Sometimes, probably more often than I like to admit, I have the urge to utter something so stupidly candid that some people have called it career suicide and discourteous towards my industry peers. This, I fear, maybe one of those moments - perhaps even more so than the time I told a Health Economics Master's Student that I would prefer a world in which medical tourism facilitators did not exist. A bold statement, indeed. Especially considering that, at the time, I had just overseen what was arguably one of our most successful business years - one in which a substantial portion of revenue stemmed precisely from that: medical tourism facilitation.

And yet, I would not be who I am - nor even half as content - if I spent my days worrying over how others perceive my thoughts. No, I stand by that statement. In fact, I would go further. Not only do I believe medical tourism facilitators should not exist, but medical tourism itself would be obsolete in an ideal world. My reasoning is far more measured than most might expect.

Medical tourism is a symptom. It’s the piercing neon sign of global health inequality brightening the highway shoulder. And yes, some might consider it a sign of health inequity, but I do not like to use or even acknowledge the term. Inequity is a concept so achingly distant from reality that it is too far removed from anything I can grasp, even when talking about the loftiest of ideals I might hold. Maybe I am not optimistic enough. I probably ain’t. I leave that for others to decide.

If the world were as it should be, if healthcare were truly just, then there would be no need for desperate journeys across borders in search of something as fundamental as competent medical care. Or affordable medical care. Or timely medical care. Or any medical care at all.

However, that is not the world we live in - nor is it likely to be anytime soon. At its core, medical tourism is bound to the necessity of travel. In my view, seeking medical care while abroad does not qualify as medical tourism. Of course, in the absence of a universally accepted definition, I rely on my own: incidental medical treatment while travelling is not the same as medical tourism. But that is not the point I wish to spend my evening or your time on.

The point is that medical tourism is not just an industry - it is, again, a symptom. It exists because, for some, travelling is not a choice but a necessity - their only path to receiving the care they need. The reasons for this inequality are diverse. Political incompetence, resource distribution, conflict or simply by design. There is many others. I know people who travelled to receive medical services due to the immense distrust they had in their healthcare system. You might not consider this a necessity, but if you feel safer and more comfortable travelling abroad for a service you can have in a timely manner and within your budget in your domestic setting, it probably is a necessity even if it’s one only for you.

Why, beyond my own conviction, do I feel compelled to say this? Because I believe we must all recognize the uncomfortable truth: we work in an industry that, in an ideal world, would have no reason to exist. It could not sustain itself, nor should it. If healthcare were equal and accessible to all, medical tourism would simply have no justification.

And yet, as ever so often, here we are. Which is precisely why those of us who operate in this industry - those of us who are entrusted with the hopes and vulnerabilities of others - must hold ourselves to the highest standard. If this industry exists because the world is imperfect, then let our work be the proof that even within that imperfection, integrity and responsibility can prevail.

In closing, I want to return some of the levity from which I might have derived you in this short read. And it has absolutely nothing to do with medical tourism. I received a large shipment of dates from Saudi Arabia. Believe me when I say there are few things in life as delicious. I have eaten many a date in my life but it is still beyond me how something can be tender to the bite, slightly chewy, a tiny bit austere but still juicy. Once I figure that out I’ll probably write a post on Substack about that.

In others words, yes, our world is unequal. Divided by borders, shaped by circumstance, often marked by disparity. And while that inequality often breeds hardship, it also carves out something rare. It harbors contrast, character, charm. The elements adding colour to our often so black and white world.

Some of life’s most treasured moments exist because of these differences, not despite them. The places, the flavors, the stories that could not have been in a world mushed into sameness. Inequality may be unjust, but it is also, in its own way, inevitable. And within that inevitability, something undeniably human endures. Lifes most cherishable charms would not be, if all places were the same.