Travelling abroad for medical treatment is now a multi-billion dollar business.

From a nip-and-tuck to a heart bypass, hospitals from India to Singapore and South Korea treat more than 1 million foreign patients a year -- lured by cut-price surgery, no waiting lists, cutting-edge technology, and highly trained doctors. Industry experts predict medical tourism in Asia will grow at a rate of 15 to 20 percent a year, mainly due to the emergence of nouveaux riches in the region. "Asian medical tourism ... seems to be increasing as affluence and mobility increase in Asia," said David Vequist, head of the Center for Medical Tourism Research at the University of the Incarnate Word in Texas. "Consumer choice is a powerful force now in healthcare and is impacted by ageing and increasingly heavier, sicker, and more needy populations in Asia."

Medscape News web site has forecast medical tourism in Asia could generate $4.4 billion by 2012. The United States provides the most patients, as Americans travel abroad to avert the astronomical costs of having private treatment at home. Typically, Americans can save 40-50 percent. But there is a new patient on the operating table, and he or she is Chinese. Many of these patients are willing to spend what it takes to fix their problem.

The Philippines also sees itself as a cut-price destination, and is projecting the number of medical tourists to hit one million by 2015, generating at least $1 billion in revenue. It targets patients from the United States, Canada, Taiwan and Japan. "We can compete with the rest of Asia because we have an edge in providing high quality medical and dental services but at a much lower cost," said Marie Recarro, an official at the Department of Tourism in Manila.

RISKS AND DOWNSIDES

Some experts, however, lament the rise of the medical tourism industry, saying it exacerbates a brain drain of talent from the state to the private system, from rural to urban areas. A paper published in the International Journal for Equity in Health last year said specialists were being swayed by the higher wages and better technology of the private sector. If the industry achieved even a fraction of its projected growth "this could ultimately lead to locals being priced out of their own health care system, as demand from foreign patients can drive up the costs of providing care for everyone", it said.

Experts cite other concerns such as medical errors, lax follow-up care, and insurance, regulatory and ethical issues. The World Health Organisation said in a report late last year that rapid development of medical tourism had presented "considerable implications for public health". It said that with the influx of foreign patients, the demand for and price of healthcare might rise. "In addition, an increasing number of health services might cater for the needs of foreign patients and neglect local needs," it said.