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1. Executive Summary
The demand for healthcare tourism to emerge is inevitable. A huge population
from a variety of ethnic diversities, great economic background, and strong
cultural relationships with other countries has made India a world-leading country
and a force to be reckoned with. In this paper, we will provide a concise overview
that explains what drives the demand of healthcare tourism to exist, and a brief
explanation of why India is a suitable candidate to position itself to become a
leader in healthcare tourism. The SWOT analysis formulated in this essay will
point out the positive factors that encourage the development of the healthcare
tourism sector, as well as the many external/internal hurdles and threats that
India must address in order to uncover potential opportunities that could benefit
the country as a result of promoting the healthcare tourism industry. There are
multiple stakeholders that will be affected by the development of the Healthcare
Tourism industry in India. Directly affected will be internal stakeholders, such as
healthcare professionals, institutions and patients. Additionally, there are also
external stakeholders that will be affected. Successful development of the
Healthcare Tourism industry depends on the creation of a strategic plan that
attempts to solve the major problems of how India can better compete with other
countries, improve infrastructure to meet tourism demand, and position itself in
order to appeal to the most beneficial target market(s). Based on a thorough
review of the challenges for developing India’s healthcare tourism sector and an
analysis of potential alternatives that pertain to promoting the healthcare tourism
in India, the demands of a growing local population and a reputable healthcare
sector lend themselves as key drivers for growth of India’s healthcare tourism.
Therefore, the recommendation proposed maintains the Indian Government must
step in to support the healthcare tourism in any way possible with an eye towards
improving the plight of the Indian people as a whole. Through constant
collaboration between local industry officials as well as officials from the private
healthcare sector the country will be able to organize its leadership position on
three fronts: cost advantage, quality healthcare, and a major tourist destination.

2. OVERVIEW
There has been growing demand for inexpensive, high-quality medical
care due the amount of patients that are not medically covered by their insurance
companies and the heavy growth of baby boomers, which needed extra care
from health centers. Factors that supported the emergence of healthcare tourism
included heavy reliance on out of pocket health expenditure, overburdened public
healthcare system, non-coverage of selected medical procedures, and large
price differentials for health procedures among countries. Many developing
countries such as Thailand, South Africa, and Costa Rica have developed strong,
low cost medical care specialties that are competitively priced compared to those
of United States. India is a very densely populated country with strong economic
influence all over the world. India has also made headlines as one of the top
outsourcing destinations for many multinational corporations. The country’s
revenue’s largely come from its services sector, mostly from its tourism industry.
India should leverage the amount of profits it generates from tourists’ recreation,
leisure, and holiday activities in response to the growing demands for
inexpensive and high quality healthcare in order to attract more foreign
customers.
SWOT ANALYSIS
Strength
Setting up healthcare tourism in India is a marvelous idea, as India has
been known to be one of the top foreign tourists’ destinations. Tourists visit India
to do a variety of recreational activities. India has become the number one
destination country for outsourcing due to its cheaper labor costs compared to
other developed countries. This outsourcing factor has been great for amassing a
greater quantity of stronger connections with other foreign countries. India also
has many accredited private hospitals that offer great hospital services and use

3. top of the line medical equipment at competitively lower prices compared to other
foreign countries, especially United States. Aside from the high-tech medical
equipment and great hospitality, those private hospitals also possess a high
volume of educated doctors and nurses. Since India has a large pool of
educated, English-speaking citizens, it is only natural that they have many
medical professionals in their hospitals that are fluent in English as well.
Weaknesses
While there are many reasons why India should position itself as a leader
in healthcare tourism, there are factors that could ruin its potential if left
uncontrolled. Almost all of India’s hospitals are private, which makes them less
accessible to the eyes of the public. This excess privatization of India’s
healthcare sectors makes it even harder to promote healthcare tourism out there
for the public. India also has very underdeveloped infrastructure. This is evident
by lack of air connectivity to other many nations, unsatisfactory airport facilities,
and bad road conditions that seemed to be the main sources of tourists’
complaints. Another bump on the road is the fact that India faces stiff competition
in the health tourism market from other developing countries that have emerged
before India’s ascent, such as Thailand.
Opportunities
There are definitely some areas that India could foresee as potential
opportunities that could become potential competitive advantages in the
healthcare tourism business. The first one is to add variety of benefit packages
that comes along with customers’ healthcare payment to where they see fit.
These benefit packages could be developed through partnerships with airlines to
make it easier for foreign tourists to travel to India. For example, a benefit
package would be created around a visitor’s healthcare itinerary so he/she does
not have to worry about other factors such as accommodations. India could also
develop partnerships with insurance companies to extend the insurance
coverage for foreign customers. Partnering with more insurance companies could

4. definitely benefit India, since not all foreign tourists are covered by their own
insurance in other countries. Some of those foreign tourists could really use
India’s healthcare and medical coverage, since some of them come from
countries that have healthcare prices that are overpriced, such as those of United
States and United Kingdom. India could also leverage its medical systems and
procedures to comply with international accreditation standards in order to better
compete in attracting more tourists. Another opportunity that could be exploited is
for India to invest in R&D and IT sectors to develop its infrastructure, as the
current infrastructure isn’t exactly up to par compared to other developing
countries.
Threats
Just like in any new business sector that is trying to grow, there are many
hurdles that get in the way for the business sector to achieve success. There are
many healthcare tourism contenders such as: Thailand, Costa Rica, and South
Africa that could pose as threats for India as a newcomer in healthcare tourism.
Most of these competitors have strong Information Technology, and their IT has
propelled their healthcare services as the best in the industry. Another potential
threat for India is the potentially high-cost of traveling from overseas due to the
lack of direct flights to India from developed countries. India has also been
relying on the private healthcare sector to develop the nascent industry
particularly through institutions such as Apollo Hospitals, Wockhardt, and Max
Healthcare leading the charge. The reliance on the private sector is not adequate
due to the overcrowded demands from the baby-boomers and other types of
patients. The last thing that India needs to worry about is the fact that most
tourists see India as a historical and cultural vacation destination instead of a
healthcare tourism center, which is not good if India is trying to position itself as
market-leader in the industry.
Stakeholders Analysis

5. Internal
• Employees: The influx of patients will affect the jobs of doctors and
nurses, who will need to be more organized in order to handle the
increase of patients entering their offices and surgery tables.
 Management: Hospitals will need management that can be reliable and
responsible for accurately developing systems and operations that can
successfully meet tourists demand and increases in patients.
• Development committees: Indian officials will need to plan, develop, and
implement a strategy for the sector of healthcare tourism so that the
supplies can effectively meet the demand and the medical tourists will be
satisfied with their experiences.
• Medical service facilities: Hospitals, spas, alternative therapies, cosmetic
surgery facilities, and additional medical treatment facilities will have to
grow to meet the demand and influx of patient volumes.
• Medial schools: The education system in India will have to increase the
number of doctors and nurses they produce, while also keeping a
commitment to high-rating standards.
• Patients: Indian patients may potentially experience longer wait times for
health services and treatments by specific specialists because of the
increase in (international) patient volumes.
External
• Suppliers: medical equipment suppliers will benefit from their influx in
dependency on their top standard equipment. With more usage, more
equipment will be bought from the suppliers (due to various needs and
replacements).

6. • Government: the Indian government may need to step in and support in
future growth, and infrastructure development, of the healthcare tourism
sector.
• Local Population: Indian locals will be sharing their communities with and
increased number of international tourists.
• Service industry: Air, ground transportation, and hotels that are a part of
the India service industry will need to meet demand of increase in
customers that use their services and expect high customer service.
• Transportation industry: Air and road vehicles will see greater volumes of
traffic due to increased visitors to India. This could cause more than
normal wear and tear to their physical conditions.
• Partnerships: Insurance companies who partner with Indian health
services will benefit from the ability to offer new coverage to certain
customers who may be willing to pay additional premiums for healthcare
tourism coverage.
• Competition: Established healthcare tourism locations will lose market
share and international patients.
• Economy: As healthcare tourism increases, the country will receive more
foreign currency and see a consequent boost in GDP.
Central Issue Statement
In August of 2006 Mr. K.R. Arya, the Director of Overseas Marketing
Division for the Ministry of Tourism in India, was given a task to develop a

7. strategic plan on how to develop India into a major health destination. He
faced major obstacles because he would have to decide on how to address
the issue of competition, infrastructure growth to meet tourist demands,
positioning, and selecting the appropriate target markets.
Major Problems
Primary Problem
 Competition:
 Thailand, Costa Rica and South Africa were already established
healthcare tourism locations, experiencing growth in tourist’s volumes per
year, and increasing in medical service diversity and quality. Also, these
locations provide stiff competition because of the vacation elements they
offer the healthcare tourist.
 The estabished competitive environment could harm India’s ability to gain
strong, competitive, market share in the healthcare tourism industry.
 Infrastructure:
 55% of travelers to India claimed poor road conditions as a criticism of
traveling to India. Also, 30% of long-haul travelers criticize the high cost of
airfare and lack of direct flights to India during their travel. In addition, the
ministry of Tourism, which is the committee responsible for planning how
the India infrastructure will meet the demand of potential and expected
healthcare tourists in the near future, admits to a dependency on the
private health sector to meet these demands while at the same time
doubting the sectors’ ability to meet those demands.
 The weak infrastructure in India could hurt the healthcare tourism sector
image, cause healthcare tourists to choose competitors, and also cause
for India to not meet the demand of tourists and/or deliver the (possible)
promise of high quality care and luxury vacation to its potential customers.

8. Second Problem
 Positioning:
 India is a highly visited location for tourists from long-haul countries and
other locations. It experienced ~25% in foreign exchange earnings form
tourists from 2003-2005. The major reason people travel to India is for
leisure, recreation, to observe and learn the rich cultures, society, and
landscape.
 The current image of a vacation spot excludes the healthcare services. If
India does not transform this image to include that it is a location of
healthcare services for tourists, the full healthcare tourism sector may
dissolve.
 Target market:
 During strategies and campaigns to promote healthcare tourism in India,
the industry and players within (the hospitals), have been targeting various
demographic and geographic markets such as developed and developing
countries, and neighboring as well as long-haul countries.
 Targeting numerous markets could in effect turn the Indian healthcare
tourism promotions into mass marketing, instead of directly targeting the
strongest markets (using targeted messages) that offer the greatest
revenue potential to the country. This could affect the volume of potential
customers.
Significant Factors
 Resources: India has competitive medical service resources of ~500,000
doctors and ~737,000 nurses in their medical system and also produces
~20,000 more per year. They have advanced information technology, which
allows them to offer telemedicine services to patients outside of India. These
strengths can be used to position India as a leading competitor against
Thailand and other established healthcare tourist locations.

9.  Transportation industry: The poor road conditions, airport facilities, and lack
of direct airline connections to long-haul countries, as well as the high cost of
airline travel from around the world to India could harm India competitively as
they attempt to become a leading location for tourists to receive medical
treatments for life threatening illnesses.
 Facilities and equipment: India has high-quality medical facilities (78% of
which are private) and equipment. It has accredited hospitals and has
decreased trade tariff import duties ~20% to enable a plethora of state of the
art US medical equipment to enter India. Its major private hospital, Apollo
rd
hospital, is the 3 largest hospital in the world. Apollo provides healthcare
tourism concierge services (airport greeting, registration, discharge, and post
treatment travel arrangement services), and partners with US health
insurance companies. These factors will allow India to position itself as a
leading quality medical service provider and target the developed, long haul
market.
th
 Prices: Medical treatment in India is 1/6 price that of developed countries.
This economic factor will positively allow India to target developed markets
and compete with the potential patient’s home country medical system.
 Marketing: Private hospitals in India have been marketing independently to
health tourists. They have been offering different specialties to target
audiences. This initial beginning could enable easier development and entry
for India as a medical tourist location, but could also cause for potential
confusion in the marketplace as India attempts to standardize and
strategically carry out a comprehensive marketing program for their
healthcare tourism sector.
 Organizational structure: 78% of healthcare services in India are privatized,

10. which could hamper the ministry of tourisms ability to control the development
necessary to meet health tourist’s demands.
 Tourism: India experiences a large volume of international tourists from both
developing and developed countries, but ~30% more from developed
countries. Visitors tend to stay in India for longer durations (roughly 7-18
days) than the average 16 days that vacationers stay in other countries during
vacation. This trend will enable India to more easily target its healthcare
services to developed markets.
 Language: India has a large population of English speakers so it is a large
factor affecting the choice of destination for tourists visiting India. This
commonality will strengthen India’s position as a competitor in targeting US
and UK patients against other medical tourism locations that do not as widely
speak English.
 Products and Services: The Indian medical system offers a high volume of
different and popular medical services carried out by specialist and super
specialists, such as open-heart surgery, pediatric heart surgery, hip and knee
replacements, cosmetic surgery, dentistry, bone marrow transplants, and
cancer therapy. This diversity in service offerings will strengthen India’s
ability to position, compete and target certain markets.
 Image:
1. India is seen as a vacation location for travelers to experience leisure,
recreation and also learn about and experience a rich culture and
landscapes. Transforming this image to include healthcare services for
tourists could be a challenge on deciding how to position itself.
2. The Indian medical system has a great reputation built from receiving

11. accreditations for training centers, hospitals, research and PhD programs.
In addition, India has experienced success in major surgeries, meeting
international standards and lower than average rates of mortality and
infection due to medical treatments. This high standard image will offer
India the ability to position itself as a strong medical services location and
compete against other medical tourism locations.
Evaluation of Alternatives/Recommendation/Implementation
Alternatives (1 or 2 or 3):
1. India tourism agency should work in collaboration with the private
hospitals to target their services through separate market segments to
attract visitors from both developed and developing nations.
OR
2. Given India’s good reputation for delivering quality healthcare, India
should leverage its tourism potential through partnerships with European
and US tourism boards to offer comprehensive travel packages and
position India as a land of enchantment and a place to holistically improve
the mind, body and soul.
OR
3. India tourism Ministry could establish a medical tourism committee
comprised of officials from the Ministry of Commerce, Ministry of Public
Health and the major private healthcare institutions to develop a
comprehensive marketing framework to leverage the country’s low cost
advantage, its quality of healthcare services, and vacation aspect.
Marketing planning opportunities
Networking

12. • Insurance companies with foreign healthcare providers and multinationals
• Promotions through professional meetings and medical conferences
• Government web-based bulletin boards for the latest in healthcare
developments in India
Publicity
• Publicity events – Government projects, partnerships
• TV/Radio – World wide cable networks
• Press Releases – Government, insurance companies, healthcare
institutions
Advertising
• Newspapers
• Magazines
• Sponsorships
• Web
Cross-Promotions
• Giving discount coupons/certificates to a complementary business such as
travel
• Co-sponsor special events and promotions
• Co-sponsor with non-profit organizations
Recommendation/Basis for Recommendation
Recommendation:
India tourism Ministry should establish a medical tourism committee
comprised of officials from the Ministry of Commerce, Ministry of Public Health
and the major private healthcare institutions to develop a comprehensive
marketing framework to leverage, and promote, the country’s low cost
advantage, quality of healthcare services, and vacation aspect.

13. Basis for Recommendation:
In order to capitalize on India’s success in healthcare sector, the country
must garner public support in order to incentivize the Government to implement
project initiatives pertaining to improving people’s negative perception of India’s
public hygiene and facilities such as airports, hotels, and roads. By establishing
an association between government agencies and private healthcare institutions,
the Government will be in a position to better understand the needs of the
healthcare tourism industry and leverage that with the needs of its local
population in an effort to stimulate the local economy. As infrastructure
improves, it will enable India to position as a vacation location that also offers
healthcare services. This will open doors to directly target developed, and long
haul, markets who benefit from the low cost of healthcare tourism, and also be a
strong leader against competition in the industry.
Implementation Strategy:
The newly formed sub-committee will develop a three-pronged marketing
approach based on three types of medical tourists: Foreigner’s coming especially
for treatment, foreigner’s coming for treatment and leisure, and expatriates. For
those coming specifically for treatment, the government should implement
uniform policies in order to satisfy international accreditation standards in order to
facilitate the medical process. For those coming for treatment and leisure, the
Government should offer comprehensive vacation packages in order to mitigate
the costs from airfare and accommodations. Lastly, for expatriates, the
Government should implement policies that ease regulations between insurance
companies and multinationals to ensure they can also benefit from India’s vast
array of medical services.
Contingency Plan:
Best-case scenario

14. India’s GDP will increase to levels never seen before as a result of India’s ability
to market its healthcare tourism industry across national boundaries.
Worst-case scenario
Healthcare tourism remains dominated by the private sector and does not
materialize into the next big success story of India due to India’s weak
infrastructure and the Government’s lack of public support for the industry.