MEDICAL TOURISM
IN ZIMBABWE
Linda Mukusha
(Mrs)
Presentation Outline
• Definition of medical tourism
• Zimbabwe healthcare delivery industry
• Medical Funding Industry
• Driver of Medical Tourism
• Arrangements in place
• Comparison of cost
• Market views
• Future of medical tourism
Definition of medical tourism
• Medical tourism is when consumers elect to travel across
international borders with the intention of receiving some
form of medical treatment.
Presenter logo
to come here
• This treatment may span the full range of medical services,
but most commonly includes dental care, cosmetic surgery
for reconstructive purposes not aesthetic, elective surgery,
and fertility treatment.
(Neil Lunt, Richard Smith, Mark Exworthy, Stephen T. Green, Daniel Horsfall
and Russell Mannion)
Healthcare Delivery Industry
• Population +13m
• 70% Government Institutions
• 30% Private Institutions
• GP to patient ratio less than
1:300 (fuels fraud )
Declines in
numbers of
specialist
(left the
country
during the
2007 – 2009
crisis)
Government institutions near
collapse, old equipment
• Private institutions catering for
most treatments
• MSA last revised in 2004, allows
Minister of Health to set tariffs for
service providers
Medical Funding Industry
Medical Funding Industry
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28 local medical funders, 1 SA player
Virtual / International players such as Bupa
10% of population on medical cover
Tariffs negotiated at AHFoZ level not individual funder
Economy not performing well therefore affecting viability of
funders
Post dollarisation (2009) balance sheets of most funders
wiped out
Loss ratio +80%
Required to keep 3 months cover of subscriptions
Claims to be paid within 60 days
Medical funders entering the healthcare services as survival
strategy
Size +/- US$300 million a year
Drivers of
medical
tourism in
zimbabwe
Drivers
• No preferred service provider networks where tariffs can be
negotiated and agreed, Minister of Health will not allow this
• No agreement on tariffs with service providers. Three
different tariffs in the market, AHFoZ which most funders
reimburse on, Association tariffs and ZIMA tariffs (bronze,
silver and gold based on American model)
• Sub-economic subscriptions in comparison to treatment
costs
• Minister of Health increased tariffs by 75% on GPs and
about 5% across other disciplines (July 2014)
• Service providers argue that medical inflation is at CPI
+300%.
Drivers
• Hospitals asking for +20% yearly
• Service providers pass on capital costs to funders through
exorbitant marks ups on services +100% to +500%
• Lack of Specialist skills eg heart bypass surgery
• Lack of Specialist equipment , private institutions affected,
ie quality
• Affordability on the part of the patient (benefit limit does not
cover treatment costs in Zimbabwe)
• High loss ratios suffered by medical funders
Arrangements in place for
patients
Drivers of
medical
tourism in
zimbabwe
Embassies / Hospitals
• Funders have arrangement with top 3 Hospitals in India
• India Embassy facilitating treatments in that country by
issuing visas on production of referral letter
• Visas issued within 21days
• No visas required for SA, Malawi and Zambia
• Indian hospitals arranging packages that accommodate an
accompanying spouse or relative
• Total cost of treatment plus airfare and accommodation
lower than Zimbabwe treatment
Brokers
• Brokers in India entering into partnerships with Zimbabwean
companies
• Zimbabwean funders flooded with proposals from brokers
• Patients have the option to use a broker or not
• Not charging patients but remunerated by hospitals
Arrangements in place for
Comparison of cost of
patients
Drivers
of
treatment
medical
tourism in
zimbabwe
Source of Data
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Medical Funders who are registered with Ahfoz
2012 iFHP Comparative Price Report
Service providers
86% survey response
2012 and 2013 data collected
NB: Heart Bypass Surgery not available in Zimbabwe
Figures could be a lot higher taking into account
• +3 million Zimbabweans in South Africa
• +500,000 in UK
Cataract 433% more expensive in Zimbabwe
Impact– Brain Tumor Excision
Country
Cost
Patients
Total Cost
Zimbabwe
$20,000
20
$400,00
India
$10,000
20
$200,00
Malawi
$10,000
20
$200,00
Saving
50%
Impact– Hip Replacement
Country
Cost
Patients
Total Cost
Zimbabwe
$11,000
20
$220,00
India
$7,000
20
$140,000
South Africa
$9,000
20
$180,000
Malawi
$7,000
20
$140,000
Saving
57% / 22%
236 patients for 2012 and 2013
• SA 18.4% decrease. India 103% increase. India cheaper than SA
*Organs refers to transplants, excisions and organ failures not
otherwise specified
Cardiovascular, cancers & musculoskeletal 85%
Musculosketal increase of 46%. Cancer decrease of 43%. Cardiovascular 38%
India +229%. Malawi +7%. -SA 43%
How has the market received medical
tourism
• PATIENTS: are happy they have choice and can get
affordable treatment that preserves their benefit
• FUNDERS: manage claims costs resulting in better financial
performance
• SERVICE PROVIDERS: want all treatments to be done in
Zimbabwe except for treatment not available. Raise
arguments for post treatment care and externalisation of
funds
• REGULATOR : their position not clear as no comment has
been received from the office
Future of medical tourism in Zimbabwe
• Until such a time as the healthcare delivery system has
normalised, with service providers charging tariffs are in
sync with the region, medical tourism will continue to grow
• It is highly unlikely that there will be strong opposition from
the government or regulator seeing that most government
officials seek treatment outside the country
THANK YOU