Medical Tourism in Developing Countries

130 ● Medical Tourism in Developing Countriesmobility of their personnel. Both exporting and importing countries areseeking to eliminate barriers such as visa formalities, prohibitions, andquotas, nonrecognition of professional qualifications and licensing requirements,discriminatory treatment, and wage parity issues. The eliminationof these barriers will make the promotion of medical tourism easier.The Example of IndiaAccording to the World Bank, liberalization of the Indian economy is oneof the most important reasons for the phenomenal growth of its servicesector. 121 This is true also for medical tourism, for without extensive liberalization,India would not be at the industry’s global forefront. Corporatehospitals such as the Apollo chain would not have risen to their prominencein the absence of economic reforms that increased the role of the privatesector, provided a legal infrastructure that protected business, and liberalizedtrade so that modern medical equipment could be imported.Since Independence, India has been a democracy with rule of law andthe protection of its citizens’ private property. It had a banking system, andpublic and private accountability. Still, it was not a liberal economy and thefunctioning of the market system was curtailed. In the post–World War IIperiod, India was characterized by strong government involvement in theeconomy. Industrial policy promoted heavy industry, government controlswere extensive, foreign trade and exchange was regulated, and prices of basiccommodities were set. The license system enabled central authorities todetermine production quantities, allocation of resources, and prices ofinputs (and sometimes even output). A license or stamp of approval wasneeded for all business transactions, no matter how minute. Those licenseswere strictly regulated and required much time to get (and often bribes aswell). During the period of import substitution, in addition to licenses,there were also a combination of high tariff and quotas placed on allimported goods.While India first implemented reforms in the 1970s, only two of themwere liberalizing: relaxing industrial regulation to promote efficiency, andpromoting exports. 122 It is only the reforms of 1991, under Rajiv Gandhiand the Prime Minister P. V. Narasimha Rao (1991–96) that stand outas the first comprehensive attempt at reviving the economy by seriouslydecreasing the government’s role and increasing that of the market. 123 TheNew Industrial Policy (NIP) of 1991 scaled down the industries reservedfor the public sector from 29 to 8, industrial licensing was abolished in all,but 18 industries, private sector competition was introduced, and the governmenthalted nationalization. 124 Nevertheless, the Economic Survey putout by the Finance Ministry in 2000 said that further reforms were