Medical tourism

Medical tourism (의료관광/醫療觀光) refers to such services typically sought by travelers as include specialized surgeries like joint replacement (knee/hip), cardiac surgery, dental surgery and cosmetic surgeries. However, virtually every type of health care, including psychiatry, alternative treatments, convalescent care and even burial services are available.

Medical tourism is also called "medical travel", "health tourism" or "global healthcare". Korea like more than 50 countries has identified medical tourism as a national industry.

During the past few years, Korea has seen the number of foreign patients visiting Korea soaring at an annual rate over 30 percent since 2009. It is said that attracting three to four patients with serious illnesses creates a comparable economic effect to exporting a Hyundai Sonata.

Key words
medical tourism, global healthcare, foreign patient, hospital, medical tourism agent

Legal Background
It was as early as in 2000 that the government policy-makers were interested in medical tourism. In the early 2000, the Ministry of Health and Welfare reported health tourism as one of the strategies to make Korea one of the Top 10 Advanced Countries in health industries.

As a result, the medical tourism was provided in the Tourism Promotion Act (관광진흥법), which became effective on September 25, 2009, and related regulations. Also the Medical Services Act allowed medical tourism for the first time in the admendment in 2009.

In the international scenes, under the General Agreement on Trade in Service (GATS, 서비스무역 일반협정) of the World Trade Organization, medical tourism, medical travel, global healthcare belong to Mode 2: consumption abroad.

Global healthcare in Korea
In January 2009, Korea adopted global healthcare as a new engine industry powering economic growth and overall activities to “attract foreign patients” based upon the newly-amended Medical Services Act in May 2009. In this regard, Korea’s global healthcare policies and legal framework have some problems to be improved. They will be discussed as explained below by reviewing relevant legal concepts, trends and administrative issues in global healthcare.

Some Suggestions
(a) The two terms, “medical tourism” and the “inducement of foreign patients (global healthcare)” may be used interchangeably. However, when legal problems arise, medical issues shall be handled within the scope of medical practices under the Medical Services Act (hereinafter the "Act") while other issues are subject to separate legal decisions.

(b) Currently, general hospitals are permitted to admit foreign patients, up to 5% of their total number of beds (Art. 27-2(5) of the Act). However, such restrictions are expected to be lifted as market principles are applied to global healthcare.

(c) Registration requirements for global healthcare medical institutions and businesses that facilitating foreign patients shall include the employment of at least one customer supporter (global healthcare coordinator), who has completed an annual mandatory 8-hour training course on healthcare laws, immigration procedures and general affairs (specialization of global healthcare professionals).

(d) Due to the advent of the internet and borderless medical travel, legal systems must be revised (Art. 40 Enforcement Decree of the Act) to permit all global healthcare medical institutions and business to post medical advertisements, to abolish domestic advertisement restrictions, and to use foreign languages, body parts and disease names within the names of medical institutions.

(e) A medical tourist visa was introduced on May 11, 2009, to simplify visa application procedures (C-3-M: 90 days, G-1-M: one year documents to submit: a copy of previous medical records financial statements to guarantee the costs of treatment and proof of a medical appointment in Korea).

(f) In general, medical treatment agreement is considered a delegation, but it is reasonable to view medical travel as a subcontract because of the existence of preconditions and inducement activities. Therefore, medical treatment agreements shall be written in foreign languages and explicitly express the aforesaid matters before being filled out, explained and signed (including the duties of patients, terms for guardians, applicable laws and jurisdictions, medical dispute resolution procedures and CP).

(g) It is necessary to provide medical cost estimates during consultations and to standardize international medical fees for researching and comparing for reasonable cost (examinations, in-patient care, insured treatments, uninsured treatments, pharmacies, material costs, and commissions) based on medical examination fees and per treatment fees in competing countries.

(h) Inducement of agreement in medical disputes involving foreign patients → full application of the Medical Disputes Mediation Act → In order to increase efficiency, the forms of mediation shall be included in the medical contract, or shall be induced, and applicable laws and court jurisdictions should be decided after reviewing the advantages and disadvantages of each country’s medical litigation system.

(i) After departure from Korea, it is necessary to provide post-treatment care and services, such as issuing medical documents written in foreign languages at the time of discharge (Art. 17 of the Act), referral agreements with local hospitals (and doctors), remote medical examinations, and U-Health (Art. 34 of the Act).

(j) Based on case studies in leading countries and analyses of the economic effects of for-profit hospitals aiming to provide global healthcare, it is advisable to introduce for-profit hospitals only within the Free Economic Zone and Jeju Self-Governing Province as the forerunners of global healthcare.

Medical Tourism Hotel
In November 2013, the Korean government amended the Enforcement Decree of the Tourism Promotion Act to allow big hospitals and/or medical tourism agents to operate large or small medical tourism hotels, or "meditels", for the convenience of foreign patients and their guardians.

In addition, Korean doctors who have pulished sophisticated clinical treatment methods on the medical journals are easily searched via Google and visited by foreign patients all over the world. For an instance, an eye doctor named Dr. Ji-won Kwon has developed a unigue solution to erase a nevus (오타모반) from the white of the eye and published her article on a U.S. ophthalmologistic journal several years ago. Recently Dr. Kwon working at a hospital at Goyang City, Gyeonggi-do has been very busy to answer via e-mail many questions from foreign patients suffering birthmarks of their eyes, who have sought her article through Google. So far nearly a dozen patients were treated by Dr. Kwon with satisfaction.