i have just read the source i think you are very right it is about global health but again not about medical tourism which is a subcategory of globalized healthcare driven by the patient movement for example the reference article starts with the example of dave who had traveled to tanzania as a part of global health rotation in this case tanzania is neither the medical destination nor the developed country with collapsed or collapsing social health care system therefore no interest to medical tourism studies it is clearly not relevant to the medical tourism i think if medical tourism would be defined with economics terms such as imports and exports by the way i do not like it in this way just to clarify we might not be so confused like developing countries medical tourism destinations are the exporters and the developed countries are the importers i would suggest to remove such texts and references which are out of topic even though some of them are quite interesting for other studies