By Barbara Krooss –
Medical tourism is undoubtedly popular—like hundreds of billions of dollars popular. But is it safe and worthwhile? Depends on who is answering the question and where procedures are being done. Coming up with the right answer is even more difficult thanks to press reports that conjure up images that range from patients visiting inexpensive but ultramodern care facilities to those where visitors received fatal injections of God knows what by God knows who in seamy and unmentionable locations.
Unfortunately, there is probably a bit of truth in both descriptions. The first step in the search for what is possible and safe is to distinguish health tourism from medical tourism. Health tourism focuses on feel-good trips and destinations that include spa visits, treatments for stress reduction and funky folk healing. Medical tourism is about hitting the international road for medical, dental or surgical treatment. Amazingly, it’s not new. Ancient Greeks and Romans made pilgrimages to shrines of the healing god, Asclepius, whose trademark serpent-entwined staff remains an international symbol of medical care.
Today, however, the motivation behind medical tourism is different. It is about saving money and getting difficult or domestically banned treatments. And it is big business. It’s hard to get exact numbers. But there are thousands of companies that specialize in facilitating these trips by liaising between patients and treatment providers and helping travelers obtain passports, flights, lodging and local transportation.
Precedence Research projects that medical tourism’s global market size will increase to $ 346.1 billion in 2023 from $ 115.6 billion in 2022 thanks in part to a Covid-19-related decline in overseas trips.
The U.S. government estimated that the U.S. accounts for about 10 percent of the world’s medical tourists. The Centers for Disease Control and Prevention (CDC) adds that most of these patients remain in the Western Hemisphere because of its proximity and convenience.
Mexico and Canada don’t rank as medical tourism destinations since they involve ground travel, but South America does and it garners 26 percent of traveling patients, while the Caribbean attracts about 20 percent and Central America pulls 18 percent. Other destinations included Europe at 15 percent, Asia at 14 percent and the Middle East at 5 percent.
The best choice for quality and cost depends on a patient’s needs. Nomad Capitalist does provide some clues on where to aim via its list of the top ten countries for medical tourism. It includes Malaysia, Singapore, Thailand, India, Turkey, the Czech Republic, Costa Rica, Panama, Mexico and Brazil.
Despite media-fueled images, few medical tourists are celebrities getting stealth cosmetic work or detox while “vacationing.” The biggest reason for medical tourism is cost, followed by the availability of techniques and procedures, quality of care and comfort.
“Our market has always been what I call the ‘working poor’ and they just keep getting poorer,” said Josef Woodman, chief executive of Patients Beyond Borders. “The pandemic has gutted low-income and middle-class people around the world and for many of them the reality is that they have to travel to access affordable health care.”
This is especially true in the U.S. where health care is not universal, and insurance costs are high. Travelers from other countries can be motivated to move because procedures may not be covered at home or because there are extensive wait times.
Many procedures, especially those not covered by insurance, are cheaper and easier to obtain abroad. These include cosmetic, orthopedic, gender-affirmation and bariatric (weight-reduction) surgery. Travelers can also stock up on drugs and get access to medicines and surgery not yet approved in the U.S.
Many traveling patients are simply desperate to find help overseas, such as those suffering from cancer or waiting for an organ transplant. Others may be seeking assisted suicide support, which is illegal in the U.S. but available in Belgium, Canada, Luxembourg, the Netherlands, Switzerland and New Zealand. In addition, there are those who may travel for an abortion or treatments for in-vitro fertilization and surrogacy.
Medical tourism may be booming for good reason, but it can have disadvantages and risks. The CDC notes that besides encountering hassles from cultural and language difficulties when overseas, air travel may pose barriers for ill or recovering patients. Foreign facilities also raise concerns regarding low-quality care, lack of proper training, accreditation, sanitation, infectious diseases and problems with antimicrobial drug resistance. Continuity of care may be another issue as doctors at home or overseas need full access to records and care instructions before and after any treatment, especially if problems occur.
Planning ahead, assessing the medical risks and logistical challenges, and getting a handle on international and domestic insurance are essential for any overseas trip. Fortunately, help is available. The American Medical Association and the American College of Surgeons both offer planning guides. The CDC also provides guidance on researching clinician and facility qualifications. In addition, accreditation standards for healthcare facilities can be provided through groups like the Joint Commission International, DNV GL International Accreditation for Hospitals and the International Society for Quality in Healthcare.
