Health exports have increased to 100 billion dollars per year and it has become an important item in service exports all over the world. Demographic structures are changing with the old population in developed countries, and health tourism among countries has increased. This chapter aims to study health tourism in European Union, aiming to create a single market with member countries and with free movement of people among member countries. EU policy permits member countries' citizens to get health service from any other member country. A literature review shows that the differences between member countries' national health systems is one of the main issues to be resolved and that the countries with old populations who need health care affect health tourism from developed countries with old population countries to countries with young population like Spain. Along with the legislation, ethical, social issues, and standard international rules accepted by all countries covering all aspects of health tourism must be set by international organisations like the WHO to avoid potential risks for the patients.
TopHealth Tourism
Tourism is regarded as a leisure activity and includes, in a sense, the consumption of goods and services that are not required (Urry, 2002). Health tourism is also defined as externalization of health and health services (Kher, 2006). At the same time, it is defined as “export of patients” and importation of medical services (Herrick, 2007). Another definition of health tourism is organized trips from one's own place to another in order to protect or improve one's mental and physical health (Carrera, 2006). Health tourism covers people’s travels from their permanent living and workplaces and temporary accommodation necessities (Olalı, 1988),
According to (UNWTO, 2017), the difference between definitions of tourism, health tourism and wellness tourism are: Tourism (travel) activity helps wellbeing. Health tourism covers both subtypes tourisms i.e. wellness and medical tourism. In other words, health tourism covers both mental, spiritual health via medical and wellness-based tourism. The first subtype of tourism is wellness tourism which covers items like healty eating, fitness, relaxation etc. The second subtype of tourism is the medical tourism, which covers diagnosis, cure, treatments, preventation etc.
As the data of health tourism covers many aspects therefore the statistical data showing the size and growth estimates vary, according to Medical Tourism Association, the market size is 100 billion US Dollars and according to Patients Beyond Borders the market is between 45,5 to 72 million dollars (World Tourism Organization and European Travel Commission, 2018). With the increase in the health care costs, middle- and low-income countries increased medical tourism (Hopkins and et al, 2010). In other words, Medical tourism high-income countries’ patients travelled to low- and middle-income countries to have cheaper medical care (Mazzaschi, 2011).
Connell claims that although medical tourism has increased in the past years, reliable estimates are not available because it is difficult to identify medical tourists (Connell, 2013). Medical tourism income has been estimated about 60 billion United States dollars (US$) per year and is expected to grow about 20% annually (Heung, Küçükusta, Song, 2011). In 2007, an estimated 50 000–120 000 residents of the United States of America travelled abroad to obtain medical services (Johnson, and Garman, 2010). UK’s estimate for the year 2010 is that 63 thousand went abroad for medical care (Hanefeld, Horsfall, Lunt, Smith, 2013). According to some of the estimates, Thailand received 104830 medical tourists in 2010 (Noree, Hanefeld, Smith, 2010).
The first dimension of health tourism is planning and realization of travels (Glinos, Baeten, 2006); the second dimension includes the provision of accommodation, health care and other complementary services to those coming for the purpose of health care (Turner, 2008); the third dimension includes the patient's return to his / her country after receiving health care and controlling the recovery process when necessary (Kültür ve Turizm Bakanlığı, 2009).