Understanding the variety of visa-free, e-visa and visa-on-arrival rules by nation is something that medical tourism businesses and countries must begin to grasp and use. Ian Youngman argues there is no point spending millions on promoting medical tourism, if visa problems stop medical tourists coming.

In a resounding demonstration of Asia’s growing power and influence on the world stage, Japan, Singapore, and South Korea now hold joint top spot on the Henley Passport Index for visa-free/visa-on-arrival scores.

For medical and health tourism, both for visitors and investment, the Henley Passport Index suggests that countries need to take much more notice of visa rules being applied by their competitors, before they begin deciding target countries.

For example, China is seen as the biggest potential medical tourism market source and one that many countries are fighting over. Chinese outbound health and medical tourists now have visa-free access to 74 destinations, however there are still 154 destinations that require a visa or e-visa.

Another source target is Russia. Russians have visa-free access to 118 destinations, but still need a visa for 108 destinations. In contrast, potential USA medical travellers only need a visa in 42 destinations.

Henley Passport Index on visa rules

The 2019 Henley Passport Index and Global Mobility Report is a unique publication that brings together commentary from leading scholars and professional experts on the major trends shaping global and regional mobility patterns.

The Index is the original ranking of all the world’s passports according to the number of destinations their holders can access without a prior visa. The ranking is based on data from the International Air Transport Association (IATA), which maintains the world’s largest and most accurate database of travel information, and this is then enhanced by extensive research by global residence and citizenship planning consultants, Henley & Partners.

The Henley Passport is updated in real-time, as and when visa-policy changes come into effect. Along with the Kälin – Kochenov Quality of Nationality Index, also published by Henley & Partners, it is considered a major reference tool for global citizens and the standard reference for governments.

The Index website provides up-to-date, printable lists of the countries people can access visa-free, with an e-visa, with a visa on arrival, or with a normal visa.

Targeting international investment for health and medical tourism

An increasing number of countries seek international entrepreneurs and businesses to develop local health and medical tourism, but success levels vary significantly. Many politicians talk about attracting such people and companies, but few really know how to attract foreign investors in this highly competitive sector.

Problems with visas for themselves, key employees and customers are thought to put off international investors, but it is very much an area with poor information.

The Henley Passport Index may help shed some light on the matter and perhaps those politicians and their teams should study this website. It is not a static situation; just before publication of this article, news arrived that from June, Brazil will remove the need for a visa for travellers from the USA, Canada, Australia and Japan; a recent move from paper to electronic visas contributed to an increase in US visitors by 35%.

Visa access has a direct connection with travel flow

The situation on visas and related rules is known to directly affect the number of tourists and the number of medical tourists.

Dr. Christian Kalin of Henley & Partners and the inventor of the Passport Index concept, says: “With some notable exceptions, there is a growing acknowledgment that policies of engagement, collaboration, and openness yield the greatest results, for both individual nations and the global community as a whole. The current strength of Asian passports is emblematic of this progressive shift, and it seems certain that more and more countries will follow suit in order to benefit from global flows of talent and capital.”

Asian visa-waiver agreements taking the lead

As well as illustrating the widespread adoption of open visa policies, the latest rankings reflect the transformative effect that Asian development and growth is having on networks of transcontinental cooperation and connectivity. With all Asian countries topping the index, there is a clear momentum behind the region taking centre stage in globalisation.

The steady rise of China through its visa-waiver agreements shows how incremental and reciprocal measures can lead to significant increases in numbers.

The increasing importance of Asia and China in global movement and tourism is mirrored by an economic move away from the USA/Western Europe axis to the China/Russia/Asia one.

The moving axis is best shown by Italy being the first European country to join China’s multi-trillion dollar Belt and Road Initiative (BRI), the largest infrastructure project in history. BRI is pushing Asian, European, Arab, and African countries to continue to seek more seamless access to each other’s countries. This will benefit both China and all countries participating in the rising trade, including healthcare, along the new Silk Roads.

BRI is also having an increasing impact in the Middle East. The recent ratification of the visa-waiver agreement signed between the UAE and Russia is a direct outcome of strengthening trade and diplomatic relations between the UAE and Russia, and a strategic attempt by the UAE to replicate its success as a key trading, logistics, and financial hub in the Middle East to Asia.

Rather than compete politically and economically in the part of the world that is growing the fastest in population and economic growth, China, Russia and the UAE are working together, although perhaps with some suspicion and reluctance. The UAE’s formalisation of a strategic partnership with China may benefit it as the bridge linking people and trade between Asia and the Middle East.

Top 10 countries for access

Japan, Singapore, and South Korea hold joint top spot on the Henley Passport. For Q2 2019, following a visa-exemption from Uzbekistan, Germany is in 4th place. Five countries share 5th place 87: Denmark, Finland, France, Italy, and Sweden. The UK is now in 10th place and the USA in 11th.

The UAE continues its upward trajectory and, after the visa-waiver agreement with Russia, UAE passport holders are now able to access 165 destinations around the world without a prior visa.

Albania has moved up 28 places on the index over the past ten years, with citizens of this once closed-off nation now able to access 116 destinations without a prior visa. China’s ascent is less dramatic, but it is a change far more significant from a geopolitical point of view.

In more detail:

• In Africa, the Seychelles, Mauritius, and South Africa, continue to hold the top 3 spots
• In the Middle East, the UAE is in 1st place, Israel in 2nd place, and Turkey in 3rd place
• In the Caribbean, the top 3 spots are held by Barbados, the Bahamas, and St. Kitts and Nevis, respectively
• In Russia and the Commonwealth of Independent States, Ukraine holds 1st place, Moldova holds 2nd place, Russia holds 3rd place and Georgia has 4th place
• In Southeast Asia, Singapore, Malaysia, and Brunei, respectively, hold the top 3 spots, while Myanmar remains poorest performer in the region. The Philippines has dropped 12 places
• In North Asia, Japan and South Korea are the global and regional leaders. South Korea and China are tied for highest regional climber in the region over the past decade

To conclude, countries targeting citizens of country X should not be surprised that expected numbers are not reached, if the potential travellers have to make the effort to get a physical visa or an electronic visa. Constructing a medical tourism programme without sorting out visa problems is like driving a car and not putting petrol in it. You come to a stop very quickly.

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