Archive for the ‘Asia’ Category

February 12th, 2008

The Next Suprime Victim: Japan

There is still $300bn of bad debt out there, and Japan could be hiding most of it.

Just as battered investors had begun to glimpse signs of recovery in America, the next shoe has dropped with an almighty thud in Japan. The Tokyo bourse has crumbled, suffering the worst start to the year since the Second World War. The Nikkei index is down 17% since Christmas, and the shares of Japanese banks are leading the slide. Americans and Europeans have so far confessed to $130bn of the estimated $400bn to $500bn of wealth that has vanished into the sub-prime hole.

 

February 11th, 2008

Boiler Room Scams Popping Up Everywhere

Boiler Room: An unflattering term used to describe a fraud scheme in which salespeople are hired to call unsuspecting individuals and push investment opportunities.

“Boiler rooms” that use high-pressure tactics to lure investors to buy stocks have become a worldwide problem, with operations identified in areas as far-flung as southeast Asia and Africa. Trying to close these operations, which commonly cold call potential investors and use fraudulent methods to push overpriced stocks, is a challenge because they can set up shop virtually anywhere and are hard to track.

Boiler rooms, a term that refers to the kind of makeshift offices these operations often use as their base, have been a focus of U.S. authorities for years. They involve brokers who refuse to say anything negative about the stocks they push and make baseless predictions about how much the shares are likely to jump.

One problem in monitoring the schemes is that the deceptive brokerages may hold themselves out as legitimate firms that are set up in one place but in fact are operating out of another locale. Southeast Asia and Africa are two regions where such activities have been identified, as well as in parts of Europe such as the UK and Spain.

International Organization of Securities Commissions (IOSCO), an umbrella organization for the world’s securities regulators, whose group promotes international cooperation among securities regulators, is pressing roughly half of its more than 100 member countries that have not yet signed a 2002 memorandum of understanding on sharing information. Most countries in the larger financial markets, including the United States, the UK, France, Germany, Japan and Australia, have signed the memorandum.

 

February 11th, 2008

China’s ‘Special’ Rule For Their Olympics

Britain Bows To China 

Beijing Olympic organisers said Monday they backed a ban on political protests by athletes attending this year’s Games, amid uproar over an effort to silence British athletes. China is believed to be concerned that some of the 10,000 athletes expected here for the Games could be used by human rights activists and other groups to stage protests designed to draw attention to their causes.

The controversy erupted in Britain after a Sunday newspaper reported that the British Olympic Association (BOA) had threatened that any athlete who refused to sign the gag order would not be allowed to travel to China. Basically, any British participant who signed the order and then spoke out during the Games would be sent home, according to the initial plan.

Prince Charles has already let it be known that he will not be going to China, even if he is invited by Games organisers.  His views on the Communist dictatorship are well known, after this newspaper revealed how he described China’s leaders as “appalling old waxworks” in a journal written after he attended the handover of Hong Kong. The Prince is also a long-time supporter of the Dalai Lama, the Tibetan leader.

The controversial clause in the contract stated that athletes “are not to comment on any politically sensitive issues.” It then refers to Section 51 of the Olympic Charter, which says, “No kind of demonstration or political, religious or racial propaganda is permitted in any Olympic sites, venues or other areas.” Issues considered politically sensitive in communist-ruled China range from human rights, religious freedom, Tibet, Taiwan to Beijing’s role in Sudan.

The BOA took the decision even though other countries – including the United States, Canada, Finland, and Australia – have pledged that their athletes would be free to speak about any issue concerning China. To date, only New Zealand and Belgium have banned their athletes from giving political opinions while competing at the Games.

 

February 7th, 2008

Happy Chinese New Year

It’s the year of the Rat!

Chinese fortunes are based on a belief that events are dictated by the different balances in the elements that make up the earth — gold, wood, water, fire and earth. The lunar calendar is based on the cycles of the moon and associates each of the 12 years forming a partial cycle with an animal. Fortune-tellers base their predictions on the relationship between the zodiac animals and the characteristics of each.

The Rat is the first of the 12 animal signs, so marks new beginnings of changes with leadership in the United States, Russia and Taiwan. It is followed by ox, tiger, rabbit, dragon, snake, horse, goat, monkey, rooster, dog and pig.

 

January 17th, 2008

U.S. And Europe Neck To Neck

 A Power Shift Is Underway

The US looks poised to lose its mantle as the world’s dominant financial market because of a rapid rise in the depth and maturity of markets in Europe, a study suggests. The change may have occurred already, not least because US markets are beset by credit woes, according to research by McKinsey Global Institute. “We think the differential growth rates are so significant that it is quite likely Europe has overtaken the US,” said Diana Farrell, author of the report. The credit crisis has dented confidence in the health of America’s financial institutions and its model of finance.

A power shift is also under way in Asia as the Chinese market continues to boom while markets such as Japan stagnate. McKinsey suggests China’s booming trade surplus has put it into the position of being the world’s largest net exporter of capital, topping Japan, Germany and the oil exporters for the first time. The findings are likely to attract attention from bankers and policymakers since they come amid an intensifying debate about the changing pattern of financial power.  

Meanwhile, since the launch of the single currency in 1999, European markets have been steadily growing in liquidity and size. And other parts of the world, such as Asia and the Gulf, are enjoying rapidly growing financial clout due to their large surpluses - a shift exemplified by the recent decision of Asian and Gulf Sovereign Wealth Funds to take large stakes in big US banks.

In 2006, McKinsey calculates that America’s markets had some $56,100bn ofassets. Europe, including the UK, had $53,200bn of assets, a sharp increase on recent years. On recent trajectories, this implies that Europe overtook the US in 2007.

 

January 16th, 2008

CSRC At Its Best

Warning To The Bulls

Managers of Government-run Chinese mutual funds keep coming up with the same can’t-miss moneymaking opportunity for Lin Rongshiand for themselves. The messenger might be a low-level functionary or a trusted middleman. Lin, a private fund manager, said the message sometimes would be delivered in his high-rise office overlooking Shanghai’s financial district or, more discreetly, by mobile phone. “They notify us first, and they would buy a few days later [for the fund], then they would come back to us to split the profit I make from buying at a lower price,” says Lin.

This front-running scheme would net an almost guaranteed haul for Lin and for the state-sector employees. Some others, –insiders all, would profit, too. The only outsiders in the transaction would be the mutual funds’ customers, average Chinese investors who have little idea how routinely their money is abused on the Shanghai and Shenzhen stock exchanges. They come to this man to cheat a fortune from the stock market because he was once an expert at it.

Lin says he made his first $100,000 from a trade made on inside information ten years ago, at age 23. He clocked close to a million dollars by the time he was 25, on insider trading, front-running and stock manipulation in the last Chinese bull market, before losing it all and more in 2001 on his last and biggest play.

Rich shareholders, fund managers, even the top management of listed companies–all have approached Lin in the last year, he says. Chinese investors often suspect manipulation behind the sudden, sharp rises in share prices, but their typical reaction is not outrage. Few stock cheaters get caught, and those who do are rarely jailed. The regulator, the CSRC, China Securities Regulatory Commision, is lacking in staff to hunt down cheats, lacking in legal power to punish them severely and sometimes lacking in political clout to take on some of the well-connected state-owned companies it is supposed to watch. Lawsuits are even less effective. The Communist Party, wary of any organized group of malcontents, essentially does not permit class actions.

So, how do you short Chinese stocks when shorting the Chinese mainland market is not allowed? There are several work-arounds, but none are perfect:

  • Go through one of China’s Qualified Foreign Institutional Investors. QFII’s—including Citigroup, Goldman Sachs, JP Morgan, Merrill Lynch, HSBC, UBS and several dozen others—are allowed to buy A shares on the Shanghai and Shenzhen exchanges, the playground of domestic Chinese investors. A QFII can offer investors short positions through derivatives. The downside: More middlemen means more transaction costs.
  • Short-sell exchange-traded funds that are comprised of Shanghai and Shenzhen A shares. The WISE CSI 300 China Tracker and the iShares FTSE/Xinhua A50 China Tracker are both listed in Hong Kong. The downside: You can’t bet against individual stocks.
  • Short-sell a QFII’s closed-end A share fund, like Morgan Stanley’s China A Share Fund. The downside: Even if the value of the fund’s assets falls, that doesn’t mean the fund’s share price also has to fall.
  • Bet against Chinese companies listed in Hong Kong. Direxion offers a China Bear 2X Fund and ProFunds Group offers ProShares UltraShort FTSE Xinhua China 25, both betting against the same 25 Hong Kong-traded stocks. If you’re betting on an all-China slump, these funds will rise 2% for every 1% that the 25-company index falls. The downside: Valuations on the Hong Kong “H share” market are not as sky high as on the A share market.
  • Wait until China opens its own futures market, which has been expected for some time. The downside: You might miss your chance while you’re waiting. China might not want people betting against their stocks until at least after the Beijing Olympics.

 

January 4th, 2008

The Battle of Asian Educations

Grudgingly, Japan is starting to respect its neighbors in terms of education methods.

Japan is suffering a crisis of confidence these days about its ability to compete with its emerging Asian rivals, China and India. But even in this fad-obsessed nation, one result was never expected: a growing craze for Indian education. Many Japanese are feeling a sense of insecurity about the nation’s schools, which once turned out students who consistently ranked at the top of international tests. That is no longer true, which is why many people here are looking for lessons from India, the country the Japanese see as the world’s ascendant education superpower.

Newspapers carry reports of Indian children memorizing multiplication tables far beyond nine times nine, the standard for young elementary students in Japan. Viewing another Asian country as a model in education, or almost anything else, would have been unheard-of just a few years ago, say education experts and historians. Much of Japan has long looked down on the rest of Asia, priding itself on being the region’s most advanced nation.

Last month, a national cry of alarm greeted the announcement by the Organization for Economic Cooperation and Development that in a survey of math skills, Japan had fallen from first place in 2000 to 10th place, behind Taiwan, Hong Kong and South Korea.  Most annoying for many Japanese is that the aspects of Indian education they now praise: learning more at an earlier age, an emphasis on memorization and cramming, and a focus on the basics, particularly in math and science.

Japanese parents have expressed very, very high interest in Indian schools. Eager parents try to send their children to Japan’s roughly half dozen Indian schools. The boom has had the side effect of making many Japanese a little more tolerant toward other Asians.

 

December 18th, 2007

What Every Investor Should Know About U.S.-China Relations

Everyone plays up the notion that we are in huge amounts of debt. This is simply not true.

With Treasury Secretary Henry Paulson in China this week to discuss a range of issues related to U.S.-Sino commerce, we thought it would be an opportune time to separate fact from fiction and highlight some key issues that presently define the economic ties between the United States and China:

1. U.S. Foreign Investment in China — Not As Much as You Think     Rarely does a day pass without the media reporting yet another American firm de-camping the United States for China. Reality is quite different. U.S. foreign direct investment (FDI) to China has climbed over the past decade, but a little perspective is in order. The $15.5 billion the U.S. has sunk in China this decade equates to only 1.6% of the global total. U.S. FDI in Ireland and Germany was roughly triple the level of investment in China over the same period.

2. The U.S. Enjoys a Huge Lead over China in FDI     It is no secret that Chinese investors are quite interested in increasing their direct investment position in corporate America. Equally, it’s no secret that any planned purchase of a U.S. company by Chinese investors is subject to a great deal of scrutiny in Washington. Next to America’s massive trade deficit with the mainland, China’s foreign investment in the U.S. has emerged as a key tension point between the two parties. That said, it’s interesting to note that when it comes to foreign direct investment — or the corporate presence of the U.S. in China versus China’s presence in the U.S. — the U.S. enjoys an overwhelming advantage over the mainland. In 2006, for instance, U.S. foreign investment in China on a historic cost basis totaled $22.2 billion, a figure well in excess of China’s investment stakes in the U.S. In other words, U.S. firms have far better access to the Chinese market than their Chinese counterparts in the United States. This investment gap represents a strategic competitive advantage to corporate America.

3. What really attracts U.S. firms to China? Consumers     Contrary to popular opinion, access to the Chinese consumer remains the key motivation of U.S. firms entering China. Keep in mind that China is not a unified market of 1.2 billion people but a collection of markets with different dialects, varying levels of development, and disparate per capita incomes. These variables, along with many others (the brand-sensitivity of Chinese consumers coupled with intense foreign and local competition) dictate that American firms adapt to local tastes and operate on the ground. Customer proximity, in other words, is key in China.

4. “Made in China” — What It Really Means     The mainland has emerged as an exporting powerhouse, with “Made in China” the most ubiquitous signature in the world. Yet lost on many folks is this: A great deal of what China exports to the United States and the world are goods from so-called foreign-invested enterprises, or foreign subsidiaries of various global multinationals. “Made in China” is not what most people think. Thousands of low-cost Chinese firms are not flooding the U.S. market with goods, displacing U.S. workers in the process. Rather, foreign firms are increasingly leveraging low-cost China to their competitive advantage.

5. The U.S. Trade Deficit with China: A Dangerous Scorecard     Much has been made of China’s merchandise trade surplus with the United States, which topped $230 billion in 2006. That’s a large figure, to be sure, although the figure does not accurately reflect the true nature of bilateral commerce between the United States and China. Missing from this equation are local sales of goods and services of U.S. foreign affiliates operating in China. The latter totaled some $86.5 billion in 2005 (the latest available data. Missing from the trade debate is the following: The primary means by which U.S. firms deliver goods and services to China is via foreign affiliate sales, not exports. At the end of the day, China does sell more to the United States, but not by the lopsided margin some might suppose.

6. Capital — China’s Top export to the U.S.     China’s most important export to the United States is capital — or U.S. dollars to be more exact. Lost on many legislators in Washington that want to punish China for running such a large U.S. trade surplus is this simple yet critical fact: China not only provides U.S. consumers with cheap, high-quality goods, it also provides the capital to purchase such goods by recycling greenbacks earned from trade back into U.S. treasuries and other dollar-denominated assets.

7. The Mainland — An unlikely Source of U.S. Profits     The lopsided nature of U.S.-China trade gives the impression that all the benefits go to the Chinese. That is simply not true. One of the best kept secrets on Wall Street is this: U.S. firms are making tidy sums of money in the Middle Kingdom.

Data on foreign affiliate income from the government’s Bureau of Economic Analysis corroborate these findings, with U.S. foreign affiliate income in China rising from $1.2 billion in 2000 to $4.7 billion last year. The bottom line: At a time when the U.S. is threatening to impose greater trade sanctions against China, U.S. firms with operations in China are posting record profits.

Here’s the rest of the list.

 

December 14th, 2007

Offshore Battles: Caymans vs. Bermuda

Consider Bermuda As An Alternative? 

Bermuda’s main commercial district is home to thousands of the world’s top hedge funds. But the British colony has been struggling to catch up to its Caribbean cousins, the Caymans and British Virgin Islands, in the race for the $2 trillion hedge fund industry’s fast-growing offshore business. That could soon change.

In the next 12 months, the 22-square-mile land of pink beaches and rolling golf courses expects to raise the number of registered funds by 50% to 3,000. While Bermuda dominates the offshore insurance industry, the Cayman Islands is the epicenter for hedge funds, with about 9,000 of these loosely regulated investments registered in the British territory. But Bermuda is competing hard, having recently made registration quicker, easier and cheaper. It also touts its proximity to the United States. It is only a two-hour flight from New York, while a trip to Caymans is much longer and often involves a stopover in Florida.  

Managers who invest for foreigners or tax-exempt U.S. clients, such as pension funds and colleges, are attracted to offshore centers because costs are lower and regulatory requirements less stringent than in the United States. In return, hedge funds bring lucrative business to the offshore centers at a time when many islands are trying to diversify revenue away from tourism. To reach the ambitious goal of registering roughly 1,000 new hedge funds in the next year, Bermudans are jetting to international conferences. The primary targets are in Europe, the Middle East and Asia. For years, U.S. lawyers have urged hedge funds to set up in the Caymans. The Caymans occasionally suffer from a reputation of relaxed oversight, thanks to several recent hedge fund collapses. And the 1993 Hollywood movie “The Firm” is about a law firm whose nefarious activities include money-laundering in the Caymans.

 

December 6th, 2007

Asia’s Trust Fund Babies

Watch out for a growing number of trust fund babies in Asia

The opportunities for private banks in Asia Pacific are big, and still growing. The region is home to more than a quarter of the world’s high net worth individuals (HNWIs) - the industry jargon for people with $1m of investable assets. Their wealth is growing by 8.5% a year. By 2011, their combined riches will total $12,700bn.

The difference between North America and Europe? The wealth management business in Asia is a lot more diverse than in Europe or north America - in terms of providers, legal jurisdictions and customers. Potential clients might be a Japanese aristocrat whose family has been rich for generations, or a Malaysian entrepreneur who grew up in a kampong (village) and now wants to invest the proceeds of an IPO according to Islamic shariah principles.

China continues to boom - there are estimated to be at least 300,000 Chinese HNWIs. Foreign private banks are setting up branches as quickly as they can. They are starting to move inland from the wealthy cities along the coast to service the growing number of entrepreneurs in China’s West. India is also showing enormous promise too. Asian HNWIs tend to be more mobile than their counterparts in Europe or north America. That diversity may mean opportunities in providing specialist tax services, for example.

Asian clients may have very different ideas about what private bankers should do for them. A western approach based solely on analysing risk tolerance in accordance with modern portfolio theory, and recommending appropriate products, may not sit well with a customer who is just looking for share tips. It takes time to build trust with such clients, and help them to understand that wealth preservation and growth is more complicated than betting on shares on China’s overheated stock market.

The need for private banking is likely to intensify as a big wave of wealth starts to flow down the generations. “In Asia people may not be as open with me as western clients about all of their investments, so I can’t always make appropriate recommendations,” says one private banker.  The “rags-to-riches” ethnic Chinese entrepreneurs of south-east Asia are beginning to die off. Many left home to seek their fortunes as manual workers in the tin mines of Malaya, or fled China when the communists took over, to start small businesses that grew into family conglomerates. Such patriarchs learned about business the hard way. Many may not have been educated past primary school. But their grandsons - and granddaughters - may well have been to top international business schools, and have very different ideas about how the family business should be run. They may even consider whether the business should be sold off, and the cash invested instead. Watch out for a growing number of trust fund babies in Asia.

Research suggests that many rich families in Asia are ill-prepared for generational change. Only half of the 33 families surveyed in Hong Kong, India, Malaysia and Taiwan said they involved the next generation in managing the business. Many young graduates even felt that inheriting the family company would be a burden, as it constrained their career choices.

Asia, outside of Japan, and the Middle East would need 10,000 new private bankers by 2010. Private bankers need more than quantitative skills. They must watch the markets, in case the client asks their opinion. It also helps to speak a few languages, especially Chinese dialects. Such people are rare and no bank seems happy with the recruitment situation. Publicly, managers talk about providing staff with friendly environments and great career opportunities to win the battle for talent.  93% of customer relationship managers in private banks in Asia said they had been approached by rivals in the past year.  One in seven private banks risked losing a third of its staff or more. It is not unusual for entire teams to follow a talented manager and take their clients with them. 

The boom in private banking is sharpening traditional rivalries between the north and south-east Asian hubs of Hong Kong and Singapore. Both have trustworthy reputations as financial centres. Wealth managers have traditionally clustered in Hong Kong. But Singapore, which has the world’s fastest growing population of dollar millionaires, has been catching up.

 

November 13th, 2007

Abandoning The U.S. Dollar

7 Countries Saying Bye Bye To The US Dollars

1. Saudi Arabia:  Saudi Arabia has refused to cut interest rates along with the US Federal Reserve. This is seen as a signal that a break from the dollar currency peg is imminent.
2. South Korea:  In 2005, Korea announced its intention to shift its investments to currencies of countries other than the US. There are whispers that the Bank of Korea is planning on selling $1 billion US bonds in the near future, after a $100 million sale this past August.
3.  China:  China is threatening a “nuclear option” of huge dollar liquidation in response to possible trade sanctions intended to force a yuan revaluation.
4. Venezuela:  In September, Chavez instructed Venezuela’s state oil company Petroleos de Venezuela SA to change its dollar investments to euros and other currencies in order to mitigate risk.
5. Sudan:   Sudan is, once again, planning to convert its dollar holdings to the euro and other currencies. Additionally, they’ve recommended to commercial banks, government departments, and private businesses to do the same.
6. Iran:  Iran is perhaps the most likely candidate for an imminent abandonment of the dollar. Recently, Iran requested that its shipments to Japan be traded for yen instead of dollars.
7. Russia:  They’ve discussed pricing oil in euros, a move that could provide a large shift away from the dollar and towards the euro, as Russia is the world’s second-largest oil exporter.

Why The Weak Dollar?  First, there’s the difference between the interest rate in the United States (the one the Federal Reserve just dropped) and the interest rates of other central banks around the world. When the United States dropped its rate, other banks did not follow. Now the spread between the interest rate at the European Central Bank and the Federal Reserve is smaller than it has traditionally been, and that has weakened the value of the dollar against the euro.

Second, central banks around the world have been diversifying their holdings away from dollars to euros, British pounds and so on. That means there are more dollars out there in currency markets available to purchase. More dollars floating around means diminished value.

What’s This All Mean?   Many of them want to protect their financial interests, and a number of them want to end the US oversight that comes with using the dollar. Although it’s not clear how many of these countries will actually follow through on an abandonment of the dollar, it is clear that its status as a world currency is in trouble. The dollar’s status as a cheaply-produced US export is a vital part of our economy. Losing this status could rock the financial lives of both Americans and the worldwide economy.

 

November 8th, 2007

The World’s Largest Mobile Phone Market

Nearly 9 out of 10 Chinese who own cellphones send text messages. Only 49% of U.S. cellphone users send text messages

E-mail has become the new snail mail for many Chinese as they turn to the immediacy of text messages on cellphones and instant messages on personal computers. The most affluent and educated use e-mail, but by and large people here rely much more heavily on the shorter, faster and more conversational methods of electronic communication. China’s mania for messaging — particularly mobile messaging — is largely a product of how technology developed here. Like other emerging global markets, rural regions of China lacked phones or even a television as recently as two decades ago. The country modernized just as mobile technology was broadly accessible throughout the world. China is now the world’s largest mobile phone market.

China’s 455 million cellphone users chat, cajole, joke and flirt via short messages about 33 billion times a month, according to government statistics and IResearch Consulting Group, a market research firm that focuses on Chinese Internet and wireless industries. More people in China get news or weather via the Web on their cellphones than from personal computers. Most Chinese people can’t afford a PC for their home because it’s a pretty big investment. Mobile phones have achieved iconic status in China, where technology is viewed as an important part of the country’s rapid modernization.

 

November 8th, 2007

Outsourcing Surrogate Mothers To India

Customer service, tech support…these days we outsource everything to India.

Surrogate motherhood once was limited in India to helping close relatives who couldn’t complete a pregnancy due to medical difficulties. But now, poor Indian women are renting out their wombs to foreigners. Leading gynecologist Dr. Kamla Selvaraj says it’s now becoming a regular “profession” in India, with more and more women willing to carry babies for others, for a fee. India has for years been providing foreigners with in-vitro fertilization (IVF) treatment at a cheaper rate than the equivalent services in Western countries. While a couple in the U.S. will generally pay tens of thousands of dollars to a surrogate mother and affiliated agencies, in India the cost could be around $5,000, plus medical and attendant costs. If you haven’t seen the episode on Oprah, here you go.

 

November 5th, 2007

The World’s Largest Company By Market Capitalization

Today PetroChina Co. became the world’s first company valued at more than a trillion dollars

Analysts expect PetroChina to surpass Exxon Mobil as the world’s largest company by market capitalization. PetroChina shares, already traded in New York and Hong Kong, are expected to be seized on by a market awash with cash and investors eager for new opportunities. The ebullience with which Chinese investors have embraced the Shanghai and Shenzhen markets has made China home to some of the world’s most expensive companies. It has the biggest bank, insurance company and airline by market capitalization. Five of the world’s 10 largest companies are there.

 

November 5th, 2007

Going Abroad For Surgeries No Longer Uncommon

Cashing in on Medical Tourism

Medical tourism is a $40 billion business globally, and the people packing their bags most frequently are Americans. Numerous nations–notably India, Singapore, Thailand and Malaysia–are making a lot of money off the American healthcare system’s problems, but it isn’t all bad news for the U.S. Medical tourism companies are cropping up across the country–approximately 50 so far–and there’s no end in sight. It’s not just a case of Americans traveling abroad for surgery. Europeans and Arabs are going to other countries as well.

How do the doctors feel about this? Some physicians will say that it’s a great way to offload treatments that don’t pay well, anyway, because the insurance companies will only pay $19,000 for that $100,000 operation, and $19,000, by the time they take care of overhead, isn’t that much.

Americans could contact an accredited hospital in Malaysia directly to find out if one of its surgeons can do a kidney transplant, but because it’s complicated to determine which hospital is right for each person and operation the medical tourism agencies have caught on. A few American health insurance agencies already have pilot programs looking into the feasibility of paying lower costs for people to travel abroad and have expensive surgery, which means that businesses may soon be offering medical tourism packages to their employees. Even more telling, some American hospitals now have branch hospitals overseas to capitalize on medical tourism. Yes! Who can beat having plastic surgery for $5,000 versus $16,000 to $20,000 in the U.S.