Medical Tourism and Globalization

        Medical tourism is a phenomenon that has been steadily increasing. It can be defined as “patients (that) are seeking to reduce costs of treatment through international outsourcing of medical and surgical care” (Forgione and Smith 2006). In the past, it was merely a tactic used by the rich in developing countries to achieve quality healthcare that their host country just couldn’t provide. However, it is no longer just an option to the rich, but is now a possibility for middle-class citizens of developed countries with high healthcare costs.  The cost of health expenditures and waiting times in developed countries such as the U.S., Great Britain, and Canada drive their citizens to seek affordable or timely healthcare elsewhere.
       With the desperation to achieve affordable healthcare no longer bound by national borders, other countries started to take notice of a market that could possibly bring money into their economy. Countries in Asia, and particularly Southeast Asia, decided they could market their countries as medical tourism destinations, and provide top of the line medical care to international patients at a fraction of the cost that it would cost them in their own country, but still more than it would cost for the host country’s local patients (Turner 2007). A heart valve replacement that would cost $160,000 in the US, would cost 9,000 in India, and 10,000 in Singapore; a knee replacement in the US would cost 40,000, but in India it would cost 8,500, and in Thailand it would cost 10,000 (AMA). So why is the price differential so steep? There are three main reasons: lower labor costs, lower or no malpractice costs, and lower pharmaceutical costs (Forgione and Smith 2006).
        The “Trickle Down” (Ramirez de Arellano 2007, Turner 2007) effect is commonly cited as a positive outcome for host countries who participate in medical tourism. It states that revenues acquired through this new market will “stimulate the economic growth and development” (Connell 2011) of the country in more sectors than just health related areas. However, as we have discussed globalization’s effects in this class, we are aware that the economic benefits to the poor in these countries are questionable.
       Countries in Southeast Asia have opened their borders to international patients, and created large, private hospitals that have top-of-the-line facilities and personnel to cater to international patients’ needs. However, the problem is that these hospitals are not only too expensive to cater to the locals of these countries, but the influx of international patients getting expensive operations is slowly driving up the national costs of healthcare for the entire domestic population. As privatization of healthcare is beginning to occur in these countries, the public facilities are becoming dormant, as physicians who used to work in these government run facilities are now being recruited to these impressive, private facilities, creating an “internal brain drain” (Godwin 2004) of medical personnel.
       Is medical tourism ultimately going to be detrimental to the domestic populations of these countries who are trying to turn a profit by creating a market for international patients? In countries where there are great social and structural inequalities, it seems to me that commodifying health before all have access to basic healthcare is going to create even greater inequalities instead of decreasing them, leaving some even further behind.

References

Connell, John. 2011. “A new inequality? Privatisation, urban bias, migration and medical tourism.” Asia Pacific Viewpoint 52(3):260-271.

Forgione, Dana A. and Pamela C. Smith. 2006. “Medical Tourism and Its Impact on the US Health Care System”. J Health Care Finance 34(1): 27-35.

Godwin, S. K. 2004. “Medical Tourism: Subsidising the Rich”. Economic and Political Weekly 39(36): 3981-3983.

Ramirez de Arellano, Annette B. 2007. “Patients without Borders: The emergence of Medical Tourism.” International Journal of Health Services 37(1): 193-198.

Turner, Leigh. 2007. “ ‘First World Health Care at Third World Prices’: Globalization, Bioethics and Medical Tourism.” BioSocieties 2:303-325.