Observing the Trends: Southeast Asia Competes for the Medical Travel Pie, Is Singapore's Leading Advantage No Longer? | Lianhe Zaobao
With the booming development of the global medical tourism industry, Singapore has previously held a leading position due to its high-quality medical services and multilingual environment. However, the rise of countries such as Malaysia, Indonesia, Thailand, and Vietnam, especially with their price advantages, has put pressure on Singapore. Although the quality of medical services in Singapore is still recognized, its advantages in the Southeast Asian medical tourism market are gradually weakening
About half a year ago, Indonesian building materials businessman Bayu Santoso (54 years old) decided to follow the advice of Indonesian doctors and undergo coronary artery formation surgery due to worsening angina.
Santoso learned that surgeons in Singapore and Malaysia had better reputations and superior service quality, so he contemplated choosing between the two countries.
In an interview with Lianhe Zaobao, he revealed that he once contacted a medical service consulting agency in Indonesia to understand the differences in medical costs between Singapore and Malaysia.
The consultant said that the cost of surgery in a private hospital in Malaysia is about $8,000 (approximately SGD 10,383); the fees charged by private hospitals in Singapore exceed $12,000.
Despite the significantly higher costs in Singapore, Santoso ultimately decided to come for treatment, stating, "Both the doctors and consultants said that overall, the quality of medical services in Singapore hospitals is better. After some consideration, I still chose to seek medical care in Singapore."
Santoso's cross-border medical treatment can be classified as medical tourism. In addition to surgical procedures, the medical services sought by patients generally include cancer treatment, orthopedic surgery, cosmetic surgery, fertility treatment, dermatological aesthetics, and dental aesthetics.
Looking at Southeast Asia, Singapore is the first economy to lay out a medical tourism industry, launching the "Singapore International Medical" (SingaporeMedicine) initiative in 2003, integrating resources from various government departments and industries to make Singapore a leading medical tourism hub in Asia, with a goal of serving 1 million foreign medical tourists annually by 2012.
Twenty-two years later, Singapore's medical tourism industry is now filled with "internal and external troubles." Even with more medical tourists like Santoso favoring the country, it is difficult to hide the relative disadvantages of this industry locally.
In the past, many were concerned that a large influx of medical tourists would drive up medical costs, including leading to fierce competition for healthcare personnel between public and private hospitals.
In 2015, the Singapore Tourism Board stopped publishing separate data on the number of medical tourists and the revenue contributed by the medical tourism sector. According to a study by Singapore Management University, Singapore's medical tourism revenue in 2012 was SGD 1.11 billion.
In 2018, the Ministry of Health began to restrict public hospitals from engaging in medical tourism activities. The following year, then-Minister of Trade and Industry Chan Chun Sing also confirmed in a written response in Parliament that medical tourism is not part of Singapore's tourism strategy.
Illustration by He Hancong
High Local Medical Costs Deter Some Tourists
Beyond policy resistance, high medical costs hang like a sword over Singapore's medical tourism industry.
According to Patients Beyond Borders, the costs for patients seeking medical care in Malaysia and Thailand are, on average, 60% to 75% less than in the United States; in contrast, Singapore's costs are only relatively cheaper by 30% to 35%
The costs of various medical services in Singapore are significantly higher than in other Southeast Asian economies. According to a report by Industrial Securities, the cost of knee replacement surgery in Singapore is at least USD 12,000, while in Malaysia, Thailand, and Indonesia, the costs range from USD 598 to USD 10,000; for cosmetic facelift surgery, the cost in Singapore is about USD 7,500, while in Malaysia, Indonesia, and Thailand, the costs range from USD 1,350 to USD 2,400.
Strong Singapore Dollar Weakens Medical Tourism
In an interview with Lianhe Zaobao, the president of Singapore Medical Group, Meng Deliang, stated that the strong performance of the Singapore dollar over the past five years has undoubtedly weakened the affordability of Singapore's medical services for some overseas patients.
He also revealed that rising rents for medical facilities have further contributed to the increase in medical service costs. "If operators pass on the costs to patients, it will further weaken our competitiveness."
Shekhar Jaiswal, head of equity research at UOB Kay Hian, also mentioned in an interview: "High operating costs and a strong Singapore dollar have weakened the competitiveness of Singapore's medical tourism industry. Price-sensitive patients will prefer lower-cost economies like Malaysia and Thailand."
Additionally, Meng Deliang candidly stated that attracting and retaining medical talent in Singapore is not easy, including specialists, healthcare professionals, rehabilitation therapists, nutritionists, and psychological counselors.
According to predictions by the World Health Organization, by 2030, the global shortage of healthcare workers could reach up to 78 million.
Meng Deliang continued to point out that as global demand for highly skilled medical professionals continues to grow, the competition for talent is becoming increasingly fierce. "High-quality medical professionals are the cornerstone of success. To maintain competitiveness, our country should invest more resources in education, training, and professional development to build a sufficient pool of medical talent."
Regional Countries Eyeing the Market, Each with Unique Strategies
Meanwhile, Southeast Asian countries are eyeing the medical tourism market and actively competing for a share.
In Malaysia, for example, the country has climbed the ranks in the medical tourism sector over the past decade, leveraging its multilingual environment and decent medical quality. Penang, located in the northern part of the peninsula, attracts many wealthy medical tourists from Indonesia due to its proximity to Medan.
According to data from the Malaysia Healthcare Travel Council (MHTC), Malaysia's medical tourism revenue reached 1.3 billion ringgit (approximately 401.13 million Singapore dollars) in 2022, a 116% increase over ten years.
The newly established Johor-Singapore Special Economic Zone (JS-SEZ) this year has further attracted domestic and international medical enterprises such as Thomson Medical Group, Q&M Dental, KPJ Healthcare, and Columbia Asia, further strengthening Malaysia's medical tourism industry Indonesia is also not to be outdone, developing a comprehensive medical tourism project in the Sanur Economic Zone in Bali, which includes international hospitals, multiple specialty clinics, and medical research centers. The Indonesian government estimates that the project could attract 120,000 to 240,000 domestic and foreign patients annually, significantly reducing the number of Indonesians seeking medical treatment abroad.
Indonesian Health Minister Budi Gunadi Sadikin confidently stated that the potential for Indonesia's medical tourism could reach $84 billion, coupled with the fact that Indonesians spend an average of $10 billion annually on overseas medical services, thus Indonesia needs to adopt a multi-faceted approach to develop this industry.
According to industry research firm Imarc, the market size of Indonesia's medical tourism industry reached $1.73 billion last year, and it is estimated to soar to $9.68 billion by 2033.
Data from reputation and policy management consulting firm Sandpiper indicates that Indonesia is the largest source of medical tourists for Singapore, accounting for about 60% of the total number, so Indonesia's upward momentum inevitably poses a threat to our country.
Thailand is also not to be outdone, offering various incentives with one hand, such as exempting corporate income tax and import duties, simplifying regulatory procedures, etc., to attract more medical equipment companies to settle in and create a complete medical ecosystem; with the other hand, it has launched a new visa category that allows medical tourists holding Destination Visa (DTV) to enter multiple times, with a maximum stay of 180 days.
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According to data from American market analysis company Grand View Research, the market size of Thailand's medical tourism in 2023 is $2.57 billion, and it is expected to see a compound annual growth rate of 10.49% from 2024 to 2030 Vietnam has rapidly risen due to its low prices and improving medical quality year by year. According to data from the Vietnam National Administration of Tourism, the number of medical tourists visiting Vietnam has grown by about 12% annually from 2017 to 2024, mainly from economies such as South Korea, Japan, China, Cambodia, and Laos. Currently, the medical tourism industry generates approximately USD 2 billion in revenue for Vietnam each year.
Our country focuses on high-difficulty treatments and seeks breakthroughs through quality rather than quantity
In the face of fierce competition, can Singapore's medical tourism industry break through?
Wang Junli, CEO of Concord Medical Group, stated in an interview that our country should no longer compete for the affordable medical tourism market but instead position itself as a hub for complex and high-difficulty medical services.
"Singapore's main advantage lies in having specialized talents capable of handling complex cases across fields such as oncology and proton therapy. For patients seeking cutting-edge services, our country remains a recognized regional leader."
Rather than viewing it as competition, Wang Junli prefers to see the development of medical tourism in Southeast Asian countries as mutually beneficial. For instance, as regional medical service options and reputations rise, attracting more medical tourists, our country will also benefit from this growth.
Prem Kumar Nair, CEO of IHH Healthcare, shares the same view.
In an interview, he mentioned that the group's hospitals in Singapore are moving towards complex and high-value services such as oncology and neurology. "Since we cannot compete on price, we must continue to improve our medical standards."
IHH Healthcare's hospitals are enhancing the accuracy of computed tomography (CT) scans through artificial intelligence technology. (Provided by IHH Healthcare)
Local groups are going overseas to seize market growth dividends
Seeing the booming global medical tourism opportunities, many Singaporean medical enterprises are also "going overseas."
Concord Medical Group invested approximately SGD 500 million in 2023 to acquire FV Hospital in Ho Chi Minh City, Vietnam, marking the largest healthcare acquisition in Vietnam's history. Currently, the group is also developing the Thomson Iskandar medical hub in the Johor Bahru economic zone, with a total development value (GDV) exceeding SGD 5.5 billion.
Concord Medical is owned by billionaire "stockbroker king" Lin Rongfu. The group chairman is Huang Simian, and the executive vice chairman is Lin Rongfu's son, Lin Weijie
Kangsheng Medical Group invested 500 million yuan to acquire FV Hospital, marking the largest healthcare acquisition in Vietnam's history. (Provided by Kangsheng Medical Group)
According to Wang Junli, the Johor project benefits from the growing regional demand and the transportation convenience brought by the new Johor-Singapore Rapid Transit System (RTS).
Singapore Medical Group has extended its footprint to Indonesia, Australia, and Vietnam.
Meng Deliang stated that the demand for high-quality medical services in these economies is continuously rising. "By exploring emerging markets like Vietnam and Indonesia, we hope to attract patients who originally considered seeking medical treatment in Singapore, allowing them to enjoy world-class medical services on par with Singapore in these emerging economies."
Going overseas is undoubtedly profitable, but it does not mean it will be easy, as competition is equally fierce.
Strong Local Players Make It Difficult for Our Enterprises to Break Through
Taking Malaysia as an example, the Columbia Asia Group and local healthcare giant Johor Healthcare have already established a solid foothold; the Indonesian market has strong players like Bali International Hospital and Sanglah Hospital.
Seka observed that most economies with strong demand have local players holding significant market shares. If our enterprises do not make substantial investments or develop differentiated strategies, they will face difficulties.
Additionally, companies must also deal with operational challenges. Seka cited the example of Raffles Medical Group's operations in China, stating that building new hospitals overseas often faces initial operational losses and delays in regulatory approvals. "Companies will also be limited by a shortage of talent."
Wang Junli admitted that the aforementioned operational challenges are unavoidable, which is why Kangsheng Medical Group is particularly cautious when expanding into new markets, ensuring a deep understanding of the local medical environment, patient preferences, and social culture before making decisions.
Analysis: Layout in the Chinese and Vietnamese Markets, Local Medical Stocks Have Mid-term Potential
As local and listed medical enterprises in Singapore actively layout in the medical tourism sector, how should stock market investors seek opportunities?
Interviewed analysts believe that attention should be paid to the overseas markets the companies are targeting and whether their service offerings are diversified.
Hu You, an analyst from FSMOne Singapore Research and Investment Portfolio Management Department, pointed out that Raffles Medical Group has partnered with Renji Hospital affiliated with Shanghai Jiao Tong University School of Medicine and the First Affiliated Hospital of Chongqing Medical University to expand its footprint in the Chinese market. "In the first half of this year, the group's net profit has increased by 4.8% year-on-year, and with the expansion of overseas business scale, performance is expected to grow further." At the same time, the group's sources of income also include hospitals, clinics, and corporate medical support services.
Speaking of overseas expansion, Seeka is optimistic about Kangsheng Medical Group, stating, "Through FV Hospital, the group can share in the rapidly growing dividends of the Vietnamese medical market."
He continued to point out that the group's expansion in Malaysia, as well as the ongoing diversification of its medical service portfolio, such as incorporating oncology and orthopedics, will also help achieve performance growth in the medium term.
With IHH Healthcare actively increasing bed capacity in India, Malaysia, and Turkey to meet the rising demand, DBS Group Research believes that the company will also benefit from growth in overseas markets, thus giving it a "Buy" rating with a target price of 2.61 yuan.
IHH Healthcare's footprint spans Malaysia, Turkey, India, mainland China, and Hong Kong. Future expansion into other markets is not ruled out.
Nair said, "We will pay attention to every growth opportunity, but before entering any market, we will inevitably consider several questions, including whether it can generate profits quickly, whether it aligns with the group's strategy, and whether there are synergies. We are also quite concerned about whether potential investment locations have sufficient skilled labor, whether the geographical location is excellent, and regulatory issues."
In addition, recent corporate activities can be observed. Maybank analyst Wang Baochun prefers Raffles Medical Group, with a target price of 1.13 yuan. He stated that the group has committed to repurchasing up to 100 million shares over the next two years, which will help enhance return on equity (ROE) and earnings per share (EPS)
