by Sara Shariati

Graphic design by Anne McGrath

Medical tourism, which refers to individuals traveling abroad to seek healthcare, is a booming industry with a global market worth billions of dollars.¹ While the concept of traveling for medical treatment has existed since the 20th century–primarily involving individuals from less affluent countries seeking advanced care and technology in more developed nations–a new trend has lately emerged.² In recent years, there has been a significant increase in individuals from developed countries traveling to developing nations for medical purposes, giving rise to a form of “reverse globalization” where markets from developing nations expand autonomously and become increasingly popular.¹ 

Difficulty in Quantification

One of the challenges in comprehending the scale of medical tourism lies in the difficulty of accurately quantifying the number of medical tourists. Many individuals do not explicitly state that healthcare is their primary reason for travel on official forms. Some immigrants and dual citizens, for instance, undergo elective or cosmetic surgeries when visiting their home countries, but this may not be documented as the primary purpose of their trip. Similarly, tourists often combine vacation with minor medical procedures, such as dental care, which might not be reported. Consequently, the reported figures likely underestimate the true extent of medical tourism. Despite these challenges in acquiring accurate statistics, the available data shows that the market for medical tourism grew from less than ten billion dollars in 2000 to over 100 billion dollars in 2012.¹

Popular Destinations

Although precise statistics are elusive, certain destinations have emerged as well-known hubs for medical tourism, with countries in Asia and Latin America–such as India, Thailand, Turkey, Singapore, Malaysia, the Philippines, Cuba, Mexico, Argentina, and Brazil–being the preferred choices for many medical tourists.³ These countries have become popular hubs for medical tourists by offering a wide variety of medical, surgical, and dental services in modern, well-equipped facilities and affordable accommodations.³  

Motivations for Travel

The motivations behind medical tourism are diverse, but two major factors stand out: reduced wait times and cost-effective treatments. Patients often choose to travel abroad to bypass lengthy waiting lists in their home countries. Additionally, elective and cosmetic procedures are typically more affordable in destination countries. For instance, the cost of medical services in India could be as low as 10% of prices in the United States.³ Given that cosmetic and elective treatments are often not covered by public healthcare or private insurance plans, cost is a significant consideration for many patients. Furthermore, specific medical procedures, such as certain fertility treatments, may not be accessible to patients in their home countries.

Numerous medical tourism packages are now available, providing all-inclusive options for patients seeking treatment abroad. For example, breast implant or liposuction packages in Thailand on the website placidway.com start from a few thousand dollars.⁴

Opportunities for Destination Countries

Medical tourism serves as a vital economic stimulant for destination countries, creating a ripple effect that benefits various sectors. Beyond job creation and revenue generation, it promotes investments in healthcare infrastructure, thereby raising the overall standard of medical care in these nations.

Destination countries recognize the potential of medical tourism in bolstering their healthcare systems. They often allocate resources to improve medical facilities, adopt advanced technologies, and provide specialized training for healthcare professionals.⁵ Some governments have also utilized medical tourism to bring back healthcare workers who had previously emigrated, thereby reversing the brain drain from their countries.⁵ 

Moreover, medical tourism encourages investments in the hospitality industry, leading to the construction of hotels, resorts, and other accommodations. These developments create employment opportunities, stimulate local economies, and contribute to the growth of the tourism sector. The synergistic relationship between healthcare and tourism bolsters the nation’s economic stability, reducing its dependence on traditional industries.

It is important to note that the length of stay for medical tourists varies depending on the complexity of their procedures. While simpler treatments, like dental care, may require only a few days of stay, more complex surgeries could necessitate several weeks or even months of residence in the destination country, thereby bringing in more funds for these nations.

Ethical Concerns

As the medical tourism industry flourishes, it becomes imperative to address the ethical dilemmas associated with it comprehensively. One of the primary concerns revolves around access inequality. The majority of medical tourists belong to the middle class, which means that the lower-income population may be unable to afford such travel, exacerbating access inequality issues in the home countries of medical tourists.³ 

Additionally, the outsourcing of patients to other countries can lead to complacency within the healthcare systems of the home countries of medical tourists. Instead of addressing systemic issues, such as prolonged wait times or limited access to specialized treatments, governments may become less motivated to enact reforms when they perceive a temporary relief in demand.

Within destination countries, the preferential treatment of medical tourists can result in unequal access to healthcare services for the local population. Immediate attention and resources may be directed towards tourists, pushing local patients onto waitlists, creating disparities, and engendering frustration among residents.⁵ Furthermore, experienced and highly trained physicians in destination countries may be drawn to work in hospitals and medical facilities catering to tourists, due to competitive salaries and more advanced equipment; this would further reduce the quality of public healthcare for the local residents of destination countries.⁵

Quality of care is another ethical concern. The standards and regulations governing medical practice can vary widely between countries. Thus, patients may not have the same level of legal protection or recourse in the event of malpractice in destination countries as they do in their home countries. Given the transient nature of medical tourists’ stays, complications arising from procedures may also be challenging to address, potentially putting patients’ health at risk.³

Furthermore, cultural and ethical differences can affect the overall patient experience in medical tourism destinations, impacting patient-provider communication and informed consent processes. Ensuring that patients are adequately informed and prepared for such cultural and ethical variations is crucial to maintaining ethical standards in healthcare delivery.

Conclusion

In conclusion, medical tourism is a multifaceted phenomenon with far-reaching economic and ethical implications. While it offers advantages, such as opportunities for economic growth in developing countries, increased investments in healthcare infrastructure, and higher affordability of treatment, it also raises ethical concerns related to access inequality, complacency in home countries, health disparities within destination countries, and quality of care. Navigating these challenges requires stringent regulation, ethical awareness, and a commitment to upholding patient rights and well-being. In an interconnected world, addressing the ethical dimensions of medical tourism is essential to ensure that healthcare remains accessible, affordable, and of high quality for all, transcending geographical boundaries. Addressing these ethical issues requires dialogue, discussion, and cooperation between healthcare professionals and medical experts in home and destination countries. 

References

1. Sun X. Research on the Model of Cross-Border Medical Tourism Decision-Making under the Background of Globalization. Open J. Soc. Sci. 2018;6:230-246. doi: 10.4236/jss.2018.69016.
2. Meng CK, Piaralal SK, Islam MA et al. International medical tourists’ expectations and behavioral intention towards health resorts in Malaysia. Heliyon. 2023;9:e19721. doi: 10.1016/j.heliyon.2023.e19721.
3. Horowitz MD, Rosensweig JA, Jones CA. Medical Tourism: Globalization of the Healthcare Marketplace. MedGenMed. 2007;9:33.
4. All-Inclusive Medical Treatments Packages in Thailand. PlacidWay. [https://www.placidway.com/search-medical-packages/All/Thailand/1.]
5.  Smith R, Martínez Álvarez M, Chanda R. Medical tourism: A review of the literature and analysis of a role for bi-lateral trade. Health Policy. 2011;103:276-282. doi: 10.1016/j.healthpol.2011.06.009.