical tourism has become even more cost-efficient.

Medical tourism has also become a platform for individuals from one LDC to out seek medical care from another LDC. It has become an interaction between parties, both of whom are from developing countries, for example, Afghan patients who commonly travel to India for medical treatment. The interaction between individuals from different LDCs allows for the connection of different cultures and paves a way for building an interconnected network among the LDCs.

A growing globalized network among LDCs could prove very useful in providing LDCs access to patrons working towards improving quality of life through medical care. The effects of medical tourism are to allow them to utilize resources surrounding them and depend less on foreign aid, and focus more on not only improving quality of life but also the economy of their countries.

Carla Salas

Photo: Flickr

In front of representatives and officials from more than 80 countries, Dubai was presented with the award for “Destination of the Year” at the 10th World Health Tourism Congress.

Those in attendance at the reception, which took place in Dubai Healthcare City at the Mohammed Bin Rashid Academic Medical Center, included senior government officials, ministers, and health and medical experts, as well as tourism industry stakeholders.  

According to Dr. Ahmed Bin Kalban, the CEO of the Hospital Services Sector at Dubai Health Authority (DHA), the city is known for its high-quality medical care and attractiveness as a destination. Both factors are key drivers for medical tourism in Dubai, a concept in which people travel to another country to receive medical care.

The top services offered in the medical tourism field in Dubai include orthopedics, aesthetics, dental care, fertility tests, and preventive health and wellness. In the first half of this year, 260,000 medical tourists visited Dubai, generating revenues of over one billion dirhams, equivalent to more than $272 million.

His Highness Sheikh Mohammed bin Rashid Al Maktoum, Vice-President and Prime Minister of the UAE, Ruler of Dubai, created DHA in June 2007 via Law 13 to serve as the strategic health authority for the nation. It works to set policies and strategies for health and make sure both are implemented.

DHA’s aim is to deliver an efficient, accessible and unified healthcare system, improve the quality of life, and protect public health. The mission of the body is to guarantee access to health services, improve the status of health for nationals, residents and visitors, and supervise an effective and modern health sector.

Prior to the creation of DHA, the authority for the delivery of health services in the UAE was the Department of Health and Medical Services (DOHMS), which was established in 1973.

Matt Wotus

Sources: CDC, Prometric, Zawya,
Photo: Pixabay

Medical Tourism
The medical tourism industry is booming in India. Thousands of people are coming to the country to receive inexpensive treatment by some of the world’s best physicians. Spending money on travel and lodging during their stay boosts the Indian economy, but not without a price.

Large health disparities exist between social classes. The majority of India’s 1.1 billion people utilize the free healthcare system because they cannot afford to be consumers of private healthcare. In this public sector, there are too many patients and not enough physicians, supplies or hospital beds to accommodate every person, regardless of their ailment. Hospitals are overcrowded and their conditions are poor. It’s not uncommon for people to travel for multiple days to see a doctor, only to wait in line and never be seen.

This picture is drastically different from the medical tourism industry; where approximately 150,000 medical tourists travel to India each year to receive major medical services at a reduced cost. The other appeal is little to no waiting time to see a physician and receive treatment. India’s 23 private hospitals also have the luxury of excess resources, including open hospital beds. Apollo Hospital, often referred to as the “Taj Mahal” of medical excellence, claims to reserve 30% of their beds (free of charge) to India’s poor patients, however the reality is that they are hard to obtain and rarely filled to capacity. Citizens must first contact the government to even get a permit and be admitted into the free ward, a process which can take months.

Medical visas that are now being issued marks the expansion of the medical tourism industry. Although medical tourism may seem beneficial on the surface, expansion may mean brain drain for the rural areas, which would deepen these health disparities. “Medical tourism could worsen the internal brain drain and lure professionals from the public sector and rural areas to take jobs in urban centers.” Dr. Nilima Kshirsagar, the dean of one of Mumbai’s largest public hospitals, agrees the focus needs to placed on Indian citizens and improving their access to healthcare; “The need to benefit Indian patients is the main goal, and medical tourism cannot be at their cost.”

Maris Brummel

Sources: ABC, WHO