Medical Tourism in Developing Countries

10 ● Medical Tourism in Developing Countriesconditions under which medical tourism can be a successful growth strategycrystallize. Chapter 6 contains a discussion of the obstacles faced by developingcountries that have chosen to promote medical tourism. Having theadvantages discussed in chapter 5 does not imply that countries face noobstacles in the promotion of medical tourism. To the contrary, there arenumerous hurdles, both domestic and international, that have to be overcome,circumvented, and otherwise dealt with. These obstacles, discussed inchapter 6, are barriers to trade in medical services and are mostly, but notexclusively, legal in nature (pertaining to regulation, insurance, accreditation,patents, etc.). Finally, chapter 7 discusses the potential of medical tourismto alleviate the public health plight in destination countries. While itundoubtedly adds to the public health crisis (by reinforcing a dual healthdeliverysystem), medical tourism can contribute to the solution of healthcarecrises insofar as it is a profitable activity that can be tapped, with theappropriate macroeconomic policy, to fund public health. In this way, italleviates the budgetary pressures of the public sector and enables morewidespread basic health services. This chapter contains a discussion of therelationship between medical tourism and public health with respect to boththe crowding-out and the crowding-in effects. It is argued that an improvementin public health will contribute to increasing human capital that inturn can contribute to economic growth. It is also argued that medical tourismprovides the capacity to alleviate health-care crises in countries that havethe incentive to do so. Clearly, the greater a country’s advantages (discussedin chapter 5), the greater its ability to address public health challenges.In each of the above chapters, the political economy perspective is clear.Such a perspective highlights the important role played by political institutionsat the local, national, and international levels in the provision ofmedical tourism. Indeed, international organizations such as UNCTAD,WHO, and the World Tourism Organization (UNWTO) set the frameworkfor the consumption and provision of medical tourist services, thenational governments formulate policy for it, and the local-level administrationtakes care of the details. The role of political institutions is clear intourism and even clearer in questions of health provision because health,even if provided by the private sector, is different from other industries (asnoted in a U.S. Department of Commerce trade conference document:“The ethical and human welfare dimensions make [the health sector] qualitativelydistinct from most other industries and endow it with a high degreeof political sensitivity [italics mine]” 51 ). Moreover, this book has a strongpolicy bias insofar as it emphasizes the role of the public sector in enablingmedical tourism and then, once it is entrenched, in using macroeconomicpolicy to alleviate the chronic health concerns of developing countries.