What has politics got to do with medical tourism?

“Politics has nothing to do with medical tourism” is often the view of medical tourism organisations globally and nationally. But nothing exists in a vacuum so medical tourism needs to grasp what is happening and why, says IMTJ analyst Ian Youngman.

To name a few current politically-driven influences on medical tourism:

• Ukraine: The war changed the number of outbound Russian medical tourists and where they went.
• Cuba: The USA continues to ban medical tourism to Cuba.
• Afghanistan: outbound medical tourism is strangled by USA sanctions.
• Iran: European and USA sanctions mean medical tourists from many countries cannot go there.
• Venezuela: Sanctions on Venezuela look to be lifting.
• USA sanctions target and affect a number of countries including Belarus, Myanmar, Nicaragua, Syria, and Zimbabwe.
• Sanctions on North Korea by many countries mean medical tourism never started.

There is however a ‘contra’ to many of the above. Russians go to new countries such as Turkey; medical tourists go to Iran from Iraq and other countries not aligned to the West, instead of Asia or Europe; and Canadians and Americans pretending to be Canadians go to Cuba via indirect routes.

So the assumption by medical tourism that politics does not affect it is bogus.  The changing picture of politics and its effect on medical tourism can be highlighted in these examples:

AFGHANISTAN

• The Biden administration has blocked Afghanistan’s central bank from accessing US$7 billion in its foreign reserves held in the United States. US$2 billion is blocked by European authorities. Afghanistan’s economy and the local healthcare system has been collapsed.
• Medical tourism effect: Afghans can neither afford nor access overseas treatment. Afghans treated overseas are charity cases.

CUBA

• The US embargo against Cuba is one of the oldest and strictest of all US sanctions regimes, prohibiting nearly all trade, travel, and financial transactions between the United States and Cuba since the early 1960s. Over the last year, 250,000 Cubans, of the island’s 11 million population, have migrated to the United States. This displacement is largely driven by economic challenges.  It is illegal for Americans to travel to Cuba for medical treatment.
• Medical tourism effect: A handful of Americans and Canadians went there for medical care in the past. This trade seems to have almost ended.

IRAN

• USA and EU sanctions on Iran ban most trade and financial transactions with Iran. Western debit and credit cards cannot be used.
• Medical tourism effect: Iran is a major medical travel destination but gets no UK, USA or European medical tourists. But it gets many from places that do not like the UK, USA or Europe.

NORTH KOREA

• The United States sanctions on North Korea have been in place since the 1950s. US sanctions cover most finance and trade. The European Union and Japan have similar sanctions.
• Medical tourism effect: North Korea tried and failed to enter medical tourism. There is no inbound or outbound medical tourism.

RUSSIA

• US sanctions on Russia’s financial, energy, and defence sectors began after the 2014 annexation of Crimea. Newer sanctions are from the United States, the United Kingdom, and the European Union in response to the 2022 invasion of Ukraine, with the barring of most financial transactions, Russian oil and gas imports, and freezing of Russian assets abroad. Russia’s economic development will be in reverse for years.
• Medical tourism effect: Fewer Russians can afford overseas medical treatment. Bans, high air fares, plus currency and card problems reduced outbound numbers. Russians are now going to Turkey and some EU countries that put tourism above politics, as they are far away from Ukraine.

VENEZUELA

• The Biden administration is lifting sanctions.
• Medical tourism effect: Outbound medical tourism will resume. Inbound medical tourism will be led by cosmetic surgery.

From 15+ years of tracking what national and global medical tourism bodies do, unfortunately none have a response when asked about politics. And when it comes to rebuilding tourism, the absence of these bodies in discussions is harming the sector.  Being detached from economic and political reality is often how global tourism views medical tourism, when it even thinks of it.

For a full picture of the medical tourism reality and future potential in these countries, visit IMTJ Country Profiles.