For the past three and a half years, Jason Yap, MD, has promoted Singapore as a destination for medical travelers seeking advanced patient care.

During that period, Yap led international marketing at SingaporeMedicine, a partnership committed to strengthening that country's position in Asia's medical industry.

Yap continues to see Singapore as a medical travel destination, but now from the provider's point of view. He recently took over as marketing director for Raffles Hospital, a 380-bed tertiary care hospital and the flagship hospital of the Raffles Medical Group, a private healthcare provider in Singapore and South East Asia. In his new position, Yap will try to integrate Raffles "into the newly globalizing healthcare networks" around the world.

"When I started, the media talk was all about Thailand and India, and Singapore was barely mentioned—a strange situation considering that Singapore has been the destination of choice in the region for many decades," Yap said in a recent e-mail to me. "Today, it would be fair to say that Singapore is much better known . . . countries like South Korea, Taiwan, Australia, and even Armenia have publicly commented that they like or will follow Singapore's example."

Yap is responsible for marketing Raffles Hospital to both local and international customers. The facility sees patients of more than 120 nationalities, including expatriates in the region, and Yap estimates patients come from more than 60 countries.

He says medical travel growth in the region has the potential to help, rather than hurt, the business of healthcare in the United States.

"While outsourcing is considered a bad word by many, it does offer a way to reduce the sheer number of dollars spent on healthcare, and may provoke compensatory adjustments that bring the cost structure of healthcare in the U.S. more in line with the rest of the world," Yap said.

Although there are some in the United States who are actively working against medical travel to Asia, for example, Yap says they need to understand the relative sizes of the nations' healthcare economies.

"There simply isn't enough capacity in the rest of world to really threaten the U.S. healthcare economy," Yap said, although adding that some providers, like orthopedic surgeons, may suffer some loss if medical travel becomes more common.

"The bottom line here is that the total value of all global medical travel today is possibly less than the year-on-year inflation of U.S. healthcare costs," he said.

The dire state of the U.S. economy has led some to put off doctor visits, and the high cost of American healthcare has led to reform efforts by the Obama administration. But while it's true that many people have much less money and therefore less ability to travel specifically for medical treatment, some have found that seeking cheaper, good quality healthcare becomes all the more important, Yap said.

"Patients travel because their home country does not provide the healthcare they seek in terms of availability, affordability, quality, and accessibility, and experience," Yap said.

Each medical travel destination has different dynamics, he adds: Singapore receives patients from Indonesia for higher quality and reliable healthcare, from the United States for cheaper procedures, from India for procedures unavailable there, from the whole of Southeast Asia for plastic surgery.

"In a sense, there is no single market for medical travel as it is a mass of niche markets," Yap said. "There are many niches which can continue to grow."

Yap says he is confident the medical travel business will expand in the future and possibly see a huge increase once the economy improves.

"Some healthcare providers have reported a flattening of demand," Yap said of the medical travel business. "Just as during the SARS year of 2004 and the Asian financial crisis in 1998, many elective procedures are postponed. Incidentally, we saw booms following both of these two down periods as the pent-up demand is released."

With the global healthcare business continuing to attract medical travelers, accreditation by organizations such as The Joint Commission International may be more important to travelers looking for a legitimate destination for their medical needs.

Raffles Hospital, for example, began looking at the JCI system in 2004 and implemented many of its constructs, Yap says. He adds that while there was much less attention paid to obtaining the actual certification itself because local patients did not demand it. Earlier this year, Raffles achieved JCI accreditation after having already implemented much of its processes.

"In the coming healthcare globalization, the ability to explain and assure the patients of the quality of care will become increasingly important, especially for newcomers to international healthcare and to newly-built facilities," Yap said.