A Swedish view of medical tourism and cross-border care


The Health Consumer Powerhouse (HCP) monitors and compares healthcare systems among 35 countries, including all EU member states as well as Canada. Using more than 20 different health consumer indexes this Swedish organisation provides guidance to patients and information to governments. In 2005 HCP launched its first Euro Health Consumer Index.

Johan Hjertqvist, founder of HCP offers an outsider’s view of medical tourism:

“Medical travelling, health tourism, cross-border care – when there is hype the labels tend to grow in numbers. Every week I get invitations to medical tourism fairs and exhibitions, activities perhaps more frequent and economically important than the travelling and treatments as such. Not least Europe east of the EU seems to catch up, with numerous conferences and exhibitions in Russia, Belorussia and Ukraine.”

“Today probably not too many people would think of going to Kiev or Minsk to have a hip replacement but things might change. Belarus even claims to have a "medical tourism city". In Russia the target group seems to be wealthy residents interested to go abroad to avoid the many downsides of Russian healthcare.  Going West is expensive for Russians but the steady flow of medical tourists already flying from Moscow to London, Zurich or the US suggests that they can afford it.”

“As the inter-EU exchange of cross-border patients becomes more organised, with the cross-border directive implemented into national law, you can expect two major routes of patients to emerge: one for publicly funded treatments, according to the directive, and one for out of pocket paid services. The private one is already rich of cosmetic and life-style surgery but probably as well, complicated, resource demanding and sometimes acute specialist procedures not available in the country of the patient. The public version will deal with treatments suffering from long waiting lists, lack of quality or unavailability at home.”

“The public road may not prove broader than the private one as many governments want to restrict travelling for care. In the private lane there is a tradition of simplifying access, picking up the visitor at the airport and providing a smooth procedure.”

“As decided by the European parliament in 2011, by October 2013 every citizen of the EU will have the opportunity to go abroad to have a medical treatment. The patient will have the right to the same public funding that otherwise would be available for a treatment in their own member state.”

“Governments will be obliged to provide foreign visitors with information about their legal rights, what to do in case of poor treatment and also about treatment options, access, quality of care, patient safety etcetera.”

“But while a few EU member states will allow citizens to make their own judgment to travel to another country, the vast majority of member states will be using roadblocks  with many conditions before allowing treatment abroad, or not.”

“You can expect some governments to be at the front, welcoming mobility and transparency, while many others will lag behind, offering a minimum of information and with little co-ordination work.”

Recent HCP reports include ’ Impatient for change’, an overview of European health systems and the political context within which they exist; and ’Social media – nothing for Swedish healthcare’, an intriguing analysis of why with a very high IT-penetration and many users of social media, Swedish healthcare is reluctant to open up for such communication with patients. But there are a few limited efforts, mainly in the big cities, including Stockholm that has put a healthcare guide system on Facebook.



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