Medical Tourism in Developing Countries

Promoting Medical Tourism ● 101human capital must be appropriate for local conditions, otherwise itsproductivity-enhancing properties cannot be fully exploited. Medical tourismrequires a wide variety of skills to satisfy the wide range of manpowerdemands.The medical tourism industry necessitates a wide range of skills that arenot distributed along a bell shaped curve, but rather are concentrated at thetwo ends. The result of this bipolar distribution is a sharply segregated duallabor market. At one end, lie the highly skilled doctors, nurses, researchers,as well as the Westernized resort managers (in all likelihood holding businessdegrees and fluent in several languages). They embody the humancapital that is the backbone of large-scale, organized medical tourism as wellas the hospitality industry. At the other end, lie the unskilled and uneducatedlocal populations with few employment alternatives. They are thehospital janitors, the hotel chambermaids, and the rental car washers.With respect to sheer size, most employment in the labor-intensive touristindustry tends to be low skilled, barriers to entry are minimal, and workerturnover is high. With respect to income earned, the advantages are in favorof the highly skilled workers.Which workers are more important for the development of medicaltourism? Some scholars claim it is the highly skilled workers in whoseabsence the industry would not get off the ground. Indeed, it has beenclaimed that African countries have not realized their tourism potentialbecause they lack general economic management skills and in particular,specific management skills within the tourism sector. 18 On the other hand,the unskilled perform a crucial function and in their absence, the industrywould not be able to function.When appropriately skilled labor is available locally then the number ofexpatriate workers can be reduced and/or the costs of training labor abroadcan be eliminated. This benefits the local population in the form ofincreased employment, and for foreign companies, it represents a cost-savingmeasure.With respect to quantity, it is necessary to identify the optimal size inorder to avoid a surplus or shortage of workers. During a surplus, thereare too many workers and the economy cannot absorb them. They becomeredundant, and their overabundance acts as a drag on the economy. In somedeveloping countries, brain drain relieves the demand for employmentwhile arresting the downward pressure on wages and the strain on infrastructure.For this reason, regions with high population densities andinsufficient opportunities for their workers encourage out-migration. Thisis often supported by the central government as part of a regional policy(as in the Philippines). However, it is very costly, especially in the case of