Health Care Analysis

, Volume 25, Issue 2, pp 138–150 | Cite as

How Medical Tourism Enables Preferential Access to Care: Four Patterns from the Canadian Context

  • Jeremy SnyderEmail author
  • Rory Johnston
  • Valorie A. Crooks
  • Jeff Morgan
  • Krystyna Adams
Original Paper


Medical tourism is the practice of traveling across international borders with the intention of accessing medical care, paid for out-of-pocket. This practice has implications for preferential access to medical care for Canadians both through inbound and outbound medical tourism. In this paper, we identify four patterns of medical tourism with implications for preferential access to care by Canadians: (1) Inbound medical tourism to Canada’s public hospitals; (2) Inbound medical tourism to a First Nations reserve; (3) Canadian patients opting to go abroad for medical tourism; and (4) Canadian patients traveling abroad with a Canadian surgeon. These patterns of medical tourism affect preferential access to health care by Canadians by circumventing domestic regulation of care, creating jurisdictional tensions over the provision of health care, and undermining solidarity with the Canadian health system.


Medical tourism Canada Preferential access Equity 



R.J. holds a Doctoral award from the Canadian Institutes of Health Research. V.A.C. is funded by a Scholar Award from the Michael Smith Foundation for Health Research and holds the Canada Research Chair in Health Service Geographies.


  1. 1.
    Bailey, S. (2010). Newfoundland’s Danny Williams quits politics. Toronto Star, November 25.Google Scholar
  2. 2.
    Bookman, M. Z., & Bookman, K. R. (2007). Medical tourism in developing countries. New York: Palgrave Macmillan.CrossRefGoogle Scholar
  3. 3.
    Bounajm, F., Labonté, R., & Runnels, V. (2015). Should Canada’s hospitals open their doors to medical tourists? Health care in Canada: An economic growth engine. The Conference Board of Canada.
  4. 4.
    Canadian Broadcast Corporation. (2010). ‘My heart, my choice,’ Williams Says. CBC, February 23.
  5. 5.
    Caulfield, T., & Zarzeczny, A. (2012). Stem cell tourism and Canadian family physicians. Canadian Family Physician, 58(4), 365–368.PubMedGoogle Scholar
  6. 6.
    Cohen, I. G. (2014). Patients with passports: Medical tourism, law, and ethics. London: Oxford University Press.CrossRefGoogle Scholar
  7. 7.
    Crooks, V. A., Kingsbury, P., Snyder, J., & Johnston, R. (2010). What is known about the patient’s experience of medical tourism? A scoping review. BMC Health Services Research, 10(1), 266.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Donchin, A. (2010). Reproductive tourism and the quest for global gender justice. Bioethics, 24(7), 323–332.CrossRefPubMedGoogle Scholar
  9. 9.
    Doyle, J. R. (2010). Canadian premier’s heart surgery plans raise questions about health care. Fox News, February 4.
  10. 10.
    Even, D., & Zinshtein, M. (2010). Israel gives medical tourists perks denied to citizens. Haaretz, November 18.Google Scholar
  11. 11.
    Fayerman, P. (2010). Plan to sell health care to foreigners problematic; among the biggest challenges is the optics of offering top-notch care to others while Canadians wait in long lines. The Vancouver Sun, April 29, p. A12.Google Scholar
  12. 12.
    Fayerman, P. (2012). Johns Hopkins and Westbank First Nation discuss luxury medical tourist facility: Is it viable? Vancouver Sun, April 17.Google Scholar
  13. 13.
    Flood, C. M. (2012). Canada’s approach to the public/private divide and the perils of reform via court challenge. Public Policy Review, 8(2), 191–214.Google Scholar
  14. 14.
    Fowlie, J. (2010). BC could become surgical-tourism mecca; ‘Why can’t [we] be the Mayo Clinic of the North?’ health minister asks. Times Colonist, March 10, p. A6.Google Scholar
  15. 15.
    Geddes, J. (2010). Here’s hoping Danny Williams got Canadian-style heart surgery. Macleans, February 22.Google Scholar
  16. 16.
    Geddes, J., Gulli, C., & Henheffer, T. (2010). What the Danny Williams’ case says about Canadian health care. Macleans, February 9.Google Scholar
  17. 17.
    Goar, C. (2014). Medicare is a public trust, not a business venture. Toronto Star, November 2.Google Scholar
  18. 18.
    Grant, K. (2014). Toronto hospital courts wealth ‘medical tourists’. The Globe & Mail, April 1.Google Scholar
  19. 19.
    Hall, C. M. (2011). Health and medical tourism: a kill or cure for global public health? Tourism Review, 66(1/2), 4–15.CrossRefGoogle Scholar
  20. 20.
    Hopkins, L., Labonté, R., Runnels, V., & Packer, C. (2010). Medical tourism today: What is the state of existing knowledge? Journal of Public Health Policy, 31(2), 185–198.CrossRefPubMedGoogle Scholar
  21. 21.
    Hunter, J. (2010). Kevin Falcon’s clash: For surgical tourism, against: Locals jumping treatment queues. The Globe and Mail, March 26, p. A7.Google Scholar
  22. 22.
    International Medical Tourism Journal. (2014). Canada, Turks and Caicos: Fly the doctor and the patient to an island. International Medical Travel Journal.
  23. 23.
    Johnston, R., Crooks, V. A., Snyder, J., & Kingsbury, P. (2010). What is known about the effects of medical tourism in destination and departure countries? A scoping review. International Journal for Equity in Health, 9(1), 24.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Komarnicki, J. (2014). Have scalpel, will travel. Calgary Herald, January 18.Google Scholar
  25. 25.
    Lewis, S. (2012). Private hospital development planned by Westbank Nation. Windspeaker, 29(11).Google Scholar
  26. 26.
    Lunt, N., & Carrera, P. (2010). Medical tourism: Assessing the evidence on treatment abroad. Maturitas, 66(1), 27–32.CrossRefPubMedGoogle Scholar
  27. 27.
    MacLeod, A. (2010). Bring on medical tourism, says private provider. The Tyee, March 17.Google Scholar
  28. 28.
    Seymour, R. (2014). Luxury private hospital plan still viable, Westbank First Nation chief says. Kelowna Daily Courier, December 17.Google Scholar
  29. 29.
    Sheppard, C. E., et al. (2014). The cost of bariatric medical tourism on the Canadian healthcare system. The American Journal of Surgery, 207(5), 743–747.CrossRefPubMedGoogle Scholar
  30. 30.
    Snyder, J., et al. (2014). ‘I knew what was going to happen if I did nothing and so I was going to do something’: Faith, hope, and trust in the decisions of Canadians with multiple sclerosis to seek unproven interventions abroad. BMC Health Services Research, 14(1), 1–10.CrossRefGoogle Scholar
  31. 31.
    Snyder, J., Crooks, V. A., & Johnston, R. (2012). Perceptions of the ethics of medical tourism: Comparing patient and academic perspectives. Public Health Ethics, 5(1), 38–46.CrossRefGoogle Scholar
  32. 32.
    Snyder, J., Crooks, V. A., Johnston, R., & Kingsbury, P. (2011). What do we know about Canadian involvement in medical tourism? A scoping review. Open Medicine, 5(3), e139.PubMedGoogle Scholar
  33. 33.
    Strachan, B. (2012, April 13). B.C. First Nation plans private hospital. CBC News.Google Scholar
  34. 34.
    Trotter, M., & Fionda, F. (2015). Public hospitals profiting from foreign patients. Global News.
  35. 35.
    Turks and Caicos Weekly News. (2013). First hip repl acement performed at local medical centre. Turks and Caicos Weekly News.
  36. 36.
    Turner, L. (2007). First world health care at third world prices: Globalization, bioethics and medical tourism. BioSocieties, 2(3), 303–325.CrossRefGoogle Scholar
  37. 37.
    Turner, L. G. (2010). Quality in health care and globalization of health services: Accreditation and regulatory oversight of medical tourism companies. International Journal for Quality in Health Care, 23(1), 1–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Jeremy Snyder
    • 1
    Email author
  • Rory Johnston
    • 1
  • Valorie A. Crooks
    • 1
  • Jeff Morgan
    • 1
  • Krystyna Adams
    • 1
  1. 1.Simon Fraser UniversityBurnabyCanada

Personalised recommendations