Medical Tourism in Developing Countries

106 ● Medical Tourism in Developing Countriesimmigration policy to encourage the inflow of nurses and technicians fromIndia, Jamaica, and the Philippines. 33 In 2006, the United States lifted thecap on the number of foreign nurses American hospitals and clinics canhire. 34 In the twenty-first century, even Germany, Britain, and Australia areintroducing immigration legislation that favors skilled workers. In addition,there are companies such as IGH (Innovative Healthcare Group) that specializein recruiting highly skilled foreigners into American health centers. 35All of these are reflected on the ground, so to speak, with the skill levels ofthe immigrants. In England, three-quarters of Africa’s emigrants have tertiaryeducation, as do some one-half of Asian and South American emigrants.36 Some 30 percent of Ghanians and Sierra Leoneans with tertiaryeducation live abroad. Western countries are clearly benefiting, as a recentstudy showed it would have cost the rich countries $184,000 to train eachof the 3 million professionals now working in the MDCs. In total, theysaved $552 billion while poor nations spend $500 million per year traininghealth workers. 37To make matters worse for developing countries, skilled workers aredisproportionately likely to leave their homes. While 3 percent of Indiandoctors emigrated in the 1980s, the proportion of the graduates from theAll India Institute for Medical Sciences, the best in the country, was56 percent during 1956–80 and 49 percent during the 1990s. 38 In 2004,India received the highest number of American visas for temporary skilledworkers (H-1B), more than double that of the next ranking country. 39Similarly, 30 percent of all Mexicans with PhDs are in America, eventhough only 12 percent of the total labor force is there. A study in theBritish medical journal Lancet claims that some 10,000 health personnelwho worked in the UK in 2003 came from just four African countries—South Africa, Zimbabwe, Nigeria, and Ghana. 40 It goes on to report thatdoctors from English-speaking African countries are attracted to SouthAfrica, South African doctors are attracted to the UK, and doctors in theUK are attracted to the United States and Canada. There is also a trend ofskilled workers from one developing country going to another developingcountry. For example, in the Gulf area, Arab states rely on expatriate humanresources such as physicians, nurses, midwives, and technicians from Indiaand Southeast Asia, as well as Egypt, Jordan, and Lebanon. 41 At the sametime, Lebanon is hiring nurses from the Philippines. In response to suchtrends, an alliance of health workers in the Philippines has asked the governmentto rescind its commitments to the GATT since it allows countriessuch as the United States and Britain to lure Philippine doctors and nursesabroad as an expression of liberalization of trade in services.