An international comparative case study of health equity impacts of medical tourism in developing nations
Canadians take part in medical tourism (MT) when they travel to other countries to intentionally access medical care without a physician referral that is typically paid for out-of-pocket. It has been speculated that the travel of international patients from more-developed nations such as Canada to developing nations via MT is exacerbating health inequities in destination countries. Meanwhile, evidence is lacking that clearly demonstrates this is indeed the case. Alternatively, evidence is also lacking to support claims that MT is having a positive impact in developing nations through enhancing health care infrastructure and bringing revenues into the public sector. In this international, comparative case study we aim to address this pressing knowledge gap by examining the health equity impacts of MT in six purposefully selected sites: Bridgetown, Barbados; Guatemala City, Guatemala; Monterrey, Mexico; Mexico City, Mexico; Chennai, India; and Delhi, India. The results of this study will be important and useful to Canadians and Canadian health service providers and administrators because MT poses particular challenges to this country. While the ethos of our health care system rejects two-tiered care for essential services, the number of Canadian medical tourists paying out-of-pocket to go abroad is already considerable and steadily increasing. Research into MT will allow for valuable insights to be gleaned early on in the global conversation about MT, thus allowing Canadian patients to make choices regarding engaging in and ethical and equitable MT, Canadian health care providers and administrators to provide needed guidance to patients. Also allowing Canadian health policy makers to ensure that we are meeting our normative and legal obligations to improve global health equity and are not undermining efforts to expand universal health care and sustainable health system financing efforts in developing nations.