2022 JC2 H2 Prelim CSQ1 (Suggested Answers)

Question 1: Medical Tourism Trends Extract 1:International Medical Tourism Market Growingdemandfor healthservicesis a globalphenomenon,linkedto economicdevelopmentthat generatesrisingincomesand education.Demographicchange,especiallypopulationageingandolderpeople'srequirementsformoremedicalservices,coupledwithepidemiologicalchange,i.e.risingincidenceofchronicconditions,alsofueldemandformoreandbetterhealthservices.Waitingtimesand/ortheincreasingcostofhealthservicesathome,coupledwiththeavailabilityofcheaperalternativesindevelopingcountries,hasledto newhealthcareconsumers,ormedicaltourists,to seektreatmentoverseas.Theinternationalmedicaltourismmarketis expectedto growbyUS$131.35billion by 2025, with an average annual growth rate of 20%.Source: National Library of Medicine, 8 May 2022 Extract 2:Technology Trends Artificial intelligenceHospitalsandagenciesarenowleveragingadcompaniesthatuseAIinordertotargetpotentialpatientsanywherein theworld.Thisincludespeoplewhoengagein orviewcontentontheinternetrelatedtomedicaltourismandmedicalprocedures.Withthegrowthof targetedadvertisementsonpeople’s internetbrowsersandsocialmediaplatforms,AIhas aided in increasing the number of medical tourists. TelehealthTechnologyhasenabledtheadvancementoftelehealth,wherehealthcareservicescanbedeliveredremotely. Telehealthcanrangefromthedigitaltransmissionofdiagnosticscanstovideoconferencingsessionsbetweenpatientsandphysicians.Healthcareis nolongerlimited by physical geography.Forpatientsseekinghealthservicesoversees,barrierstotreatmentplanningandbothpreandpost-operationconsultationshavebeenalleviatedbytelemedicine,wherepatientsareableto obtaintheprocedurein a foreigncountryandreceivefollow-upcareat home.Telehealthhasencouragedpatientsto obtainmedicalproceduresabroad,andvirtualcommunicationhasallowedforseamlesscaretotakeplace.Thisminimisessomeoftheconcerns of receiving health services abroad.Source: Medical Device Network, 15 Jun 2021 Table 1: Current expenditure on health (% of GDP): United States & South KoreaCountry 2017 2018 2019 2020 2021United States 16.8 16.6 16.7 18.8 17.8 * South Korea 7.1 7.5 8.1 8.4 8.8 * *ProjectedSource: Organisation for Economic Co-operation and Development (OECD) Extract 3: Effects of Medical Tourism 1

Medicaltourismcancontributetowidereconomicdevelopment,whichisstronglycorrelatedwithimprovedpopulationhealthstatusasawhole,e.g.increasedlifeexpectancy, reducedchildmortalityrates.Encouragingforeigndirectinvestmentinhealthcareinfrastructureandrelatedindustries(egpharmaceuticalandhospitality)andmedicaltouristinflowswithcorrespondentrevenuecancreateadditionalresourcesfor investmentin healthcare.Furthermore,medicaltourismmayslowor reversetheoutmigrationof healthworkers,particularly of specialists. However, unlessproperlymanagedandregulatedonthepolicyside,thefinancialbenefitsofmedicaltourismforhealthsystemsmaycomeattheexpenseofaccesstoanduseofhealthservicesbylocalconsumers.Governmentsandindustryplayerswoulddowelltorememberthathealthiswealthforbothforeignandlocalpopulations.Inaddition,medicaltourismdoesescalateotherdetrimentalimpactonthecountry. Forinstance,thenaturalgreeneryor forestcoverof a regionis compromisedin orderto accommodatemorebuildings,hospitalfacilities,roads,treatmentordiagnosticcentersetc.Inaddition,thereisacontinuousdischargeofpollutedair, solid-toxicmedicalwaste,littersofsewageconsistingof oilandchemicals.Also,withpatienttravels,thereissignificantriskofcorrespondingbacterial travel. Recent superbug research has created significant alert. Adapted: National Library of Medicine, 4 May 2011 andMedical Tourism Magazine Extract 4:South Korea: IncreasedMedical Travellersin 2021TheSouthKoreangovernmentdatashowsthatthenumberofmedicaltravellersvisitingSouthKoreaexpanded25%between2020and2021,despitetheCovid-19pandemic.ThedatashowsmedicaltouristpatientsfromtheUSandChinaaccountedfor39%ofthetotalmedicaltourists.Thenumberof foreigntravellerswhovisitedSouthKoreaforhealthcheck-upsskyrocketedby278.9%,andthoseforintegratedinternalmedicine,64.7%,andophthalmology, 55.2%.Incontrast,medicaltouristsforcosmeticsurgeryremainedalmostunchanged, and those for dermatology fell 22.3% in 2021.TheKoreaTourismOrganization,partneredwiththeMedicalTourismAssociation,theworld’sleadingmedicaltravelexpert,toexpandhealthcareofferingstoawiderinternationalpatientbase.Thankstoa partnershipagreementwithleadinglocalhealthcarefacilities–SeoulNationalUniversity, SeoulSt.Mary’s,AsianMedicalandSamsungMedical—oil-richArabnationshavebeensendingtheirpatientstoKoreaforgastrointestinediseases,andcardiovascular, cancer, infertility, orthopedicandspinalpainconcerns.In turn,KoreanhospitalsaredoingtheirsharetotransfermedicalsystemstocounterpartsinSaudiArabia.Undera projectcalledtheMedicalSystemsTwinningProject,oneof sixagreementsbetweenthetwohealthministries,Koreahasagreedtoestablishhospitals–amongthemforbrainimagingtechniquesandneuroscienceresearch–intheMiddleEastcountryandbring educational and management expertise to their medical staff. Source: LaingBuisson, 5 Jul 2022 & Medical Tourism Magazine, Jan 2020 Extract 5: India’s Medical Tourism Industry

Indiaofferslessexpensivetreatmentoptionscomparedto the US andUK withoutcompromisingthequalityofhealthcareservices.ThetreatmentcostsinIndiaarearoundaquarter of those in America. In termsof alternatemedicaltreatment,theIndianmedicaltreatmentsystemsof yoga,ayurvedaandrejuvenationtherapyareamongthemostancientmethodsof medicaltreatmentin theworld.VariousrelevantdataonForeignTouristArrivalwasanalysedtostudytheexistenceofpriceelasticityinmedicaltourism.Itwasestimatedthattheelasticityof demand with respect to price of tourist location is -0.6 to -0.8. TheMinistryof Tourismhastakenseveralinitiativesto promoteIndia’s medicaltourismindustry:● Medical Visa was introduced in June 2005● In 2018,the governmentestablisheda dedicatedfundof US$641millionforenhancing12ChampionServicesSectors,withmedicalvaluetravelbeingoneofthem.Thee-touristvisalaunchedinSeptember2014toeasethevisaregimewassubsequently expanded to include medical visits.● TheMarketingDevelopmentAssistanceSchemeoffersfinancialassistancetoapproved tourism service providers.● Publicitymaterials,suchasbrochures,intendedto promotemedicalandhealthtourismhavebeencirculatedintargetmarketsbytheMinistryofTourism.Medicaltourism has been announced on various international forums. To makeIndiaa brandinthemedicaltourismsector, whatIndianeeds,accordingtoDr.MansukhMandaviya,isasystemtoobtainfeedback/testimonialsfromtouriststravellingtothecountryformedicalpurposes.Criticalfactorssuchastrainedmedicalprofessionalsanddoctors,fluencyin English,availabilityof thelatestmedicaltechnologyandaffordablemedical treatment have helped India emerge as a hub for medical tourism. Source:Journal of Emerging Technologies and InnovativeResearch, Feb 2021 & IndiaBrand Equity Foundation, 24 Jun 2022 3

Questions (a) With reference to Table 1,(i) Comparethe currentexpenditureon healthas percentageof GDPbetween United States and South Korea. [2] (ii) Usinga productionpossibilitycurvediagram,explainthelikelyimpactofUSgovernmentcontinuedexpenditureonhealthcareonitseconomicgrowth. [4] (b) TheSouthKoreangovernmentdatashowsthatthe numberof medicaltravellersvisitingSouth Koreaexpanded25%between2020and2021,despitethe Covid-19 pandemic. Discusswhetherdemandor supplyfactorshavea greaterimpactonthenumber of foreign patients visiting South Korea. [8] (c) WithreferencetoExtract5,accountforthevalueofpriceelasticityofdemandof India’s medical tourism services. [2] (d) Explaina possiblemeasurethatgovernmentscanadoptto mitigatetheadverse effects of increased medical tourism. [4] (e) DiscussthepossiblepolicyoptionsthattheIndiangovernmentcanadopttoincrease medical tourism revenue. [10] [Total: 30]

Suggested Answers (a) With reference to Table 1,(i) Comparethe currentexpenditureon healthas percentageof GDPbetween United States and South Korea. GeneralTrend: BothUnitedStatesandSouthKorearegisteredpositiveincreaseincurrentexpenditureonhealthaspercentageofGDPbetwe