Medical Tourism
Singapore 2020

An in-depth analysis of Medical Tourism in Singapore.

Last Updated: January, 2020. Latest available data from September, 2019.

Highlights

  • Singapore receives 500,000 medical tourists each year. The government previously projected it would receive one million annually by 2012. Medical tourism spend today accounts for less than 4% of overall tourism receipts.
  • Knee replacement surgery in Singapore costs S$22,000, more than double Malaysian prices at S$10,000. For the same price as surgery in Singapore, a family of four could buy return flights to Penang, stay 14 nights in a 5-star hotel, include one knee replacement surgery, with $5K to spare.
  • Singapore’s medical cost inflation was 10 per cent in 2018, 10 times the estimated rate of 1 per cent. Meanwhile, the cost of medical visits and treatments in Singapore has increased by approximately 9% since 2015.
  • Singapore is ranked the most expensive city in the world for the 6th year running. But its healthcare still remains competitive compared to the US. For instance, a knee replacement surgery costs more than double in the US at US$35,000 compared to US$16,000 in Singapore.
  • More than half of Singapore’s medical tourists are from Indonesia, with approximately 250,000 Indonesians visiting Singapore for medical care each year.

Medical Tourism overview

The global medical tourism market was valued at USD 16,761 million in 2018, and it is expected to reach USD 27,247.6 million by 2024.

Asia-Pacific accounted for the largest share of around 40% of the global market.

The most common procedures that people undergo on medical tourism trips include cosmetic surgery, dentistry (general, restorative, cosmetic), and heart surgery, as well as orthopaedics (joint and spine; sports medicine); cancer (often high-acuity or last resort); reproductive (fertility, IVF, women’s health); and weight loss (LAP-BAND, gastric bypass).

International patients visit Singapore each year for a whole range of medical care from health screenings to high-end surgical procedures in specialties such as cardiology, neurology, oncology, ophthalmology, organ transplants, orthopaedics, and paediatrics.

Singapore is finding it increasingly harder to retain its title as one of the region’s top medical tourism destinations, as patient’s eye better value for money in neighbouring countries such as Thailand, Malaysia and India.

How many tourists visit Singapore each year?

In 2018, approximately 18.5 million international tourists visited Singapore. This represented a 6.22% increase on the numbers in 2017, when 17.4 million tourists visited Singapore.

For 2019, the STB has forecast total visitor arrivals to be in the range of 18.7 million to 19.2 million, an increase of 1 to 4 per cent over last year.

How many tourists visit Singapore each year?

International visitor arrivals to Singapore

*International visitor arrivals numbers to Singapore exclude; Malaysian citizens arriving by land; returning Singapore citizens, permanent residents and pass holders; non-resident air and sea crew (except for sea crew flying in to join a ship); air transit and transfer passengers; and arrivals staying in Singapore for more than a year.

How many medical tourists visit Singapore?

The number of medical tourists is estimated by the Singapore Tourism Board (STB) using exit surveys at Changi Airport.

In 2007 there were 348,000 medical tourists. This was 15% less than the previous year, 2006 (410,000).

In 2008 the government projected that Singapore would treat one million foreign patients annually by 2012. 

However, in 2018, the Republic is said to get just half of that - an estimated 500,000 medical tourists every year.

International visitors by country

Where are the majority of Singapore’s tourists coming from?

Based on 2018 figures the top five visiting countries to Singapore are:

China, Indonesia, India, Malaysia, and Australia. Visitor numbers from all these originating countries is up on 2017, with India showing the greatest increase at 13.4% with 1.44m visitors.

Arrivals from China, India, Philippines, UK, USA, Vietnam, and Germany hit record-high numbers in 2018.

International Visitors Arrivals by Country

Arrivals by country

Medical tourist arrivals by country

Among the top source market for Singapore Medical Tourism, Indonesia topped the list, taking around 60 per cent of the market share. That amounts to approximately 300,000 Indonesian tourists visiting Singapore to seek medical care each year.

Latest figures show that Indonesia had 600,000 patients travelling overseas for medical care with half of those heading to Singapore.

Malaysia is standing at the second spot in terms of medical tourist arrivals to Singapore. China is the third largest source market for Singapore medical tourism. United States, Philippines, Africa and India are competing closely to grab maximum share of the Singapore medical tourism market. Australia, UK, Hong Kong and Thailand are the other popular source markets for Singapore medical tourism.

What do visitors to Singapore spend their money on?

Overall tourists’ spend rose 1.0% to S$27.1 billion, mainly due to growth in the number of visitor arrivals.

Tourist spending grew but was slowed by declines in spending on;

Shopping (14%)
Accommodation (5%)
Food & beverage (4%).

But there was increased spending on;

Sightseeing, entertainment & gaming (6%)
And Other components (21%) this includes medical tourism and local transport including airline carriers.

The STB has forecast tourism spending to grow by 1 to 3 per cent for 2019.

Overall tourism receipts by country

Tourism receipts (excluding sightseeing, entertainment and gaming) by country of origin reflect the number of visitors from each destination, with Chinese tourists topping the spending at S$3.9 billion.

International Visitors Spending by country of origin

Spending by country of origin 2018

Proportionally of the top 10 originating destinations in 2018;

  • Chinese tourists spent the most on shopping (47%)
  • Travellers from the US spent the most on accommodation (40%)
  • Travellers from the Philippines spent the most on food and beverage  (17%)
  • Visitors from Indonesia spent the most ‘Other tourism receipt components’ which includes medical tourism (47%).

How much is spent on medical tourism in Singapore?

According to figures from the Singapore Tourism Board (STB), medical tourism receipts stood at $1.1 billion in 2012, then dropped to $832 million the following year, before going up slightly to $994 million in 2014.

Since 2015, STB has stopped providing data on medical tourism receipts.

Instead, medical tourism has been placed under a generic category called Others, which includes money tourists spend on local transport, education and business.

STB declined to comment publicly on the change.

The figure for Others stood at $5.8 billion in 2017.

Visitors from Indonesia spent the most ‘Other tourism receipt components’ which includes medical tourism (47%).

In recent years medical tourism spend has accounted for less than 4% overall tourism receipts, according to the STB.

Clinics used by medical tourists see a drop in profits

Meanwhile, western clinics, the segment with the highest profitability ratio in 2017 of 21.8 per cent, saw a drop, compared to 24 per cent in 2007.

This could be attributed to rising manpower costs, which accounted for close to half of the sector's business costs in 2017. But some also cite a slowdown in medical tourism from the region as a contributing factor.

"Increased competition from Malaysia and Thailand in healthcare services could potentially place pressure on the local healthcare market in the upcoming years," a 2018 PwC report says.

Healthcare costs in Singapore

Healthcare has become increasingly expensive in Singapore. For example, data from the Singapore Department of Statistics indicates healthcare inflation has outpaced overall inflation by about 9.5% over the past 5 years. Furthermore, the cost of medical visits and treatments have increased by approximately 8% and 9% since 2015, respectively.

While these rates may seem high, they are not as high as healthcare inflation in the US, which was about 13% over the past 5 years. Still, these figures do indicate that Singapore is becoming an expensive place for those that require regular healthcare visits and treatment.

Raising Cost of Healthcare in Singapore (1990 - 2018)

Rising Cost of Healthcare in Singapore (1990 - 2018)

Source: ValueChampion

Medical cost inflation in Singapore

Singapore’s medical trend rate - which measures medical cost inflation - was 10 per cent in 2018, 10 times the Singapore economy's estimated 2018 inflation rate of 1 per cent, according to Mercer Marsh Benefits' 2019 Medical Trends Around the World report.

The economic inflation figure was obtained from the International Monetary Fund's World Economic Outlook Database in January 2019. Singapore's headline inflation officially came in at 0.4 per cent.

Singapore's medical cost inflation was slightly lower than the Asian average of 10.4 per cent, with Singapore coming in sixth highest out of 11 Asian countries surveyed.

Vietnam was top with a 14.5 per cent increase, neighbouring Malaysia increased 13.4 per cent and at the lowest end of the table, South Korea's medical trend rate increased by 6 per cent.

Medical Cost Inflation

Country/ Region

2018 Medical Trend rate Experienced

2019 Projected Medical Trend Rate

Global

9.7%

9.6%

Australia

4.0%

3.3%

Canada

8.5%

8.5%

China

9.7%

10.2%

Hong Kong

9.3%

9.1%

India

8.5%

9.3%

Indonesia

11.0%

10.5%

Malaysia

13.4%

13.6%

New Zealand

8.0%

7.0%

Phillippines

13.0%

13.7%

Singapore

10.0%

10.1%

South Korea

6.0%

5.0%

Taiwan

11.5%

9.1%

Thailand

7.9%

8.5%

Vietnam

14.5%

14.2%

Source: Mercer

Cost of specific treatments in Singapore

The following price ranges are for specific treatments in top private healthcare facilities in Singapore, including a private room (when applicable), as provided by the Singapore Ministry of Health. It is not a comprehensive list, but it provides an example of certain medical costs in Singapore. Next to the prices with “+” you can expect even higher fees if any complications or auxiliary procedures take place during the course of treatment.

Cost of specific treatments in Singapore

Delivery (normal):

$6,048 - 11,267 +

C-section delivery:

$9,024 - 17,125 +

Gallbladder removal surgery:

$5,500 - 8,600 +

Haemorrhoidectomy:

$3,00 – 3,500 +

Hand, wrist or finger surgery:

$4,300 - 7,200

Heart bypass surgery:

$16,050 - 25,00 +

Hernia repair:

$4,400 - 8,000 +

Hip replacement:

$8,550 - 12,850

Hysterectomy for benign conditions:

$6,400 - 9,500

Arthroscopic knee surgery: 

$8,550 -10,700 +

Knee replacement surgery:

$11,750 -17,100

Urinary stones with lithotripsy:

$3,200 - 5,150

Tonsillectomy and/or adenoidectomy: 

$4,050 - 5,350

Breast lump removal/biopsy:

$5,450 - 10,700 +

* Health care costs vary depending on surgeon and hospital. 
Source: www.moh.gov.sg

Private Hospitals

Cost of Medical Specialties (Private Hospitals)

Ward Class

Average Cost/ Day

Average Total Bill 

Top 10% Patients Paid More Than

Top 5% Patients Paid More Than

Private

$1,327 - $5,310

$3,906 - $24,687

$7,670 - $38,733

$9,521 - $73,287

Cost of Surgical Specialties (Private Hospitals)

Ward Class

Average Cost/ Day

Average Total Bill 

Top 10% Patients Paid More Than

Top 5% Patients Paid More Than

Private

$3,340 - $7,053

$8,109 - $18,993

$12,626 - $36,147

$14,749 - $46,194

*Costs exclude John Hopkins for a more accurate reflection of an average Singaporean adult’s hospitalisation bills.

Source: Ministry Of Health *Information above is last updated in 2015 since MOH stopped tracking ward costs from then on, but tracks in terms of conditions instead

Singapore medical costs versus global

The rise of India, Malaysia and Thailand as medical tourist destinations come at the expense of Singapore, which is rapidly losing market share to its neighbours which are able to offer cheaper healthcare and compelling savings to tourists.

For instance, neighbouring Malaysia offers excellent facilities and care, with prices 30-50% percent lower than Singapore.

Compelling savings as compared to other major medical tourism markets

Source: Patients Beyond Borders

Let’s look at Malaysia and Thailand, Singapore’s closest competitors;

(Prices in US dollars unless otherwise stated)

  • Surgery costs in Singapore are pricier than Malaysia and Thailand. A heart bypass costs US$23,000 in Singapore, although patients going through Malaysia and Thailand need only shell out US$14,000 and US$13,000, respectively.
  • A knee replacement process costs about US$16,700 in Singapore but costs only US$10,900 in Malaysia and US$11,400 in Thailand. 
  • Similarly, patients needing gastric bypass surgeries can save US$11,400 if they go to Malaysia where the surgery goes for $8,600 compared to US$20,000 in Singapore and US$16,700 in Thailand.
  • In Singapore, a relatively low-cost total hip replacement surgery at a private hospital would set a patient back around $13,000. In comparison, the same procedure at Mahkota Medical Centre in Malaysia - which treats more than 80,000 foreign patients a year - costs the equivalent of only $8,800.
  • Doctors and nurses in Singapore also enjoy higher pay compared to their peers in Malaysia and Thailand, implying a heavier cost burden on the city's healthcare providers that could be transferred to patients.

To give some perspective, a knee replacement in Singapore costs around S$22,000 as opposed to S$10,000 in Malaysia.

A tourist from Singapore could travel with their family to Georgetown, the centre of medical tourism for Malaysia and here’s what they would get for the same price as staying in Singapore for surgery;

  • Flights from Singapore to Penang on Singapore Airlines $148. Total for 4 people is $592.
  • A 14-night stay at a family suite in the Shangri-la Hotel in Georgetown costs $6,300.
  • That leaves more than $5K for spending money.

Cost of a knee replacement in selected countries as of 2018 (in U.S. dollars)

Cost of a knee replacement in selected countries as of 2018

A knee replacement surgery in Singapore costs US$16,000, less than half the price in the US at US$35,000.

Medical tourism in Malaysia and Thailand

An estimated two million international patients went to Thailand in 2017 out of its 35 million overall tourist arrivals. Positioning itself as a 'Medical and Wellness' destination, Thailand is a global leader in cosmetic surgery and treatment as well as wellness and traditional medicines.

Malaysia, meanwhile, is promoting itself as the ‘Cardiology and Fertility Hub of Asia’ thanks to its renowned National Heart Institute, and the 33 centres which support it. Its strong in-vitro fertilisation (IVF) success rates are also above the global average.

And the medical tourism scene in Malaysia is booming. In 2018, approximately 1.2 million people visited the country to seek medical treatment - and this number is growing.

Accredited healthcare centres in Singapore

Key to Southeast Asia’s success in attracting medical tourists is its strong base of Joint Commission International (JCI) accredited healthcare centres – considered the ‘Gold Standard’ in healthcare and patient safety.

Currently Singapore has 21 JCI accredited centres compared to Thailand which has 67 and Indonesia with 31.

Joint Commission International (JCI) accredited healthcare centres in Southeast Asia

Joint Commission International (JCI) accredited healthcare centres in Southeast Asia

Singapore ranked 2nd behind Hong Kong in a global study of health-efficiency

Despite such stiff competition, Singapore still ranks highly when it comes to health efficiency, according to a study by Bloomberg.

Two hundred economies were studied and a health-efficiency index was created to rank those with average lifespans of at least 70 years, GDP per-capita exceeding USD 5,000 and a minimum population of 5 million.

Singapore remains in second place but once again Thailand is rapidly catching up having moved up 14 places to No. 27, the biggest annual improvement - per-capita spending declined 40 percent to only USD 219, while life expectancy advanced to 75.1 years. Medical Tourism industry is among Thailand’s fastest-growing industries.

Singapore ranked 2nd in a global study of health-efficiency

Rank

Rank 1Y Ago

Change

Economy

Efficiency Score

Life Expectancy

Relative Cost %

Absolute Cost (USD)

1

1

-

Hong Kong

87.3

84.3

5.7

2,222

2

2

-

Singapore

85.6

82.7

4.3

2,280

3

3

-

Spain

69.3

82.8

9.2

2,354

4

6

+2

Italy

67.6

82.5

9.0

2,700

5

4

-1

South Korea

67.4

82.0

7.4

2,013

6

7

+1

Israel

67.0

82.0

7.4

2,756

7

5

-2

Japan

64.3

83.8

10.9

3,733

8

10

+2

Australia

62.0

82.5

9.4

4,934

9

12

+3

Taiwan

60.8

79.7

6.2

1,401

10

9

-1

U.A.E.

59.7

77.1

3.5

1,402

Why is Singapore’s Medical Tourism falling behind the rest of Asia?

The main reason Singapore is falling behind is that hospitals in countries such as Malaysia and Thailand have stepped up their game.

While they may not have the state-of-the-art technology that Singapore's private hospitals possess, they can carry out standard surgery at a fraction of the cost.

The value of the Singapore dollar and its appreciation also make it less affordable... flight and accommodation costs also contribute to this, especially if patients require regular follow-ups.

For instance, the MYR has appreciated at a less benign rate of 21% against the IDR over 2013-2018, as compared to 34% for the SGD-IDR.

Looking ahead, the Maybank currency team forecasts the SGD-IDR to be 2% lower by end-2019 vs 2018, and the MYR-IDR to be flat in the same time frame.

Change in

SGD-IDR

MYR-IDR

2009

-12%

-13%

2010

5%

6%

2011

-1%

-2%

2012

13%

10%

2013

22%

18%

2014

-3%

-5%

2015

4%

-9%

2016

-4%

-6%

2017

9%

12%

2018

4%

4%

YTD

-1%

-1%

2013-18

34%

21%

Singapore is the most expensive city in the world

Added to this is the fact that Singapore is once again ranked as one of the world’s most expensive cities (2018).

The Worldwide Cost of Living study from The Economist Intelligence Unit has given the title of the world’s most expensive city to three places. Singapore marks its sixth straight year at the top of the rankings, and is joined there by Hong Kong and Paris. The survey, which compares prices across 160 products and services, finds that living costs in all three cities are 7% higher than in New York, the benchmark city. 

What is Singapore doing to attract more medical tourists?

The Singapore Tourist Board (STB) has confirmed that it no longer pursues medical tourism as a travel strategy.

Despite this, some hospitals are continuing to chase the medical tourist dollar and have developed innovative ways to make medical travel about more than just treatment.

At Farrer Park Hospital, for instance, where foreigners make up half the number of patients, a tablet can be used to view medical records, order meals and even shop online, and have the purchases delivered to a location of the patient's choice.

Singapore has also set up International Patient Service Centres (IPSCs) that work like 'medical travel agencies'. IPSCs are designed specifically for medical tourists and expatriate patients, and are attached to hospitals to provide information and assistance for international patients. IPSCs provide hospital pricing to patients, and coordinate appointments with health care specialists.

Singapore is also expanding by opening new hospitals overseas and reaching out to the emerging countries.

For instance, the Singapore Medical Group took the "forward approach" by partnering Indonesia's Ciputra Group to set up an eye-care centre in Jakarta.

Thomson Medical refers patients from its centres in Malaysia and Indonesia here - or vice versa - if they require technology or expertise that is not readily available in their home country.

Health experts believe that Singapore will remain a popular destination for complex treatments, drawing patients from new markets such as China and India.

And it will continue to be known as a high-end medical tourist destination attracting wealthy patients from neighbouring countries such as Indonesia who are not so cost-conscious.

Citations:

https://www.straitstimes.com/singapore/health/where-are-the-patients-0
https://www.pacificprime.sg/medical-tourism/
http://www.smarttravelasia.com/MedicalTourism.htm
https://www.guidemesingapore.com/business-guides/immigration/get-to-know-singapore/healthcare-in-singapore
https://www.channelnewsasia.com/news/asia/malaysia-penang-medical-tourism-hospital-treatment-affordable-11827532

Disclaimer:

Data on this website was sourced in September 2019 with the latest available data from August 2019. Auto & General Insurance (Singapore) Pte. Limited does not guarantee the accuracy or completeness of the data and accepts no liability whatsoever arising from or connected in any way to the use or reliance upon this data.