Medical Tourism in Developing Countries

164 ● Medical Tourism in Developing Countriesresulted in the creation of an international health-care market [italics mine]” 90 ).The United States leads with respect to those rising costs. It has the world’shighest spending on health care: 14 percent of GDP, namely $1 trillion.It is largest service sector in the economy. 91 The Medicaid budget is increasingby 9–10 percent every year and the uninsured are further burdening thesystem by overconsumption of expensive emergency room care. Employer’shealth plans are rising at double digits and twice the rate of inflation. 92General Motors, for example, laid off some 20 percent of its workforce in2006 primarily to reduce its annual health care budget of $5 billion. 93Given such rising costs, coupled with budgetary constraints and decreasinginsurance coverage, further privatization and globalization of health carewill occur. Indeed, in order to control costs at home, Western hospitals anddoctors were the first to turn to LDCs when they began contracting theirskilled manpower to transcribe medical records and read X-rays. It was onlya matter of time before patients themselves began to go. And if they go inlarge numbers, the costs of medical care could be reduced. 94 In a studyof medical tourism, Mattoo and Rathindran found that the savings tothe United States, if just 5 percent of patients went overseas, would be$692 million per year. If 20 percent went, that number would rise to$2.7 billion. 95Overemphasis on costs in medical care raises important concerns forsource and destination countries, not the least of which are ethical innature. In private health care, the patient-doctor relationship is alteredwhen medical services are sold for a profit and medical care becomes abusiness transaction. Under those circumstances, as Teh and Chu noted,there is the possibility that we lose sight of the fact that we are discussinga humane and morally driven discipline. We will begin to look at the practiceof medicine as a market opportunity. 96 That will require a reassessmentof the rules pertaining to organ sales raised in chapter 4.Bottom line: The ramifications of medical tourism on source-countryhealth-care costs are likely to be far-reaching and affect resource prices inindustries not immediately affiliated with medicine.Health InsurancePrivate and public health insurances in Western source countries will increasinglybe affected by medical tourism. With respect to the former, it is likelythat demand for expensive health plans will drop as domestic patients travelabroad for health care that requires out-of-pocket payments. That is sure toaffect the profit margins of commercial insurance companies. 97 Moreover, ifhealth care costs at home decline due to decreasing demand, that will further