Medical Tourism in Developing Countries

158 ● Medical Tourism in Developing Countriesa lag, after the patient has had follow-up care with a physician at home?These are all legitimate questions, born out of circulating rumors of incompetentdoctors or sub-par facilities. 79 Some of these questions are raised ona website (www.bumrungraddeath.com) maintained by a grieving fatherwhose 23-year old son died in 2006, after treatment in Thailand. While thecourts are deciding whether Bumrungrad Hospital was negligent, the fatherhas posted recommendations and alerts for potential patients urging themto check their legal rights and destination country malpractice histories.LDCs promoting medical tourism must make adjustments to their legalsystems in order to address issues of concern to international patients.Obstacle V: Entry Requirements and TransportationIf the Indian government had cumbersome visa restrictions, the Americanpatient would be less likely to go. If the Thai national airline made threerefueling stops on its way from London to Bangkok, the English patientwould probably go elsewhere for his Lasik surgery. Entry requirements andvisas translate into government-imposed barriers to the international tradeof medical services. Airline routes and prices of travel also translate intogovernment-imposed barriers since transport industries in LDCs are largelygovernment owned and controlled.These are obstacles to the development of medical tourism that arenational in origin and, therefore, their elimination requires appropriatesteps on the part of national authorities. Unlike international obstacles suchas the lack of insurance portability, domestic obstacles are easier to addresssince they are largely under domestic control.Entry RestrictionsIn an exercise of their sovereignty, all countries control their borders. Theydo so because of security concerns, illegal flow of manpower and smugglingof goods. Border regulations limit numbers of crossings and set eligibilityconditions. In order to assess who enters the country and for what purpose,governments require information such as that provided on a visa requestapplication. The successful applicant receives an entry permit for a specificpurpose that includes tourism, study, or employment.Embassies and missions abroad process such applications in cooperationwith home authorities. The efficiency with which such paperwork is processedand the breadth of inclusion of international applicants has an effecton the number of visitors. Among these are international patients who comewith the specific goal of purchasing services. There is an inverse relationship