Registed Nurses' Association of Ontario


Ban medical tourism: RNAO speaks out for medicare

Right click to see image

As Canadians, we value our publicly funded, not-for-profit health system, where everyone is given equal access to care. To protect this system, RNAO stands at the forefront of a movement to ban a profit-driven practice that threatens the foundation of medicare. We have created a coalition including Doctors for Medicare, the Association of Ontario Midwives, and the Association of Ontario Health Centres who all believe medical tourism runs counter to the spirit of Medicare.

A number of Toronto-area hospitals have been engaging in medical tourism – raising millions of dollars by actively seeking and treating international patients on a pay-for-care basis. RNAO worries this represents a shift to for-profit health care, creating a system where those who pay access care ahead of others.

RNAO has reached out to politicians, the media, and called for action from its membership. Our message is clear: the government must immediately ban medical tourism in order to protect and strengthen our public health system.

Frequently Asked Questions

What is medical tourism?

Medical tourism refers to a practice where patients travel across international borders to receive health care on a pay-for-treatment basis, as a means to generate revenue. This practice puts paying patients ahead of Ontario residents who are waiting for care, jumping the queue and displacing Ontarians who need care.

Is this happening in Ontario?

Yes. According to staff, media reports, and online documents, some Toronto hospitals are actively engaging in medical tourism. Examples include:

What is the harm?

Medical tourism is the beginning of the end of Canada’s publicly funded not-for-profit health system. It contradicts the very nature of our Medicare system, turning health into a commodity.

This is the first step toward two-tiered Medicare, where a parallel for-profit system provides care to those who can pay. Once we set the precedent that international patients can get preferential care for a fee, what’s to stop wealthy Canadians from demanding the same?

Our health system is funded by Ontarians, yet many of them languish on wait lists and in emergency departments due backlogs in that very system. RNAO believes that Ontario’s health resources should be used to improve care for its ailing citizens. Our public hospitals and their services should be driven by need and not the size of our wallets.

In 2013, prior to the development of its international patients program, Sunnybrook Health Sciences Centre gave an excellent explanation as to why treating these patients for money is a big problem.

Shouldn't we use our health-care system to help people in need from other countries?

Canada has some of the best hospitals and health professionals in the world. We should, and do, provide humanitarian and emergency care to people from across the globe. Medical tourism, however, is a much different matter – it is driven by a for-profit mentality, marketed actively and puts priority on ability to pay over the needs of Ontarians.

This difference is summed up on Sunnybrook Health Sciences Centre’s website: “All international patients receiving an assessment, consultation and/or treatment at Sunnybrook will have to pay upfront, or have the appropriate insurance coverage, for all services provided. The IPP is not a humanitarian program.”

Where does the Ontario government stand on this issue?

The provincial government has turned a blind eye to medical tourism. In April, when RNAO's concerns reached the media, then Minister of Health Deb Matthews expressed her support for the practice as a means to generate revenue to be funneled back into the health system. Shortly afterward, at the insistence of RNAO and other health groups, Matthews asked for an informal review of medical tourism.

Since being named Ontario’s new Minister of Health, Dr. Eric Hoskins has said he supports medical tourism only if “zero public dollars” are used and Ontarians are not displaced. Then, again, he too asked for a review.

What has RNAO done?

RNAO was approached in 2012 by a veteran RN and RNAO member working at UHN, who was concerned about what they had seen within the international patient program. In 2013, RNAO’s board of directors unanimously passed a motion that the association do all it can to end medical tourism in Ontario.

Since then, we have repeatedly engaged the premier and minister of health, spoken out in the media, and mobilized our membership toward stopping this dangerous trend. We will continue with this commitment to protect our universal health system until medical tourism is banned.

Political action

Open letter to Minister Eric Hoskins: Ban medical tourism, August 18, 2014

Open letter: Strengthen Ontario’s health system by immediately banning medical tourism and rejecting for-profit plasma collection, July 4, 2014

Joint letter to Premier Kathleen Wynne on medical tourism, April 11, 2014

Media coverage

Medicare is a public trust, not a business venture: Goar - Toronto Star Nov. 3, 2014

Health groups urge Ontario to ban 'medical tourism' - The Sudbury Star, Oct. 29, 2014

Ontario health organizations want to put an end to medical tourism - Global News, Oct. 29, 2014

Letters: medical tourism - Doris Grinspun, The Windsor Star, Oct. 14, 2014

Medical tourism fees for international patients return little cash to hospital The Globe and Mail, Oct. 10, 2014

Nurses attack Windsor Regional’s ‘medical tourism’ foray - The Windsor Star, Sept. 30, 2014

Nurses group asking Ontario for records on medical tourism - Canadian Press, Sept. 30, 2014

Medicare advocates decry medical tourismCanadian Medical Association Journal, Aug. 21, 2014

Ontario hospitals urged to stop pursuing ‘medical tourists’ – Antonella Artuso, Toronto Sun, Aug. 21, 2014

Medical tourism ‘inviting a lawsuit’ – Theresa Boyle, Toronto Star, Aug. 5, 2014

Nursing association calls for ban on inbound medical tourismInternational Medical Travel Journal – July 23, 2014

Medical tourism: the beginning of the end of Medicare – Doris Grinspun, Registered Nurse Journal, May/June 2014

Chipping Away at MedicareToronto Star, April 4, 2014

Toronto hospital courts wealthy ‘medical tourists’ – Kelly Grant, The Globe and Mail, April 1, 2014

Ontario’s health-care system should serve need, not greed – Doris Grinspun, Toronto Star, April 1, 2013

Media releases

Health organizations call for ban on medical tourism, Oct. 29, 2014

Nurses launch freedom of information request to get to the bottom of medical tourism, Sept. 30, 2014

Open letter from Ontario's RNs, health centres and midwives calls on Minister of Health Eric Hoskins to immediately ban medical tourism, Aug. 20, 2014

Immediately ban medical tourism and reject for-profit plasma collection: Open letter from Ontario's RNs to Premier Kathleen Wynne, July 4, 2014

Health groups urge Premier Wynne to stop medical tourism, April 16, 2014

Other resources

International patients: what care can’t be bought at the hospital - Sunnybrook Health Sciences Centre, Jan. 7, 2013

Ban Medical Tourism Poster