Considerations for Stakeholders of Medical Tourism: A Comprehensive Examination

Introduction

Medical tourism is a phenomenon and not a policy-driven consequence. With several countries competing for a higher share in $100 billion market, the situation is as interesting as it can get. Even though the phenomenon of medical tourism is centuries old, the world has witnessed a trend reversal. In earlier times it was the rich from the developing countries that used to travel to the developed world in order to seek quality care. But now, it is the not so rich people from the developed world who are now willing to seek care in low and middle-income countries like Thailand, Malaysia, and India.

Over-reliance of United States’ on the private sector for care substantially increased the cost. While in the United Kingdom, the health system tilted towards socialist approach post World War II (Richmond et al, 1996) and solely relied on public provision of healthcare. Both systems faced unintended consequences and resulted in a high cost in the US and long waiting time in the UK. Meanwhile, second and third world countries were recovering post-de-colonization. Their health system was not in good shape even for their own citizens leave aside foreign patients. Over time, the effects of liberalization and globalization spilled over to various sectors including health. And with increased global migration, developing countries gained access to opportunities in the developed world.

The global education system enabled medical practitioners to be trained in a developed country which empowered the workforce in a developing country to have international standard medical services. Close proximity due to international migration further helped to build the trust between the citizen of developed countries and the workforce of the less industrialized world. At that point, it was difficult to determine the consequences of such an exchange on healthcare. With the passage of time, second and third world countries ramped up their health system to match their quality with that of developed at a cheaper cost. Simultaneously, rich countries faced issues with insurance coverage, long waiting in their health system. As per 2011 estimates, 15 percent of the US population was uninsured. Europe achieved almost 100 percent coverage under NHS (except Greece, Bulgaria, and Cypress) (Gilbert, 2015) but patients faced long waiting time. Under these circumstances, the boundaries of health care seeking expanded, the flow of patients reversed, and ‘healthcare’ joined the commodity list of the international market place.

A whole new economy prospered around medical tourism with various stakeholders including patients, hospitals, insurers, medical tourism facilitators and the government. The prime focus of this chapter is to discuss the concerns and considerations of these stakeholders while transacting in the medical tourism market. The chapter sequentially discusses the (1) stakeholder's purpose, power, and position, (2) theories of medical tourism followed by (3) Enabling factors of medical tourism and its framework; (4) Medical tourism disparities and (5) Future of medical tourism.