OPINION: Medical tourism in Japan and Japanese lobby in the WHA

Sakthi Muralikrishna | Kyodo News

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The Japanese Delegate and other Delegates discuss their policy in the World Health Assembly (WHA).

Japan remains a hot-spot for medical tourism throughout the world for world-class cancer treatments, aesthetic procedures and other advanced treatments with its first-class medical technologies and research. Although medical tourism seems to be an absolute positive for the development of healthcare on the surface, many issues lie with it.

Many international patients default on their medical payments due to improper insurance and visas. Whilst this mainly poses losses to the medical tourism industry, these patients may also face incomplete medical care, alongside inadequate support and data about their medical care following international treatment. The Japanese Delegate proposed a smart solution to the World Health Assembly (WHA) - a digital interface to support medical tourists, making medical tourism easier and fairer for both patients and healthcare providers.

The delegation of Japan and its Bloc have put forth a policy known as the Cross-border Healthcare Investigation for Life and Lifestyle (C.H.I.L.L) to implement a digital interface and database to reduce complications in medical care across borders. The policy aims to focus on 4 main aspects: Visas, Insurance, Medical Data & Accreditation.

C.H.I.L.L proposes that aftercare of medical procedures should be handled by the destination country of medical tourists, with specialised Visas to be implemented for this purpose. Furthermore, this visa would only be granted to internationally accredited hospitals and would be limited to prevent strain on healthcare systems. Proper insurance options and transparency regarding costs would also be provided in the interface, to ensure proper payment to healthcare providers and give patients more transparency about medical payments and policies in destination countries.

The policy also seeks the streamlined transfer of medical data through the digital interface. Furthermore, the policy will also oversee an international accreditation system to ensure that medical tourists only receive care from said accredited hospitals covered under the system. Therefore, the policy seeks to, overall, provide just medical care to international customers with greater transparency and accountability.

The Japanese delegation has garnered major support regarding C.H.I.L.L., with over 8 nations in their bloc. Other blocs led by the delegation of India argue for more focus on regulation through an International Ombudsman Office to oversee proper accreditation of hospitals internationally and standardise healthcare provision throughout the world.

On the other side of the coin, the Delegation of South Africa focuses more on combating the loss of medical staff due to immigration, through bilateral scholarships funded by more economically developed countries (MEDCs). These scholarships also include a bond in said countries to fund medical studies and increase the medical workforce.

While it seems near definite that accreditation and international databases would be set up, the debate rests on whether it will be spearheaded by the Japanese bloc – with comprehensive coverage on insurance and visa issues, or by the bloc headed by the Indian delegation – with greater emphasis on regulation of patient data, regulation regarding accreditation and standardised healthcare provision.

The proposal of the South African delegation, however, lacks backing. Medical staff origin countries, which the policy aimed to target, are sceptical on whether the bond would truly encourage medical staff to return to their home countries after their bond in the MEDCs. Rather, the policy seems misguided, where the students – after having finished their bond – would likely remain in the MEDCs for better pay and opportunities.

The implementation of medical tourism policies to make it more accessible to international patients is undoubtedly beneficial for the medical tourism market in Japan. However, the accreditation system, likely to be provided first to private hospitals that accommodate medical tourists, may cause an imbalance in medical staff in said private hospitals compared to the crucial public hospitals of Japan.

Many rural public hospitals are facing grave losses. In 2024, profits from the 844 public hospitals of Japan rose 2.3% to ¥4.68 trillion, while operating costs rose 4.2% to ¥5.72 trillion. Expenses have overtaken profit in public hospitals, culminating in a record high loss of ¥395.2 billion (US$2.56 billion). Resultingly, public hospitals serving rural areas like Aomori have been under immense strain.

With C.H.I.L.L. looking to make medical tourism in Japan more accessible, the future of medical tourism in Japan and the economic benefit from it seem promising. However, the losses public hospitals in Japan might face must be addressed. Medical tourism has already redirected funds and incentivised medical staff to work in the private sector. It is of utmost importance that the Japanese government sees that the rural populace is not sidelined due to the prospects of medical tourism.