{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T11:01:27Z","timestamp":1777892487711,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T00:00:00Z","timestamp":1527811200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of the Royal College of Physicians of Edinburgh"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:p>Brexit will have profound implications for British tourists visiting the rest of the European Union, in particular because of the likely loss of coverage of healthcare should they be injured or fall ill. This paper compares the cost of travel insurance within the EU and in comparable countries outside it, asking how it varies by age and pre-existing conditions.<\/jats:p>\n                  <jats:p>Fictitious patients, differing by age, pre-existing condition, and destination (France, an EU Member State; Israel and Canada, two high income non-EU frequent destinations) were entered into an insurance price comparison website to assess the influence of these characteristics on prices quoted.<\/jats:p>\n                  <jats:p>Cost of travel insurance increases with age, pre-existing health conditions and by destination. In those with no pre-existing conditions, there is a marked difference between France, where the cost rises steadily with age, and Israel and Canada, where there is a sharp increase after age 75. For individuals with any one pre-existing condition, there is no similar jump in cost but rather a progressive increase with age, although the rate of increase accelerates as the individuals concerned get older. For all travellers, the cost of insurance is highest for Canada and lowest for France<\/jats:p>\n                  <jats:p>At present, pre-existing health conditions in British tourists travelling in the rest of the EU are covered by the European Health Insurance Card. With the UK's probable exit from the EU and almost certain loss of this coverage, travellers in the older age groups may have to pay much more for their travel insurance, with some possibly tempted to forgo travel insurance coverage because of the cost.<\/jats:p>\n                  <jats:p>It is essential that health professionals understand how leaving the EU may impact on those seeking their advice.<\/jats:p>","DOI":"10.4997\/jrcpe.2018.501","type":"journal-article","created":{"date-parts":[[2018,6,15]],"date-time":"2018-06-15T06:20:08Z","timestamp":1529043608000},"page":"134-140","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["What Might Brexit Mean for British Tourists Travelling to the Rest of Europe?"],"prefix":"10.1177","volume":"48","author":[{"given":"D","family":"McKee","sequence":"first","affiliation":[{"name":"Occupational Health Nurse, Occupational Health Department, Central and North West London NHS Foundation Trust, St Pancras Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"McKee","sequence":"additional","affiliation":[{"name":"Professor of European Public Health, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,6,1]]},"reference":[{"key":"bibr1-jrcpe.2018.501","first-page":"4","author":"Janson K","year":"2017","journal-title":"Tourism"},{"key":"bibr2-jrcpe.2018.501","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmp.2017.01.004"},{"key":"bibr3-jrcpe.2018.501","unstructured":"O'Halloran B. Brexit effect to cost tourism &eu;100m this year. Irish Times 2017. https:\/\/www.irishtimes.com\/business\/transport-and-tourism\/brexit-effect-to-cost-tourism-100m-this-year-1.3137899 (accessed 3\/4\/18)."},{"key":"bibr4-jrcpe.2018.501","unstructured":"Singh A. Monarch: Brexit and lack of confidence in Tories partly to blame for airline's collapse, says Vince Cable. The Independent 2017. http:\/\/www.independent.co.uk\/news\/business\/news\/monarch-collapse-brexit-vince-cable-blames-government-eu-uk-latest-a7978951.html (accessed 3\/4\/18)."},{"key":"bibr5-jrcpe.2018.501","unstructured":"European Council. European travel information and authorisation system \u2013 Council agrees negotiating position 2017. http:\/\/www.consilium.europa.eu\/en\/press\/press-releases\/2017\/06\/09-etias (accessed 3\/4\/18)."},{"key":"bibr6-jrcpe.2018.501","unstructured":"Eaton G. EU passport control delays are a preview of Britain's Brexit fate. New Statesman 2017. https:\/\/www.newstatesman.com\/politics\/uk\/2017\/08\/eu-passport-control-delays-are-preview-britains-brexit-fate (accessed 3\/4\/18)."},{"key":"bibr7-jrcpe.2018.501","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2012.07.001"},{"key":"bibr8-jrcpe.2018.501","doi-asserted-by":"publisher","DOI":"10.1111\/jorc.12088"},{"key":"bibr9-jrcpe.2018.501","unstructured":"Offical Journal of the European Union. Directive 2011\/24\/EU of the European Parliament and of the Council 9 March 2011. https:\/\/eur-lex.europa.eu\/legal-content\/EN\/TXT\/PDF\/?uri=CELEX:32011L0024&from=EN (accessed 6\/4\/18)."},{"key":"bibr10-jrcpe.2018.501","unstructured":"NHS Choices. European Health Insurance Card (EHIC) 2016. http:\/\/www.nhs.uk\/NHSEngland\/Healthcareabroad\/EHIC\/Pages\/about-the-ehic.aspx (accessed 3\/4\/18)."},{"key":"bibr11-jrcpe.2018.501","unstructured":"Select Committee on the European Union, Home Affairs SubCommittee. Brexit: Reciprocal Healthcare. House of Lords; 2017. http:\/\/data.parliament.uk\/writtenevidence\/committeeevidence.svc\/evidencedocument\/eu-home-affairs-subcommittee\/brexit-reciprocal-healthcare\/oral\/72965.pdf (accessed 3\/4\/18)."},{"key":"bibr12-jrcpe.2018.501","unstructured":"Office for National Statistics. International Passenger Survey. 2016. https:\/\/www.ons.gov.uk\/surveys\/informationforhouseholdsandindividuals\/householdandindividualsurveys\/internationalpassengersurveyips (accessed 3\/4\/18)."},{"key":"bibr13-jrcpe.2018.501","unstructured":"Office for National Statistics. International passenger survey QMI. 2015. https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/leisureandtourism\/qmis\/internationalpassengersurveyipsqmi (accessed 3\/4\/18)."},{"key":"bibr14-jrcpe.2018.501","doi-asserted-by":"publisher","DOI":"10.1111\/j.1708-8305.1999.tb00526.x"},{"key":"bibr15-jrcpe.2018.501","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60240-2"},{"key":"bibr16-jrcpe.2018.501","unstructured":"McKee M. The devil is in the detail \u2013 why retaining the European Health Insurance Card may be an impossible dream. BMJ. 2017. http:\/\/blogs.bmj.com\/bmj\/2017\/11\/16\/martin-mckee-the-devil-is-in-the-detail-why-retaining-the-european-health-insurance-card-may-be-an-impossible-dream (accessed 3\/4\/18)."},{"key":"bibr17-jrcpe.2018.501","doi-asserted-by":"publisher","DOI":"10.1163\/157180912X615158"},{"key":"bibr18-jrcpe.2018.501","unstructured":"Garc\u00eda de Cort\u00e1zar Nebreda C. Coordination of social security schemes between the European Union and Euromed countries. Brussels: European Economic and Social Committee; 2016. https:\/\/www.eesc.europa.eu\/sites\/default\/files\/resources\/docs\/qe-02-16-992-en-n.pdf (accessed 3\/4\/2018)."},{"key":"bibr19-jrcpe.2018.501","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31926-8"},{"key":"bibr20-jrcpe.2018.501","unstructured":"Office for National Statistics. Overview of the UK population: March 2017. https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/populationandmigration\/populationestimates\/articles\/overviewoftheukpopulation\/mar2017 (accessed 3\/4\/18)."},{"key":"bibr21-jrcpe.2018.501","unstructured":"House of Commons. Health Services: Reciprocal Arrangements: Written question \u2013 65772 2017. http:\/\/www.parliament.uk\/business\/publications\/written-questions-answers-statements\/written-question\/Commons\/2017-02-27\/65772 (accessed 3\/4\/18)."},{"key":"bibr22-jrcpe.2018.501","doi-asserted-by":"publisher","DOI":"10.1002\/9781118834732"}],"container-title":["Journal of the Royal College of Physicians of Edinburgh"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4997\/jrcpe.2018.501","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4997\/jrcpe.2018.501","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:30:49Z","timestamp":1777617049000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4997\/jrcpe.2018.501"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.4997\/jrcpe.2018.501"],"URL":"https:\/\/doi.org\/10.4997\/jrcpe.2018.501","relation":{},"ISSN":["1478-2715","2042-8189"],"issn-type":[{"value":"1478-2715","type":"print"},{"value":"2042-8189","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6]]}}}