Medical Tourism in Developing Countries

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.