Medical Tourism in Developing Countries

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Inequalities in Health Care ● 171of infectious diseases, but also in lengthening life expectancy, decreasinginfant mortality rates, and improving maternal health. 2 Jeffrey Sachs alsooffers some success stories in medical care in developing countries, includingsome in the countries promoting medical tourism. 3A variety of indicators can be used to measure the state of health in thedestination countries under study, including demographic indicators (suchas life expectancy and infant mortality rates), morbidity data (that highlightpersistent diseases), and indicators of health services (that show servicesoffered such as number of beds or doctors per person as well as governmentexpenditure on health care). Some of these are included in table 7.1. Forthe purpose of comparison, Norway and Niger are included because theyranked the highest and lowest on the HDI in 2005. It is clear from thedata that India and South Africa, with their large and dispersed rural populations,rank the lowest among the countries under study with respect tomost health indicators. By comparison, Cuba outperforms most countriesin health indicators (except for Costa Rica with respect to life expectancy).Paradoxically, its basic health indicators are comparable to those of manyWest European countries.Health insurance covers about 70 percent of the Thai population. 4 InIndia, coverage is poor; some two-thirds of spending for health care is outTable 7.1 Health indicators in ten destination countriesLife expectancy2003 (%)Infant mortalityrates (per 1,000)2003Doctors(per 1,000)2000–03Hospital beds(per 1,000)2000–03Argentina 74.5 17 n.a. 3.29Chile 77.9 8 1.09 2.67Costa Rica 78.2 8 0.90 1.68Cuba 77.3 6 2.98 n.a.India 63.3 63 0.51 n.a.Jordan 71.3 23 2.05 1.80Malaysia 73.2 7 0.70 2.01Philippines 70.4 27 1.16 n.a.S. Africa 48.4 53 0.69 n.a.Thailand 70.0 23 0.24 1.99Norway 79.4 3 3.56 14.60Niger 44.4 154 0.03 0.12LDCs 65.0 60 n.a. n.a.WORLD 67.1 54 1.65 n.a.Source : United Nations Development Programme, Human Development Report, 2006 (New York: UNDP),table 1, and 10; and John Allen, Student Atlas of World Politics, 7 ed. (Dubuque, IA: McGraw Hill, 2006),table H.
172 ● Medical Tourism in Developing Countriesof pocket since private, social, and community insurance covers only some14 percent of the population. 5 In Chile, private insurance covers 23 percentof the population and the public covers 63 percent. 6 The remaining14 percent either have no insurance, or are covered by other private plans.The problem with looking at average aggregates in health care is thatthey mask inequalities. This inequality manifests itself in a lot more thanthe difference between care for rich foreigners and poor locals. In developingcountries, there is vast income inequality, more so than in the West andthat is reflected in the health care that people receive. Samuel Preston notesthat the higher the average income per capita, the longer the life expectancy.7 Pearce offers data from Africa to show that health differentials followincome and class differentials (he states that class membership affects thetime of death and types of illnesses experienced: for example, children ofprofessionals have lower mortality rates than others 8 ). Associated withincome and class is also privilege, and Pearce notes that some diseases aremore prevalent among privileged people, including sleeping sickness. 9(This is because the tse tse fly is dependent on horses and other animals,so those who can afford to own horses are at risk.) In addition to incomeand class, gender and age are also factors in health-care inequality. Indeed,women, children, and the elderly are especially at risk. Moreover, there isinequality based on geographical location, especially along the urban/ruraldivide. The urban bias that Michael Lipton identifies in developing countriesextends to health insofar as rural areas lack the health professionals andhealth facilities that urban areas enjoy.When inequality among people and regions is so prevalent, the benefitof conquering illnesses is partially lost. Diseases and illnesses do not respectgender or income boundaries. Disease spreads faster and penetrates deeperwith globalization. No matter where the health crisis is, in an increasinglyintegrated world, everyone has the potential to get it. For these reasons, theWHO says that equitable access to health care must be one of the top policyobjectives in developing countries. 10Basic Health Care and Economic DevelopmentIs it important for a chambermaid in an LDC resort to have access to cleanwater and basic sanitation, sufficient food to eat, and medical attention ifshe needs it? The answer is of course yes, but on more than moral grounds.Extending the question to the entire labor force, and even the entire population,the answer would still be affirmative. The reason, beyond basichuman rights, is that there is a circular, self-perpetuating, causal relationshipbetween basic health care and economic development.
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List of AcronymsAIDS Acquired Immun
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2 ● Medical Tourism in Developing
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10 ● Medical Tourism in Developin
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Table 1.1 Economic indicators and t
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Plastic Surgery is Not Peanuts ●
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Table 5.4 Indicators of physical in
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Page 201 and 202: 188 ● NotesTreatment Abroad Could
Page 203 and 204: 190 ● Notes60. Emerging markets i
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Page 207 and 208: 194 ● Notes57. Economist, July 31
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Page 217 and 218: 204 ● Notes99. Chanda, “Trade i
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Page 227 and 228: 214 ● Notes30. Joint Commission I
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224 ● Selected BibliographyBower,
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226 ● Selected BibliographyJohans
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228 ● Selected BibliographyRoffe,
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232 ● Indexbrain drain/gain 105-9
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234 ● Indexdestination countriesa
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236 ● Indexhealth careon airplane
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238 ● IndexJJohanson, Misty 44, 9
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240 ● Indexmedical tourism (conti
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242 ● Indexpublic health (continu
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244 ● Indextourism sectormarket s
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Medical Tourism in Developing Countries

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