A Medical Tourism Primer

Medical Tourism

A Little History of Medical Tourism

Medical tourism is often thought of as a recent phenomenon. The truth, however, is that people have been traveling long distances to better their health for thousands of years. Granted, it’s hard to picture a swarthy chieftain traipsing across the desert on his camel to barter for a nicer set of pearly whites. Were clinics and hospitals even around that long ago, thousands of years ago?

Archaeological evidence from the third millennium B.C. suggests that ancient Mesopotamians traveled to the temple of a healing god or goddess at Tell Brak, Syria, in search of a cure for eye disorders. A few thousand years later the Greeks and Romans would travel by foot or ship to spas and cult centers all around the Mediterranean. The Asclepia Temples, dedicated in honor of the Greek god of medicine, were some of the world's first health centers. Pilgrims would sometimes spend several nights in the temple, hoping Asclepios would appear in a dream and suggest a diagnosis or treatment.

Later in the 16th and 17th centuries, spa towns such as St. Moritz and Bath became prime destinations for the European upper classes looking to soothe their ills. What kind of “procedures” were the ancients seeking? No butt lifts or hip and knee replacements, that’s for sure. Many were looking for “healing” waters or the benevolence of the gods to cure common ailments of the time such as rheumatism, syphilis, gonorrhea, blindness and paralysis.

Modern medical tourism as we know it today has largely been the result of several factors including the high cost of medical care in first world nations, ease of long distance travel, and advances in information technology.

What is Medical Tourism?

Medical Tourism is the generally accepted phrase used to describe the phenomenon of people traveling outside their home country for medical care, dentistry and surgical procedures. The phrase came into use in the later 1990s in business reporting in the Far East, where hospitals targeted the international market for medical services.

Since the last decade it has expanded its horizon like anything because of better treatment option, quality medical services, at an affordable price and with luxury tour if opted.

Medical Tourism is an option worth exploring for anyone who is facing significant out-of-pocket expenses for millions more who are underinsured. Medical Tourism is also a viable option for all individuals considering any elective surgery, not covered by insurance. Specifically, the demand for high quality, lower cost cosmetic surgery and dentistry has been on the edge of the wave of Medical Tourism originating in the United States and Western Europe.

Going abroad for care is also a reasonable choice for patients who want care not available to them locally. Some hip resurfacing procedures, for example, have been performed in India for years but have only recently been approved in the United States. The use of silicone gel breast implants, sought by many cosmetic surgery patients, has been restricted for years in the United States but they are widely available in the rest of the world. Procedures related to fertility, stem cell research and organ transplantation also draw a number of patients from around the world.

Finally, Medical Tourism can be an option worth considering for those in countries with what many call "rationed" health care, particularly Canada and the United Kingdom. Though both countries have national health care, there can be a lengthy wait for procedures and surgeries that are classified as non emergency. In the UK and Canada, this inconvenient forced wait is applicable to a large number of orthopedic surgeries that cause great pain and require extensive wait times before local health care is made available to patients.

Who are medical tourists?

Initially, medical tourists were composed of only the affluent and well-to-do people from all over the world, who could afford to travel abroad to receive the best medical attention. Although many wealthy people still do so, medical tourists now also consist of average earning individuals, or individuals without access to affordable healthcare. The standards of medical care and quality of facilities in the major metropolitan areas of the world are now comparable to those in the United States, while costs are much lower. Medical tourism, as it pertains to the U.S., UK, Canadian, Middle Eastern and Western European residents, is largely a price and convenience driven experience.

Medical tourists today come from all walks of life. In common, they have a desire for affordable, high quality care or surgery that is beyond their financial means or unavailable to them at home.

There are two categories of medical tourists. The first is the tourist who is on holiday and decides to purchase medical services that don’t interfere with leisure travel like check-ups, dental care and eye laser surgery. These are basic, low risk and low-cost procedures. The second is the tourist who specifically comes for healthcare. This medical tourist is usually coming for more intensive medical and surgical procedures like cosmetic surgery, spinal surgery or cardiac surgery.

What Kind of Medical Tourism Are You Looking For?

Medical tourism comes in many different flavors but can be grouped primarily under the following four branches:

Medical Tourism For “Major” Medical Procedures

Also referred to as non-elective or critical procedures, these tend to be relatively complex surgeries that, due to their urgent nature, must be procured in a relatively short time period. They include but are not limited to orthopedic procedures such as knee and hip replacements, cardiac surgery, neurosurgery, gynecology procedures and general procedures such as hernia repairs and gallbladder removals. These procedures tend to be characteristic of the baby boomer generation and are therefore expected to increase in popularity as more North Americans enter this demographic age group.

Medical Tourism for Plastic Surgery or Cosmetic Surgery Procedures

From breast lifts to tummy tucks and buttock augmentations, these are the glamorous procedures most commonly associated with the term medical tourism. They are known as elective procedures as you elect or choose to have them done usually based on non life threatening considerations such as bettering your appearance. These procedures are normally not covered by insurance and its adherents are usually between the ages of thirty-five and sixty-five (though there are many exceptions to this rule).

Dental Tourism a Form of Medical Tourism

As the heading suggests, this is the side of medical tourism that focuses on fixing your smile. Though the name may conjure up images of a tanned thirty-something brandishing a sparkling smile and strolling along a palm-fringed beach, the truth of the matter is that for many people, going abroad is the only way that they can afford to take care of sometimes complex dental problems. Popular treatments and procedures include teeth whitening and veneers all the way up to implants, crowns and complex cases such as maxillofacial surgery (correcting injuries and defects in the head, neck, face and jaw).

Health Tourism for Wellness & Alternative Treatments

This is a rapidly growing sub-niche of medical tourism that has been around for many years. It is technically two sub-niches (though they do overlap) as we must differentiate between travel for alternative treatments and wellness tourism.


The Medical Subject Headings (MeSH) Section staff of the National Library of Medicine classifies alternative medicine under the term complementary therapies. This is defined as therapeutic practices which are not currently considered an integral part of conventional allopathic medical practice. Others would define it as any medical intervention not available at U.S hospitals. These “interventions” include but are not limited to certain cancer therapies, homeopathy, chiropractic, naturopathy, mega-vitamin therapy, herbalism, acupuncture, massage, and new age healing. Wellness tourism, on the other hand, is characterized by generally healthy people seeking to preserve or promote their health through preventative care treatments such as medical check-ups, mega-vitamin therapy, yoga and meditation.

Why should I consider medical or surgical procedures outside the U.S.?

About 500,000 Americans traveled overseas last year to undergo surgeries that cost two to three times more in the United States, according to the National Coalition on Health Care.

Western Europeans and Canadians have joined Medical tourism and have already bypassed the long wait periods that are part of their national health plans. Ten percent of EU patients seek treatment outside their own country and spend an estimated 12 billion Euro. Medical Tourism is a rapidly growing industry even in the so-called developing countries like Mexico,Brazil,Costa Rica,Dominican Republic,Hungary,India, Israel,JordanLithuania,Malaysia,South Africa,Thailand and Philippines actively promoting it.

Its not just US patients that are considering medical tourism. Australians are also investigating a wide range of medical tourism options in India, the Philippines, Malaysia, Thailand, and Singapore.

Why Travel Overseas For Medical Care?

At this point you might ask: why would someone fly halfway around the world for a medical procedure? Why go through all the trouble of finding a doctor and hospital in Costa Rica, India, Thailand or the Philippines if there is great medical care available in the U.S. and Canada?

No one will doubt that the U.S. and Canada boast some of the world’s best physicians and medical facilities. So much so that for years many foreign doctors have come to train at our universities and hospitals in order to learn the latest techniques and to have access to cutting-edge technology.

However, the fact that each year more and more people are traveling abroad for medical care goes to show a simple truth: it does no good to have a dazzling Porsche parked in your garage if you don’t have access to the keys. For the nearly fifty million uninsured Americans who can’t afford quality healthcare, the keys to the Porsche might as well be locked in a concrete box at the bottom of the Pacific Ocean. By offering low-cost healthcare at top-quality international hospitals, Medical Tourism gives you the keys to the Porsche (or at least makes them much more accessible).

Why Medical Travel

There are three factors driving the increased popularity of medical travel:

  • Access to Quality Medical Care At A Fraction Of The Price
  • Immediate availability of procedures without long waitlists, and
  • Innovative treatments that may not be available where you live

As we're seeing globalization take place in all aspects of our lives, from telecommunications to commerce, medicine is no exception. Healthcare providers are involved in worldwide collaboration, the availability of state-of-the-art medical technology is ever-broadening and facilities all over the globe are adhering to standards formerly associated only with western medicine.

Due to the ever-rising costs of malpractice insurance, education and infrastructure, healthcare in the US is among the most expensive in the world. By traveling internationally, individuals can receive the same treatment from qualified, proven physicians for 30-80% less.

What Are The Forces and Drivers Behind Medical Tourism?

Over the last ten years, several factors have contributed to the increasing popularity of medical tourism. Chief among these are rising health costs.

In the U.S, the rising cost of healthcare is pushing people to look for other options and is also responsible for millions of Americans being uninsured or underinsured. In 2006 the US Census Bureau stated that the number of uninsured Americans jumped in 2005 from 15.3% uninsured and a total of 44.8 million to 15.8 percent of people in 2006 for a grand total of 47 million. Based on these numbers one can only estimate that in 2007 the number will be close to 50 million uninsured Americans. Contrary to popular belief, these people belong not only to the lower class, but to the middle and upper middle class as well.

Additionally, in 2005, 60.2% of those people with health insurance were provided it through their employer. In 2006, this percentage decreased to 59.7%. This means in 2006 over one million Americans had lost their health insurance through their employer. Let’s take a look at how a person might actually begin the medical tourism process. Say we have a fictional character named Tom Gruber, who is a 54 year old retail store owner living in middle America. During an exam his primary physician discovers that he needs prostate surgery. The price he is quoted is close to $50,000, and under his individual health insurance policy, he would still be responsible for $17,000 of the tab.

Through a friend Tom hears that there may be more inexpensive options abroad. An internet search brings up a hospital in Central America where Tom learns that the exact same procedure costs only $7,000 dollars. After carefully researching the hospital and talking to doctors and former medical tourism patients, Tom decides to fly there for his procedure. His total expenses including round-trip air-fare and lodging - $9,500. With savings like this, it’s not hard to see why medical tourism is becoming so attractive.

Why is Medical Tourism a Solution for the United States, Canada, and the United Kingdom?

At this moment the healthcare crisis in the U.S can be likened to a pressure cooker that is about to blow its top. The number of uninsured or underinsured Americans is close to Fifty million, and shows little sign of diminishing.

According to the U.S. Census Bureau, the elderly make up twenty-three percent of the major costs of U.S healthcare spending and each year more people are entering these age brackets as the baby boomers mature and get older.

It is projected that:

The number of Americans aged 65 or over will double by 2050

The number of people age 85 or over will quadruple by 2050

By 2030 over half of U.S. adults will be over age 50

The over 65 population will nearly triple as a result of the aging Boomers.

More than six of every 10 Boomers will be managing more than one chronic condition.

Although Canada has an admirable healthcare system in many respects, many residents admit that there is a serious crisis brewing. Poor government funding has led to a notable lack of physicians, nurses, and state-of-the-art medical equipment. This, in addition to the long waiting times for many surgical procedures, has created unrest and an urgent call for healthcare reform.

According to a 2007 article in the Christian Science Monitor, Britain's Department of Health reported that at any given time, nearly 900,000 Britons are waiting for admission to National Health Service hospitals, and shortages force the cancellation of more than 50,000 operations each year.

In each of these cases the government has failed to adequately meet the basic healthcare needs of many of its citizens. As baby boomers age and the current healthcare system is stretched to the breaking point, expect individuals and businesses to look at new ways of regaining control of their healthcare. The medical tourism phenomenon is a natural outgrowth of these conditions – an outlet if you will, for people trapped by an unwieldy system that offers little hope for a better tomorrow.

Long wait times for certain procedures is also a big factor for residents of Canada and other countries with socialized medicine, and is effectively forcing people to look for other options, including medical tourism. Wait times of a year or more are quite common in Canada and England. Contrast this with “wait times” of weeks or even days at many medical tourism destinations.

Why is it so cheap? Is it safe?

Medical care in the Philippines is equal to, comparable to, sometimes better than what you're going to find in the United States or Europe. The standards and the experience levels are similar given the right facility and surgeon.

What Kind of Savings Are We Talking About from Medical Tourism?

Chances are the main reason you are even looking into medical tourism is because of the savings. The fact is, on average you can expect to save anywhere from 50% to 80% of what you would normally pay in the U.S.

To get a good idea of the exact amount of money you’ll be saving, you need to consider not only the cost of the procedure, but also the air fare, lodging and other travel related costs.

Currently there are about 10-15 well known medical tourism destinations that offer internationally accredited hospitals and a variety of price points for various procedures.

For example, a triple coronary bypass can cost approximately one hundred thousand dollars in the U.S. A hospital in Mexico may advertise the same procedure for approximately thirty thousand dollars. But hold on, before speeding across the border you may want to take a glance at India or Thailand, where the same procedure runs for about ten and fifteen thousand dollars respectively.

Do you have a bad knee? A total knee replacement procedure costs about forty thousand dollars in the U.S. Several hospitals in India will replace your knee for less than ten thousand dollars. Maybe you don’t want to fly half-way across the globe for your surgery. No fear, hospitals in Mexico and Costa Rica are advertising a total knee replacement procedure for about eleven thousand dollars, which is still an attractive price considering the shorter travel distance and cheaper airfare.

Why is Medical Care Cheaper Outside the United States, Canada, and the United Kingdom?

The short answer is that most popular medical tourism destinations are third world (developing) nations. Wages are lower, infrastructure costs are less, and physicians don’t normally pay exorbitant amounts for liability or malpractice insurance. It is also important to note that in the U.S, particularly, insurance and administrative costs take up much of the healthcare budget. Here are a few more reasons why healthcare is less expensive overseas:

  • Lower cost of malpractice insurance - fewer law suits
  • Lower cost of labor
  • Lower real estate values
  • Lower construction costs (to build hospitals)
  • Favorable exchange rates
  • Lower government taxes
  • No accounts receivable collections issues with medical tourism patients (cash / credit card payment before release from hospital)
  • No emergency room bad debt
  • Less administrative paper shuffling
  • Less bureaucracy / red tape
  • Less expensive medical supplies/equipment/medications

Is Medical Tourism Safe?

This then begs the question, are prices cheaper overseas due to substandard quality? Generally, when people ask if going abroad for surgery is "safe," (and they do ask it, just that way) what they really want to know is "Is it as safe as if I went to my local doctor or hospital?" And the short answer is that "Yes, it is probably just about as safe".

Generally, when people ask if going abroad for surgery is "safe," (and they do ask it, just that way) what they really want to know is "Is it as safe as if I went to my local doctor or hospital?" And the short answer is that "Yes, it is probably just about as safe" - with the proviso that the patient does his or her homework, picks a good doctor or surgeon and facility and plans the trip wisely. Many medical tourists take nothing for granted, as they might at home; they want to know everything that might happen, everything they might encounter in advance, and thus are perhaps better prepared for their care or surgery than they might have been if they had stayed closer to home.

Along with price, safety is a key issue for anyone thinking of traveling internationally for medical care (medical tourism). How can I be sure that my international doctor is truly qualified – or even a real doctor? What about the standards of care at that hospital in Manila, Philippines, are they similar to what I’m used to at home? These and other questions like these will undoubtedly pass through your mind as you consider traveling abroad for medical care.

Substandard quality can be found anywhere – including in many so-called first world nations. Keep in mind though, that most established medical tourism destinations are competing against each other to lure first world medical tourism patients. Hospitals, and in many cases governments, have worked hard to provide foreign patients with world-class facilities, a dream team medical staff and cutting-edge technology. Many have taken the time and effort (as well as invested considerable funds) to become accredited by organizations such as Joint Commission International.

This same type of “our hospital needs to be better than your hospital” mentality motivates international hospitals to lavish medical tourism patients with personalized attention and services that you will seldom find at any U.S hospital. Patient rooms at some Asian hospitals seem better suited to a hotel like the Ritz Carlton. At least one hospital in Costa Rica offers medical tourism patients (or family members) free massages, haircuts and pedicures before or after their procedures.

Amenities aside, you do need to do your research, ask questions and make sure you have chosen an experienced doctor and choice facility regardless of where you choose to have your surgery.

I Would Like to Have Surgery Performed Abroad. Will my Health Insurance Cover me if I Have Complications?

Quite possibly it will not. One of the things that anyone who is contemplating surgery abroad should do is check with their insurance company on what care, if any, is covered under this circumstance. Some medical tourists may wish to buy additional insurance. Those without insurance should make sure they have the resources to extend their trip, in the event of complications, until they are fit to travel.

Why Go Abroad for Medical Procedures?

There are several reasons why our customers choose to go abroad for medical treatment. This includes: Cost Savings 

  • High Quality Care
  • Insurance Excluded Treatments
  • Specialty Treatments
  • New Country New Experience

Is Medical Tourism Legal?

Medical Tourism is not illegal. You have the right to go outside of your country's healthcare system to receive treatment.