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.
Valorie Crooks
Professor, Department of Geography, Simon Fraser University.
Ronald Labonté
Professor and Canada Research Chair (Globalization and Health Equity)
School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa
Jeremy Snyder
Professor, Faculty of Health Sciences, Simon Fraser University.
Corinne Packer
Researcher, Globalization and Health Equity Unit, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa
Gustavo Nigenda
Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
Prasanna Saligram
Lecturer, Public Health Foundation of India
Rupa Chanda
Professor, Indian Institute of Management, Bangalore.
Walter Flores
Director, Center for the Study of Equity and Governance in Health Systems
Vivien Runnels
Researcher, Globalization and Health Equity Unit, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa.
Paul Kingsbury
Professor, Department of Geography, Simon Fraser University.
Rory Johnston
PhD student in the Department of Geography at Simon Fraser University.
Suresh Venkatesan
Henry Fraser
Thelma Narayan
Co-initiator, Society for Community Health Awareness, Research and Action, India.
Chantal Blouin
Associate director, Centre for Trade Policy and Law; Co-director of the Health and Foreign Policy Initiative, Norman Paterson School of International Affairs, Carleton University.
Ayona Bhattacharjee
Indian Institute of Management, Bangalore.
2017
Labonté, R., Runnels, V., Crooks, V. A., Johnston, R., & Snyder, J. (2017). What does the development of medical tourism in Barbados hold for health equity? An exploratory qualitative case study. Global Health Research and Policy, 2(1), 5.
2016
Crooks, V., Johnston, R. Labonté, R, Snyder, J. “Critically reflecting on Loh’s “Trends and structural shifts in health tourism””, Social Science and Medicine (2016) 152:186-0.
2015
Labonte, R. Medical tourism isn’t always a fair deal for developing countries. (2015). The Conversation.
2014
An Overview of Guatemala’s Medical Tourism Industry. Cerón, A., W. Flores, V.A. Crooks, R. Labonté, and J. Snyder. (2014). Department of Geography, Simon Fraser University. http://tinyurl.com/ousk4fh
An Overview of Mexico’s Medical Tourism Industry. Núñez, E.O., Arias, R.M.B., Martínez, M.E.A., Larios, J.A.R., Crooks, V.A. Labonte, R., Snyder, J. and Nigenda, G. (2014). Department of Geography, Simon Fraser University. http://tinyurl.com/og9ds48
An Overview of the Medical Tourism Industry in Bangalore, India. Saligram, P.S., A. Bhattacharjee, V.A. Crooks, R. Labonté, A. Schram, and J. Snyder. (2014). Department of Geography, Simon Fraser University. http://tinyurl.com/pauqvsk
An Overview of the Medical Tourism Industry in Chennai, India. Suresh, V. Madha, V.A. Crooks, R. Labonté, A. Schram, R. Kalaivani, S. Nithya, and J. Snyder. (2014). Department of Geography, Simon Fraser University. http://tinyurl.com/oy9uxnj
Cafe Scientifique- Borders, Babies and Body Parts: The Ethical Dilemmasof Medical Tourism. May 7, 2014.
2010-2013
An Overview of Barbados’ Medical Tourism Industry. Johnston, R., V.A. Crooks, J. Snyder, H. Fraser, R. Labonté, and K. Adams. (2013). Department of Geography, Simon Fraser University. http://tinyurl.com/ns2gzns
Alsharif, M.J., Labonté, R. and Zuxun, L. “Patients Beyond Borders: A Study of Medical Tourists in Four Countries.” Global Social Policy, 10(3): 315-335, 2011. http://gsp.sagepub.com/content/10/3/315.full.pdf
Runnels, V., and Turner, L. “Bioethics and Transnational Medical Travel: India, “Medical Tourism”, and the Globalization of Health Care.” Indian Journal of Medical Ethics, 8(1): 42-44, 2011. www.globalhealthequity.ca/webfm_send/36
Hopkins, L., Labonté, R., Runnels, V. and Packer, C. “Medical Tourism Today: What’s the State of Existing Knowledge?” Journal of Public Health Policy, 31: 185-198, 2010. http://www.ncbi.nlm.nih.gov/pubmed/20535101