We don’t want your medical tourism business

An article by Dr Constantine Constantinides of healthCare cybernetics that appeared in the IMTJ looks at the resentment factor in medical tourism.

We don't Want Your Medical Tourism Business...
We have known for some time that several hospitals in Ontario, Canada have been providing care on a “for-profit basis” to people from outside Canada and generating millions of dollars in revenue.
But in November 2014, we read that the (Liberal) Canadian Government had taken steps to put the brakes on medical tourism into Ontario, and that this was greeted as welcome news by the coalition of health organisations that had been calling for the government to end the practice.
But why should this be “welcome news”?

The Canadian “Directive” on medical tourism

In 2014, Minister of Health, Eric Hoskins issued a letter to all Ontario hospitals requesting that they not market to, solicit or treat international patients with the exception of international patient activity related to a hospital's existing international consulting contracts. Back in 2012, Dr. Hoskins’s predecessor, Deb Matthews, had warned hospitals that they could only treat international patients in non-emergency cases if no public dollars were used, no Ontario patients were displaced, and all the revenue generated was spent on hospital services for Ontarians.
Hoskins also pledged that the Ministry of Health would work with relevant hospitals on a framework to ensure compliance with the outlined principles and requirements. In the interim, he asked hospitals not to enter into new international consulting contracts that include the treatment of foreign nationals in Ontario.
So, what motivated this move? For me, the move was motivated by the medical tourism resentment factor.

The Asia incident... disruption of a medical tourism industry event

I seem to remember reading (in 2014) about placard-wielding protesters who disrupted a Medical Tourism Congress being held in a prominent Asian medical tourism destination. The Asian protesters were likewise ill-disposed towards the idea of medical services being offered to international patients.
Like their Canadian counterparts, the Asian protesters were apparently opposed to any scheme that turns health into a “for-profit commodity” to be bought and sold, especially if it involves providing export quality healthcare services to foreigners.

The resentment towards “inbound” medical tourism…  

In 2009, I briefly addressed the benefits and losses (for a destination) associated with the provision of medical tourism services in an IMTJ article (Medical tourism: The Resentment Factor and the (beneficial) Ripple Effect).
We know that medical tourism development delivers benefits for a destination and its “providers”. But some feel that, at the same time, the provision of medical tourism services is associated with “loss”, at least for a sector of the population.
The medical tourism resentment factor, in essence, refers to anger felt and expressed by locals towards the practice of treating paying foreign patients at local hospitals.
The resentment to inbound medical tourism is primarily fueled by the feeling that scarce healthcare resources are diverted away from the poor “entitled” locals and channeled to rich “unentitled” foreigners.
When it comes to inbound medical tourism, the following issues cause resentment:

• Export quality healthcare services, provided exclusively to foreigners (inequality).
  
• The subsidizing of medical tourism development and promotion with taxpayers’ money (taking from the poor to give to the rich).
  
• Internal brain and resources drain (diversion of human and technical resources away from the locals and channeling them towards foreigners).
  
• Healthcare services “free-loading” (e.g. unentitled foreigners making use of free public healthcare services as experienced in the UK’s National Health Service)
  
• Unsavory practices (such as the trade in kidneys, which discredits the country)

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On the other hand, other countries can be thankful, even if they do not express these thanks in any manner -- Germany for instance. Germany has by far the highest turn-over in Medical Tourism in the EU. The fact does not seem to have had effects on the quality of medical services offered to the national population.
In other countries, it might even help raise the standards for the population as well; the fact that a country is selling medical tourism presupposes the existence of quality medical services among other things. As the level of services offered to medical tourists expands, such service level may become more accessible to the population as well.
Hopefully. 
India could be the example here...