Meghann Ormond

Transnational healthcare, cross-border perspectives.

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En route: Transport and Embodiment in International Medical Travel Journeys Between Indonesia and Malaysia

Abstract International medical travel is increasingly major business. Using Indonesian patient-consumers’ transport experiences in the pursuit of private medical care in Malaysia, this study explores how transport operators and infrastructure are responding and adjusting to the embodied specificities of the growing market’s access and travel needs. In offering faster and more frequent linkages, they have both expanded the physical and geo-political scope and increased the immediacy of care provision. This underscores the value of examining how the mobile spaces of transport common to international medical travel actively intersect with, blur and re-articulate diverse understandings of ill-health and impairment, care and subjectivity.

Medical tourism in Malaysia: how can we better identify and manage its advantages and disadvantages?

Following the identification of medical tourism as a growth sector by the Malaysian government in 1998, significant government sector and private-sector investments have been channeled into its development over the past 15 years. This is unfolding within the broader context of social services being devolved to for-profit enterprises and ‘market-capable’ segments of society becoming sites of intensive entrepreneurial investment by both the private sector and the state. Yet, the opacity and paucity of available medical tourism statistics severely limits the extent to which medical tourisms impacts can be reliably assessed, forcing us to consider the real effects that the resulting speculation itself has produced and to reevaluate how the real and potential impacts of medical tourism are – and should be – conceptualized, calculated, distributed, and compensated for. Contemporary debate over the current and potential benefits and adverse effects of medical tourism for destination societies is hamstrung by the scant empirical data currently publicly available. Steps are proposed for overcoming these challenges in order to allow for improved identification, planning, and development of resources appropriate to the needs, demands, and interests of not only medical tourists and big business but also local populations.

Policy Implications of Medical Tourism Development in Destination Countries: Revisiting and Revising an Existing Framework by Examining the Case of Jamaica

BackgroundMedical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional scale, but interest in the practice is growing in locations where it is not yet established. Numerous governments and private hospitals in the Caribbean have recently identified medical tourism as a priority for economic development. We explore here the projects, activities, and outlooks surrounding medical tourism and their anticipated economic and health sector policy implications in the Caribbean country of Jamaica. Specifically, we apply Pocock and Phua’s previously-published conceptual framework of policy implications raised by medical tourism to explore its relevance in this new context and to identify additional considerations raised by the Jamaican context.MethodsEmploying case study methodology, we conducted six weeks of qualitative fieldwork in Jamaica between October 2012 and July 2013. Semi-structured interviews with health, tourism, and trade sector stakeholders, on-site visits to health and tourism infrastructure, and reflexive journaling were all used to collect a comprehensive dataset of how medical tourism in Jamaica is being developed. Our analytic strategy involved organizing our data within Pocock and Phua’s framework to identify overlapping and divergent issues.ResultsMany of the issues identified in Pocock and Phua’s policy implications framework are echoed in the planning and development of medical tourism in Jamaica. However, a number of additional implications, such as the involvement of international development agencies in facilitating interest in the sector, cyclical mobility of international health human resources, and the significance of health insurance portability in driving the growth of international hospital accreditation, arise from this new context and further enrich the original framework.ConclusionsThe framework developed by Pocock and Phua is a flexible common reference point with which to document issues raised by medical tourism in established and emerging destinations. However, the framework’s design does not lend itself to explaining how the underlying health system factors it identifies work to facilitate medical tourism’s development or how the specific impacts of the practice are likely to unfold.

Resorting to Plan J: Popular Perceptions of Singaporean Retirement Migration to Johor, Malaysia:

This exploratory study analyzes user-generated web content in Singapore and Malaysia to examine how the management of Singapores rapidly aging population within the emerging cross-border metropolitan space of Singapore and the Southern Malaysian state of Johor is perceived and framed by different social actors. It reveals a range of perspectives on the growing numbers of Singapore seniors and their families beginning to consider Johor as a post-retirement alternative to an over-priced and overcrowded Singapore to satisfy their needs and desires for more affordable medical and residential care, larger homes and greater independence.

Reflections on ‘medical tourism’ from the 2016 Global Healthcare Policy and Management Forum

In October 2016, the Global Healthcare Policy and Management Forum was held at Yonsei University, Seoul, South Korea. The goal of the forum was to discuss the role of the state in regulating and supporting the development of medical tourism. Forum attendees came from 10 countries. In this short report article, we identify key lessons from the forum that can inform the direction of future scholarly engagement with medical tourism. In so doing, we reference on-going scholarly debates about this global health services practice that have appeared in multiple venues, including this very journal. Key questions for future research emerging from the forum include: who should be meaningfully involved in identifying and defining categories of those travelling across borders for health services and what risks exist if certain voices are underrepresented in such a process; who does and does not ‘count’ as a medical tourist and what are the implications of such quantitative assessments; why have researchers not been able to address pressing knowledge gaps regarding the health equity impacts of medical tourism; and how do national-level polices and initiatives shape the ways in which medical tourism is unfolding in specific local centres and clinics? This short report as an important time capsule that summarises the current state of medical tourism research knowledge as articulated by the thought leaders in attendance at the forum while also pushing for research growth.

Government and governance strategies in medical tourism

This chapter provides an overview of current government and governance strategies relative to medical tourism development and management around the world. Most studies on medical tourism have privileged national governments as key actors in medical tourism regulation and, in some cases, even facilitation and provision. However, with the multiplication of supra- and sub-national regions, each with their own distinct responsibilities and levels of autonomy, it is important to consider the various nested and overlapping governance types and practices at play in medical tourism. This chapter, therefore, identifies how governments at various levels (e.g., national, sub-national, supra-national) in both source and host contexts play different, yet often overlapping, roles relative to medical tourism as facilitator, regulator and provider.

Healthcare entitlements for citizens and trans-border mobile peoples in Southeast Asia

This chapter focuses on transborder issues shaping transitions in Southeast Asian countries’ health systems. In section 1, we address the regionalisation of health governance by examining economic and social policies and charters affecting health and healthcare within ASEAN. We look specifically at sovereignty concerns and shifts in national and sub-national responsibility/accountability, the circulation of health workers within the scope of the AEC, and the ‘emptiness’ of multi-lateral commitment on public health issues (e.g., tobacco and pollution). In section 2, we focus on the privatisation/commoditisation of health care, giving attention to the status of universal health coverage in select Southeast Asian countries as well as the growth in transborder flows of investment/ownership and health care provision/pursuits. Section 3 is dedicated to questions of vulnerability, health equity, rights and justice. It explore the effects of the issues described in sections 1 and 2 on different citizen/non-citizen and internal/international populations (e.g., economic migrants, refugees/asylum-seekers, environmental displacees, etc.).

Knowledge transfer in the “medical tourism” industry: The role of transnational migrant patients and health workers

Tapping into migrants’ diverse tacit healthcare knowledge can bring a range of stakeholders in countries of origin great insight, at both macro and micro levels, not only into how to improve on local healthcare delivery but also how to effectively respond to the needs and interests of ‘medical tourists’, travellers and other migrants. This chapter reviews recent literature on migration and ‘medical tourism’ in order to look in greater detail at the role, first, of migrant patients and, second, of migrant health workers in the development of Global South destinations’ ‘medical tourism’ industries. It offers a series of lessons drawn from the many examples of migrant knowledge transfer and barriers presented.

Editorial: Transnational healthcare, cross-border perspectives

eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher’s website.