Transnational medical travel: patient mobility, shifting health system entitlements and attachments

Abstract

Transnational medical travelthe temporary movement by patients across national borders in order to address medical concerns abroad that are (considered to be) unable to be sufficiently met within their countries of residenceis an important therapeutic coping strategy used by growing proportions of peoples with a diverse range of mobility profiles and intensities of global moorings. Studying this phenomenon provides useful insight into a rapidly globalising era of health governance, where an ever-wider array of state and nonstate actors are transcending the increasingly restrictive national containerisations of health care and engaging in cross-border action to effectively address contemporary health challenges at both individual and collective levels. In our introduction to this special issue on transnational medical travel, we draw on both 'medical tourism' and migrant health scholarship to acknowledge the diversity of motivations among migrant and non-migrant patients alike and the complex nature of mobile patients' attachments to the multiple places in which they seek care. We then bring attention to how dynamic structural issues in mobile patients' countries of residence and destination shape their attachments to places and health systems over time, examining the linkages between vitality of the political and social systems in these places to which they are differently attached and their dis/ satisfaction and dis/enfranchisement with them. KEYWORDSHealth care; place attachment; transnationalism; migrant health; medical tourism; disenfranchisement ing within a country's borders, however, is necessarily included in this national social pact, nor are those who are included formally necessarily included informally. How inclusion in and exclusion from national health systems are defined and classified is the focus of heated political and societal debate, especially now when, across the globe, many national health systems are experiencing significant resource strain, leading to the tightening of eligibility

Transnational healthcare as process: multiplicity and directionality in the engagements with healthcare among Polish migrants in the UK

“…The merging of these two fields of inquiry is prevalent within a transnational framework. Transnational approaches with a focus on people's access to services beyond national borders have recognised the contribution of both medical tourism and migrant health literatures, highlighting the attachments and links between places and health systems that each of them makes (Ormond and Lunt 2019). Migrants' access to healthcare beyond the nations where they reside can be considered as an instance of wider movements of patients across borders, long understood either as a public health issue or as a market development phenomenon.…”

Diasporic medical tourism: a scoping review of quantitative and qualitative evidence

“…Ormond & Lunt [9] suggest that countries with robust welfare systems are directing their attention as to how to respond to the situation of transnationality of their citizens, while countries with declining welfare systems are trying to benefit from it. The model of 'diaspora as resource' translates into an increased engagement by the states with their populations abroad [72].…”

“…As for the former: many times in literature motivational factors for DMT are compiled into a few general groups: cultural, linguistic and communication (i.e. [9,10]). Our scoping review demonstrates that under general headlines, more detailed elements are distinguished.…”

Risk entrepreneurship and the construction of healthcare deservingness for ‘desirable’, ‘acceptable’ and ‘disposable’ migrants in Malaysia

“…The ways in which non-citizens are signified as being 'deserving' of health care offer up a useful lens through which to examine these incorporations. Stereotypes and public discourses about different types of non-citizens shape the way that healthcare providers, policy-makers and migrants themselves think about 'deservingness', thus influencing laws, policies and administrative practices regarding their rights and entitlements to health care (Ormond and Lunt 2019).…”

“…While those who take a rights-based approach to health find it ethically problematic to restrict or deny care to anyone regardless of their migration status, political and fiscal conservatives find differential extensions of the state's duty of care to citizens and non-citizens to be both legitimate, even necessary (see Singer and Castro 2004;Jacobs and Skocpol 2010;Sargent and Larchanché 2011;Willen, Mulligan, and Castañeda 2011). With the spread of neoliberal austerity measures and political populism around the globe, therefore, migrants with irregular status are increasingly framed as less deserving ofand more of a risk to and burden ongovernment-subsidised health and social care resources than citizens and authorised migrants, leading to greater discrimination and poorer care access and health outcomes (Fassin 2005;Quesada 2012;Ormond and Lunt 2019).…”