In San Juan del Sur, there are plans for a new kind of hotel. It will boast 61 rooms, foreign chefs, ocean-view rooms, a four-star rating, and a whole floor dedicated to medical treatment for its guests. Speaking at this month’s Central American Advantage Conference in Managua, the owner of the proposed medical resort, Nelson Estrada, told the audience that his development will be the first of its kind in Nicaragua.
“No one else is offering this,” he said.
If Estrada can get the necessary investment, he says work will begin on “Solest MedResort, Hotel and Spa” by August and the project would open in 2015. Once completed, the medical resort will offer clients a boutique hotel and an extensive range of medical procedures all under one roof. The medical resort will specialize in elective cosmetic surgery, but Estrada hopes to expand available treatments in the future.
The planned development is just one aspect of Nicaragua’s growing participation in the global medical tourism industry. Medical tourism is defined as the process of travelling from a highly developed country to a lesser-developed country for more affordable medical treatment.
While medical tourism has become increasingly common in more developed neighboring nations such as Mexico, Costa Rica and Panama, the industry is still inchoate in Nicaragua.
Competing with Costa Rica
Arlen Perez, manager of medical tourism at Managua’s Hospital Metropolitano Vivian Pellas, says there are a “limited number of places equipped for this industry within Nicaragua.” In the capital, only Hospital Metropolitano and Hospital Central are actively promoting themselves as medical-tourism options for foreign travellers.
Hospital Metropolitano, the country’s most modern health facility, says Nicaragua is ready to give Costa Rica a run for its medical-tourism money.
“Nicaragua has the same elements as Costa Rica to make medical tourism a success: safety, quality of doctors, logistical convenience—we are in the center of the Americas—and experience,” said Perez.
But Nicaragua has the added benefit of being less expensive than Costa Rica.
“The price is the most attractive reason for medical tourism here,” Perez said. For example, she says, a full annual check-up that includes blood tests, x-rays, cancer screens, an electrocardiogram, and much more, would normally cost upwards of $3,000 in the United States. In Nicaragua, it costs a little under $420, and is even less expensive for patients under 40. For most surgeries and medical procedures, healthcare in Nicaragua costs 70-80% less than it does in the United States, she says.
In addition to the reduced costs, various health insurance providers in the United States and Canada will cover medical bills in Nicaragua.
Inexpensive healthcare does not mean cheap treatment or poor facilities. The Joint Commission International, an internationally recognized authority for hospital standards, accredited the Hospital Metropolitano in 2010, making it the first recognized hospital in Nicaragua and the fifth in Central America. Many of the doctors who work at Hospital Metropolitano were trained in the United States and are bilingual.
Medical tourism: a booster shot for the travel industry
According to Helen Korengold, author of the book “Medical Tourism Nicaragua,” the industry is still in its “infancy” compared to services provided in neighbouring Costa Rica, Mexico, Panama, and even Guatemala.
In 2011, the medial tourism industry in Costa Rica netted $400 million—more than Nicaragua’s entire tourism industry generated in revenue that year.
While Nicaragua has no statistics for medical tourism revenue, anecdotal evidence from Perez indicates that most of Hospital Metropolitano’s foreign clientele are expats who reside in either Managua or Granada. Most of the hospital’s foreign patients are from North America, and the most common form of treatment is dental work, orthopaedic and cosmetic surgery.
But as the tourism industry grows in Nicaragua, Perez is confident the hospital will soon reach its target of 50 medical tourists per month. To put that in a regional perspective, Costa Rica receives about 40,000 medial tourists per annum, up 25% in the past three years alone.
To catch up to its southern neighbour, Nicaragua needs more hospitals that can cater to medical tourists and a coordinated promotional campaign, Perez says. But Nicaragua is making a serious effort.
“The government has been 200% behind us,” Perez said. “They come with us to international medical tourism symposiums, and they want us to work as a country instead of as individual hospitals.”
The Nicaraguan Tourism Board (INTUR) is currently helping Nicaraguan hospitals to create a national association for the promotion of medical tourism.
So far, however, Nicaragua lacks the type of medical tourism infrastructure that allows Costa Rica to offer all-inclusive medical tourism vacation packages.
Is medical tourism a drain on healthcare?
While Nicaragua’s top doctors and medical facilities cater increasingly to foreign patients, some wonder about the impact on the average Nicaraguan hospital and the type of services available to those who can’t afford to be medical tourists.
According to Perez, medical tourism will increase tourism revenue and encourage other local hospitals to “try to be better and keep higher standards to compete with us.”
But studies from other countries with medical tourism industries show the opposite can also happen. A study funded by the World Health Organisation entitled “The effects of medical tourism: Thailand’s experience,” found that “foreigners’ demand for health-care services could undermine local patients’ access to quality health care” by luring highly skilled physicians and specialists out of the public and teaching hospitals and relegating most Thais to “health-care services of lesser quality.”
Another study, published in 2010 in the International Journal for Equity in Health, reached similar conclusions.
“The argument that destination countries should view investment into technology-intensive infrastructure for medical tourists as beneficial is undermined when the types of services being offered by hospitals are contrasted with the pressing health care needs of the local population,” the report said. “This contrast is all the more troubling when public money that could be used for wide-reaching, inexpensive primary health care initiatives is used to incentivize private investment into expensive tertiary care with a more limited impact.”
While medical tourism will undoubtedly provide an added value to Nicaragua’s steadily growing tourism industry, the challenge will be to manage that growth in a way that’s sustainable and beneficial to the country, without excluding the many to benefit the few.
Editor’s note: the statistics in the tenth paragraph have been corrected. Healthcare costs in Nicaragua are 70-80% less expensive than they are in the United States.