Written by: Sakura Koner
Edited by: Lauren Breen
One would not always associate tourism with medical procedures, yet the term ‘medical tourism’ captures a growing trend. It is not about leisure travel at all, but about finding a slightly more economical way of funding medical procedures, which extends from cosmetic to non-cosmetic ones like cancer care, dental care, fertility treatments, etc. The Centre for Disease Control (CDC) defines medical tourism as “international travel for the purpose of receiving medical care”, with reasons for seeking care abroad including lower costs, personal recommendations, the opportunity to combine treatment with a vacation, cultural preferences in care, or access to treatments not available at home. As this trend takes off, it uncovers crucial issues of fairness, accessibility, and the broader impact on global healthcare systems. Medical tourism is a multibillion-dollar market that is continually growing as globalization and medical costs continue to rise worldwide. Increasing medical costs puts United States citizens at the forefront of those seeking medical tourism, especially in economically weaker countries like India, Argentina, Thailand, Malaysia, Turkey, etc. According to Euromonitor International, global medical tourism revenues have significantly increased from US$ 24,175.9 million (with 2023 prices) in 2009 to US$27,931.5 million in 2022, representing a compound annual growth rate (CAGR) of 4.1%. While the sector faced substantial challenges during the COVID-19 pandemic in 2020, it demonstrated a rapid recovery in 2021 and 2022, indicating its robust resilience.
However, while its successes of interest are evident, we must not be blinded to the negative impacts, including the challenges it poses to medical insurance for those seeking treatment abroad and the strains it places on the host countries offering treatment. For one, medical tourists may face major medical complications when they return to their countries or they require some post-operative care. There is also the secondary issue that the required care may be a diversion of public resources, especially if the patient’s domestic system is partly or completely funded by public financing. For example, an Australian study demonstrated that treating an acutely infected total joint arthroplasty that had been performed abroad resulted in costs that were nine times what would have been spent had the patient received the procedure in a domestic hospital.
While this case vividly depicts the possible public costs of post-operative care stemming from medical tourism, the authors note that even with a 5% failure rate, the cost savings potential offered by medical tourism are so substantial that the Australian healthcare system would save public money by allowing patients to pursue the operation overseas and receive reimbursement. Patients in other countries with publicly-funded healthcare systems may also be reimbursed by their governments for pursuing some elective surgeries abroad, likely lowering cost barriers to engaging in medical tourism. For instance, a very small number of Canadian medical tourists have been reimbursed by their provincial public Medicare systems upon returning home if, prior to departure, they were able to demonstrate that the care being sought was medically necessary and unable to be provided in a timely manner in Canada. However, in such cases, medical tourism becomes a viable option only for those who can afford to first pay out-of-pocket.
Further, Medical tourism has regularly been accused of exacerbating healthcare and ultimately health inequities in destination countries. One such criticism is that it exacerbates ‘brain drain’ within destination countries. The higher wages and advanced technologies available at facilities offering medical tourism act as a lure for healthcare providers working in more modest facilities. It also exposes inequity between medical tourists and local citizens in host countries. While tourists accept higher costs for treatment, these prices are often unaffordable for local patients. At the same time, when patients from countries with strong publicly-funded healthcare systems engage in medical tourism, they undermine the ethos that has allowed these very systems to develop and survive. They do this by effectively introducing a second tier of care available only to those with the ability to pay, an option that runs contrary to the provision of exclusively publicly-funded health care. Their actions extend further than the appearance of inequity, as each medical tourist puts his/her support behind the private provision of health care and a conception of health care as a commodity. This also applies to countries lacking in public health care, as the affordability of medical tourism works to neutralize pressure for reform and the equitable distribution of resources.
Medical tourism is not a phenomenon that will subside anytime soon, in fact, it is only growing as the economies of the world continue to evolve. Despite the negative effects of medical tourism, it continues to help and treat people across the world and I reckon that we are just at the precipice of a bigger boom in the medical tourism business. Thus, as we witness immense growth and significant results, it is important to remain mindful and make these avenues more equitable while continuing to profit all involved parties.
References
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