Medical Tourism in Developing Countries

160 ● Medical Tourism in Developing CountriesThe program is called MaSingThai, indicating three countries that arevisited together.Obstacles: ConclusionsVisa requirements and inadequate transportation are obstacles to the developmentof medical tourism that are domestic in origin and, therefore, aremore easily addressed. The other obstacles discussed above undoubtedlyrequire steps and adjustments to be taken by national authorities, but theyare harder to overcome. Not only do they involve changes in the legalstructures that are often cumbersome and expensive, but they also entailmeshing with international regulations.Authorities in all ten countries under study are aware that withoutfundamental revisions of the laws and regulations that in any way preventthe efficient functioning and growth of the health-care industry for export,their medical establishments will not be competitive in the rapidly changinginternational health-care market. Given the advantages discussed in chapter 5,these countries have the necessary political, economic, and institutionalconditions to overcome the obstacles.Implications of Medical Tourism for Source-Country MedicineTo the extent that developing countries can overcome the obstacles to furtherexpansion of their medical tourism industries, the implications forhealth care in Western source countries will be huge. Knowing that, SenatorGordon Smith has recently called for a federal-level interagency task forceto be convened, including the Departments of Health and Human Services,Commerce, and State; 82 and physicians from South Texas lobbied againstallowing HMOs to operate in Mexico because they claimed they could notcompete with lower costs. Although not the focus of this book, some ofthese implications are introduced below.Shifting Sites of ProductionAs noted in chapter 2, during the twentieth century production of goodsand services moved from one location to another in response to changesin production and transportation costs (for example, manufactured goodssuch as hand calculators were first made in the United States, then inJapan, then in Malaysia, and most recently, in China). As the productionof some goods and services moved away, economies had to adapt to newconditions by reevaluating, restructuring, and reequilibrating in order to