Medical Tourism in Developing Countries

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Promoting Medical Tourism ● 119Undeveloped financial institutions not only restrain the development ofmedical tourism, but can also make international trade harmful to theoverall economy. As Stiglitz and Charlton pointed out, lack of physicalinfrastructure constrains the free flow of resources within labor markets andacross regions, a crucial aspect of competing in the global markets. 89 To theextent that financial institutions are undeveloped, it prohibits people fromhaving access to credit and participating in business, and the industries inwhich the country might have comparative advantage cannot respond todemand because of bottlenecks.Among the countries under study, South Africa ranks highest withrespect to financial market sophistication while Malaysia ranks highest interms of the ease of access to loans (table 5.5). For both indicators of thebanking industry, all countries fall more or less in the middle range withthe exception of Argentina, that ranks 111th globally in terms of access toloans (this is the result of residual financial issues from the crisis of 2002).Advantage V: Developed Political and Legal InstitutionsOn the Dubai Heathcare City website, political and economic stability istouted in the second introductory paragraph. 90 That is because a countrywith a political system characterized by peaceful transitions, where legalinstitutions are developed and respected, and where the authorities manageto maintain law and order, has an advantage in the provision of medicaltourism. Clearly, tourists will be drawn to a region without risks of coups,revolutions, or uprisings. They will want assurance that rule of law existsand that law and order can provide a safe environment for their medicalservices. Western patients will go to a country where the local politics arenot distasteful to them. They want to know that corruption is not rampantenough to threaten their personal interests. International patients don’twant to think that a simple change in government will bring about nationalizationof the very hospital where they have scheduled knee replacementsurgery. They want to know there is protection of property rights andpeaceful changes in government. Indicators of the political environment,the legal system, the provision of law and order, and corruption in tendestination countries are studied below.Political EnvironmentMature democracies have multiparty political systems and hold regular electionsto ensure adequate representation of the population. Leaders cater tothe electorate and are sensitive to the demands and needs of the people.
120 ● Medical Tourism in Developing CountriesThe constitution and legislation reflect those demands and needs. Politicalinstitutions are based on political values that dominate in society. Politicalvalues and political culture are said to be liberal, emanating from theWestern tradition. These liberal values include respect for freedom of individualsand human rights. Constitutions reflect respect for individuals, andsubsequent laws reinforce it. In most democracies, rights of individuals areprotected, irrespective of gender, race or religion.Indicators of political systems are presented in table 5.6. With the exceptionof Cuba, all countries under study are either republics or constitutionalmonarchies. Jordan, Malaysia, and Cuba are the only ones that are notelectoral democracies. With respect to political rights and civil liberties ofthe population, only Cuba received the lowest possible score, namely, seven.Jordan and Malaysia had midlevel scores of four and five. Finally, only Cubawas characterized by Freedom House as not free (Jordan, Malaysia,Philippines, and Thailand are all rated as partially free). All of this indicatesthat politically, Cuba stands apart from other destination countries while atthe opposite end are Argentina, Chile, Costa Rica, India, and South Africa.The remaining countries, even if they are not electoral democracies,are nevertheless politically stable with little change and few disruptive tendencies.Although some of the monarchies may be called authoritarian, theyare by no means like many developing countries of Africa and AsiaTable 5.6 Political characteristics in ten destination countriesForm ofgovernmentElectoraldemocraciesPoliticalrightsCivillibertiesFreedomratingArgentina Federal republic Yes 2 2 FreeChile Republic Yes 1 1 FreeCosta Rica Republic Yes 1 1 FreeCuba Single partyNo 7 7 Not freecommunist stateIndia Federal republic Yes 2 3 FreeJordan ConstitutionalNo 5 4 Partly freemonarchyMalaysia ConstitutionalNo 4 4 Partly freemonarchyPhilippines Republic Yes 3 3 Partly freeSouth Africa Republic Yes 1 2 FreeThailand ConstitutionalmonarchyYes 3 3 Partly freeNote : Political rights and civil liberties are ranked by Freedom House from 1 (highest) to 7 (lowest), 2005.Source : John Allen, Student Atlas of World Politics, 7th ed. (Dubuque, IA: McGraw-Hill, 2006), table B; andFreedom House, www.freedomhouse.org/uploads/pdf/Charts2006.pdf, accessed February 11, 2006.
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List of AcronymsAIDS Acquired Immun
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2 ● Medical Tourism in Developing
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10 ● Medical Tourism in Developin
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Table 1.1 Economic indicators and t
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Plastic Surgery is Not Peanuts ●
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170 ● Medical Tourism in Developi
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188 ● NotesTreatment Abroad Could
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190 ● Notes60. Emerging markets i
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192 ● Notes21. Woodward et al.,
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194 ● Notes57. Economist, July 31
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196 ● Notes25. New York Times, De
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198 ● Notes73. Rupa Chanda, “Tr
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200 ● Notes16. Peter Schofield,
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202 ● Notes56. Thomas Friedman, T
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204 ● Notes99. Chanda, “Trade i
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206 ● Notes21. Marvin Cetron, Fre
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208 ● Notes71. Chanda, “Trade i
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210 ● Notes116. Cited in Rashmi B
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212 ● Notes2. Simonetta Zarrilli,
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214 ● Notes30. Joint Commission I
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216 ● Notes65. Mattoo and Rathind
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218 ● Notes102. It is a problem i
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220 ● Notes29. Larry Solomon, “
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224 ● Selected BibliographyBower,
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226 ● Selected BibliographyJohans
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228 ● Selected BibliographyRoffe,
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232 ● Indexbrain drain/gain 105-9
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234 ● Indexdestination countriesa
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236 ● Indexhealth careon airplane
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238 ● IndexJJohanson, Misty 44, 9
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240 ● Indexmedical tourism (conti
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242 ● Indexpublic health (continu
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244 ● Indextourism sectormarket s
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Medical Tourism in Developing Countries

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