Medical Tourism in Developing Countries

Inequalities in Health Care ● 179adopted an Act of Parliament on Telemedicine in 1997 that designated fivemajor hospitals to provide care to remote regions.However, by far the most important way in which medical tourism canenhance public health is through macroeconomic redistribution policy. Ascountries become globally competitive in medical tourism, internationalpatients help generate more taxable income and profit. The resulting taxrevenue could be partially allocated for public health, namely for theincreased access, greater coverage, and improved quality of care for the localpopulation. In that way, medical tourism can provide a social benefit, andits growth and development can produce a positive externality. This is discussedbelow.Financing Public HealthAccording to the Alma Ata Declaration, primary health care includes at leastthe following: “Education concerning prevailing health problems and themethods of preventing and controlling them; promotion of food supply andproper nutrition; an adequate supply of safe water and basic sanitation;maternal and child health care, including family planning; immunizationagainst the major infectious diseases; prevention and control of locallyendemic diseases; appropriate treatment of common disease and injuries; andprovision of essential drugs.” 33 Providing basic medical care has proven to bequite difficult. It is like any public good—everyone wants it, but no onewants to provide it. Supplying medical care to the poor who have no abilityto pay for it is not a profit-generating activity. As a result, basic health is oftenthe focus of charities, NGOs, and corporations wishing to make a difference.While many of those efforts have been successful, many are too inconsistent,unsustainable, and limited in scope to have a broad impact. Therefore, theresponsibility for providing basic public health rests with governments.Government is in the best position to finance basic health care thatreaches the maximum number of people, and then to implement thathealth care through its primary care network. Macroeconomic policy, specificallyfiscal policy that redistributes income through taxes, can play acrucial role in the government’s ability to provide access to quality preventive,curative, and rehabilitative health care at the local levels.In developing countries, where many pressing problems compete forscarce funds, what is the source of resources that might aid public health?For some countries, the answer is medical tourism.Siphoning funds from high-growth sectors or industries in order to payfor health care is hardly a novel idea. The World Bank has imposed a