The Decibel - The rise of medical tourism

Episode Date: December 18, 2025

This travel season, Canadians might be headed away for something other than a vacation.More Canadians are participating in medical tourism, travelling to another country to receive medical treatment, though some question its safety and the threats this poses to Canada’s public health care system.Sarah Bartnicka, a freelance writer for The Globe, explains the costs, the risks and what Canadians can keep in mind for best practices when travelling abroad for a medical procedure.Questions? Comments? Ideas? E-mail us at [e-mail] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

It's travel season. Some of us are heading home to our families. Some are heading south in search of sun. And some might be heading to countries like Turkey in search of hair plugs. More Canadians are traveling for medical treatments. According to the Medical Tourism Association, an estimated 430. 32,000 Canadians were expected to seek medical care abroad this year. That's up more than 44% compared to two years ago.

But just how safe is this? And what does it say about growing concerns over privatization of Canada's health care system? Freelance journalist Sarah Bartnika looked into the costs, the risks, and whether traveling for treatment is worth the trip. I'm Mikhail Stein, sitting in for Cheryl Sutherland, and this is the decibel from the Globe and Mail. Sarah, thank you so much for being here. Thank you so much for having me.

So when we talk about medical tourism, what kind of treatments or procedures are people traveling for? So people travel for almost every treatment and procedure that you can imagine. They travel for cosmetic surgeries, for dental work and fertility treatments, but then they also travel for more serious procedures like knee and hip replacements. You can't really generalize, but younger Canadians tend to opt for more elective and often cosmetic surgeries like hair transplants or nose jobs, while older Canadians are more likely to travel in connection to kind of more serious health issues, so knee replacements, hip surgeries, things like that. There are also people who might be chronically or terminally ill who seek out alternative experimental or trial treatments or procedures as well. so it's really quite the range. Okay, so it sounds like we have a few different categories here. We have cosmetic and elective procedures.

We also have more serious procedures and then kind of more experimental treatments. There's a lot. Yeah. Okay. It sounds like there's especially this growing interest in elective procedures. So how are we seeing the clinics and the doctors who are offering these services abroad? How are we seeing them respond to this increased demand? Yeah, it's a booming industry, and it's hard to overstate that. So what we're seeing in these global medical tourism hubs is that hospitals and clinics have been scaling up very quickly over the last few years to meet the growing demand for medical tourism. And you see it in all sorts of different ways. You know, the facilities will be quite sophisticated. They are staffed with English-speaking people. And sometimes, although not that often, they will offer

all-inclusive travel packages tailored specifically at North Americans. I spoke to Jonathan Adelheight from the Medical Tourism Association, who has been in the industry for decades, and he said that it's really night and day compared to what he saw 20 years ago, especially when they're thinking about the options available for patients. So it's truly overwhelming, and often if you are considering medical tourism, you just really don't know where to look. It sounds like you can, like, have it all with a vacation. like this. You know, you have a little pool time, a little recovery time, maybe a little recovery time at the pool. You know, it's something a little different. It's very common. People will often bring their friends and family, although typically the tourism part of medical tourism is advised to do before the procedure and not after so that you can properly recover. That sounds like some wise insight there. Right. Where are these medical tourism hubs? Oh my gosh. I mean, every country has a

medical tourism offering. I can't speak to each one. But part of it really also just comes down to marketing. You know, there's a reason it's called a Brazilian butt lift. But similarly, listeners might know that Mexico is known for weight loss surgeries or dental work. And Turkey is known for hair transplants. Meanwhile, South Korea is known for skin care. So the list really goes on. But I mean, we're looking at Thailand, Costa Rica, Vietnam. It's really all over the map. And so again, it can be very challenging to navigate as a patient. If you have a valid passport, you literally have access to a world of options and it can be a lot. So this is an interesting thing, Sarah, because we have all these options. We can go anywhere in the world. But Canada has universal

health care and that's funded by us. It's funded by taxpayers. So why are more Canadians seeking treatment outside the country? Yeah. So oftentimes it does come down to high weight times. If you are needing a hip replacement and you're looking at a year-long weight, you might start looking into options to expedite the process just so you can get back to feeling like yourself again. And we have numbers on this, right? Like the Canadian Institute for Health Information released an analysis a couple months ago that found while Canada's capacity to perform surgeries increased in recent years, our system has not kept up with population growth and rising demand due to an aging population. biggest increases in median waiting times for hip and knee replacements have been seen in Quebec, Newfoundland, and BC, and nationally, the median waiting times for cancer surgeries has increased compared to pre-pandemic years.

What about these elective surgeries? Why do people want to get elective surgeries in other countries? So, of course, it varies depending on the type of procedures, but since elective treatments are not covered under provincial health care plans, cost is a driving factor. And I'm sure we'll get back to that. But I also want to mention that I think there's an aspect of this industry that has very much been amplified by social media. It's seen as quite trendy to visit a clinic that might be hard to access or gives you a good deal or offer something that might not be available in Canada. And then, you know, the other aspect is the marketing piece I mentioned. And so all in all, I mean, it is possible

to get a very high standard of care. And in some cases, for less money than what you're you would pay in Canada. And that's what this like ideal version of medical tourism looks like. Okay. So there's longer wait times. There's cost and kind of sounds like a bit of a status thing. What about cost for more essential procedures like dental work? Is that a factor as well? Yeah. So dental work is a little bit tricky because what might feel essential to you might not be essential under the province's guidelines. One example of a very popular procedure that people will do abroad includes implants and crowns and, you know, that is considered a elective procedure, but for a lot of people, it's very desirable. So the gentleman that I spoke to for this piece,

Ken Hagan, is a 76-year-old. And when he got the treatment done, he wasn't covered under the provincial health care plan to get implants and crowns. And so, when he was quoted in Canada, he thought, you know, he couldn't possibly afford the cost. And then he started to look at other options abroad. So what did those options look like for him? So he ended up getting a word of mouth recommendation from a client and ended up settling on a dental clinic in San Jose in Costa Rica. He traveled down to Costa Rica three times within a year, first to get the implants, to install the crowns, the first appointment was more of a consultation. And all in all, he says that he spent about $14,000 in the procedure, which sounds like a lot, but he says

that it is about 40% less than what he would have spent in Canada based on quotes that he got here. And there's a lot of other people out there like Ken. Even under Canada's expanded dental care plan, there are some more serious procedures that just aren't covered. Hmm. So it would have cost him a lot more to get it done, Canada, and that's without any of the travel costs. Yeah. The price that he ended up paying in the end was with travel included. It was with the stays in the hotel included. It's important to note that Ken felt comfortable going down by himself to get the treatment done. A lot of people don't. They will bring a family member or a friend, which of course brings the cost up. And fortunately, there were no complications with this procedure, but something that people, of course, have to keep in mind. is, you know, sometimes your recovery is a little bit longer than you anticipate or, you know, there can actually be complications as well. And so these are all costs that people have to budget into their decision to travel. But for Ken, he says it made a lot of sense. Do we know on average how much

money Canadians are saving by traveling for medical care? It's very difficult to say. But according to an estimate that was provided to us by the Medical Tourism Association, depending on the destination and what procedure you're actually getting done, Canadians can expect to save between 30 to 90 percent compared to what they would pay back home. And that's compared to what people would pay at private clinics in Canada? Exactly. And just to be clear, these elective surgeries, procedures, and treatments, those are not covered by our health system.

And while we have plastic surgeons and skincare experts here in Canada, there has been a trend of people finding cheaper offerings abroad. We'll be right back. Before we get into the potential risks and best practices that people should take before booking a trip like this, can you just give us a sense of how it works? You mentioned Ken, who went to Costa Rica for his dental work. How did he determine that that clinic was really the best option? Yeah. So after one of his clients recommended the clinic to him, after having done the same procedure, Ken started looking into it. He actually flew down for his initial consult, even though you don't have to for a lot of clinics. He kind of wanted to check things out in person. And once he got there, he said he was impressed by how professional and friendly, everyone was at the clinic. Everyone spoke English. The facilities looked good. And so, I mean, everything kind of checked out.

Okay, so it sounds like going to visit the clinic beforehand really helped to reassure Ken and, you know, he had a good experience, but that might not be the case for everyone. Can you walk us through the potential risks of traveling for medical care? Yeah, and there are a lot. And while it would be very nice if there was some sort of centralized database where you could look up what clinics and medical professionals are good at what they do, there is no universal standard of care. And if something does go wrong when you are abroad, it could be challenging to address not just on the ground, but when you come back home.

Of course, there's costs associated with all of this too. If you need to lengthen your recovery time, there's a cost associated with that. If you've brought friends or family with you, there's a cost associated with that as well. And that's kind of like the best case scenario. You know, if you're looking at a serious complication, you could be taken in for emergency medical care in the country where you're staying. And there's really no way of then being able to know how much that will cost you and ultimately if you're going to be able to get the care that you need. Yeah. If something does go really wrong, what kind of options do Canadians have when they're abroad? I mean, in some places, you may have no options. In Canada, doctors pay out of pocket for malpractice insurance, which covers you the patient if they make a mistake or act in a way that is.

is considered negligent, but that's definitely not the case everywhere. So, you know, not only could you be, as I mentioned, facing complications, but it could also come with a really high price tag that you have no path to recouping those funds, then at the end of it. I spoke to Valerie Crooks, a researcher at SFU that has been covering the space for a very long time. And she told me that in some cases, some of the cost savings you might see abroad might be because a clinic doesn't have those types of protections.

And just so we all know what we're talking about, SFU is Simon Fraser University. That's correct. Okay, so it sounds like going abroad for medical treatments can be a bit of a gamble. But Sarah, for people who really do want to take this kind of trip, what should Canadians keep in mind when it comes to best practices? So there's definitely a bit of a checklist that you can follow. So the first thing would be to assess the clinics and the doctor. kind of in the background, you want to verify that they have the credentials that they say they have, that they are licensed to operate in the way that they are operating. And that's kind of the first step. Once you've identified a clinic that passes that bar, you will want to book in a consultation with the provider that is going to be doing the procedure. It's very important that it's the person that's actually going to be doing it because you're going to have a lot of questions for them. You're going to want to ask them exactly what the procedure or treatment entails, the steps that are going to be followed, what material.

they're using, what technology they're using, and ultimately have a really good sense of what the recovery is like and the downtime and the aftercare as well. So that's kind of your moment to ask all the questions that you have. When you get into the cost comparison option, I mean, you're going to want to account for insurance. You're going to want to account for, you know, that scenario that I kind of mentioned. What is the worst thing that can kind of happen? And are you financially equipped for that? And is this trip still worth it if that were to happen? And so that's very important as well. The last thing is, I think, and that's not an exhaustive list whatsoever, but I would say that once you get on the ground, even if everything's going really smoothly and

really well and you're feeling good about it, if you get into that clinic and something feels off, you know, trust your gut and get out of there. If the professional is not the same person that you spoke to on a video call or that was in your initial consultation, if the air conditioning's broken. That could be a sign that maybe the sanitation and like is a little bit off. And so really, really just trust your gut and get out of there. And the last thing I'll say is that when you are making payment, try to do it with a credit card. If you are wiring money, if you're paying in cash, if something goes wrong, you will be very limited with the options that you have to recoup any of those funds because it'll be harder to trace. Sarah, is it enough to take these kinds of precautions?

What do Canadian healthcare professionals? Think about Canadian. traveling for medical care? I'm sure this won't be surprising to anyone, but Health Canada generally advises Canadians to seek treatment at home. A spokesperson told me that those who do choose medical tourism are advised to buy insurance covering anything that goes wrong that is not your standard travel insurance.

This is like a souped up kind of insurance that would actually cover medical procedures abroad. It's very rare. It's difficult to get, but make sure you have something like that. When I spoke to Valerie, the researcher at SFU, she had mixed feelings about it, right? I mean, medical tourism can be a very positive experience for some people is what she told me. But ultimately, in her many years of research, she's found that the industry is hurting more than it's helping. You know, she told me that on the international market, you are going

to find people who are going to take risks, especially if there are no to little consequences for negative outcomes. And she listed some considerations that people might not consider as well. You know, when people are traveling for cost savings, they might shorten their recovery times to save on overall costs. People might be pursuing surgeries that they're not a candidate for at home. And there might be a really good reason for that. So in both of those cases, people can struggle to access follow-up care in Canada. And ultimately, I mean, you're never going to be able to properly account for all the unknowns around accessing health care. And that goes for whether it is at home or whether it's abroad. But staying home does limit the risks. Yeah. And I can imagine

that if something does go wrong and you do end up needing follow-up care in Canada, it must be difficult for a doctor who didn't know anything about what was done in the first place to address any issues that came up because of it? It can be, yeah, because you have such limited information. So, Sarah, with these procedures being more promoted online, is there a sense that we might actually be over-normalizing what can actually be quite invasive and maybe ultimately unnecessary procedures? Absolutely. There's a risk of that. And, you know, if you, you open your phone and, you know, you're just being fed that type of content. Of course, it's going to feel a little bit more normal for you. And it's important to keep in mind that

what you're seeing online and your listeners will know this, but it's never the full picture. And oftentimes these surgeries, especially, you know, cosmetic surgeries, these are very invasive procedures that have considerable downtime, considerable risks involved. And that's never the story that you're going to see online. But, you know, we have seen also, you know, an uptick of people starting to talk about maybe when things go wrong. And so, I mean, you can see both sides of the story, but it's certainly not representative what you're seeing online of what is actually happening.

Sarah, just before we let you go, in Canada, our universal health care system has always been this source of pride for us. Do you think there's a risk that this increase, interest in private health care abroad could have an effect on our public health care system. I do know that those who support medical tourism will say that it can actually reduce the strain on an overburden system. Meanwhile, critics will say that it doesn't actually solve the core issue. And as we spoke about earlier, inevitably, when things go wrong, it falls on the Canadian health care system to fix. And so what I'm really interested

in is what this broadening maybe acceptance around paying for health care means for our universal system, of which there are aspects that have started to feel a little bit private. But it's hard to speculate on the impact of an industry that we can't actually properly measure, at least yet. Sarah, this has been such a fascinating conversation. Thank you so much for joining us today. Thank you so much for having me. That was Sarah Bartnika, a freelance writer for the globe.

That's it for today. I'm Mikhail Stein. I produced the show with Madeline White and Ali Graham. Cheryl Sutherland hosts the decibel. David Crosby edits the show. Alyssa Wheeler is our Brooke Forbes fellow. Adrian Chung is our senior producer, and Angela Pichenza is our executive editor.

Thank you for listening, and Cheryl will be back tomorrow. Thank you.