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Medical Tourism: Travel to Another Country for Medical Care

Traveling to another country to get medical care can be risky. Learn about the risks and how to minimize them.

Traveling Internationally for Medical Care

Each year, millions of US residents travel to another country for medical care which is called medical tourism. Medical tourists from the United States most commonly travel to Mexico and Canada, and to several other countries in Central America, South America, and the Caribbean.

The reasons people may seek medical care in another country include:

• Cost: To get a treatment or procedure that may be cheaper in another country
• Culture: To receive care from a clinician who shares the traveler’s culture and language
• Unavailable or unapproved procedures: To get a procedure or therapy that is not available or approved in the United States

The most common procedures that people undergo on medical tourism trips include dental care, cosmetic surgery, fertility treatments, organ and tissue transplantation, and cancer treatment.

Medical Tourism Can Be Risky

The risk of complications depends on the destination, the facility where the procedure is being performed, and whether the traveler is in good health for the procedure(s). Other issues that can increase a traveler’s risk of complications include:

Infectious Diseases.  All medical procedures have some risk of infection. Complications from procedures performed in other countries include wound infections, bloodstream infections, donor-derived infections (in the case of transplantations or transfusions), and diseases such as hepatitis B, hepatitis C, and HIV.

Antimicrobial resistance.   Highly drug-resistant bacteria and fungi have caused disease outbreaks among medical tourists. Antimicrobial resistance happens when germs develop the ability to not respond to drugs such as antibiotics used to treat infections. Antimicrobial resistance is a global problem. Healthcare facilities in another country may not have adequate infection control practices and medical tourists could be at risk for getting a drug-resistant infection.

Quality of Care. Some countries’ requirements for maintaining licensure, credentialing, and accreditation may also be less than what would be required in the United States. In some countries, counterfeit medicines and lower quality medical devices may be used.

Communication challenges. Communicating with staff at the destination and healthcare facility may be challenging. Receiving care at a facility where you do not speak the language fluently could lead to misunderstandings about your care.

Air Travel.  Flying after surgery can increase the risk for blood clots, including  deep vein thrombosis . Delaying air travel for 10-14 days following major surgeries, particularly those involving the chest, will minimize risks associated with changes in atmospheric pressure.

Continuity of Care.  Travelers may need to get health care in the United States if they develop complications after returning. Follow-up care for complications might be expensive. Treatment might be prolonged and might not be covered by your health insurance.

How You Can Minimize Medical Tourism Risks

Research the clinician and facility.

• Check the qualifications of the clinician who will be doing the procedure and the credentials of the facility where the procedure will be done. Accrediting groups, including Joint Commission International, DNV GL International Accreditation for Hospitals, and the International Society for Quality in Healthcare, have lists of standards that healthcare facilities need to meet to be accredited. Please note that all surgeries carry the risk of complications and accreditation does not guarantee a positive outcome.
• If you go to a country where you do not speak the language, determine ahead of time how you will communicate with your clinician and others who will be caring for you.

Before you travel

• Get a pretravel consultation. See your healthcare provider or a travel medicine clinician at least 4–6 weeks before the trip to discuss general information for healthy travel and learn about specific risks you may face because of your health status, the procedure, and travel before and after the procedure.
• Obtain international  travel health insurance  that covers medical evacuation back to the United States.
• Find out what activities are not recommended around the time of the medical procedure, such as swimming or hiking, and plan accordingly.

Maintain your health and medical records

• Bring copies of your medical records with you, including results of lab tests and other tests related to your condition and care. Inform the medical staff at your destination of allergies you may have.
• Pack a  travel health kit  with your prescription and over-the-counter medicines in their original packaging. Bring enough medicine to last your whole trip, plus a little extra in case of delays. Also, bring copies of all your prescriptions and a list of medications you take, including their brand names, generic names, manufacturers, and dosages.
• Get copies of all your medical records from the medical facility at your destination before you return home. You may need to get them translated into English.

Arrange for follow-up care before you travel

• Identify where you will be staying immediately after the procedure.
• Make sure you can get any needed follow-up care in the United States. Follow-up care for medical complications can be expensive and might not be covered by your health insurance. Travelers considering procedures outside the United States should understand the potential financial costs associated with follow-up care or emergency care in the event of complications, review their health insurance policies to determine what, if anything, is covered and plan for the possibility of paying for additional care out-of-pocket.
• Supplemental travel health insurance may also be available to cover follow-up or emergency care from procedures received abroad.

Related Resources

• CDC Yellow Book: Medical Tourism
• American Medical Association Ethical Guidance on Medical Tourism
• Organization for Safety, Asepsis, & Prevention's Traveler’s Guide to Safe Dental Care
• The International Society of Aesthetic Plastic Surgery guidelines for travelers
• International Travel (US Department of State)
• Your Health Abroad (US Department of State)

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Why Patients Are Turning to Medical Tourism

Statistics, Benefits, and Risks

Planning Ahead

Frequently asked questions.

Medical tourism is a term that refers to traveling to another country to get a medical or dental procedure. In some instances, medical tourists travel abroad seeking alternative treatments that are not approved in the United States.

Medical tourism is successful for millions of people each year, and it is on the rise for a variety of reasons, including increasing healthcare costs in the United States, lack of health insurance, specialist-driven procedures, high-quality facilities, and the opportunity to travel before or after a medical procedure.

According to a New York Times article from January 2021, pent-up demand for nonessential surgeries, as well as the fact that many Americans lost their health insurance during the coronavirus pandemic led to a surge in medical tourism once other countries re-opened.

However, there are specific risks that come with traveling overseas for surgery. If you're thinking of pursuing a medical procedure in another country, here's what to know about the benefits and the risks.

Medical Tourism Benefits

The most common procedures Americans go abroad for include dental care, cosmetic procedures , fertility treatments, organ transplants , and cancer treatment.

This is not to be confused with having an unplanned procedure in a foreign country due to an unexpected illness or injury.

Among the reasons a person might choose to go abroad for a medical procedure are:

Lower Costs

Medical tourists can save anywhere from 25% to 90% in medical bills, depending on the procedure they get and the country they travel to. There are several factors that play into this:

• The cost of diagnostic testing and medications is particularly expensive in the United States.
• The cost of pre- and post-procedure labor is often dramatically lower overseas. This includes labor costs for nurses , aides, surgeons , pharmacists, physical therapists , and more.
• High cost of malpractice insurance—the insurance that protects medical professionals against lawsuits—in the United States.
• Hospital stays cost far less in many overseas countries compared to the United States. In other words, quality care, hospital meals, and rehabilitation are far more affordable abroad for many people.

For someone who doesn't have insurance , or someone having a procedure that is not covered by insurance , the difference can be enormous.

Popular Countries for Medical Tourism

Dominican Republic

South Korea

Culture and Language

Many immigrants prefer to have treatments and procedures done in their country of origin—a sensible decision, considering just how much language barriers alone can affect the quality of their care.

Furthermore, at least 25% of immigrants and noncitizen residents in the United States are uninsured, compared to 9% of American citizens. Children with at least one noncitizen parent are also more likely to be uninsured.

Practicalities aside, many people choose to have their procedure done in their country of origin simply because it allows them to be close to family, friends, and caretakers who can assist them through their recovery .

Insurance Incentives

Some insurance companies have started promoting medical tourism. The reason behind this is simple: savings for the insured means savings for the insurance provider and vice versa.

Several insurance providers, including Aetna have programs specifically geared at promoting safe medical tourism. Some insurance providers even offer financial incentives for medical tourism, like discounts on medical bills .

That said, many insurance companies will not pay for surgery performed outside of the country unless it is an emergency.

Luxury and Privacy

Medical tourism is a lucrative business for many countries, and much of the money brought in by medical tourists is reinvested into the local economy and health infrastructure.

The effect of this is apparent in the spa-like luxury that some foreign hospitals offer, providing medical tourists the opportunity to be pampered during their stay for a fraction of the cost they would pay at home.

Some facilities offer hospital rooms that are more like a hotel suite than a traditional hospital room. Other hospitals offer one-on-one private nursing care, which is far more generous and attentive than the staffing ratios that most hospitals allow.

Medical tourists who seek that added layer of privacy can find it abroad. Many can return home from their "vacation" without anyone knowing they had a procedure at all.

Vacation in a Foreign Country

Medical tourists often take advantage of their stay in a foreign country to travel for pleasure by scheduling a vacation before or after their procedure.

This is an especially inexpensive way to travel to a foreign country, especially if their insurance provider is paying for the flight and the cost of staying is low. 

While it seems logical to recover on a beach or in a chalet by the mountains, keep in mind that it's important not to jeopardize your recovery.

Swimming isn't recommended until your incisions are completely closed. You may not feel up to doing much more than napping in the days following your procedure, either.

Don't let your vacation disrupt your recovery. Any time you have a procedure done, especially a surgery, it's important to listen to your body, take your medications as directed, and follow your doctor's recommendations closely.

Bypassing Rules and Regulations

Some travelers seek surgery abroad to bypass rules that are set in place by their own government, insurance company , or hospital. These rules are typically in place to protect the patient from harm, so getting around them isn't always the best idea.

For example, a patient may be told that their weight is too low to qualify for weight loss surgery . A surgeon in a foreign country may have a different standard for who qualifies for weight loss surgery, so the patient may qualify overseas for the procedure they want.

Talented Surgeons

Surgeons in certain countries are known for their talent in a specific area of surgery. For example, Brazilian surgeons are often touted for their strong plastic surgery skills .

Whereas in the United States, insurance companies might only cover cosmetic procedures if it is medically necessary, cosmetic surgery is often free or low-cost in Brazil's public hospitals—giving cosmetic surgeons there ample practice.

Thailand is reported to be the primary medical tourism destination for individuals seeking gender reassignment . It is often easier to qualify for surgery and the cost is significantly reduced. Surgeons are performing the procedures frequently, and as a result, many have become quite specialized in them.

It is often surprising to many medical tourists that their physician was trained in the United States. Not all physicians are, of course, but a surprisingly high percentage of them working in surgery abroad are trained in English-speaking medical schools and residency programs and then return to their home country. These physicians often speak multiple languages and may be board certified in their home country and a foreign country, such as the United States.

Medical tourism isn’t limited to countries outside of the United States, either. Many people travel to the United States for medical care due to the country's cutting-edge technology, prescription medication supply, and the general safety of healthcare.

Medical Tourism Risks

The financial and practical benefits of medical tourism are well known, and you may even know someone who had a great experience. Nonetheless, the downsides of medical tourism can be just as great if not greater. Sometimes, they can even be deadly.

If you are considering a trip abroad for your procedure, you should know that medical tourism isn't entirely without obstacle and risks. These include:

Poorly Trained Surgeons

In any country—the United States included—there will be good surgeons and bad. And just as there are great surgeons abroad, there are also some surgeons who are less talented, less trained, and less experienced.

Regardless of what procedure you are getting or where, you should always do some preliminary research into the surgeon or physician who will be treating you as well as the hospital you will be treated at.

In the United States, it is fairly easy to obtain information about malpractice lawsuits , sanctions by medical boards, and other disciplinary actions against a physician.

Performing this research from afar can be challenging, especially if you don't speak the local language. Yet countless people take the risk anyway, without knowing whether the physicians who will treat them are reputable.

A physician should be trained in the specific area of medicine that is appropriate for your procedure. For example, you should not be having plastic surgery from a surgeon who was trained to be a heart doctor. It isn’t good enough to be a physician, the physician must be trained in the specialty .

Prior to agreeing to surgery, you should also know your surgeon’s credentials : where they studied, where they trained, and in what specialty(s) they are board-certified. Do not rely on testimonials from previous patients; these are easily made up for a website and even if they are correct, one good surgery doesn’t mean they will all be successful.

Quality of Staff

Nurses are a very important part of healthcare, and the care they provide can mean the difference between a great outcome and a terrible one.

A well-trained nurse can identify a potential problem and fix it before it truly becomes an issue. A poorly trained nurse may not identify a problem until it is too late. The quality of the nursing staff will have a direct impact on your care.

Once again, it's important to research the hospital staff where you will be having your procedure done. Read the reviews but don't trust them blindly. If you can, seek out a recommendation from someone who can vouch for the medical staff where you will be going.

Quality of the Facility

While researching healthcare facilities for your procedure, you want to learn not just about the quality of the facilities themselves, but about the country's healthcare system as a whole.

In some countries, there is a marked distinction between public hospitals and private hospitals. In Turkey, for example, private hospitals are considered on-par with hospitals in the states, while many locals will advise you to steer clear of public hospitals if you can.

You will also want to seek out facilities that are internationally accredited. In the United States, the Joint Commission evaluates hospitals and certifies those that provide safe, quality care. The international division does the same for hospitals outside the United States.

Once you have a few options for potential facilities, you can start to investigate specifics. For one, you should find as many pictures and reviews of the facility as you can. Ask yourself whether the facility is state of the art or whether it seems dirty and outdated.

You will also need to find out if the facility has ICU level care available, in case something goes wrong. If not, there should be a major hospital nearby so that you can be transferred quickly.

To learn more about a healthcare facility, consider joining expat groups on social media for the city or country you will be traveling to. Ask the group for recommendations, or inquire about any positive or negative experiences they may have had at a particular facility.

Flying Home After Surgery

Any surgery comes with risks, including infection and blood clots . Flying home increases the risk of blood clots, especially on long-haul flights that are longer than four hours.

Try to avoid flying home in the days immediately after surgery; waiting a week will decrease the chances of developing a blood clot or another serious complication during the flight.

For longer flights, plan on getting up and walking up and down the aisles each hour to improve blood flow in your legs. You might also benefit from wearing compression socks with your doctor's approval.

If you are taking blood thinners or are at-risk of blood clots , be sure to talk to your doctor about how you can reduce your risk of blood clots after your procedure and while traveling.

Furthermore, you should know the symptoms of blood clots and stay alert.

Unplanned Illness

Any time you travel abroad, you run the risk of catching an illness that you have never been exposed to or that your body is not prepared to fight off. This is especially a concern when spending time in a foreign hospital.

If you have a sensitive stomach, you may also want to think long and hard about having surgery abroad. The food is often very different in foreign hospitals, and in some areas, there is a risk that even the water will be upsetting to your body.

Having diarrhea or postoperative nausea and vomiting makes for a miserable recovery experience, especially if you do not have a friend or family member nearby who can help you through it.

Before you travel abroad, check with your doctor to see if you need any vaccines to travel to your destination or if there are any foreign illnesses you should be aware of. Picking up an illness abroad, particularly after your surgery, can potentially be life-threatening.

Language Barriers

If you are having surgery in a country where English is not the primary language, you will need to make preparations in order to be able to communicate with the staff.

You may be pleasantly surprised to learn that the staff speaks your primary language well. If not, then you will need to consider how you will make your wishes and needs known to the surgeon, the staff, and others you will meet.

Whether you are at home or abroad, remember to speak up and advocate for yourself to make sure your needs are met. If you don't speak the local language, download a language translation app on your smartphone and don't hesitate to use it to communicate your needs. Hiring a translator is another option.

A Word About Transplant Tourism

Transplant tourism is one area of medical tourism that is strongly discouraged by organ and tissue transplant professionals in multiple countries. Most international transplants are considered “black market” surgeries that are not only poor in quality, but ethically and morally wrong.

China, for example, the country that is believed to perform more international kidney transplants than any other country, is widely believed to take organs from political prisoners after their execution.

In India, living donors are often promised large sums of money for their kidney donation, only to find out they have been scammed and never receive payment. Selling an organ in India is illegal, as it is in most areas of the world, so there is little recourse for the donor.

Then there is the final outcome: how well the organ works after the surgery is complete. With black market transplants, less care is often taken with matching the donor and recipient, which leads to high levels of rejection and a greater risk of death. Furthermore, the new organ may not have been screened for diseases such as cytomegalovirus , tuberculosis , hepatitis B , and hepatitis C . It is often the new disease that leads to death, rather than the organ rejection itself.

Finally, transplant surgeons are often reluctant to care for a patient who intentionally circumvented the donor process in the United States and received their transplant from an unknown physician.

It is important to arrange your follow-up care prior to leaving your home country.

Many physicians and surgeons are hesitant to take care of a patient who received care outside the country, as they are often unfamiliar with medical tourism and have concerns about the quality of care overseas.

Arranging for follow-up care before you leave will make it easier to transition to care at home without the stress of trying to find a physician after surgery .

Just be sure to inform your follow-up care physician where you are having your procedure done. After you return, they will also want to know what prescription medications you were given, if any.

What are popular countries for medical tourism? 

Mexico, India, Costa Rica, Turkey, Singapore, Canada, and Thailand are among the many countries that are popular for medical tourism.

How safe is medical tourism?

Medical tourism is generally considered safe, but it's critical to research the quality of care, physician training, and surgical specialties of each country. There are several medical tourism organizations that specialize in evaluating popular destinations for this purpose.

What countries have free healthcare? 

Countries with free healthcare include England, Canada, Thailand, Mexico, India, Sweden, South Korea, Israel, and many others.

A Word From Verywell

If you are considering medical tourism, discuss the risks and benefits with your doctor, and consider working with your insurance provider to arrange a trip that balances financial savings with safety. (Also, before you embark on a trip overseas for your procedure, make sure you are financially prepared for unexpected events and emergencies. Don't go abroad if you don't have enough money to get yourself home in a crisis.)

A medical tourism organization such as Patients Without Borders can help you evaluate the quality and trustworthiness of healthcare in various countries. Making sure a high level of care is readily available will lead to a safer, more relaxing experience.

Centers For Disease Control and Prevention. Medical Tourism: Getting medical care in another country . Updated October 23, 2017.

University of the Incarnate Word. Center for Medical Tourism Research .

Patients Beyond Borders. Facts and figures .

Kaiser Family Foundation. Health coverage of immigrants . Published July 2021.

Paul DP 3rd, Barker T, Watts AL, Messinger A, Coustasse A. Insurance companies adapting to trends by adopting medical tourism . Health Care Manag (Frederick). 2017 Oct/Dec;36(4):326-333. doi: 10.1097/HCM.0000000000000179

Batista BN. State of plastic surgery in Brazil .  Plast Reconstr Surg Glob Open . 2017 Dec;5(12):1627. doi:10.1097/GOX.0000000000001627

Johns Hopkins Bloomberg School of Public Health - Global Health Now. Brazilians' risky right to beauty . Published May 2018.

Chokrungvaranont P, Selvaggi G, Jindarak S, et al. The development of sex reassignment surgery in Thailand: a social perspective .  Sci World J . 2014 Mar;2014(1):1-5. doi:10.1155/2014/182981

The Joint Commission. For consumers .

Centers for Disease Control and Prevention. Blood clots and travel: what you need to know . Reviewed February 2021.

Hurley R. China harvested organs from political prisoners on substantial scale, says tribunal . BMJ . 2018 Dec;363(1):5250. doi:10.1136/bmj.k5250

Ambagtsheer F, Van Balen L. I'm not Sherlock Holmes: suspicions, secrecy, and silence of transplant professionals in the human organ trade . Euro J Criminol . 2019 Jan;17(6):764-783. doi:10.1177/1477370818825331

Centers for Disease Control and Prevention. Transplant Surgery. Key facts . Reviewed January 2019.

By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.

Our Response to COVID-19 →

Medical Tourism

A comprehensive guide to selecting a trustworthy medical tourism company.

Medical tourism has become an increasingly popular choice for individuals seeking affordable and high-quality medical treatments abroad. However, the success and safety of your medical journey greatly depend on the medical tourism company you choose to work with. Selecting a reputable and trustworthy company is crucial for a smooth and satisfactory experience. In this comprehensive guide, we will explore essential tips to help you find a reliable medical tourism company.

Understand the Importance of Accreditation

In the realm of medical tourism, accreditation serves as a vital indicator of a company's commitment to quality and patient safety. Look for internationally recognized accreditations such as JCI (Joint Commission International) or ISO (International Organization for Standardization). These certifications ensure that the medical tourism company adheres to rigorous standards, protocols, and best practices.

Verify Certification of Medical Travel Professionals

Certified Medical Travel Professionals (CMTPs) play a crucial role in guiding patients throughout their medical travel journey. The Certified Medical Travel Professional program is a recognized certification that demonstrates a professional's expertise in the field. Ensure that the medical tourism company employs CMTPs who possess the necessary knowledge and skills to provide comprehensive assistance and support.

Assess the Range of Services Offered

A reputable medical tourism company should offer a wide range of services to cater to diverse patient needs. Evaluate whether the company provides comprehensive assistance, including pre-travel consultations, treatment planning, travel arrangements, accommodation, and post-treatment follow-up. A holistic approach ensures a seamless and stress-free experience for patients.

Scrutinize Patient Reviews and Testimonials

Patient reviews and testimonials provide valuable insights into the experiences of previous medical travelers. Check reputable online platforms and forums to gauge the overall satisfaction level of patients who have used the services of the medical tourism company you are considering. Pay attention to reviews that address factors such as quality of care, communication, and overall support.

Evaluate Transparency and Communication

Transparent communication is vital when dealing with a medical tourism company. Assess whether the company provides clear and detailed information regarding treatment options, costs, potential risks, and expected outcomes. A reliable company will address all your concerns, provide transparent pricing, and maintain open channels of communication throughout your medical journey.

Consider Destination Expertise

A reputable medical tourism company should have in-depth knowledge and experience in the chosen destination. They should be well-versed in local regulations, medical facilities, and healthcare providers. Ensure that the company has established partnerships with renowned hospitals and clinics, offering a wide range of specialties to meet your specific medical needs.

Seek Recommendations from Trustworthy Sources

Consulting trustworthy sources such as healthcare professionals, friends, or family members who have had successful medical travel experiences can be invaluable. They can provide insights, recommendations, and firsthand accounts of their journeys, helping you make an informed decision when choosing a medical tourism company.

In conclusion, Choosing a reputable medical tourism company is paramount to the success and safety of your medical travel experience. By assessing factors such as accreditation, certifications, patient reviews, transparency, destination expertise, and seeking recommendations, you can make an informed decision. Remember to prioritize quality, patient safety, and comprehensive support throughout your medical journey. With careful consideration and research, you can find a trustworthy medical tourism company that meets your needs and ensures a positive and successful medical travel experience.

To receive a free quote please click on the link: https://www.medicaltourism.com/get-a-quote

Patients are advised to seek hospitals that are accredited by Global Healthcare and only work with medical tourism facilitators who are certified by Global Healthcare Accreditation or who have undergone certification from the Certified Medical Travel Professionals (CMTP). This ensures that the highest standards in the industry are met. Click the link to check out hospitals accredited by the Global Healthcare Accreditation: https://www.globalhealthcareaccreditation.com/

It is recommended that consumers do not share their personal and confidential information on random medical tourism platforms as they may not be secure. Consumers must be cautious when disclosing their private information as some organizations may not protect their privacy and could misuse their information. Additionally, there are agencies that may prioritize their commissions over the well-being of the patients. Consumers should avoid choosing the cheapest price and instead make a thorough comparison across multiple facilitators to make an informed decision.

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The Medical Tourism Magazine (MTM), known as the “voice” of the medical tourism industry, provides members and key industry experts with the opportunity to share important developments, initiatives, themes, topics and trends that make the medical tourism industry the booming market it is today.

Released in July 2020 ‍ Medical Tourism Index 2020-2021

The one and only comprehensive analysis of the Medical Travel industry is back with its third edition, at a critical juncture in the history of healthcare. The Medical Tourism Index (MTI) ranks American perceptions of 46 international healthcare destinations, providing insight into how consumers view 41 criteria across three primary dimensions, including Destination Attractiveness, Safety, and Quality of Care.

Watch the Video

2020-2021 MTI Overview

Click on a region to explore further or purchase the report for access to all of the data tools..

Middle East

(try turning your phone to landscape to better select destinations)

2020-2021 MTI Overall Ranking

The mti reports.

The Medical Tourism Index brings you its third edition. The MTI 2014-2015 assessed the attractiveness of 25 countries as medical tourism destinations. In 2016-2017, the MTI expanded to 41 destinations across five regions, doubling the size of the sampling. The 2020-2021 Medical Tourism Index comes at a time where the industry, and the entire world, has been changed forever by COVID-19. The 2020-20121 MTI addresses this very question.

MTI Tools Access

The Medical Tourism Index includes special member access that unlocks data for comparison of destinations by year, by dimension, and much more.

Top 5 Destinations

The Winning 5 of 2020-2021

Dimensions of Measurement

The Medical Tourism Index considers three primary factors as the drivers of medical tourism, and each of the three factors has a subset of items that allows a more detailed comparison in order to measure each destination’s attractiveness and brand awareness as a medical tourism destination.

Destination Environment

Medical Tourism Industry

Quality of facilities & services, destination ranking.

The development of the MTI was a multi-year, multi-step, multi-stakeholder approach. Our research methodology followed a rigorous eight-step approach that included methodological, statistical, and index construction procedures to develop this psychometric, sound measurement tool used by healthcare executives and government officials from around the world.

• THE SURVEY The data was gathered by conducting a national survey with 3,030 Americans of every age, gender, education level, and socioeconomic status.
• THE REPORT The 100+ page report includes 46 Destinations that with statistical evaluation and commentary on each.
• ONLINE DATA TOOLS Included with the purchase of the MTI is a member access portal that provides users with the ability to compare data between destinations through a variety of dimensions and plot custom charts and graphs.

Demonstrate the Economic Impact of Medical Tourism in your Destination

The Medical Tourism Calculator (MTC) is an adaptable tool used by all industry stakeholders to demonstrate the total economic impact of a medical travel program. Important factors like job creation and tax revenue, as well as the impact on hospitality and tourism, have been less emphasized in medical tourism forecasts.

• Provides data on the impact of healthcare tourism
• Provides the current economic impact of medical tourism in your region
• Provides a forecast of the total economic impact of medical travelers

Purchase the 2020-2021 Medical Tourism Index

About the developers.

Renée-Marie Stephano

Renée-Marie Stephano is president and founder of the Medical Tourism Association® and editor-in-chief of Medical Tourism Magazine® and the Health and Wellness Destination Guide Series of books. Ms. Stephano has authored several books from “Developing International Patient Centers, Best Practices in Facilitation,” to “Medical Tourism for Insurers and Employers,” and the most recent, “Engaging Wellness ~ Corporate Wellness Programs that Work.” Her articles have been published in publications all over the world. Most recently she co-authored an article which was peer reviewed and published in Tourism Management Academic Journal. Ms. Stephano is an attorney and specializes in working with governments and hospitals to develop sustainable medical tourism/international patient programs and strategies. To that end she provides consultancy to organizations all over the world. She deals directly with ministers of health, tourism and economic development to establish public-private partnerships that support medical tourism and, at the same time, provide a benefit and return to the local community. Ms. Stephano has performed feasibility studies for cities, nations and hospitals worldwide in which she has relayed opportunities for international expansion, clinical development and affiliations and partnerships. She also consults governments in the development of sustainable medical tourism zones & free healthcare zones. Ms. Stephano is a keynote speaker at international conferences, has spoken at hundreds of events and is a featured source of reference on issues related to health, travel and tourism for media outlets around the world. She is the Executive Director of the International Healthcare Research Center, a 501c(3) organization dedicated to research in medical tourism, wellness travel and corporate wellness. IHRC is the publisher of the Medical Tourism Index (MTI). ‍

Dr. Marc Fetscherin

Dr. Marc Fetscherin is an Associate Professor of Marketing at Rollins College (FL), United States. His expertise is in international marketing with a specialization on marketing strategy, marketing research and branding with a specific focus on global brand management, corporate branding, human brands, consumer brand relationships, and destination branding. Previously, he was a Fellow at Harvard University as well as a researcher at the University of California Berkeley. He taught or teaches MBA and executive MBA courses at various institutions worldwide such as East China University of Science and Technology (China), the Copenhagen Business School (Denmark), Jacobs University(Germany), the University of Lausanne, HEC (Switzerland) or the University of Fribourg (Switzerland). He won multiple teaching and research awards. He has extensive international experience and lived and traveled to over 30 destinations. He speaks 5 languages (German, English, French. Spanish, Russian). Previous his academic career he was a consultant for McKinsey & Company and CEO of a Swiss luxury company. He was also a member of the Federal Commission ofConsumer Affairs, an advisory body for the Swiss Government. He has published 3 books, multiple book chapters and journal articles. His articles have appeared in peer reviewed journals such as Harvard Business Review, Journal of Business Research, International Journal of Market Research, International Marketing Review, European Journal of Marketing, Journal of Consumer Marketing, Journal of Brand Management, Journal of Product and Brand Management, Management International Review, International Business Review, or Tourism Management among others. He is in the editorial board of the Journal of Brand Management and the Journal of Place Branding and Public Diplomacy. He is also an Expert for the Association of Place Branding and Public Diplomacy.

MedicalTourism.com

MedicalTourism.com is a free, confidential, independent resource for patients and industry providers. Our mission is to provide a central portal where patients, medical tourism providers, hospitals, clinics, employers, and insurance companies can all find the information they need. Our site focuses on patients looking for specific knowledge in the fields of medical tourism, dental tourism, and health tourism.

People are ditching US healthcare and flying to other countries for medical procedures they can actually afford

American travel writer and editor olivia balsinger got veneers in colombia for a fraction of the price she would have paid in the us. olivia taylor.

• On June 5, American vlogger Alyne Tamir posted a video about how she saved money on healthcare by having medical procedures abroad.
• Every year, millions of Americans leave the country in order to save money on exorbitant medications and surgeries — a phenomenon called " medical tourism ."
• Many Americans have saved thousands of dollars by getting dental work, undergoing surgeries, picking up prescription medication, and even giving birth in other countries.
• According to American healthcare providers, there are a myriad of factors that are responsible for driving up the cost of healthcare in the US.
• Most Americans who travel for medical procedures claim that, despite the low cost of health services in other countries, the quality is comparable — or even superior — to that of the US.

The American healthcare system is known for being  notoriously expensive . It doesn't help that, according to data collected in 2017 by the Gallup-Healthways Well-Being Index, 11.3% of Americans are not able to afford health insurance .

Even those who do have health insurance often find themselves struggling to pay sky-high medical fees. For example, a Reddit user went viral in 2013 when he posted a photo of the hospital bill  he received when he was treated for appendicitis. The total charges came to over $55,000, and even with health insurance, he had to pay over $11,000 out of pocket. 

This story is nothing new. Compared to the rest of the world, people in the US  pay much higher prices for medical services such as hospitalization, doctors' visits, and prescription medication.

In June, American vlogger Alyne Tamir posted a video about how she saves money on healthcare by having medical procedures abroad.

An American vlogger born in Santa Monica, California, who has been traveling full-time for over two years, Tamir has been documenting her experiences abroad through a blog and Facebook show, Dear Alyne .

On June 5, she posted a video about how "a simple toothache" opened her eyes to a "whole new world." In the video, Tamir explained it would have cost $1,500 to fix her tooth in the US. Instead, she had her root canal done in Egypt. 

"A nice hotel in Egypt costs around $70 a night," she told INSIDER. "And the actual root canal was only $120. This was at a fancy dentist too; you can definitely get it for way cheaper somewhere else in Egypt."

Tamir said that the Egyptian dentist did an "amazing job" fixing her tooth. She told us that when she got her teeth checked again in Australia, the dentist there commented that the Egyptian dentist had done a particularly fine job.

Every year, hundreds of thousands of Americans travel abroad in order to receive medical procedures at a much lower cost — a phenomenon called "medical tourism."

According to a 2015 report by the US International Trade Commission (USITC), between 150,000 and 320,000 Americans travel abroad every year to receive healthcare .

Given the high cost of healthcare in the US, Americans cite savings as the most common reason to travel abroad for health treatment. For Americans without health insurance, the difference in cost can be staggering. The USITC study claimed that, while uninsured Americans can expect to pay $30,000 for a knee replacement in the US, they could get the same surgery for $12,000 in India.

And even for Americans who are insured, most health insurance policies do not cover everything. According to America's Health Insurance Plans (AHIP), most medical insurance plans  do not cover dental work , cosmetic surgeries, and many prescription medications. Even giving birth in an American hospital can be prohibitively expensive. As a result, many Americans would need to pay hundreds or thousands of dollars out of pocket to receive these medical services.

Some Americans accidentally discover that medical services abroad are much more affordable when they sustain an injury or illness on vacation.

Patrice Raplee , a Seattle-based travel photojournalist and editor, was on vacation in Florence a few years ago when she said she bit down hard on a nut embedded in her roll. She said it split her tooth right down the center and caused her to bleed profusely from her mouth.

Raplee said she went to a hospital in Florence to get an emergency medical procedure. She told INSIDER that the doctors spent a few hours administering painkiller and repairing the tooth. At the end of the procedure, she said she asked if her health insurance would be able to cover the cost of everything.

"I remember thinking, 'Oh my god, how much is this going to cost me?'" Raplee said.

However, the emergency medical procedure, which Raplee estimated would have cost at least $1,000 in the US, ended up costing her 15 euros — the equivalent of $17.43. And the anti-inflammatory medication that she picked up later at the pharmacy cost her three euros, or $3.49. In total, Raplee spent around $20.92 for the entire medical treatment she received.

Melissa Wright  claimed she had a similar experience after being mugged and hospitalized in Spain. After spending eight hours in the emergency room and getting treated by six different specialists, she said she received a bill for 108 euros, or $125. According to Wright, when she previously visited the emergency room in the US for a kidney infection, she was charged over $4,000 after she spent two hours in the hospital and had a five-minute consultation with a doctor.

Many Americans take advantage of the lower costs of healthcare abroad to save money on cosmetic surgeries and dental work that are not covered by their health insurance in the US.

Since dental work and cosmetic surgery is not usually covered by most health insurance plans in the US, many Americans find that they are able to save thousands of dollars by traveling abroad for these costly procedures.

According to Physicians for a National Health Program, an estimated  108 million Americans have no dental insurance  simply because most insurance companies do not offer dental coverage for adults. And dental work is not cheap in the US. According to Authority Dental, basic dental exams can cost between $50 and $200 , X-rays can cost anywhere from $25 to $250, and cleanings can go from $75 up to $200.

As a result, many Americans simply do not visit the dentist at all. According to a Gallup poll conducted in 2014, about one-third of Americans did not visit a dentist even once in the past year.

But dental work can be much less expensive abroad. Nina Ragusa , the author of travel blog Where in the World is Nina?  who has been traveling full-time since 2011, told INSIDER that she received a dental exam, X-ray, and cleaning from a dentist in Bangkok for $50. When she traveled to Mexico, she did the same thing for $25, and also got a night guard — which typically  costs around $300 to $500 in the US — for $25 while she was there.

Cosmetic surgery, which isn't covered by most American health insurance, can also be very costly. In the US, for example, the average cost of LASIK eye surgery is $2,088 per eye. Ragusa, however, told INSIDER that she received LASIK in South Korea and paid a total of $1,400 — including all of the check-ups before and after the surgery, the surgery itself on both eyes, the medicine, and all future care for life. 

Travel writer and editor Olivia Balsinger  told us she had a similar experience when she got veneers in Colombia for a fraction of the cost she would have paid in the US. For eight veneers and three crowns — a procedure that would have cost around $15,000 in the US — she paid $4,000.

"The best part was that after the procedure, I wasn't going to wallow in pain in my New York City apartment," Balsinger said. "Instead, I was on the beaches of Cartagena."

Some Americans, especially those with chronic illnesses, need to travel abroad in order to access medical treatment that they simply would not be able to afford in the US.

Sarah May Grunwald is an American citizen living with severe Crohn's disease, a chronic illness that necessitates frequent hospitalization, surgeries, and medication. However, she said she had trouble receiving adequate healthcare in the US. She told INSIDER that her medical bills from the US have landed her deep in debt. And her monthly medication, which costs about $500 a month, is simply "impossible to afford."

Now that she is living in Italy, Grunwald said she is finding it easier to maintain her health. She said that she pays about five euros, roughly $5.79, every month for her medication. And the medical procedures that used to cost her thousands of dollars in the US, she said, now cost "so little" that she cannot even recall the exact cost. She estimated that she pays "under 20 euros" for every hospital visit. 

Even colonoscopies at private hospitals abroad are cheaper, according to Grunwald. She said that they cost her 400 euros, the equivalent of $463, in Italy; at her old doctor in the US, Grunwald claims the exact same procedure would cost around $3,200.

American freelance writer Rease Kirchner  told INSIDER that she went on vacation in Colombia to access the medication she needed to treat her chronic dry eye. Although she had health insurance coverage, the prescription for Restasis eye drops would have cost her $500 per month in the US. Since she needed at least a year's worth of Restasis, it would have cost her $3,000 in total. After doing some research online, she said she found that the same medication was available in Colombia for $50. Kirchner said she flew to Colombia, spent 10 days exploring four different cities, purchased a year's supply of Restatis, and still spent less than $3,000.

And some Americans have even opted to give birth abroad to save money.

The Guardian reported in January that the US is the most expensive nation in the world to give birth . A 2013 study from Childbirth Connection found that American hospitals charge an average of $32,093 for an uncomplicated vaginal birth and newborn care , and $51,125 for a standard Cesarean section and newborn care. And while health insurance does typically cover most of these costs, American families are still left to pay thousands of dollars out of their own pockets.

It's no wonder, then, that some Americans choose to give birth in other countries.

Amanda Ponzio Mouttaki , an American blogger and expat living in Morocco, told INSIDER that she had her baby three weeks ago through  Caesarean section . Mouttaki said that even though she did not have health insurance, she had to pay $1,100 for the delivery, doctor, a private room in the hospital for two nights, and medication. In total, including the cost of all the prenatal appointments, blood tests, and ultrasounds, she said she spent around $2,000.

Mouttaki said that her sister gave birth in the US, also via Ceasarean, and had a $100,000 hospital bill.

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The cost of giving birth also appears to be lower in some parts of China. Charlotte Zhang, an American citizen living in China, said that she had no insurance coverage when she gave birth to two babies in a public hospital in Renqiu, a small city in China's Hebei province. Each time, she said, cost her less than $200.

According to American healthcare providers, there are a myriad of reasons why healthcare in the US is so expensive compared to other countries.

America's Health Insurance Plans (AHIP), a national organization that advocates for the health insurance community, described in a recent brief that health insurance premiums are likely to rise in 2019. A major factor that drives up the cost of health insurance, according to AHIP, is the price of prescription drugs — a whopping 95% of specialty drugs cost more than $10,000 per patient per year. 

Amanda Guarniere, a nurse practitioner who graduated from the Yale School of Nursing, told INSIDER that another reason why the cost of healthcare is so high in the US is because there is very little competition in the healthcare market in the US. 

"If you are eligible for an employer-sponsored plan, you are likely going to choose that plan over one in the marketplace," Guarniere said. "There's not much of a choice, if any, in terms of what your plan offers."

Guarniere said that American physicians tend to have a higher salary expectation compared to those in other countries. She acknowledged that this is "partly cultural." However, she said that part of it also stems from the fact that American healthcare providers are expected to "pay an obscene amount of money" to receive their education. A higher salary, she said, is often necessary in order to pay off student loans.

However, according to Dr. Mary Jane Minkin, an OB-GYN at Yale New Haven Hospital, most physicians don't earn high enough salaries to explain the incredibly high cost of healthcare. "Physicians aren't making a lot of money these days," she told INSIDER. "Who the heck knows where all the money is going?"

Minkin said that another factor that is driving up the cost of healthcare in the US is malpractice insurance. She said that, unlike other countries where medical malpractice cases are judged by panels of experts, in the US these cases are often reviewed by juries comprised of laypeople who don't necessarily have a medical background.

As a result, American doctors face a real financial risk from patients' lawsuits. And even if they do end up winning the case, doctors still need to spend money on hiring lawyers to defend themselves in court.

According to Minkin, this fear of getting sued leads doctors to adopt other cost-driving practices. Unwilling to take the chance that something goes wrong and the patient decides to sue them, doctors will often perform unnecessary  Caesarean sections and order many expensive tests for their patients, she said.

"All of these things translate into higher cost of care," Minkin said. "You have to embed these costs into health insurance, and this forces patients to pay higher premiums."

The main problem, according to some healthcare providers, is that healthcare is a profit-oriented system in the US. Some believe that the way to improve healthcare in the US is by transitioning to a single-payer system. According to Physicians for a National Health Program, single-payer national health insurance would be funded by public taxpayer money and would provide full medical coverage for all residents of the US.

"It's not a panacea," Minkin told us. "But it would get around a lot of the issues with health insurance that people deal with."

Although healthcare providers told INSIDER that they understand why patients would be tempted to pursue medical tourism, many said that there are risks associated with it.

"I understand why people do it from a financial standpoint," Dr. Hillary Brenner, a podiatrist in New York, told INSIDER. "But what if something goes awry?

Brenner raised several concerns. "How clean are these instruments?" she said. "Here, they run tests about sterilization. And how are doctors in those countries trained, as opposed to our training here? I'd be petrified."

Minkin also questioned the safety of the blood supply at hospitals abroad. "Many surgical procedures need a transfusion," she said. "The blood supply they are using might be good, but the thing is, we don't know for sure."

According to Brenner, the risk seems to exceed the benefit. 

"You go there to save a buck," Brenner said. "But if an instrument is wrong, or not sterilized properly, then that might end up costing you more money in the long run. It's better to get it taken care of properly the first time around."

Guarniere told us that medical tourism could be a wise option, especially for patients seeking elective-type medical care such as joint replacements and cosmetic surgeries. "That being said, I would want to make sure that the facilities had appropriate patient care and safety standards," she said. 

Most of the Americans INSIDER spoke to, who have traveled abroad for medical reasons, said the quality of healthcare in other countries was excellent — though some reported having a less favorable experience. American photographer and journalist Eileen W. Cho got a vitamin drip, medicine, X-ray, and check-up for the equivalent of $40 in South Korea. Eileen W. Cho

Raplee said she was initially "rather fearful" when she walked into the hospital in Florence, and she was worried that she would receive substandard care. But she said she was pleasantly surprised to find that the hospital had modern facilities and the doctor had been trained in the US.

Despite charging her 15 euros for the emergency operation, she said the Italian doctor fixed her broken tooth so well that "the repair lasted for years." According to Raplee, her doctor in the US called it "brilliant" and said he couldn't believe it cost so little.

For Grunwald, one of the major differences between American and Italian healthcare in her experience was not only the drastic difference in affordability, but also the level of care.

"In America, doctors are much more inclined to not listen to women in pain," she said. She said that before she was diagnosed with Crohn's disease, her doctor suggested that she was depressed and hysterical — even though she claimed to be experiencing bloody bowel movements.

"In Italy, I have never been patronized as a woman," Grunwald told us. "They take my illness seriously and treat me with respect."

People have reported good experiences in other countries as well. Mouttaki said that her experience giving birth in Morocco was "top notch," despite costing a fraction of what she would have paid in the US. "I would say that the quality of care I received in Morocco was equal to or surpassed what I got in the US for my previous children," she said.

American freelance journalist Kira Zalan said that her experience seeing an endocrinologist and an orthopedist in Bangkok was also positive. "The customer service, efficiency, and cost were beyond anything I'd experienced in the US," she said. And she said she paid around $65 to $80 per visit. 

Zhang, however, said she had a less favorable experience giving birth in a Chinese hospital. She described the experience as "very cold and sterile," and she had difficulty communicating with the doctors. Her Chinese-speaking husband, who was not allowed inside the room, had to resort to "yelling his translations" at the door.

Despite these challenges, Zhang decided to give birth to her second child in China. For her, the low cost outweighed the inconveniences and discomfort.

Many of these Americans said that they intend on traveling abroad to receive affordable and high-quality medical care in the future.

Gigi Griffis , an American writer who has been traveling full-time for the past six years, told INSIDER that she has used healthcare services all over Europe and does not intend on returning to the US anytime soon.

Griffis cited expensive healthcare costs as one of the main reasons why she does not plan on living in the US. "I would never ever choose to have a procedure done in the US," Griffis said. "Paying five or more times as much for the same or worse care? No thanks."

Even Americans who do have health insurance said they find that it's less expensive to access medical care abroad. Wright said that she refuses to use her health insurance in the US. "I can barely afford the co-pays and it only covers 70% of the cost of most visits," she said. She intends to move to Germany, where she said the healthcare is just as good and much less expensive. 

Grunwald has no intention of returning to the US either. "Americans will say it is more expensive here because of malpractice insurance, but that's not true," she said. "It's because in most parts of the world, healthcare is a basic human right."

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Watch: The CEO of one of the largest health insurers in the US explains the problem with healthcare in America

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11 Best Countries for Medical Tourism in 2023

The term medical tourism in recent years has gained exponential attention due to patients seeking healthcare treatments abroad. Several factors underlie the triggering for treatment abroad. One of the major factors is to save cost. Other advantages include zero waiting time, international standard healthcare, touring after recovery, unavailability of treatment in homeland, and much more. The following destinations are often considered as the best countries for medical tourism by most people.

In the US, the healthcare system is known for being notoriously expensive. Although the treatment offered is of a high standard. But compared to the other countries the costs are a few folds higher. According to data collected in 2017 by the Gallup-Healthways  Well-Being Index , 11.3% of Americans cannot afford health insurance.

Circumvention tourism is another growing sector in this field. Services such as abortion and doctor-assisted suicide may be restricted in the home country but are allowed in the destination country.

This article is formatted to help readers with selecting the right destination for varying sectors of medical tourism. It covers destinations popular for their particular services and more insights on why one might choose to visit them.

Before starting with the list consider subscribing to get the latest medical tourism offers.

In the medical tourism index of 2020-2021, Spain ranks 4th out of the top 46 medical destinations worldwide.

Although, the visitor count may not be as high as in countries like Singapore or India, but is still very decent. The country received  140,000 patients in 2018 , and the revenue generated reached over 600 million euros.

Spain aces the highest rating on organ transplants with a donation rate of 36 donors per million people . This makes the country a go-to destination for patients seeking organ transplants. According to the World Health Organization (WHO), Spain ranks 7th as the best health care in Europe.

The cost of treatments is significantly lower than that of the UK, America, Canada, etc. Visitors can expect to save costs up to 30-70%, depending on the surgery. Plus, being a tourism-focused country, patients get to enjoy high living standards during their stay. Some notable surgeries offered are Orthopedic Surgery, Dentistry, Cosmetic surgery, Eyesight surgery, and Obesity surgery.

Spain isn’t considered to be a destination for general medical procedures. Instead, visitors come here for more complicated procedures such as plastic surgeries, fertility treatments, and so on. This also explains the reason for not having as many medical tourists as some of the Asian countries. In addition to that, Spain is relatively expensive for many Asian countries to travel to. It is more suited for European countries and a few other developed western countries.

Japan ranks 3rd in the global destination for the 2020-2021 medical tourism index. The country has recorded 31.19 million international tourists visiting various regions in 2018.

Although Japan is one of the most popular tourist attraction nations, medical tourism has never been a primary focus until recently. The country is already equipped with state-of-the-art medical technologies and great tourist attention; therefore, the government is making its effort into entering the medical tourism industry.

A promotional program started by the government in 2011 allowed tourists on a medical visa to stay up to 6 months in the country , and in the case of a normal tourist visa, the stay period was doubled.

Japan’s medical treatment standards are often better than in the US. Also, the survival rate for cancer-related treatments is far better than in many first-world countries. One important thing to note is that patients don’t come to Japan for cheaper healthcare. The cost of medical procedures is relatively high. Tourists visit the country merely because of the technologically advanced medical facilities and a higher standard of treatment.

Israel has been emerging to be a popular medical tourism destination for the past few years. The country ranks at the 8th position in the global medical tourism index and offers 20 JCI accredited clinics.

Israeli medical facilities and research are amongst the most highly valued in the world. The country specializes in cancer-related treatments. In fact, around 80% of the patients come for cancer treatments. Oncology, which is the study of tumors, is considered one of the finest in Israel.

Common treatments for medical tourism in Israel include bone marrow transplant, heart surgery, neurological, and catheterization treatments. Despite being a highly developed country, the treatment costs are considerably low as compared to that of the UK and USA. Such as, bypass surgeries in the US will cost over $100,000, whereas, less than $40,000 is needed in Israel.

For a detailed overview, read our complete guide on Israel medical tourism .

08. South Korea

South Korea hosts amongst the most technologically advanced procedures and skilled medical professionals in the world. The country ranked 1st in the OECD’s healthcare access. Plus, it stands in the second position for being the most efficient system.

By 2006, over 95% of the population was under the National Health Insurance system. South Korea’s healthcare emerged to be what it is today because of a joint project by the University of Minnesota and Seoul National University after the end of the 1950s war. The project lasted for six years, helping the country familiarized with the proper contextual medical framework needed for its success. Currently, over 70% of the population has private insurance. ( Source )

Common treatments received by foreign tourists include cosmetic surgeries such as plastic surgery and dermatology. Non-cosmetic surgery includes internal medicine and general health checkups. The rising popularity of K-pop and K-dramas has led to an increase in cosmetic surgeries in order to be a look-alike of the desired celebrities.

The mortality rate is also a major driving force for the demand for South Korea’s healthcare treatments. Implications such as cervical cancer survival rates are 76.8%, surpassing that of the US with 62.2% and Germany measuring in at 64.5%. The performance is also better for other serious procedures. ( Source )

The wide availability of medical care has also driven down the cost while maintaining the best-in-class standards. Patients coming from countries such as the US can expect to save between 30% to over 80% of what would cost in the home country.

Panama is the ideal place to get the American standard of medical care at a cost similar to that of India. Because of its suitable geographical location, Panama is a very easy country to travel to, especially for the American and European countries.

Panama is a very well-developed country and has a strong influence on American culture. In fact, for emergency cases, 911 service is also supported there but is limited to specific regions. The standard treatments for foreign tourists in Panama include cosmetic surgeries, dermatology, orthopedic surgery, fertility treatments, cancer treatments, stem cell therapy, etc.

Regarding the cost, procedures such as hip replacement are charged around $19,000 to $21,000 in the US, whereas, just $11,000 to 13,000 is needed in Panama. Similarly, costs for arthroscopy, Herniated Disc, Angioplasty, etc. are significantly cheaper in Panama than in the neighboring countries. Excluding any kind of malpractices, most treatments offered in the US are available in this country as well.

Beautiful beaches, old heritage sites, and attractive landmarks have made the country a more preferable option. Patients can get their desired treatment at a reduced cost and spend the rest on shopping or vacation trips. Tourism is one of the crucial sectors in the country’s economy with generating approx. $1400 million annually.

06. Malaysia

Malaysia is amongst the top 10 tourism destinations globally, and being a medical tourism powerhouse adds more to its appealing factor.

Malaysia’s government has a substantial contribution regarding the promotion of the country’s healthcare tourism. The country’s government considers health care one of the top 12 National Key Economic Area (NKEA). In 2019, around  $550 million  was earned through medical health care tourism.

The country has gained a reputation for having modern healthcare facilities and highly skilled medical professionals. By 2020, 5,300 more trained professionals are estimated to be required to facilitate its medical services. The ease of entry is another positive aspect that aids in making health tourism more sought after. If needed, the medical visa can be extended from 30 days to 90 days and also allows for having four people with the patient under the same visa conditions. ( Source )

A few of the sought-after procedures undertaken by foreign patients are cardiac procedures, cancer treatment, fertility treatment, cosmetic surgery, and general health screenings.

Medical tourism in India has also been gaining significant tourist traction for quite some time. Previous data from 2017 reported, over 495,000 patients traveled to the country to seek medical aid. India’s medical tourism sector is thriving because of the joint effort made by the government and the private sectors.

To make India’s medical services more accessible, the government has made various amendments to its  visa restrictions and schemes . Previously, the criteria of having a two-month gap between simultaneous visits from Gulf countries were withdrawn. Also, the stay for visa-on-arrival has been set to 30-day regarding medical reasons.

The cost of treatment is one of the cheapest in India compared to that of some other destinations. Procedures such as breast implants can cost around $2200 in India, whereas, in the UK, patients may need to cash out over $4000. Tooth whitening might cost approx. $300, as compared to approx. $500 in the UK.

Chennai, the 5th largest urban economy in the country, is named India’s health capital. It attracts 45% of the total tourists visiting India. The primary reason for such a massive influx of tourists is the cost, no waiting time, and advanced medical facilities.

A few of India’s sought-after medical treatments include bone-marrow transplant, cardiac bypass, eye surgery, hip replacement, and so on. Depending on the treatment, patients have the liberty to choose either the hospital or a paid accommodation for postoperative care.

04. Costa Rica

Costa Rica ranks 7th in the  global healthcare index  and is one of the world’s most biodiverse countries that you can find. In fact, around 4% of the total biodiversity is present in the country. People come here merely to enjoy ecotourism combined with medical tourism. For a detailed overview, read our article of medical tourism in Costa Rica .

Relaxing on beautiful beaches, eating luscious seafood, exquisite resorts, and visiting government-protected parks are the go-to activities for most tourists. Because of the geographical location, patients can visit both the Pacific and Caribbean beaches. Besides, it is not uncommon to see friendly wild animals roaming around the streets.

The healthcare system in the country is one of the best. World Health Organization frequently places Costa Rica above the American healthcare system. Hospitals here are very dynamic when it comes to offering medical services. Hospital Cima, for example, provides a list of  over 300 certified surgeons  on their website. Patients have access to their phone and email, as well as a detailed overview of their medical records. American patients visiting the country can easily expect to save 30 to 40% of the cost back home. Although dentistry and cosmetic surgeries are the most sought-after procedures, hospitals here offer the majority of the treatments available in the US.

03. Singapore

Singapore is considered an international hot spot for medical vacation . It ranks 2nd in the global top 46 medical tourism destinations and is estimated to have around  500,000 visitors each year .

Compared to some western countries, Singapore is an excellent choice for getting low-cost medical treatments. However, patients don’t come here to save costs. Instead, the country is considered one of the safest destinations for receiving state-of-the-art medical support. Plus, Singapore accounts for one of the highest numbers of JCI accredited hospitals, signifying the overall better quality of medical services.

Regarding the cost, for treatments such as heart bypass surgeries, in the US, it will cost around $123,000. Whereas in Singapore, it’s approximately $16,000 to $25,000. Other treatment costs are also low, such as normal delivery fees range between $6,000 to 12,500, Hip replacement within $8,500 to 12,000, and removal of a breast lump will cost around $5,400 to $10,700.

In Singapore, patients can save 25% to 40% compared to the same services available in the United States. The country is regarded to be the center for activities such as biomedical and biotechnological procedures. Hospitals there specialize in treatments for implications relating to cardiology, hematology, oncology, neurology, stem cell therapy, and orthopedics.

Singapore was rated as the 6th best healthcare system by the World Health Organization. This also helped the country to attract millions of international patients each year. Plus, according to 2019 data, the country enjoys the world’s longest life expectancy, with females living on average at 87.6 years and men 81.9 years. ( Source )

02. Thailand

Unique Thai hospitals, exotic beaches, medical treatments – these are the factors alluring over a million tourists each year.

Thailand is amongst the top 10 destinations for medical tourism globally. To keep up with this status, the Thai government has taken various measurements, one being the removal of fees from non-immigrant visas for medical tourists since 2013.

The language barrier is a problematic issue for foreign travelers. Hospitals are hiring professional multilingual speakers to aid with the communication difficulty. Foreign medical professionals are also allowed to practice their work in the country but must qualify for the Thai language examination.

From open-heart surgery to fertility treatments, all are available in Thailand from accredited hospitals. Also, treatments relating to gender reassignment and other fringe medical procedures are available in the country.

Even if not for surgeries, Thailand is also renowned for health and wellness tourism. Visitors can enjoy high-class integrated wellness centers that facilitate services such as Thai massage, spa, and restoration activities.

Among the medical destinations within Thailand, Bangkok is the most popular one taking in most of the tourists visiting the country.

Mexico’s popularity for healthcare has been rising for quite a few years. Its close proximity to the United States, and similar healthcare standards have been a significant influence for many western nations. For a detailed overview, read our complete guide on Mexico medical tourism .

This country is most suitable for budget-conscious Americans and Canadians. According to Renew Bariatrics , approx. One million Americans visit Mexico each year. Depending on the medical procedure, the cost savings are expected to be from 35 to 80%. The country accounts for at least 9 JCI accredited medical facilities.

In earlier days, dentistry and cosmetic surgeries used to be the most popular ones. Overtime, that has extended to orthopedic, bariatric, cardiac, eye, knee replacement, hip replacement, and various other procedures. Plus, the waiting time in Mexico is almost non-existent. International patients are offered face-to-face interaction with the doctor. Most hospitals are up-to-date with the latest technologies. The staffs are also well-trained to provide all types of medical support. Ambulance services are also offered at a cheaper cost.

Regarding the price, something simple as Bleaching discolored teeth will cost just $50. This same cost is approx.—$ 250 in US clinics. A hip replacement surgery will cost $12,500, which is 65% lower than the US. Similarly, Fertility Treatments will cost $2,650, Facelift is $4,250, Breast Augmentation is $3,800, and so on.

Finding the best places for medical tourism can be quite daunting. Not just the price or the standard of treatment – factors such as ease of communication, laws, availability, ethics also play a significant role in choosing the desired destination. We have tried to portray the best features of what each country has to offer. According to us, the list above represents the best countries for medical tourism. And you should be able to find all of your medical needs from these countries.

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Economics & Investments

Top 10 medical tourism destinations in the world.

With rising healthcare costs in the US and the rise of health tourism destinations that offer quality and affordable healthcare perked up by a beautiful travel experience, patients from around the world are scampering to book appointments with healthcare providers far away from home.

Yearly, millions of patients travel from countries lacking healthcare infrastructure or less advanced in a particular area of medical care to countries that provide highly specialized medical care. Patients book trips to countries for various medical procedures ranging from cosmetic surgery, dental work, to orthopedic procedures at affordable rates.

For the health tourism destinations and healthcare providers, the competition is fierce, requiring an interplay of factors to drive medical travel and improve their brand in the medical tourism market.

But choosing a destination for one’s medical needs can be an arduous task; with multiple risks sold by the media about medical travel, health consumers are now being more careful about their medical travel choices. The Medical Tourism Index provides a critical gauge for medical tourism destinations, evaluating countries across key indicators that define an excellent medical travel hub.  

The MTI assesses medical travel destinations across three main dimensions: Destination Environment, which provides an overview of the socioeconomic and cultural factors that promote inbound travel; Medical Tourism Industry, which assesses the medical tourism infrastructure, including seamless communication, effective medical travel facilitation, and culturally competent programs, and; Quality of Facilities and Services, which evaluates the quality of care provided, quality of healthcare professionals, as well as presence of third-party accreditations.  

Medical travel professionals, healthcare organizations, and governments around the world are investing heavily in accessing the right tools and resources to rank higher in the MTI to attract more clients and health payers.  Global Healthcare Accreditation, a global leader in healthcare accreditation helps these stakeholders to reposition themselves and conform to industry best practices to achieve these metrics.  

Global Healthcare Accreditation offers accreditations, medical training programs and certifications to help healthcare providers, governments, and medical tourism facilitators gain a comprehensive understanding of the industry and become more equipped to handle the challenges in the industry and deliver world-class service.  

Using the Medical Tourism Index 2020-2021, which ranks 46 destinations against these indicators, these are the best destinations to travel to for your healthcare needs.  

Canada’s rank as number one in the 2020 edition of the Medical Tourism Index comes as no surprise as the second-largest country in the world boasts of a robust tourism industry that attracts more than 14 million Americans each year. Its proximity to the US affords the country a massive influx of tourists and patients who seek to bypass the long wait times and high healthcare costs at home.

Canada ranks high in its reputation for offering quality and highly-specialized medical treatments and world-class healthcare facilities, particularly in orthopedic procedures and complex heart surgeries.  It is ranked at the top position for its Destination Environment, 7 th in the Medical Tourism Industry dimension, and 4 th in the Quality of Facilities out of 46 destinations assessed.  

Singapore comes second-place in the Medical Tourism Index, hitting top spot in ranking for the Quality of healthcare Facilities and Services in the country. As of 2019, more than 500,000 foreign tourists visited Singapore for its affordable and quality healthcare services.

Singapore recently set up International Patient Service Centers (IPSCs) that act as medical travel agencies to mediate between international patients and Singaporean healthcare providers, as a way to drive more growth in the industry and allow a much more seamless medical travel journey.  

Singapore boasts world-class mutli-specialist centers that collaborate with centers of excellence around the world, including the Singapore General Hospital, Gleneagles Hospital, and the Mount Elizabeth Hospital. Singapore is a choice destination for an array of cosmetic procedures and oncology treatments, with internationally accredited centers and qualified healthcare professionals.   ‍

Ranking second in the Medical Tourism Industry and the Quality of Facilites and Services categories, and 5 th in the Destination Environment dimension, Japan ranks as one of the most developed healthcare systems in the world, by every measure. Leading recent advances in technology and medicine, Japan continues to deliver top-notch healthcare services to citizens and foreign tourists, most of which come from mainland China.

Low cost of care is also a major driver of Japan’s inbound medical travel, attracting medical tourists from across the world to its expertise in minimally invasive medicine and tech-driven procedures in plastic and orthopedic surgery.  

Spain is known as one of the most visited tourist destinations in the world, with a tourist profile that pulls tens of millions of tourists every year. The country is ranked high by the MTI as the choicest medical tourist destination in Europe as it offers foreign patients excellent healthcare services with a beautiful travel experience.

Spain attracts a growing number of international tourists from the Middle East, North Africa, and the British Isles, many of who visit the country for advanced orthopedic, cosmetic, and dental procedures.

Spain boasts of several hospitals that are accredited by international bodies, including the renowned Hospital Universitario de Madrid and Sanitas Hospitales in Madrid.

United Kingdom

The UK ranks fifth in the global ranking of medical tourism destinations by the MTI. The UK is home to renowned medical institutions including the London Orthopedic Clinic, Birmingham Children’s Hospital, and the Cambridge Complex Orthopedic Trauma Center, known for top-quality healthcare services.

The UK is also a choice tourist destination center, welcoming more than 31 million international tourists every year, many of whom are attracted to the rich cultural heritage of the Great Britain.

The United Kingdom takes its highest point in the Destination Environment category, ranking 3 rd out of 46 destinations, notably for its richness as a tourist destination.  

Dubai known for its ultramodern architecture, high-rise buildings, and luxury shopping. Dubai, with a population of more than 9.4 million welcomes more than 10 million tourists every year. The congenial environment and beauty of Dubai gives a boost to travel experience for millions of international patients that arrive Dubai for world-class care.

The Medical Tourism Index ranked Dubai the top medical destination in the Arab region, as it boasts of world-class hospitals and international doctors across several specialties. Dubai welcomes medical tourists mainly from Asia and neighboring Arab and Gulf countries, and some trips from European and African nations.

Dubai continues to receive millions of tourists yearly, hundreds of thousands of which visit the DHCC for mostly complex cosmetic, dental, and fertility treatments. The city, which is home to renowned hospitals, Mediclinic City Hospital and Dr. Sulaiman Al-Habib Hospital, has become a one-stop-shop to medical tourists mainly from the GCC and the wider Arab world.  

Costa Rica is fast rising as a leader in the medical tourism market. Known for its beautiful sights and competitive prices, Costa Rica welcomes millions of medical tourists from neighboring countries including the US and Canada ‍

This Central American country has ranked high in dentistry and cosmetic surgery - above Canada and US - consistently in the last few years. The country is also building a name in the fields of eye surgery, cancer therapy, and bariatric surgery. The CheTica Ranch located in San Jose provides exotic recovery retreats for medical travelers for patients who relish recovery in a relaxing ambiance. This ranch is also staffed with highly-trained nurses to cater to the medical needs of these patients as they recover.

Costa Rica ranks 1 st in the Medical Tourism Industry category and 6 th in the Destination Environment dimension and 13 th In the Quality of Facilities and Services dimension.   ‍

‍The global Medical Tourism Index ranks Israel as the 8th top medical tourism destination in the world, citing the large pool of tourists that visit the Dead Sea and the massive drift of medical tourists seeking IVF and other fertility treatments in the country.

Israel ranked high in international reputation, patient experience, quality of healthcare, and accreditation of healthcare facilities in the MTI. Israel is 3 rd in the Qualities of Facilities and Services dimension, boasting world-class healthcare institutions and internationally trained healthcare providers.  

The renowned Sheba Medical Center, which is known for its excellence in complex surgical procedures, launched an international medical tourism division that offers medical services to thousands of international patients from around the world including Russia, Cyprus, Georgia, and the US.

The capital city and the largest emirate in the United Arab Emirate, Abu Dhabi, has built a strong medical tourism platform that can see it emerge the best in the region.

The emirate launched the Abu Dhabi Medical Tourism e-portal in 2019 that provides international patients with details of all the medical offerings and healthcare facilities in the city. Prospective patients can also access medical tourism insurance packages as well as other tourist services such as hotel bookings, transportation, and recreational activities via the e-portal.

Healthcare facilities in Abu Dhabi comply with strict quality rules set by the city’s Department of Health, ensuring they deliver nothing short of top-quality care. Abu Dhabi works closely with Global Healthcare Accreditation and the Medical Tourism Association, which have been integral to transforming the country’s medical travel and healthcare landscapes to attracting more medical tourists and health payers.  

India is one of the major players in the Asian medical tourism industry, ranking first in the Medical Tourism Industry dimension of the MTI. India is one of the most visited countries for health care, with an expanded visa policy that eases travel for medical tourists. The medical visa policy allows patients to stay up to 60 days and also offers a medical attendant visa for blood relatives that wish to accompany the patient.

The Indian government launched a to provide patients with access to their network of healthcare facilities and a list of medical services available in the country. This allows patients schedule appointments with healthcare providers and even book for other services including accommodation and recreational activities before their arrival.

India ranks 6 th in the Medical Tourism Industry and Quality of Facilities and Services categories, with world-class centers that offer complex transplant services, orthopedic procedures, and complex heart surgeries.  

To receive a free quote for this procedure please click on the link: https://www.medicaltourism.com/get-a-quote

For those seeking medical care abroad, we highly recommend hospitals and clinics who have been accredited by Global Healthcare Accreditation (GHA). With a strong emphasis on exceptional patient experience, GHA accredited facilities are attuned to your cultural, linguistic, and individual needs, ensuring you feel understood and cared for. They adhere to the highest standards, putting patient safety and satisfaction at the forefront. Explore the world's top GHA-accredited facilities here . Trust us, your health journey deserves the best.

Korea: Turning the Focus to an Emerging Global Leader in Medical Tourism

Exploring the surge of cosmetic tourism: trends and considerations in aesthetic procedures abroad, holistic healing: exploring integrative medicine and wellness retreats, meeting the surge: the growing demand for knee replacement surgeries and advances in the field, innovations in medical technology: how cutting-edge technology drives medical tourism, south korea, a medical tourism leader pioneering the future of medicine  , surgical solutions for obesity and weight management ~ a team effort, south korea ~ stepping into the spotlight in global healthcare, south africa ~ making great strides in healthcare, reusables give northwestern memorial a sharp edge on safety and sustainability, continue reading, the new silk road: deconstructing china's luxury healthcare market, the boomers are coming the boomers are coming, financial savings in medical tourism, featured reading, guide to choosing korea for medical travel, transforming healthcare through innovation: ceo spotlight interview with matthew a. love, medical tourism magazine.

The Medical Tourism Magazine (MTM), known as the “voice” of the medical tourism industry, provides members and key industry experts with the opportunity to share important developments, initiatives, themes, topics and trends that make the medical tourism industry the booming market it is today.

AZ Animals (US)

These Countries Attract the Most Medical Tourists

Posted: May 17, 2024 | Last updated: May 17, 2024

Do you travel abroad for business, pleasure, or surgery ? Surprised by that last option? Don't be. Every year, up to 26 million people cross borders for medical treatment. That includes over 50,000 Canadians, 250,000 British citizens; and two million Americans. Reasons for foreign treatment include: to gain access to procedures that are not available in the home country, to skip the waitlist and get immediate treatment, or to save on exorbitant medical expenses.

Procedures like heart surgeries and knee replacements in Asia can cost only 5-15% of what they cost in the United States, with the same standards of care and professionalism. At these prices, a medical tourist can better afford to recuperate for weeks in a luxury hotel with room service, rather than eating jello in a hospital bed somewhere in the Midwest!

So, would you choose medical tourism? We introduce you to some of the most popular options, alongside additional information for those seriously considering leaving the U.S. for treatment.

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Brazil is the destination of choice for people seeking affordable facelifts, liposuction, and breast augmentation. It also offers dental cosmetic procedures like veneers, implants, and whitening. Among the medically necessary procedures it offers, orthopedic and cardiovascular surgeries are strong areas. Additionally, fertility treatments that are prohibitively expensive in the United States are affordable and effective in Brazil.

Due to similarities in language and culture, citizens of the United States generally feel comfortable traveling to Canada . The Canadian healthcare system also has a positive reputation among a large portion of the U.S. population. Some U.S. citizens cross the border to purchase medicine at lower prices. Others go for advanced heart surgeries or orthopedic procedures.

The quality of dental care in Costa Rica ranks as high as that found in the United States, Canada, and other highly developed nations. They also have a good reputation in bariatric surgery, oncology, and eye surgeries. The CheTica Ranch is a popular place for medical tourists to relax and recover after having a procedure done in this tropical paradise.

India is one of the premier destinations for medical tourism. The United States graduates more medical students from India than of any other nationality. Many of those work in the States, making up about 9% of the total number of physicians in the country. Those who return home often go on to staff high-quality, technologically proficient clinics and hospitals in India. Medical tourists go there for complex transplant operations, heart surgeries, and orthopedic procedures.

Japan offers advanced medical treatments for cancer, cardiovascular disease, and orthopedics. Some cancer patients go there specifically for proton beam therapy, which focuses radiation very precisely to avoid damage to nearby non-cancerous tissue. Japan is arguably the most advanced society in the world for organ transplants and robotic surgeries.

Many Americans and Canadians visit Mexico for medical treatments but for different reasons. For U.S. citizens, the lower cost is the motivation; for Canadians, it's the short wait times. Dental implants, gastric bypass surgery, and hip replacements all cost about half of what they would in the United States. Many people go to Mexico for facelifts, liposuction, or other cosmetic procedures. Orthopedic and cardiac work are also strong draws.

The city-state of Singapore has one of the highest standards of living in the world. The country's prosperity shows in the high-quality health care available there. Singapore attracts over 500,000 medical tourists a year. It has a particularly good reputation in oncology and cosmetic surgeries.

Spain is a good destination for fertility treatments, including egg freezing, surrogacy, and IVF. It offers an array of cosmetic procedures like liposuction, rhinoplasty, facelifts, dental implants, orthodontics, and teeth whitening. Knee or hip replacements, laser eye surgeries, and spinal surgeries are available at the highest levels of expertise.

Thailand has a strong reputation for offering world-class health care. The country has state-of-the-art facilities and internationally trained medical personnel. Cosmetic surgery, fertility treatments, dental care, cardiology, and orthopedics are all strong suits there. Thailand is also considered a leader in gender reassignment and stem cell procedures. Thailand particularly benefits from medical tourism because it is also such a desirable tourist destination.

Like many other medical tourist destinations, Turkey offers excellent dental care, cardiology, oncology, orthopedics, and cosmetic surgeries of all kinds. It is a world leader in hair transplantation. In recent years Turkey has become advanced in robotic cardiac and urologic surgeries.

United Arab Emirates

Abu Dhabi, the capital of the United Arab Emirates, has some of the most sought-after medical facilities in the world. The country has spared no expense in building state-of-the-art facilities and recruiting international medical personnel with the highest qualifications. Some particularly strong programs there are cosmetic surgery, dental work, orthopedic treatments, oncology, robotic surgery, stem cell research, and research on genetic disorders.

Consider the Downside

We've covered the benefits of medical tourism - but before you schedule your procedure take a minute to consider the downsides:

• Patients with life-threatening conditions like cancer might pursue alternative treatments abroad that are not effective and will shorten their lifespan.
• There is limited aftercare. Patients who develop complications or side effects from medicine after some time has passed will have to pursue follow-up treatment in their home country.
• Your insurance may not cover this treatment, so you will pay 100% of the cost out-of-pocket. Depending on the terms of your coverage, it may or may not be worth it.
• Many of the destination countries do not have robust malpractice laws, so your ability to sue a neglectful doctor may be limited or nonexistent.

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They said her husband drowned snorkeling, but she saw him walk to shore. What happened?

A Michigan woman and her family are suing a Maui resort , the Hawaiian Tourism Authority, and the Hawaii Visitors and Convention Bureau after her husband died while snorkeling . She doesn’t believe it was a drowning. 

Patricia and Ray Johnson, along with four friends, arrived at the Fairmont Kea Lani on Maui on the evening of Feb. 23, 2022, with plans to visit multiple islands over several weeks. This was the couple’s sixth time in Hawaii, and they had snorkeled the Hawaiian waters many times in the past, Patricia told USA TODAY. 

On the morning of Feb. 25, some of the travelers, including Ray, went snorkeling around Wailea Beach, which fronts the resort, while Patricia opted to walk a trail that overlooks the beach. “I looked out, and I saw my husband and my friends or people out there,” she told USA TODAY. “I’m waving at him, and it hits me.” Patricia saw what looked like other snorkelers helping Ray. 

She hurried down to the beach, but “things deteriorated quickly.” At first, Ray had his head above water and was returning to the beach, but then the 64-year-old fell onto his back with his head “snapped back at one point” and had to be pulled in. “I knew he was gone,” she said. 9-1-1 was called, but medical professionals failed to resuscitate Ray. 

The autopsy report called Ray’s death an accidental drowning, which Patricia doesn’t believe. 

“I was watching him come in, how could he be drowning?” According to her friends who were snorkeling with him, Ray was talking and also diving down under the water. At one point, he came up and said, “You gotta help me, I’m having trouble breathing,” and that’s when he decided to head back to shore. “I don’t think when people are drowning in a conditional manner, you’re going to be conversing,” she said.

What to do in Hawaii? Locals weigh in on if these popular spots are worth the hype

By a landslide, the leading cause of death for Hawaii tourists is drowning. And of ocean drownings for residents and visitors, the majority occur when snorkeling. While the ocean is powerful and unpredictable, some advocates, including the Johnsons, are trying to bring attention to a lesser-known medical condition that specifically poses risks to snorkelers and hasn’t gotten much attention over the years: Rapid Onset Pulmonary Edema (ROPE). 

The Johnson family believes ROPE is the real cause of Ray’s death, and the lawsuit alleges that Hawaii travel entities have failed to educate the public on ROPE, resulting in “an important public health concern,” according to the complaint filed in the Circuit Court of the First Circuit in the State of Hawaii in February 2024. The case should begin the fact-discovery process this week.

The Hawaiian Tourism Authority, Hawaii Visitors and Convention Bureau and Fairmont Kea Lani declined to comment on the lawsuit. 

“I would like to see warnings out there,” Patricia told USA TODAY. “I truly believe my husband would still be here if we’d been warned.” 

How is snorkeling dangerous?

Breathing through a snorkel tube is similar to pinching your nose and breathing in through your mouth. The resistance is immediate. ROPE occurs when the negative pressure on the lungs ends up sucking bodily fluids out of the capillaries and into the airways, according to Dr. Raj Dasgupta , a California-based pulmonologist. 

“That snorkel resistance to airflow,” he said. “They want to breathe in but they have to breathe through that straw.”

Once fluid is in the lungs, it becomes difficult to breathe and people can experience hypoxia, or a lack of sufficient oxygen. “You slowly become weak then into a loss of consciousness,” Dasgupta said. Underlying health conditions such as heart and lung disease also increase someone’s predisposed risk for ROPE, he said.

If a person begins to feel shortness of breath, they may panic, causing more exertion, which can be life-threatening if they’re already suffering from a lack of oxygen, Dasgupta said. 

Drowning by ROPE is “fundamentally different” than typical drowning when people are aspirating water or submerged and often showing signs of distress, the complaint said.

A lack of public awareness

In October 2017, after California woman – and avid swimmer and snorkeler – Nancy Peacock died while snorkeling in calm waters off the coast of Hawaii Island in a full-face mask and no signs of struggle, the Hawaii State Department created the Snorkeling Safety Sub-Committee to “address public concern about snorkel-related drownings.”

In a Snorkeling Safety Study led by the sub-committee, 50 different snorkels were tested, and the experts examined nonfatal and fatal drownings. The interim report released in July 2020 concluded that “ROPE-induced hypoxia is a factor in fatal and nonfatal snorkel drownings.” The study also had a survey conducted at Oahu’s most popular snorkeling spot, Hanauma Bay, but only 36 participants – mostly locals – were interviewed due to the islands being closed to travel during the pandemic. 

The high altitude from air travel impacting someone’s lungs may be a contributing factor, but there wasn’t enough evidence in the study to confirm this. Since getting to Hawaii requires at least a five-hour flight, it’s possible that fatigue and stress from flying could play a role in someone’s risk of drowning by ROPE. 

The Hawaiian Tourism Authority funded the study to “develop appropriate safety messages.” However, as of April 2024, there have not been any public-facing messages on any of the official Hawaii tourism websites. Information cards have been passed out to most Kauai and Oahu tour boat operators, the subcommittee said. Although the study is preliminary and not robust in terms of participants and even calls for further investigation, it is the only one to explore ROPE in snorkelers so far.

“Why aren’t we in Hawaii letting people know?” said Jay Stuemke, an Oahu-based attorney who filed the complaint on the Johnsons’ behalf. “Pamphlets in rooms, apps, websites, in-room videos, all types of mechanisms to warn people. It’s an easy enough thing to do. We believe had they done that, Ray would still be alive today as well as many other people.” 

Snorkeling safety tips

◾ Always snorkel with a buddy, and if you can’t swim, don’t snorkel.

◾ Choose a snorkel with a wide opening and no constrictions in the mouthpiece.

◾ Learn to use the snorkel device before venturing out into water that’s too deep to stand in.

◾ If you feel shortness of breath, stay calm, remove the snorkel and get out of the water immediately, Dasgupta said.

Kathleen Wong is a travel reporter for USA TODAY based in Hawaii. You can reach her at [email protected] .

Vegas tourism authority sponsoring each Aces player for $100K in 2024 and 2025; WNBA investigating.

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LAS VEGAS (AP) — The Las Vegas Convention and Visitors Authority is providing a $100,000 annual sponsorship to each Aces player for this season and 2025.

Vegas tourism authority sponsoring each Aces player for $100K in 2024 and 2025; WNBA investigating. Back to video

The WNBA is investigating whether the sponsorships are allowed.

This isn’t the Aces first run-in with the league over the last few years. Last year, the WNBA suspended Aces coach Becky Hammon for two games and took away the Aces’ 2025 first-round draft pick because the franchise violated league rules regarding impermissible player benefits and workplace policies.

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The sponsorship does not violate the WNBA’s salary cap because the Las Vegas authority did not orchestrate it with the club. But other teams are likely to raise questions about the fairness of the sponsorship and whether it violates the spirit of the cap rules.

The authority posted a video on X of president and CEO Steve Hill telling the players in the locker room the news on Friday.

“The Aces have been on an historic run — two-time world champions,” Hill said on the video before informing the players. “We’re here to do something historic with them, too.”

The players were thrilled by the move.

“The city of Vegas I’ve always said, it’s a big small town and they just want the best for the people here,” point guard Chelsea Gray said before the Aces’ home game Saturday against the Los Angeles Sparks. “They’re investing in us and so they put their money where their mouth is. We’ve done so much for the city and having fun doing it.

“It was a great moment for me and my teammates, of somebody actually putting funds behind, saying that they’re supporting and they want to have our back.”

According to the website Spotrac, which tracks player salaries, the sponsorship is higher than the earnings of six Aces players.

“Definitely more than my salary,” said rookie Kate Martin, who makes $67,249, according to the website. “I’m super thankful. Sometimes I have to pinch myself to make sure I’m not dreaming, but this is very much real life and that is what all these players deserve. I wouldn’t be getting this crazy bonus if it weren’t for how great all of these players have played in the last few years.”

The $100,000 also is a big addition even to what the top players make. A’ja Wilson and Kelsey Plum are the highest-paid Aces at $200,000 each and Gray is right behind at $196,267.

“(For) the LVCVA to see our value and to help close that pay gap, it says a lot about the character of the people that are there,” said Alysha Clark, whose salary is listed at $110,000. “So I’m extremely grateful. I’m honored to be able to represent this organization and this city and be able to put on for the city, give back to this city and pour into the community, and that’s what they did for us. It was really, really special.”

AP Basketball Writer Doug Feinberg and AP freelance writer W.G. Ramirez contributed to this report.

AP WNBA: https://apnews.com/hub/wnba-basketball

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Mortgage lenders offering 'extreme discounts' behind the scene: Robert McLister

Would-be homebuyers are in limbo and only the bank of canada can free them, posthaste: canada's standard of living on track for worst decline in 40 years, capital gains tax hike proposal should be delayed, if not scrapped altogether, canada's home sales and prices fall as sellers return to market.

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Biden hikes tariffs on Chinese EVs, solar cells, steel, aluminum — and snipes at Trump

President Joe Biden slapped major new tariffs on Chinese electric vehicles, advanced batteries, steel, aluminum and other goods Tuesday as he embraced a strategy that’s increasing friction between the world’s two largest economies.

President Joe Biden sits down to sign a document in the Rose Garden of the White House in Washington, Tuesday, May 14, 2024, imposing major new tariffs on electric vehicles, semiconductors, solar equipment and medical supplies imported from China. (AP Photo/Susan Walsh)

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President Joe Biden speaks in the Rose Garden of the White House in Washington, Tuesday, May 14, 2024, announcing plans to impose major new tariffs on electric vehicles, semiconductors, solar equipment and medical supplies imported from China. (AP Photo/Susan Walsh)

FILE - A worker assembles an SUV at a car plant of Li Auto, a major Chinese EV maker, in Changzhou in eastern China’s Jiangsu province on March 27, 2024. The Biden administration is announcing plans to slap new tariffs on Chinese electric vehicles, advanced batteries, solar cells, steel, aluminum and medical equipment. (Chinatopix Via AP, File)

WASHINGTON (AP) — President Joe Biden slapped major new tariffs on Chinese electric vehicles, advanced batteries, solar cells, steel, aluminum and medical equipment on Tuesday, taking potshots at Donald Trump along the way as he embraced a strategy that’s increasing friction between the world’s two largest economies.

The Democratic president said that Chinese government subsidies ensure the nation’s companies don’t have to turn a profit, giving them an unfair advantage in global trade.

“American workers can outwork and outcompete anyone as long as the competition is fair,” Biden said in the White House Rose Garden. “But for too long, it hasn’t been fair. For years, the Chinese government has poured state money into Chinese companies ... it’s not competition, it’s cheating.”

The tariffs come in the middle of a heated campaign between Biden and Trump, his Republican predecessor, to show who’s tougher on China. In a nod to the presidential campaign, Biden recognized lawmakers from Michigan in his remarks and spoke about workers in Pennsylvania and Wisconsin, all battleground states in November’s election.

Asked to respond to Trump’s comments that China was eating America’s lunch, Biden said of his rival, “He’s been feeding them a long time.” The Democrat said Trump had failed to crack down on Chinese trade abuses as he had pledged he would do during his presidency.

Karoline Leavitt, the Trump campaign’s press secretary, called the new tariffs a “weak and futile attempt” to distract from Biden’s own support for EVs in the United States, which Trump says will lead to layoffs at auto factories.

The Chinese government was quick to push back against the tariffs, saying they “will seriously affect the atmosphere of bilateral cooperation.” The foreign ministry used the word “bullying.”

The tariffs are unlikely to have a broad inflationary impact in the short term because of how they’re structured, some not to take effect until 2026, but there could be price increases in the meantime for EV batteries, solar and some other specific items.

Biden administration officials said they think the tariffs won’t escalate tensions with China, yet they expect China will explore ways to respond to the new taxes on its products. It’s uncertain what the long-term impact on prices could be if the tariffs contribute to a wider trade dispute.

The tariffs are to be phased in over the next three years, with those that take effect in 2024 covering EVs, solar cells, syringes, needles, steel and aluminum and more. There are currently very few EVs from China in the U.S., but officials worry low-priced models made possible by Chinese government subsidies could soon start flooding the U.S. market.

Chinese firms can sell EVs for as little as $12,000 . China’s solar cell plants and steel and aluminum mills have enough capacity to meet much of the world’s demand, with Chinese officials arguing their production keeps prices low and would aid a transition to the green economy.

China’s commerce ministry said in a statement that the tariffs were “typical political manipulation” as it expressed its “strong dissatisfaction” and pledged to “take resolute measures to defend its rights and interests.”

Under the findings of a four-year review on trade with China, the tax rate on imported Chinese EVs will rise to 102.5% this year, up from total levels of 27.5%. The review was undertaken under Section 301 of the Trade Act of 1974, which allows the government to retaliate against trade practices deemed unfair or in violation of global standards.

Under the 301 guidelines, the tariff rate is to double to 50% on solar cell imports this year. Tariffs on certain Chinese steel and aluminum products will climb to 25% this year. Computer chip tariffs will double to 50% by 2025.

For lithium-ion EV batteries, tariffs will rise from 7.5% to 25% this year. But for non-EV batteries of the same type, the tariff increase will be implemented in 2026. There are also higher tariffs on ship-to-shore cranes, critical minerals and medical products.

The new tariffs, at least initially, are largely symbolic since they will apply to only about $18 billion in imports. A new analysis by Oxford Economics estimates the tariffs will have a barely noticeable impact on inflation by pushing up inflation by just 0.01%.

The Chinese EV maker BYD has explored the possibility of opening factories in Mexico for the Mexican market, possibly creating a way to ship goods into the United States. U.S. Trade Representative Katherine Tai said she was talking with industry and workers about the possibility and to “stay tuned.”

The auto industry is still trying to assess the impact of the tariffs. But at present, it appears they could be assessed on only two Chinese-made vehicles, the Polestar 2 luxury EV and potentially Volvo’s S90 luxury gas-electric hybrid midsize sedan.

“We’re still reviewing the tariffs to understand exactly what’s affected and how,” said Russell Datz, spokesman for Volvo, a Swedish brand now under China’s Geely group. A message was left seeking comment from Polestar, which also falls under Geely.

The Chinese foreign ministry spokesperson, Wang Wenbin, said the U.S. is trampling on the principles of a market economy and international economic and trade rules.

“It’s a naked act of bullying,” Wang said.

The Chinese economy has been slowed by the collapse of the country’s real estate market and past coronavirus pandemic lockdowns, prompting Chinese President Xi Jinping to try to jumpstart growth by ramping up production of EVs and other products, making more than the Chinese market can absorb.

This strategy further exacerbates tensions with a U.S. government that claims it’s determined to strengthen its own manufacturing to compete with China, yet avoid a larger conflict.

“China’s factory-led recovery and weak consumption growth, which are translating into excess capacity and an aggressive search for foreign markets, in tandem with the looming U.S. election season add up to a perfect recipe for escalating U.S. trade fractions with China,’’ said Eswar Prasad, professor of trade policy at Cornell University.

The Europeans are worried, too. The EU launched an investigation last fall into Chinese subsidies and could impose an import tax on Chinese EVs.

After Xi’s visit to France last week, European Commission President Ursula von der Leyen warned that government-subsidized Chinese EVs and steel “are flooding the European market” and said, “The world cannot absorb China’s surplus production.’’

Biden’s administration views China, with its subsidies of manufacturing, as trying to globally control the EV and clean-energy sectors, whereas the administration says its own industrial support is geared toward ensuring domestic supplies to help meet U.S. demand.

“We do not seek to have global domination of manufacturing in these sectors, but we believe because these are strategic industries and for the sake of resilience of our supply chains, that we want to make sure that we have healthy and active firms,” Treasury Secretary Janet Yellen said.

The tensions go far beyond a trade dispute to deeper questions about who leads the world economy as a seemingly indispensable nation. China’s policies could make the world more dependent on its factories, possibly giving it greater leverage in geopolitics. At the same time, the United States says it’s seeking for countries to operate by the same standards so competition can be fair.

China maintains the tariffs are in violation of the global trade rules the United States originally helped establish through the World Trade Organization. It accuses the U.S. of continuing to politicize trade issues and on Friday said the new tariffs compound the problems caused by tariffs the Trump administration previously put on Chinese goods, which Biden has kept.

Those issues are at the heart of November’s presidential election, with a bitterly divided electorate seemingly united by the idea of getting tough with China. Biden and Trump have overlapping but different strategies.

Biden sees targeted tariffs as needed to defend key industries and workers, while Trump has threatened broad 10% tariffs against all imports from rivals and allies alike.

Biden has staked his presidential legacy on the U.S. pulling ahead of China with its own government investments in factories to make EVs, computer chips and other advanced technologies.

Trump tells his supporters America is falling further behind China by not betting on oil to keep powering the economy, despite its climate change risks. The ex-president may believe tariffs can change Chinese behavior, but he believes the U.S. will be reliant on China for EV components and solar cells.

“Joe Biden’s economic plan is to make China rich and America poor,” he said at a rally this month in Wisconsin.

AP autos writer Tom Krisher contributed to this report from Detroit.

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