In recent years, the landscape of healthcare has undergone a transformative shift, reaching beyond national borders to cater to patients around the world. Cross-border travel to seek medical care is once again a growing area following the lifting of restrictions imposed by the Covid-19 pandemic.

Popular treatments sought by international patients include dental work, cardiovascular surgery, orthopaedic work such as knee and hip replacement, and cosmetic procedures.

The Americas, home to diverse healthcare systems, have emerged as a significant hub for medical travel, attracting patients from across the globe seeking quality medical care at competitive prices.

Here we explore the phenomenon of travelling for medical care in the Americas, examining some of the market strengths and weaknesses associated with this trend, and looking into the pros and cons of different health systems within the region.

Healthcare costs and quality

Joe Cronin, President of International Citizens Group, points out that a number of dynamics are driving people’s choices regarding medical travel, primarily cost and quality of care.

“As costs are increasing throughout the world, and access to care is becoming more limited (especially in the US, primarily driven by costs of private insurance and medical care), going abroad for healthcare is increasingly becoming a smart option.

“At the same time, the quality of care is improving worldwide. Doctors who have been trained at the top universities around the world are returning to their home countries to practise where they can find a better quality of life. As a result, you can often get top-quality doctors in many other countries for a fraction of the cost.”

There is currently a strong interest in developing medical travel in many countries in Latin America, such as Mexico, Brazil, and Colombia. These regions have invested heavily in their healthcare infrastructure following favourable government policies, which is in turn attracting patients from both North America and overseas.

But the medical travel market within the US is the largest in the area and predicted to grow rapidly over the coming years. It offers access to cutting-edge treatments and facilities, a wide range of specialists and procedures, and a private healthcare market that fosters competition and innovation.

Insurers know they can rely with certainty on the care provided by hospitals and doctors in the US and ensure a high level of satisfaction for their clients, so they may relocate patients there when they are in need of care while visiting the Americas. On the other hand, medical costs in the US are relatively high, insurance systems can be complex and administrative overheads are great.

David Ewing, International Program Marketing Manager at Jackson Health System International, explained that travelling to the US for medical care is often a necessity, as specialist physicians and treatment may not be available in the patient’s home country.

“Academic medical centres have built extensive support programmes to assist these individuals, whether it is for a virtual second medical opinion or an in-person specialty physician consult and further testing,” he said.

Furthermore, international private medical insurance often covers these consultations. “Some patients come to the US in a critical condition when all other treatment options in their home country have been exhausted and the US is their only choice,” Ewing added. “These patients – adult, neonatal and paediatric – may require extensive cardiac services, neurosurgical services, organ transplantation, trauma and burn care as well as rehabilitation, and the reputation of US healthcare is the best.

“Many of these patients arrive critically ill and go back to their home country after receiving truly lifesaving treatment with a great story to share about their experience with US hospitals.”

Ewing added that physicians often liaise with their international colleagues to ensure specialty treatments started in the US can continue in the patient’s home country before the discharge of the patient. “US healthcare is so well respected worldwide that many academic medical centres are opening satellite facilities on a global basis and training physicians through exchange programmes,” he said.

Cronin agrees this is a big opportunity for domestic insurance companies, which currently limit their network of providers to those within the client’s home country, to start expanding their network of healthcare providers into new countries. 

“For example,” he said, “a US citizen with a domestic health insurance plan can only go to doctors in the USA for care. Insurers could lower their cost of care by allowing their US clients to go to Canada or Mexico for select procedures.”

There is currently a strong interest in developing medical travel in many countries in Latin America, such as Mexico, Brazil, and Colombia

Mexico in particular is one of the rising stars of medical travel. It offers a segmented healthcare system with both public and private options, and affordable private healthcare, but its public facilities can become overcrowded and public health programmes tend to be underfunded.

The patient must ensure they are travelling to a reputable hospital – that’s where accreditation comes in. Some countries have their own national accrediting bodies, while Joint Commission International (JCI) is the largest and best-known international accrediting organisation.

Vital questions 

Dr Joel A Roos, Vice President of International Accreditation, Quality Improvement, and Safety at JCI, highlights several questions patients should ask in advance before receiving healthcare procedures in other countries, particularly in relation to safety concerns: “Can the overseas hospital handle the patient’s customs and language? Particular religious and dietary preferences vary. Are both the hospital and the local accommodations able to accommodate those?”

Regarding safety, Roos emphasised the need to “choose wisely, since it’s not just about saving money”. He said: “If a patient travels to an exotic destination and suffers post-surgical problems once back home, they then will need a medical professional in their home country to help remedy the complications. And the new doctor may not know the details of what happened.

“Will the treating hospital provide full records? This is a question the patient should ask. They should request records of everything that was done before leaving the country, such as on a CD or DVD, in a language that’s understandable in their home country.”

Following the Covid-19 pandemic, trends in international medical travel have altered and are still settling back into more predictable patterns. Before the pandemic, certain countries were regional hubs of excellence, drawing patients from all over the world, as their healthcare systems were so good. 

This drove up local competition in surrounding major countries and began attracting patients. However, as Roos explained, “this all stopped during Covid-19. During the pandemic, countries attempted to keep medical tourism within their country. This was a positive benefit of competition, since it increased quality of care, lowered costs and attracted patients.

Following the Covid-19 pandemic, trends in international medical travel have altered and are still settling back into more predictable patterns

“We currently are seeing some of that in South and Central Americas,” Roos pointed out. “There is a lot more interest in Mexico, as their economy’s growing. Healthcare procedure costs are competitive, so there are advantages for patients in this regard, especially if the patient has a condition which requires more specialised treatment.”

In his role at JCI, Roos observes patterns of healthcare improvement and a growing interest in accreditation in certain regions. “One area showing absolute growth is Brazil,” he told ITIJ. As it happens, the first hospital JCI ever accredited was in Brazil: [Hospital Israelita] Albert Einstein in the Morumbi district, on the south side of São Paulo. 

“Interest in accreditation in Brazil is a clear growth area,” Roos stated. “Brazil is very serious about investigating quality issues and finding solutions. They are a regional hub for surrounding countries. Hospitals there are actively seeking international accreditation, they’re serious about improving their healthcare systems.”

Connections across borders

In the Americas there is also a trend for patients to cross borders for cheaper medications or dental care, especially among those who live close to a border. This phenomenon is often seen at the US-Mexico border.

But patients will often visit the Americas for medical care from other continents. Roos pointed out: “Some large healthcare organisations in Spain and Portugal have hospital systems in South America. Patients may follow that and travel there, because there are connections between those organisations or healthcare systems and those located in Europe.”

The further an individual is travelling for their care, the more likely it is due to cost, increased comfort, and better specialised medical care

In addition, facilities in those locations often share a common language, especially in Brazil, where many people speak Spanish as well as Portuguese, particularly in the larger cities. Certain international healthcare organisations also have hospitals in Colombia, which is among the fastest-growing medical 
travel destinations in the world. There are concerted, ongoing efforts to make Colombia’s healthcare system attractive to international patients.

Some tropical countries have become very adept at offering “all in one” packages, Roos told ITIJ. “These offers include patient collection at the airport and accommodation, along with medical procedures – all for one price. Various countries in the Caribbean offer these types of deals.”

The Dominican Republic is one such example, and is aiming to become a leading destination in this sector. It has experienced a significant rise in international patients for medical treatments and aesthetic procedures over the last decade.

Overall, travelling to the Americas for medical care is a trend driven by many factors including cost, technology, and expertise. Health systems in the US, Canada, and Central and South American countries differ significantly, each presenting its own advantages and drawbacks for medical travel.

As Roos pointed out, the further an individual is travelling for their care, the more likely it is due to cost, increased comfort, and better specialised medical care. The advantages of cost-effectiveness, access to advanced medical technology, and reduced waiting times, are weighed against potential drawbacks such as cultural and language barriers, quality assurance and regulatory concerns, and post-operative care challenges.

Medical travel to the Americas is a well-established practice, very likely to continue to grow over time. The clear benefits of better care at a speciality hospital will continue to draw patients to this region from all over the world.