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The regions beyond borders is an important scale in healthcare.

Healthcare practices have long been restricted by the conceptual limit of ‘methodological nationalism’ due to the historically confined national regulation and protection (3). Yet several recent initiatives and phenomena have specifically demonstrated the relevance of the transnational region relative (or transregional) to emerging beyond-national initiatives of supply, demand and responsibility in healthcare.

As the recent European Union directive on patient mobility and growing cross-border patient flows facilitated by liberalised travel regimes between Association of Southeast Asian Nations (ASEAN) memberstates. Although ASEAN a 10 countries association, leading beyond-border healthcare countries are only three of them (Malaysia, Singapore and Thailand).

European Union

In the context of the European Union (EU), migrants especially from new member states bring together the biomedical regimes from their home countries to host countries. As they are no longer limited by resident or work permits, migrants (or citizens of enlarged EU countries) now have new social and economic rights, from better access to the labor market to better healthcare services. This has an enormous impact on migrants’ mobility patterns, giving them greater ease in crossing national borders and, hence, allowing them to engage with both their host and home countries’ healthcare services. Indeed, despite common assumptions in host societies, that depict migrants coming from poorer countries as potentially frequent users and abusers of their healthcare services (4). This caused the recent European Union directive on patient mobility.

In macro level;
Wealthy West Goes East,
In micro level;
Wealthy Eastern Individual Goes West

One of the most important element in the diversity of transnational healthcare practices concerns the motivations of those who travel. Research to date has explored key drivers that both ‘push or intrinsic’ and ‘pull or extrinsic or attractive’ the various actors into crossing borders. While pushing factors (intrinsic factors) cause to seek health services outside their own country, attractive factors (extrinsic factors) cause patients’ decision to travel a country other than own country. While much of the public discussion of medical travel has sensationalised ‘welfare tourism’ or tended to focus on headline grabbing stories either ‘human interest’ or ‘horror stories’ in frequent accounts of surgery abroad gone wrong (1).

Academic research has uncovered a much more multidimensional set of drivers, some of which are specific to the types of treatment accessed, some of which map onto the national healthcare and political systems of both sending and receiving countries, and some of which give us insight into the changing meanings of healthcare brought about by increasing privatisation, commercialisation and the forces of globalisation (1). Some researcher use flow theories to explore cosmetic surgery tourism, showing how cosmetic surgery needs to be seen as an interplay of places, people, things, ideas and practices. The researcher challenges ‘wealthy West goes East’ narratives demonstrating the relative economic marginality of some western medical travelers, and also foregrounds the role of the internet in facilitating cosmetic surgeries. This kind of medical travel would be impossible without web or social media resources providing information on hospitals, clinics, surgeons, agents and communities of fellow patient-consumers (2). Medical travel agents have a powerful networking role, in some cases defining the pathways that others travel along. But informal networks, often grounded in word of mouth and local social contexts, are shown to be equally important (1).


1-   “Transnational healthcare, cross-border perspectives” by David Bell, Ruth Holliday,
Meghann Ormond & Tomas Mainil
2-   Brief encounters: Assembling cosmetic surgery tourism; Ruth Holliday, David Bell, Olive
Cheung, Meredith Jones, Elspeth Probyn
3-   Methodological nationalism and beyond: Nation-state building, migration and the social
sciences; Andreas Wimmer and Nina Glick Schiller
4-   Transnational healthcare practices in the enlarged Europe: the case of Polish migrant
women in Ireland and their pregnancy and childbirth practices; Maria Węgrzynowska, B.A., M.A.
School of Nursing and Human Sciences Dublin City University Submitted for the award of PhD

Dr Ömer Tontuş

Categories: Genel

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