Does medical tourism benefit countries?

Ian Youngman, author of “MedicalTourism: Facts and Figures 2014” looks at the criticisms that are aimed at the medical tourism sector and the opposition to medical tourism from governments and other organizations.

When I first wrote about medical tourism, it was widely assumed that medical tourism was good for countries seeking medical tourists… and those sending patients to other countries.

If you read most of the medical tourism press, what the industry feeds to the global media, and what is expounded at conferences, you would assume that medical tourism is benign and harms nobody.

We have always had stories, or more correctly allegations, of dodgy cosmetic surgery, fraudulent agents, and ‘best global doctors’ who are anything but. And there are the problems of stem cell and other treatments that may be useful or may just be a very expensive way of having a holiday overseas. But the underlying premise is that medical tourism does good. For the most part it actually does!

The downside of medical tourism

The downside of the hype that surrounds medical tourism is that it has made some hospitals, doctors and governments greedy. What they see is an attractive source of income from international patients. And a legion of consultants and advisors are ready to encourage them, for a hefty fee, to find quick routes to access that revenue.

The problem with the burning desire to make money from medical tourism is that many organisations neglect to gain the support of their own doctors, nurses or even government/insurer paymasters.

Recent events

In the last few months we have seen one government effectively banning public hospitals from supporting medical tourism, two governments trying to find ways of stopping their politicians and officials from going overseas for treatment, and two nursing organizations protesting against medical tourism plans, and various legal threats.

The problems vary by country and hospital. Some of these are politically charged and depend on a view of private healthcare.

But all can be traced to one cause. That is the citizens of the sending or receiving country not getting good healthcare, often linked to under-investment in hospitals and underpayment of nurses and doctors.

The criticism is that well off hospital owners, leading surgeons and doctors, prominent politicians and government officials are either making money or getting healthcare at the expense of others.

The effect on outbound medical travel

For countries where only the elite go overseas, the argument is that they are often using (or misusing) public money to pay for it, and valuable foreign exchange flows overseas too. So outbound medical tourism is a strain on the economy and public healthcare.

Another argument is that the home country has to provide aftercare or even clear up the problems caused by overseas treatment, and this puts a strain on domestic healthcare, particularly if the problems relate to healthcare that the state system would not normally offer at home, such as cosmetic surgery.

The effect on domestic healthcare systems

Where patients are travelling to a destination and paying for treatment, the argument is that if you have X beds, Y doctors and Z nurses, all at or near capacity, then the only way that private paying medical tourists can get treatment is for services to be taken away from non-paying state patients.

Where patients are travelling to a destination and not paying for health services which they are accessing, this is where the politicians really go to town on paranoia, fear, made up facts and ignorance. If a state healthcare service is underfunded, poorly managed, and not up to par, an easy target to blame for the problems are health tourists getting free treatment to which they are not entitled.

The fact that many of these health tourists are paying patients or that they are business or holiday travellers taken ill and are on reciprocal healthcare arrangements does not matter to the politicians. They are the first to object if overseas hospitals refuse to treat their citizens abroad.

None of this is the fault of real medical tourism, but ‘medical tourist’ and ‘health tourist’ become terms of abuse which does not help businesses trying to build funded medical tourism.

Conclusion

I have no simple answers. Many people will dismiss these problems as local difficulties or things that can be ignored but, in the long term, that is a dangerous thing to do.

As we have seen several times in the UK, when you have a small problem on healthcare, you can either solve it sensibly, or turn it into a huge political argument, which is “solved” by massive administration, and legislation that causes more problems than it solves.

It is easy for politicians to turn a small problem into a huge escalating one; particularly if they can see a bandwagon to ride on, votes to keep them in office, and personal glory.

So my message is simple. Do not ignore these warnings locally or nationally. Do your research, find out the real figures, and above all do not go into defensive mode based purely on opinions and rhetoric.

If we want the medical tourism industry to flourish, we must make sure that what we do is not making life worse for patients at home or overseas.