The global medical tourism sector is projected to register phenomenal growth in the coming years. A recent report in Business Line says that the global medical tourism market will touch US$32.5 billion by 2019, up from US$10 billion currently, registering an astounding CAGR (Compounded Annual Growth Rate) of 17.9%. India (with estimated foreign exchange earnings of US$1.8 billion from medical tourism), along with other Asian countries like Thailand and Singapore, has been one of the prominent medical tourism hubs in the world. This is largely due to the cost-effectiveness of the treatment offered in Indian hospitals, which are equipped with facilities that match international standards. Figure 1 presents a comparison of the costs of selected surgical procedures in USA, Thailand and India. Further, Indian cities offer affordable living and English is spoken and understood widely. Besides, traditional Indian medicine (such as Ayurveda and Siddha) and cosmetic procedures also attract patients.
A report titled “Medical Value Travel” in India brought out by KPMG for the FICCI Heal Conference 2014 has identified various areas of improvement to promote medical tourism in India and increase the share of medical tourists among foreign arrivals in India. In 2012, out of the 6.57 million foreign tourist arrivals in India, only 2.6% were medical tourists. One significant area of improvement identified by the report is the legal framework that includes visa regulations. Countries such as Thailand and Singapore fare better than India on this count. This article will discuss the visa regulations in India concerning medical tourism with a focus on the E-Visa (https://indianvisaonline.gov.in/visa/tvoa.html) launched in November 2014.
Before the launch of the E-Visa, medical tourists desirous of visiting India had only one option – the M-Visa or Medical Visa, valid for one year and extendable in special cases. Industry insiders and experts opine that the M-visa process is complicated and subjects patients to unnecessary stress. For instance, patients have to visit the Indian embassy to submit documents such as bank statements and medical reports. There are undue delays in processing visas, and once in India, they are expected to report to the local police station periodically. Experts believe that relaxed visa norms will boost the medical tourism sector in a big way.
The launch of the E-Visa or Electronic Travel Authorisation (ETA) enables applicants from 43 countries to apply for a visa online a minimum a four days before travel. Applications are processed within 72 hours enabling the applicant to enter India through one of the nine designated airports at Delhi, Mumbai, Bengaluru, Chennai, Kochi, Goa, Hyderabad, Kolkata and Thiruvanathapuram, where he or she has been issued a Tourist Visa on Arrival (TVoA). The duration of stay in India is 30 days and grounds for travel include business or casual visits, besides short duration medical treatment.
Industry insider V.S. Venkatesh, CEO, Apollo White Dental believes that there is considerable scope for improvement because only a few of the 43 countries eligible for E-Visa have medical tourists coming to India. Figure 2 shows the top 10 countries from where medical tourists arrived in India, as identified by KPMG. Only 4 of these countries – USA, Russia, UAE and Oman, accounting for 10% of the total medical tourists figure in the list of 43 countries. India’s neighbours such as Bangladesh, Maldives, Afghanistan and Sri Lanka, which together account for 51% of the medical tourists, do not figure on the list, primarily due to strategic concerns governing foreign policy. Moreover, other countries such as UK (which accounts for 1.4% of the medical tourists) have been left out. Kenya is the only prominent African country on the list. One can, however, draw hope from reports that the government plans to extend E-Visa to most countries except ‘high-risk’ ones in a phased manner. While this certainly means that the chances of many of India’s neighbours figuring in the E-Visa list are quite less, other African and European countries are likely to be added to the E-Visa list in the future.
The E-visa covers only short duration (30 days) medical treatment and an applicant can avail the facility only twice a year. However, a large proportion of medical tourist visits to India is for procedures such as cardiac care (30% of total), joint replacement (15%) and cancer treatment (11%), which require longer duration contact with doctors. E-Visa would certainly facilitate their trip to India and consulting doctors. They would then be required to apply for the regular M-Visa to continue treatment. Therefore, E-Visa would benefit these patients in a limited sense and would give them an opportunity to experience India as a healthcare destination. Once in India, when these patients can observe the cost-effectiveness, high-quality of treatment and high success rates in Indian hospitals first hand, they may be motivated enough to stand the rigours of the M-Visa application process.
However, E-Visa is undoubtedly going to make the process simpler for traditional treatments that are promoted and regulated by the government’s Department of AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy). In recent years, celebrities such as Naomi Campbell, Demi Moore and Madonna have visited India to avail Ayurvedic massages and wellness plans. Such visits have helped increase awareness of India’s traditional healing sector in Europe and USA. Patients who wish to avail traditional healing are likely to take advantage of E-Visa since many of these treatments span only a few weeks. It is interesting to note that two (Kochi and Thiruvananthapuram) of the nine airports designated for E-Visa arrivals are in Kerala, an important centre of Ayurvedic treatment in India.
Another sector that is likely to benefit from the E-Visa launch is cosmetic and dental surgery. Insurance does not cover these procedures in the USA and other western countries and cost between 3 – 5 times less in India. In fact, these short duration treatments are sometimes excluded from the data of medical tourists because tourists often combine them with vacation and routine travel. The extension of E-Visa to other European countries will help tourists coming to India for cosmetic procedures.
To sum up, the E-Visa is likely to boost the prospects of the growing medical tourism sector in India. However, it needs to be extended to more countries and provide for longer duration stay in India to truly revolutionize the system and ease the process of obtaining a medical visa to India.
- Medical Value Travel in India (2014). KPMG. Retrieved from https://www.kpmg.com/IN/en/IssuesAndInsights/ArticlesPublications/Documents/KPMG-FICCI-Heal-Sep2014.pdf
- Shanmugam, K.R. (2013). Medical Tourism in India: Progress, Opportunities and Challenges. Madras School of Economics Monograph 26/2013. Retrieved from: http://www.mse.ac.in/pub/Monograph%2026.pdf
- Global medical tourism market set to touch $32.5 bn by 2019 (2015, January 3). Business Line. Retrieved from http://www.thehindubusinessline.com/economy/global-medical-tourism-market-set-to-touch-325-bn-by-2019/article6751138.ece?ref=relatedNews
- Ayurveda helps Kerala emerge as a key medical tourism hub (2013, April 28). Business Line. Retrieved from http://www.thehindubusinessline.com/industry-and-economy/travel/ayurveda-helps-kerala-emerge-as-a-key-medical-tourism-hub/article4663601.ece?ref=relatedNews
- India ranks among top 3 medical tourism destinations in Asia (2014, September 1). The Times of India. Retrieved from http://timesofindia.indiatimes.com/business/india-business/India-ranks-among-top-3-medical-tourism-destinations-in-Asia/articleshow/41447360.cms
- Narasimhan, T.E. & Babu, G. (2013, December 2). Medical tourism hamstrung by obsolete visa rules. Business Standard. Retrieved from http://www.business-standard.com/article/companies/medical-tourism-hamstrung-by-obsolete-visa-rules-113120201713_1.html
- E-visa for 43 nations, big boost for tourism (2014, November 28). The Times of India. Retrieved from http://timesofindia.indiatimes.com/india/E-visa-for-43-nations-big-boost-for-tourism/articleshow/45301790.cms
- India becomes West’s favourite destination for cheaper cosmetic surgery (2013, October 31). The Economic Times. Retrieved from http://articles.economictimes.indiatimes.com/2013-10-31/news/43561305_1_plastic-surgeons-plastic-surgery-countries
- Hamid, Z. (2014, December 21). The visa to good health. The Hindu. Retrieved from http://www.thehindu.com/news/cities/chennai/medical-tourism-the-visa-to-good-health/article6711443.ece