| Verified against primary record | |
| Uninsured, United States | 10.0 per cent of people under 65, about 27.6 million, full year 2025[1] |
|---|---|
| Care forgone on cost | 6.0 per cent of adults did not obtain needed medical care because of cost, 2025[2] |
| Price disclosure | United States hospitals must publish standard charges under 45 CFR Part 180[3] |
| Records read | Survey releases, the codified rule and the price methodology, 30 September 2026 |
| Independently reported | |
| Volume of travel | Reliable calculations of actual patient flow remain rare[4] |
| Bands apply only to the rows beneath them. No price comparison between countries is given, because no audited one was found. No provider-supplied figures are used. | |
Medical travel and treatment affordability concerns the proposition that patients cross borders because care costs less on the other side. It is the most frequently asserted motive in the field and the least well measured, and the two facts are related: the prices being compared are, on one side of the comparison, disclosed under penalty of law, and on the other side supplied by the seller.
The affordability pressure that is measured
Household exposure to medical costs is measured carefully in some countries. In the United States, the National Health Interview Survey found that across the full year 2025, 10.0 per cent of people under 65, about 27.6 million, were uninsured at the time of interview. Among adults aged 18 to 64 the figure was 11.6 per cent, about 23.5 million; among children under 18 it was 5.6 per cent, about 4.0 million.[1]
A different official series measures something else and is frequently confused with it. The Census Bureau, using the Current Population Survey, reports that in 2024 most people, 92.0 per cent or 310 million, had health insurance for some or all of the year, leaving an uninsured rate of 8.0 per cent.[5] That figure covers all ages and counts only those uninsured for the entire year. The gap between 8 and 10 per cent is a difference of definition and denominator, not a change over time, and the two should never be used interchangeably.
The behavioural consequence is measured directly. In 2025, 6.0 per cent of adults did not obtain needed medical care because of cost, 5.4 per cent did not obtain needed mental health care for the same reason, and 7.5 per cent did not take medication as prescribed in order to save money.[2] These are measures of care not taken, not of care sought elsewhere.
Why prices cannot be compared
Since 2019 United States hospitals have been required by 45 CFR Part 180 to publish their standard charges, comprising gross charge, payer-specific negotiated charge, discounted cash price and de-identified minimum and maximum negotiated charges. The rule requires a machine-readable file of all standard charges for all items and services, available free of charge, without a user account, without submitting identifying information, and open to automated searches and direct download, plus a consumer-friendly display covering at least 300 shoppable services. Civil penalties run from 300 dollars a day for the smallest hospitals to 5,500 dollars a day for those with more than 550 beds.[3]
No equivalent obligation exists for a hospital in a destination country marketing to foreign patients. The one official international programme that compares health prices is the Eurostat and OECD purchasing power parity exercise, and it does something different: for hospital services it collects prices for a sample of medical and surgical case types, typically from national health authorities, and those prices may be administrative or negotiated between providers and the public body responsible.[6] Its purpose is to deflate national health expenditure, not to tell a patient what a procedure costs in one country against another.
No official body was found to publish audited international price comparisons for medical procedures. The comparative price lists that circulate in this field are supplied by the providers and agencies selling the treatment, and are not audited by anyone. The asymmetry created by the disclosure rule sharpens rather than resolves the problem: American prices are now published under penalty, while the figures they are compared against remain marketing material.
What is known about cost as a motive
Cost is a documented motive in small, procedure-specific and destination-specific studies. A commissioned review of inward and outward medical tourism for the English health service records that among dental patients surveyed in Hungary, lower prices were cited as the main motivating factor, and that for fertility travel the cost of treatment and the greater number of gametes available abroad influenced decisions.[4] Dentistry is identified there as an area likely to see increasing travel by British residents given the high cost of private dentistry at home.[4]
What does not exist is a population-scale measurement. The same review states that reliable calculations of the actual volume of patient flow remain rare, that most circulating figures trace back to media reports or to academic papers quoting inaccessible sources, and it criticises by name the absence of information on how the figures in the two most-cited consultancy reports were calculated.[4] The honest position is that cost is an established motive in small samples and that its magnitude at population scale is estimated rather than measured. Any market-size or patient-count figure for cost-driven medical travel should be treated as an assertion until its derivation is shown.
See also
- Self-funded medical travel, the payment route this motive presupposes
- Medical travel and waiting lists, the other commonly asserted motive
- Medical tourism and universal health coverage, for the system-level view of cost exposure
- Insurer-arranged medical travel, where the cost comparison is made by a payer rather than a patient
References
- Cohen RA, Briones EM, Division of Health Interview Statistics, National Center for Health Statistics. Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2025. Released May 2026. Verified against primary record: official statistics release opened and read. Retrieved 30 September 2026.
- Norris T, Bottoms-McClain L, Adjaye-Gbewonyo D, National Center for Health Statistics. Early Release of Selected Estimates Based on Data From the 2025 National Health Interview Survey. Reference period January to December 2025. Verified against primary record: official statistics release opened and read. Retrieved 30 September 2026.
- United States Department of Health and Human Services. 45 CFR Part 180, Hospital Price Transparency. Electronic Code of Federal Regulations, current text; source citations 84 FR 65602, 86 FR 63998, 88 FR 82184, 90 FR 54087. Verified against primary record: codified regulation opened and read. Retrieved 30 September 2026.
- Lunt N, Smith RD, Mannion R, et al. Implications for the NHS of inward and outward medical tourism: a policy and economic analysis using literature review and mixed-methods approaches. NIHR Journals Library, 2014. Independently reported: publicly commissioned peer-reviewed research. Retrieved 30 September 2026.
- Bunch LN, Ketema H, United States Census Bureau. Health Insurance Coverage in the United States: 2024. Current Population Reports P60-288, released 9 September 2025. Verified against primary record: official statistics report opened and read. Retrieved 30 September 2026.
- Eurostat. Purchasing Power Parities: Methodology. Verified against primary record: statistical methodology page opened and read. Retrieved 30 September 2026.
Sourcing note: the survey releases, the codified price transparency rule and the Eurostat methodology were opened and read on 30 September 2026. Two American uninsured figures are given because two official series measure different things, and the difference between them is explained rather than resolved by choosing one. No comparative procedure prices appear in this entry, because a search for an audited international comparison found none; that absence is reported as a finding. No medical tourism market size or patient count is quoted, for the reasons the commissioned review sets out.