Medical tourism came on the heels of global integration, which had pried open national borders for people seeking cheaper alternatives in other parts of the world. Revenues from global medical tourism are projected to reach US$188 billion by 2013. The Philippines aims for a fair share of these earnings by capturing 10% of medical tourist arrivals in Asia which stood at 1.6 million annually, according to 2006 Philippine Manpower Summit Report. These rosy figures would mean generation of local jobs for Filipinos.

The Filipino migrant population, which is growing at a steady rate of almost one million a year, holds promise as a captive market that will serve to the advantage of the Philippines. Filipino-American retirees alone are estimated to reach 3 million by 2020, according to the Department of Health (DOH). Meanwhile, the Philippines may look to the 164,000 Filipino-Americans 65-year-old and above for retiree arrivals, and to the 77,575 Filipino-Americans with disabilities for demand in medical treatment.

How prepared is the Philippine medical and healthcare industry then for balikbayan medical tourist arrivals? Infrastructure development and immigration programs have been taking shape. The Philippine Economic Zone Authority (PEZA) is all set to beef up economic zones with international medical and retirement zones while the Philippine Retirement Authority (PRA) has gone full speed with parallel programs, which include accreditation of retirement facilities and entry privileges for foreigners intending to retire in the country.

At a Quezon City hospital, for example, two balikbayan stroke patients have been undergoing speech therapy sessions. Their insurance benefits in the U.S. thinned out for long-term care, so they decided to come back to the Philippines for cheaper treatment alternatives. Indeed, price differences between treatments in the U.S. and the Philippines can be staggering. “For as little as US$8,500, patients can have knee-replacement surgery in the Philippines, which could cost as much as US$50,000 in the U.S. Other procedures like heart bypass surgery costs only around US$10,000 in the Philippines but ranges from US$ 60,000 to US$80,000 in the U.S,” the Department of Health boasts in its website on the emerging medical tourism industry.

World-class medical and healthcare facilities, however, may not be enough reason for the Philippines to rest on its laurels. India, Thailand, and Malaysia have gone miles ahead, taking top shares in global revenues in 2004, according the Bureau of Local Employment. The PMTP hopes to surmount the challenge by building market interest in the Filipino brand of care that gives premium to warmth and friendliness. Hence, the First Philippine Medical Tourism Convention was held in November this year to launch an aggressive marketing campaign that carried the banner: “Only in the Philippines: Tender Loving Healthcare.” What remains in question, however, is the capacity of local health and medical personnel to take the call.

The outflow effect is the retention rate of 0.58 physicians, 1.69 nurses, 0.11 dentists, and 0.03 pharmacists for every 1,000 in the Philippine population, according to latest data from the World Health Organization. If the Philippines sticks to its medical tourism plan, some 160,000 will arrive in the country annually for treatment and this might further stretch the alarmingly thin supply of local health professionals into collapse. It will be doubly threatening for poorer sick Filipinos who might have to resort to medical quackery if legitimate medical attention skews toward tourists who can afford to pay.

To promote equitable healthcare services and to strengthen the industry, revenues from medical tourism should flow toward human resource development. During the 2006 Manpower Summit, participants recognized the need for improvement in the local supply of health professionals. “Industry players were in unison in highlighting concerns that affect the availability and preparedness of labor supply for medical tourism,” the Summit Report says. Hence, participants in the Summit, which included tripartite partners, made commitments for partnerships in curriculum development, competency standard setting, and skills certification.

Income gaps between health professionals in foreign countries and the Philippines also need attention. The case of nurses makes a strong argument for this. “The basic monthly pay (abroad) is US$3,000-US$4,000 a month compared to the US$150-US$250 that nurses receive in the Philippines,” says Jaime Galvez Tan, former Health Secretary, in his paper The National Nursing Crisis: 7 Strategic Solutions. Salary upgrades and training will therefore prove essential for any human resource development plan for Philippine health professionals. Health funds from medical tourism revenues should pour into these income measures.

Indeed, medical tourism industry is a full-circle moment not only for Filipino migrants but also for the country. This is the essence of circular migration, which brings emigrants back into their country of origin after years of detachment from it. As it was in the past, before diaspora had become a survival strategy for many in the country, Filipinos can begin hoping to start their lives anew on care and attention from fellow Filipinos.