A heart bypass that costs about $130,000 in the United States costs about $15,000 in Thailand and about $5,000 in India. Fourteen million people a year travel abroad for treatment, and more than half of that traffic goes to Asia.
The familiar version of this is a cheap knee replacement attached to a beach holiday. Prerna Garg's account is that the Asian hubs have moved up to complex procedures, are specializing against each other, and are now pulling in airlines, insurers and one casino operator.
"But in Asia, you just directly land and you go to the doctor."
Garg is an Asia equity strategist at HSBC and a returning guest on the bank's Asia research podcast; the two hosts run HSBC's Asian equity strategy and Asian economics desks between them, so the sector is being sized as an investable theme rather than described as a travel trend.
The full episode is covered here so you can skip it. 16 minutes of audio, 11 minutes of reading.
Here are the 7 insights that matter.
👤 Guest: Prerna Garg, Asia Equity Strategist at HSBC
🎙️ Hosts: Herald van der Linde, Head of Asian Equity Strategy at HSBC, and Frederic Neumann, Chief Asia Economist at HSBC, who present Under the Banyan Tree from Hong Kong
📰 Published: 14 September 2026 on the HSBC Global Viewpoint feed · first ran 10 September 2026 on the show's own Under the Banyan Tree feed
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Key Takeaways
A few Thai hospitals now earn more than three-quarters of their revenue from foreign patients
For insurers and airlines the same business is still small, and Garg expects that to change over a decade
India is the one large hub going backwards, because 65% of its inbound patients came from a single country
Korea drew about 3M visitors for cosmetic and dermatological treatment last year
Medical tourism has two customer bases that look nothing alike
Patients from rich countries buying speed and price, and patients from Bangladesh, Laos and Cambodia buying a standard of care they cannot get at home
Indonesia treats outbound medical travel as a currency problem, not a health one
More than 60% of Malaysia's medical visitors are Indonesian, and Jakarta is building a medical zone in Bali to hold them
The certification is what lets an insurer pay for treatment abroad, and Asia has more than 500 accredited hospitals
A casino operator has built its own in-house hospital, and an airline is selling door-to-door treatment packages
1. $130K vs $15K vs $5K
The hosts opened with the size of the market before bringing Garg in, and the numbers are the show's own rather than the guest's.
Frederic Neumann's framing figure: 14 million people worldwide travel for some form of treatment every year, and more than half of that is in Asia. His definition was deliberately plain — you need a knee replacement and you fly to Thailand to get it.
Herald van der Linde supplied the price comparison. A heart bypass runs around $130,000 in the United States, closer to $15,000 in Thailand, and about $5,000 in India.
Neumann's response: "So it's a bargain."
The hosts' second point was that price is not the whole story, because governments are treating this as an industry to build. Neumann's examples of existing specialization: Korea in cosmetic surgery, India in cardiac surgery and care, and Singapore in high-end robotic surgery.
2. Why the Boom Restarted
Van der Linde put it to Garg that the old picture — fly to Thailand, get the knee done, recover at a resort — has changed, and she agreed.
"Things have changed. One, Thailand has moved much up the value chain." People now go there for serious and advanced treatments rather than check-ups.
The trend has spread across the region, Malaysia included, and the industry took a bad hit during the years when nobody was traveling.
"But I would say since 2022, it's been just going in one direction and that direction is going up."
Garg's three demand drivers, in her order. First, cost: "One, the cost of health care is rising pretty fast in the West." Second, aging — once you cross 40 the number of treatments and routine check-ups you need goes up. Third, reputation: "And now people feel much more comfortable getting the surgeries or the procedures done in Asia at probably one tenth of the price."
Her point about reputation is that it was earned over time rather than announced; people had always traveled for some things, and she gave Turkey and hair transplants as the long-standing example.
Van der Linde added waiting lists, and Garg said they are the sharper part of the case. There are procedures for which a patient in the UK or the US waits two or three years just to see a doctor.
"But in Asia, you just directly land and you go to the doctor."
Neumann's summary of the mechanism is worth keeping, because it is the investable part: this is not only demand — aging, waiting lists, Western cost inflation — but supply, in the form of a specialized industry that exists to serve visiting patients.
3. Two Kinds of Patient
This is the section that corrects the intuitive picture of who actually flies for treatment, and it came out of Neumann pushing back.
Garg said India is still the cheapest place in Asia for treatment and still strong in cardiac work, but its medical tourism numbers have been falling since the pandemic.
The reason is concentration. "Around 65% of the inbound tourists that would come there for a health checkup originated just from Bangladesh."
Neumann stopped her there, because the conversation to that point had been about Western patients escaping waiting lists and prices, and he did not think those patients were going to India. Garg confirmed that they largely are not.
Her framework is two cohorts. Patients from developed countries who come to Asia mainly for cost and speed, and patients from developing countries — she named Bangladesh, Laos and Cambodia — whose domestic health care infrastructure is not well developed and who travel to more advanced countries in the region.
Van der Linde questioned whether the second cohort is large enough to matter. Garg's answer was that every economy has a well-off slice, and that Bangladesh is not a small country: "Well, remember, Bangladesh is also not a small country. So even 5% of the Bangladeshi population it translates into several million people."
Neumann put a number on the slice himself — "Yeah, you're talking about 10 million people maybe" — and Garg agreed
4. Korea's 3M Visitors
Asked for the emerging centers, Garg went to Korea first and then to Malaysia, and the Malaysian case turned into a policy story.
Korea is the fastest-growing center she named, and its niche is cosmetic rather than surgical. She was careful about the distinction: skin boosters, jaw structure, fillers, minimally invasive treatments.
"Last year, around 3 million people came to Korea for cosmetic and derma treatments. And that is two times bigger than the number we saw in 2024. So the number has tripled in two years."
Her explanation is culture plus capability: "And that's probably because of the K culture, the growing fascination towards Korean glass skin, but also the advancement Korea has made in this particular sector."
Malaysia's inbound flow is one country deep. "Malaysia is interesting because one, more than 60% of the people coming to Malaysia come from Indonesia. And that's because of their halal certified medical." She added geographic proximity and familiarity with the culture and language.
Neumann stopped to explain halal certification to the audience — that it follows Islamic rules and is certified as such
The consequence is that Indonesia treats this as an economic leakage rather than a health-care question. "So this is becoming a concern for Indonesian government because one, it brings down your domestic activity. This puts a pressure on your currency in your forex."
Jakarta's answer is to build a destination of its own. Neumann raised the special medical zone being discussed at Sanur in Bali, and Garg confirmed it: the government is asking overseas-listed hospital chains to set up there, attracting foreign-educated doctors, and pairing it with Ayurveda centers and luxury resorts.
5. Insurers and the JCI
Van der Linde's question was the practical one a patient would ask — does your insurance pay for treatment in another country — and the answer explains how the sector gets to scale.
It used to be out of pocket. "In the past, people used to pay it out of pocket." Now, with the sector large enough to be worth chasing, insurers are writing global packages, and Asian hospitals are approaching insurers to be added to their panels.
The hosts worked out the insurer's incentive between them. Neumann's version: if the insurer has to pay for treatment anyway and the same treatment is much cheaper abroad, the insurer saves money by sending the patient — so it should be encouraging the trip. Van der Linde said he had been thinking the same thing.
What makes that possible is accreditation, and Garg named the standard. "So there are, for example, certification called JCI. That's almost a gold standard when it comes to hospitals. And Asia has more than 500 JCI accredited hospitals."
Its function is to give confidence to the insurer and to the patient at the same time — evidence that a hospital in a city the patient has never heard of meets a globally recognized standard
6. Shenzhen for Dentistry
Neumann's aside about his co-host's dental trips produced the section on mainland China, and then the clearest statement of how the hubs now compete.
Neumann noted that van der Linde, who lives in Hong Kong, crosses into Shenzhen to get dental work done, and asked whether that counts. Garg said it does.
Mainland China's inbound medical tourism is still small, partly for language reasons and partly because most hospitals are government-owned public hospitals that do not want the added pressure of foreign patients.
But the domestic cross-border flow is large and growing fast. The Greater Bay Area — Guangdong province, Hong Kong and Macau — is trying to establish itself as the region's health-care hub.
"So every day there are hundreds of Hong Kongers and people from Macau that go to Guangdong province, especially to Shenzhen to get their dental treatment done."
Asked whether Guangdong is a competitive market, Garg widened it to the whole region, and said growth in Thailand's medical tourism has slowed over the last three or four years as a result.
The response to that competition is specialization, and she gave the positioning of each hub. "Korea wants to be known for cosmetic. Thailand wants to be known for luxury wellness along with clinical outcomes."
7. Where the Money Is
Van der Linde's last question was the investor one — which companies are listed, and how should an investor think about the trend. This is the section that justifies the episode.
Garg's first point is that the beneficiaries go well past the obvious one. "Intuitively, you would expect hospitals to benefit from it, but it goes much beyond hospitals." She named pharmaceutical companies, insurers and airlines, on the grounds that someone traveling from Europe to Asia has to be flown there.
Her example is an airline selling the whole journey rather than a seat. Malaysia Airlines has tied up with a railway company in France to offer door-to-door travel.
Neumann's paraphrase: "So wait, so they say you can come to a hospital in Penang and we get you the train ticket to the airport."
Garg's description of the package: "You have the flight is sorted out. We pick you up, bring you to the hospital. You can stay there for two weeks, get done, and we'll bring you back home. So proper door-to-door facility."
The example that is hardest to place in a sector screen is a casino operator. Garg said Melco Resorts, which is US-listed, has built its own in-house hospital.
Van der Linde asked whether the trend helps margins as well as revenue, and Garg said it does, for two reasons. "It's good for margins because one, the healthcare tourists, they tend to stay for much longer than, say, a leisure tourist." And second, medical tourists now come to Asia for complex procedures rather than check-ups.
Neumann's compression of the point: "These people spend more."
The exposure is highly uneven, which is the practical warning for an investor. "There are few hospitals that get more than three fourths of their revenue just from foreign tourists, especially in Thailand." For insurers and airlines it is still a small side business.
"It's a growing business, but probably be much bigger 10 years down the line."
Bonus Insights
The structural point the hosts landed on is about trade, not health care. Neumann said the instinct is to think of Asian economies as built on manufacturing exports and goods trade, and Garg's correction was that this is the other kind: "It's the services. It's the services trade."
Van der Linde tied the outlook to demographics, noting that Northeast Asia is now the world's most rapidly aging region, and the reply added cost pressure on insurers as the second force.
Language barriers were treated as solvable rather than structural — the argument made was that once regulation allows a Taiwanese patient to be treated in Malaysia, a hospital simply staffs Chinese-speaking people to handle it.
Neumann's summary of the whole trend was two words: "And Asia — everybody wants to look good." Van der Linde's answer was that everybody also wants a ticker that works, and that after fixing his face in Korea he would be "heading straight to India to fix my heart."
Garg's bottom line is that Asian medical tourism has stopped being a price arbitrage and become a set of specialized national industries competing on niche — Korea on cosmetics, Thailand on luxury wellness paired with clinical outcomes, Malaysia on halal certification and proximity — with the investable exposure concentrated today in a handful of hospitals and spread thinly, for now, across airlines, insurers and pharmaceutical companies.
Products, Companies & Tools Mentioned
Malaysia Airlines (Tied up with a French railway company to sell a door-to-door package: train to the airport, flight, transfer to the hospital, two-week stay and the journey home)
Melco Resorts (The US-listed casino operator that has built its own in-house hospital, Garg's example of how far outside health care the beneficiaries run)
Joint Commission International (The JCI accreditation Garg calls almost a gold standard for hospitals; Asia has more than 500 accredited hospitals, which is what gives insurers and patients confidence)
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