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Analysis

Taking on Tijuana: Medical Tourism Beyond the Border

Sat, 09/05/2015 - 13:11

The national government of the world’s second most popular destination for medical tourism is beginning to recognize the potential future worth of an industry which contributed an estimated US$4.2 billion to the country’s GDP in 2013, according to Mexico’s Ministry of Economy. Should the General Law of Medical Tourism pass Senate as expected later this year, the industry’s tighter promotion and regulation will no doubt boost the trustworthy reputation of Mexican health services in the eyes of foreign travelers. With a number of recognized templates available to travel agents, package deals can only be expected to proliferate.

Mexico’s medical tourism centers fall into three categories: border towns such as Mexicali and Tijuana, accessible urban centers such as Guadalajara and Monterrey, and established tourist destinations like Yucatán and the Rivera Maya. The first and third categories seem to have an existing center of gravity that draws medical tourists to their wards in huge quantities, but centers such as Chihuahua may benefit from a catalyst to stimulate latent potential.

TIJUANA: MODEL CITY

Tijuana straddles two of these categories. Billed as “the world’s most-visited city” its position in the American consciousness as an affordable getaway destination is unassailable. However, its medical practitioners are also world-class, leaving the city poised to turn its reputation and tourist infrastructure into a solid medical tourism offering. According to the Baja California health cluster chief, Dr. Karim Chalita Rodríguez, medical tourism is worth US$500 million to Baja California. Within Baja California, Tijuana has found a secure niche. When surveyed, medical tourism was the second most reported reason for visiting the city, with an average of 500,000 patients arriving annually as stated by Baja California’s Ministry of Tourism. By offering cosmetic procedures not commonly covered by US health insurance procedures at much lower prices, for example gastric pliation, a US$20,000 treatment, costs US$7,500 in Hospital Ángeles, hospitals can become very appealing.

The key to Tijuana’s success hinges on accessibility. Since Tijuana is only 15 minutes’ drive across the border from San Diego airport, this city leads the way for medical tourism in the country. The possibility of a footbridge between San Diego and Rodríguez International Airport in Tijuana has even been floated since November 2014. Indeed, accessibility occasionally becomes congestion. With 300,000 US citizens crossing the border at this point every day, according to US. Customs and Border Patrol, the city’s tourist board borrowed the model of Mexicali’s medical tourism lane – in operation since April 2012 – to speed up wait-times in crossing the border at San Ysidro. Passes issued by tourist officers and confirmed by doctors as part of consultations cut waiting times crossing the border from three hours to 20 minutes. Pick-up and drop-off services offered by some hospitals extend over the border to San Diego airport. The city’s push for excellence in care staff and hospital equipment has also seen Tijuana shake off its reputation as a low-cost version of US care, flooded with backstreet liposuction surgeries and imitation-brand pharmaceuticals. Hospital Ángeles, a US$60 million facility boasting 122 beds, treats around 1,500 US patients per year. The hospital’s care staff is generally bilingual, and, has lengthy experience practicing north of the border.

A drop in prices no longer means a dip in quality. While medical training is just as rigorous in Mexico as the US, costs for drugs, dental care, and consultation tend to be between 70-80% lower than they are in the US, according to figures collated from a number of hospitals. The state’s Ministry of Tourism is cognizant of its importance to the sector, offering financial support to non-profit organizations coordinating and promoting medical tourism. Medical centers in Tijuana are mainly located off the main drag, but remain central, located in upscale neighborhoods. According to The Wall Street Journal, 80% of patients who attend Médica Norte are from the US.

Baja California’s health cluster leader, Dr. Chalita, cites health tourism figures which leapt 20% between 2012 and 2013, but warns that the city’s status is precarious. Perceived insecurity and foreign tourism are inextricably linked. Baja California’s homicide rate dropped from 1,528 in 2010 to 58 in 2012, according to INEGI and the city’s health tourism surged the following year. The US State Department travel warning for Baja California has not deterred health tourism so far this year, but a spike in violence from March onwards may well have a negative influence on Tijuana’s medium- term status as a medical tourism destination. It is too early to predict whether recent violence is merely infighting between splinters of the Tijuana cartel, or if it is indicative of newer, larger groups moving in on the territory from the south, nor exactly how this will affect health tourism.

POTENTIAL RIVALS

Some border cities are better prepared than others and may try to muscle in on the market Tijuana dominates. Mexicali’s health tourism board, for instance, reports that the sector earned US$16 million in 2010 from medical tourism. Now its tourist board is seeking to double that figure in the short term, coordinating a seven-hour, US$30 round trip from Las Vegas. Since April 2012, a return pass issued by tourist officials quickens the trips back across the border. The Mexicali option appeals particularly to underinsured pensioners seeking one-off dental treatments, and, after notable successes in recent years, the tourist board is targeting Latino communities in the Coachella Valley and Phoenix. Mexicali knows its market, since 15.7% of all Nevadans are uninsured, as reported in a 2014 Gallup poll. The rhetoric of Mexicali’s tourist board bills that city as a quieter, slower-paced Tijuana, tailoring its sales pitch to an older demographic.

Accessibility and tourism together are not the only answer, however. While Chihuahua’s JCI-accredited Cumbres is collaborating under the Medical City non-profit umbrella, it has failed to become a center of gravity in the same way that Mexicali has. The city is a potential rival to Mexicali, since it boasts 40 specialized fields. Chihuahua’s hospitals have effectively targeted the lucrative US market in aesthetic surgery, obesity, assisted reproduction, angiology, and orthopedics. Chihuahua is three hours’ drive from El Paso, and only two hours from Dallas. Meanwhile, Copper Canyon’s national parks and enormous biodiversity make the destination an established point in the Mexican tourism atlas. The effectiveness of Chihuahua’s marketing strategy, however, and the impression many US travelers have that the city is “too far off the beaten track” conspire against it. Moreover, with Chihuahua able to rely on the mining and automotive industries, promoting medical tourism could not be a commercial priority.

LATENT POTENTIAL

In contrast, Leon, further south in the state of Guanajuato, has proven far more successful in marketing its medical tourism offering. The city is considered a tourism hub because of its safety, cultural capital, and a traditional center for leather goods production. Considered to be Mexico’s best planned city, local government officials have published reports on how to shape infrastructure around medical tourism. A campus of Tecnológico de Monterrey is located in the city, and hospitals have closed ties with 14 other higher-level institutions, such as UNAM’s Odontology Faculty. Accessible via national highway from Mexico City, Leon requires only a slight marketing push to open it to a global market.

Jalisco is another example of a medical cluster on the verge of a breakthrough. State capital Guadalajara, for instance, is smaller than Mexico City, but its network of over 9,500 medical professionals is only slightly less than the total number practicing in the country’s capital. The city’s 200 private medical centers perform an average of 66,000 interventions per year as stated by the Global Delivery Report. The city’s agreeable climate, culinary and cultural reputation, and its closeness to beaches like Puerto Vallarta and Sayulita mean that Guadalajara can potentially bill itself as a destination combining surgery with vacations. Mexico’s Ministry of Tourism posted figures of 600,000 visitors to Guadalajara last year, up 20% on 2013. A possible angle is the “baby boomer” market. For a large proportion of the 1.5 million US and Canadian citizens living in Mexico, medical treatment is a significant factor in relocation.

EXISTING INFRASTRUCTURE

Mayan Riviera destinations have followed the Tijuana model and interconnect medical tourism with their existing vacation grid. Two chains, Amerimed and Hospiten, specialize in locating high-quality medical care in a tourist destination. Hospiten has branches in Cancun and Playa del Carmen, while Amerimed operates in a number of beach resorts around Mexico. Recognized neurosurgical, assisted fertility, and oncology clinics all operate in the area, but dental and orthodontic care is the primary draw to medical tourists. Dentistar and Coral Dental Care offer mainly aesthetic dental treatments and surgeries to patients and Hospital Galenia, located next to the Four Points Sheraton hotel in Cancun, is an image indicative of the crossover between tourism and medical care, which is becoming the norm in this area.

SHAKING OFF TROUBLE

In one sense, Nuevo Laredo’s health cluster, run by the state’s Ministry for Development and Tourism, indicates how aggressive marketing and an established reputation can outweigh an area’s notoriety for insecurity. For instance, US and Canadian patients have worn a path to Villa de Nuevo, in the Rio Bravo municipality, over the past 30 years. Despite a year of intense violence leading to travel alerts for US citizens, hotels continue to report high occupancy rates, which indicate that mainly Texan medical tourists continue to cross the border through Brownsville, to avail of health costs which can total between 40-70% less than in the US, according to a study of hospitals in the area. A great many medical services offered in the city are covered by US insurance policies. Nuevo Laredo is only nominally a medical tourism destination, while the city has extensive museums and ecological parks, Nuevo Laredo’s proximity and quality care are the main attractions.

Reynosa has also united 560 doctors, pharmacists, and clinical laboratories since 2011, with referral and promotion services drawing Rio Bravo, Matamoros, and Nuevo Laredo into a medical tourism cluster that runs along the US border. Twice daily, public transport service routes cross the Reynosa-Hidalgo international bridge, bringing an estimated 1,200 South Texas medical patients across the border every month. Odontology is the major draw, with 30,000 consultations per year. The sector generates about US$1.5 million per month, according to the Tamaulipas Ministry of Economic Development and Tourism. About 103,000 consultations annually come under the heading of “medical tourism,” with this expected to grow in the short term.