Just as many Americans seek affordable care abroad, the United States has been a leading destination for international patients seeking care. While outbound medical tourism is driven by cost savings, inbound medical tourism has been driven by excellence. Around the world, people with complex and challenging conditions look to American medical leadership, which means access to cutting-edge treatments, world-renowned specialists, and clinical trials unavailable in many countries around the world. U.S. academic centers are often first to try new therapies, particularly in oncology, gene therapy, and rare diseases. Institutions like Johns Hopkins, Mayo Clinic, MD Anderson Cancer Center, and Memorial Sloan Kettering Cancer Center maintain extensive clinical trial portfolios offering trailblazing therapies when standard treatments fail. International patients who cannot be treated in their home countries help to create a virtuous cycle of benefits for the United States.
Leading U.S. academic medical centers benefit from treating these patients by advancing clinical knowledge and generating revenue. International patients provide invaluable clinical learning opportunities through rare conditions and novel medical cases that American providers would otherwise rarely encounter. Unlike domestic patients with negotiated insurance rates, international patients pay premium prices that generate higher margins. This revenue funds research, supports state-of-the-art facilities, buys new technologies, and attracts and retains world-class clinicians and researchers. These investments fuel innovation that, in turn, attracts more international patients and raises the quality of care for domestic patients.
To facilitate inbound medical tourism, leading U.S. medical centers offer sophisticated international patient programs with concierge services and premium accommodations. These programs provide multilingual staff who assist with medical record translation and travel logistics for patients and their companions. VIP accommodations and services — including private suites, enhanced security, and luxury amenities — attract high-paying international clientele whose spending and sizable charitable contributions help to support these centers’ mission to develop and offer medical breakthroughs.
Though leading U.S. centers assist international patients with travel logistics, many patients face barriers to obtaining a visa for medical care. Patients from 43 non-Visa Waiver Program-designated countries need extensive documentation to obtain medical visas. These requirements include a medical diagnosis from the referring health care professional, an explanation of why treatment in the United States is necessary or preferred, a treatment plan from a U.S. physician, proof of ability to pay for both medical and living expenses, and an intent to return to their home country. Even patients from Visa Waiver Program countries must obtain a visa for medical care requiring stays longer than 90 days.
Recent threats to inbound U.S. medical tourism
Recent policy shifts under the Trump administration have created significant headwinds that raise financial risks and questions about U.S. medical leadership. The January 20 executive order titled “Protecting the United States from Foreign Terrorists and Other National Security and Public Safety Threats” mandates “enhanced vetting” for all visa applicants. Consular offices already face significant backlogs, with medical visa appointments in some regions stretching months into the future. The enhanced vetting will likely exacerbate these backlogs, and patients from or tied to “high-risk” countries will surely face heightened scrutiny and higher rejection rates. While expedited processing is available in limited cases for medical emergencies, consular officers decide whether to expedite nonimmigrant visa applications. For first-time patients, longer waits for initial consultations delay critical treatments and allow diseases to progress while administrative processes unfold.
Recent changes to the Visa Interview Waiver Program have created additional barriers. Previously, returning patients could avoid time-consuming in-person interviews if their previous visa had expired within the last 48 months — a reasonable timeline for many medical conditions requiring periodic specialized follow-up care. Under new orders, the waiver now applies only to those renewing a visa in the same classification within a narrow 12-month window after expiration. This policy change affects patients who require follow-up care at intervals longer than one year, forcing them to undergo full interview processes for each return visit.
The so-called Department of Government Efficiency (DOGE) plans to reduce staffing at U.S. embassies and consulates worldwide, and there are plans to close at least a dozen consular offices by mid-2025 and consolidate services into regional hubs. These layoffs and closures will likely exacerbate delays in visa processing.
Proposed travel restrictions, informally referred to as the “Trump 2.0 Travel Ban,” threatens to block medical access for patients from 43 countries, including a blanket prohibition on travelers from 11 “red list” countries (Afghanistan, Bhutan, Cuba, Iran, Libya, North Korea, Somalia, Sudan, Syria, Venezuela, and Yemen). Many of these countries have limited advanced medical care. Even patients from countries not explicitly banned but subject to “enhanced screening” now face uncertainty about whether they can enter the United States for already-scheduled treatments — including ongoing trials where interruptions could endanger patients or compromise evidence generation. More patients may abandon treatment plans at U.S. facilities due to visa uncertainty, even after substantial financial and medical investments in their care have been made.
Beyond visa policy changes, the administration’s rhetoric regarding neighboring countries and the threat of aggressive tariffs have created a chilling effect on travel and likely on medical travel as well. For example, Air Canada reported a 10% drop in U.S. bookings with future flight bookings down 70%. This could substantially reduce medical tourism from Canada — a significant source of patients for northern U.S. medical centers.
Long-term risks to U.S. medical innovation and competitiveness
As policies restrict the flow of international patients, America’s medical leadership position may falter. American clinicians and researchers could lose access to a knowledge base — potentially slowing the pace of medical advancements that benefit all patients, including Americans. And as international revenue declines, elite academic medical centers may be forced to delay or abandon innovation investments. Meanwhile, countries like Germany, Singapore, and South Korea are streamlining processes to attract patients discouraged by U.S. policies. This could bolster their knowledge and revenue. America’s loss is their gain.
Restrictive immigration policies and associated rhetoric may also discourage foreign clinicians and researchers from working in the United States. This too can have a chilling effect on America’s medical leadership position.
The current administration has overlooked how immigration and trade policies and rhetoric can negatively impact U.S. medical innovation and leadership. To maintain America’s role as a leader in medical research and innovation, it is crucial to revisit how these policies affect inbound medical tourism. International patients contribute more than revenue — they expand clinical knowledge, support cutting-edge research, and help sustain institutions that benefit domestic and global patients alike. As other countries move to attract these patients, the United States should ensure its policies don’t intentionally or unintentionally push them away. Although national security considerations must remain a priority, policies should also preserve access for international patients seeking necessary medical care.
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