Medical Tourism - Destination - Brazil

Brazil attracts many medical tourists each year, with US citizens accounting for 95% of them, even though the country is relatively unsafe and has a poor public health care system. This could be due to the cost savings of 60% compared to the US. Many medical tourists combine their treatments with a holiday, since Brazil is known as a renowned holiday destination. Moreover, the country’s 20 JCI accredited hospitals are a pulling factor as well as the proximity to the US more over there are no visa requirements. Those who come for medical reasons wish to take advantage of Brazil’s reputation for cosmetic and plastic surgery. With the Ministry of Tourism’s promotion campaigns, the country aims to maintain its position in medical tourism.

General Culture

Brazilian culture is a blend between Native American, Portuguese and African cultures, influenced to a lesser extent by the settlement of Spaniards, Italians, Germans and Japanese. The Native American influence is particularly strong in the national food and language, while the African influence on a national level is quite subtle and obvious only in a number of regions. The cuisine varies strongly by region, but its main ingredients are corn, rice, beans and chicken. Feijoada, a black meat and bean stew, is the national dish. Brazil is famous for its music and the annual carnival, of which the festive centre is Rio de Janeiro. The national music style samba is popular with all layers of the population and, thus, a way of keeping the country united.

Safety

Brazil ranks 85 on the GPI, being safer compared to other South American countries, however, on a global scale this indicates that it is a relatively unsafe country. Tourists should be aware of the dangers when being in the slums (favelas).

Tourists Attractions and Sights

• Christ the Redeemer: the famous statue of Christ overlooking the city of Rio de Janeiro from Corcovado Hill
• The Copacabana: a lively stretch of beach running alongside Rio de Janeiro
• Salvador da Bahia: one of the oldest settlements in the Western hemisphere, a centre of Brazilian history and culture
• Amazon Rain Forest: the world’s largest rainforest, home to numerous species of flora and fauna
• Iguaza Falls: a collection of 275 waterfalls at the border with Argentina and Uruguay, some of which can reach up to 70 meters

Visa Requirements

Most countries do not require a visa for stays up to 90 days. These countries include: Andorra, Argentina, Austria, Bahamas, Barbados, Belgium, Bolivia, Bulgaria, Czech Republic, Chile, Colombia, Costa Rica, Croatia, Denmark, Ecuador, Finland, France, Germany, Greece, Guatemala, Guyana, Honduras, Hungary, Iceland, Ireland, Israel, Italy, Vatican, Liechtenstein, Luxembourg, Malaysia, Monaco, Morocco, Namibia, Netherlands, New Zealand, Norway, Malta, Panama, Paraguay, Peru, Philippines, Poland, Portugal, San Marino, Slovakia, Slovenia, South Africa, South Korea, Spain, Suriname, Sweden, Switzerland, Thailand, Trinidad and Tobago, Tunisia, Turkey, United Kingdom, Uruguay, US, Vatican City, Venezuela.

Transportation

Only 5.5% of roads in Brazil are paved, therefore, road safety outside the urbanised areas can be unsatisfactory at times. Although car density is relatively low, there can be large traffic jams in São Paulo and Rio de Janeiro. The country’s main international airports are situated in São Paulo and Rio de Janeiro. Domestic flights are expensive but due to the vast size of the country, these can be necessary to travel between destinations. Buses are a popular and reliable means of transportation. Bus rides are cheap and can bring passengers to all corners of the country, including the Amazon rainforest. Taxis are also relatively cheap and reliable and are the best way for tourists to get around in the cities.

Accommodation

In both São Paulo and Rio de Janeiro many of the major hotel chains are present, such as Marriott Hotels and Resorts, Starwood Hotels and Resorts Worldwide, Accor Hotels, InterContinental Hotels Group and Golden Tulip Hospitality Group. Accommodation ranges from budget to high end, with even the high-end hotels being affordable to the main-flow tourists as the Real has devaluated in comparison to the USD and the Euro. There are no hospitals that have cooperation with hotels.

Health Care Providers

There is a total of 7,500 hospitals, of which 61% are private and 39% are public. In Brazil, 67% of the country’s total hospital expenditure is allocated to private hospitals and 33% to public hospitals. The Brazilian government is not only financing public facilities, but also contributes to private health care providers.

Insurance

Health insurance in Brazil is provided by a universal and publicly funded Single Health System. Supplementary health care coverage can be purchased by means of private health insurance. These are strictly regulated, with mandatory minimum coverage and price controls. In 2000, 25% of the population was covered by insurance, 75% of those used a private insurance scheme. The public health system in Brazil has a lot of problems, such as crowded facilities, patchy coverage and long waiting times, even in cases of emergency.

Reforms/Policies

Brazil’s health system has undergone many reforms since the 1960’s, all of which have resulted in the current Single Health System. However, in recent years there have not been made any significant changes in this system.

General Medical Tourism Information

Brazil received 5.2 million tourists in general, which resulted in annual revenue of USD 5.78 billion (€ 3.86 billion) in 2008, making it the biggest tourism destination in South America. Brazil is a well-established destination for cosmetic and plastic surgery as it has a worldwide reputation for both elective and reconstructive aesthetic treatment. The number of medical tourists and the specific revenue is not known. This is due to Americans not needing a visa to enter Brazil.

In 2006, Brazil’s Ministry of Tourism announced plans to dramatically increase the investments in tourism promotion over the following years, which also includes the promotion of medical tourism. The investments, which were traditionally between USD 10-15 million (€ 4.46-10 million), would become USD 200 million (€ 133.6 million) in 2009. The promotion specifically targeted towards medical tourism is still mainly in the hands of private companies.

Flows

The main flow of medical tourists coming to Brazil is from the US (95%). The other regions contributing to the inbound medical tourism are Latin America and Canada.

Reasons

• Cost saving: prices for treatments in Brazil count a cost saving of 60% of the US price and 49% of the UK price.
• Holiday destination: Brazil is famous for beaches and sightseeing.
• Proximity: Brazil is situated closer to the US compared to Asian destinations.

Specialisation

Although Brazilian hospitals offer a wide range of treatments, the country’s reputation and promotion regarding medical tourism is mainly focussed on one area of expertise:

• Cosmetic and plastic surgery (elective and reconstructive)

Top Facilities

The top facilities have been selected using the following criteria’s, listed in order of importance: JCI Accreditation, ISQua accreditation, international orientation. In general national accreditation systems have not been taken into consideration, due to the fact that there are too many and judging them is out of scope of this study. Brazil has 20 JCI accreditations, which have been awarded not only to hospitals and clinics, but also to other types of facilities, such as rescue units. The four hospitals analysed in this report are:

• Hospital Israelita Albert Einstein, São Paulo
• Hospital Sirio Libanes, São Paulo
• Sociedade Hospital Samaritano, Bela Vista
• Hospital Alemão Oswaldo Cruz, São Paulo

SWOT

Conclusion

Regardless of the poor public health care system and being a relatively unsafe country, Brazil attracts many US (95%) medical tourists each year. This could be as the cost savings of 60% compared to the US draws them. This is aided by the country’s 20 JCI accredited hospitals, but, more importantly, by its proximity to the US and no visas being needed to enter. Those who come for medical reasons wish to take advantage of Brazil’s reputation for cosmetic and plastic surgery and with the Ministry of Tourism’s promotion campaigns, the country aims to maintain its position in medical tourism.

Note: All prices are estimates, and may vary widely from source to source depending on services included in the estimate (i.e. doctor’s fees, hospitalisation, administration costs or the patient’s age and medical history). Due to non-disclosure strategies of the various locations, it was not possible to make a clear separation between those factors. All prices given for the specific facilities have been provided by the hospitals/clinics themselves via email or telephone contact. The prices are given in Euros (€).

N/A means either that treatment are not available in the specific hospital, that a price estimation cannot be found or that the medical facility did not disclose the information. For the average prices, printed literature has been used before researching sources on the internet.