Medical Tourism in Developing Countries

4 ● Medical Tourism in Developing CountriesPeople travel to get care not available locally or to spend less than theywould at home. Increases in the supply of medical tourism are directlylinked to the liberalization of trade in services, the growing cooperationbetween private and public sectors, the easy global spread of informationabout products and services, and, most importantly, the successful splicingof the tourism and health sectors. The explosion of medical tourism couldnot have taken place a few decades ago, before globalization made the worldseem smaller. Cheap transportation to faraway places, coupled with growingincomes, enabled people to travel to previously inaccessible places. Theinformation revolution made gathering information easy by way of theInternet while extensive media exposure of all geographical corners ofthe globe brought distant countries closer in time and space. 23 The volumeof international trade increased as more countries became part of the internationalglobal economy. With respect to medical tourism, liberalization ofhealth services and trade, as well as the lowering of barriers to entry andforeign investment, opened up new possibilities. New telecommunicationstechnologies such as telediagnosis and teleanalysis reduced the barriersposed by geography and enabled cross-border trade in medical services totake off. Thomas Friedman, in his discussion of globalization, said, “It isnot simply about how governments, business, and people communicate, notjust about how organizations interact, but is about the emergence of completelynew social, political, and business models [italics mine].” 24 In a WHOstudy, the following is noted about globalization: “What is clear is that itis a multidimensional process encompassing economic, social, cultural,political and technological components, and that it defines much of theenvironment within which health is determined [italics mine].” 25“Who would have thought of medical tourism before it became a reality?”asked Clyde Prestowitz in his study of the phenomenal economic growth ofIndia, one of the countries promoting medical care for foreigners. 26 Indeed,who would have thought it possible that less developed countries could offersophisticated medical care to Westerners, despite the fact that the world’sfirst heart transplant surgery was performed in South Africa during the1960s, 27 and despite the clear portability of high-tech medicine into inhospitableenvironments (such as the South Pole, where Dr. Jerri Nielsen selfdiagnosed,performed a biopsy on herself, and self-administered chemotherapywith the aid of technological links to North American hospitals 28 )? Yet,medical tourism has catapulted onto the world stage and upon the globaleconomy, catching social pundits and futurists off guard.With hindsight, however, we recognize that we should have seen it comingfor several reasons. First, medical tourism is not new. Ailing Greekstraveled to Epidauria to visit the sanctuary of the healing god, Asklepios,