Medical Tourism in Developing Countries

22 ● Medical Tourism in Developing Countriesaccount of the balance of payments and generating successive rounds ofeconomic activity; leaders are therefore quick to offer their natural resources.As Cynthia Enloe noted, countries are increasingly putting all their developmenteggs in the tourist basket. 8Adding medicine for foreigners to the mix further expands the economicopportunities of developing countries. Worldwide, health services are estimatedto be worth some $3 trillion, 9 and the health-care sector is amongthe highest growth sectors in the mid-2000s. 10 Trade in medical services isa small but growing component of overall medical care. As a result, medicaltourism has been described as having endless opportunities and benefits fordeveloping countries that manage to break into the market.To the extent that tourism is a panacea for destination LDCs, thenmedical tourism is a medium through which the transfer of wealth occursbetween the more developed and the less developed countries, and it propelscountries along a growth trajectory. One crucial consideration thatprevents medical tourism from being a panacea is the fact that, like tourismin general, it depends on foreign consumer demand. Indeed, the entiremedical tourism sector is based on exogenous factors over which neither theprivate nor the public sectors have any control. Other than economic incentives,marketing efforts, and perhaps currency devaluations, little can bedone to increase foreign demand. Such powerlessness cannot but bring tomind past historical periods when countries of Asia, Africa, and LatinAmerica were economically dependent on Western capitalist states. Duringcolonialism, and often no less during the post-colonial period, developingcountries were tied to Western economies in a complex system of internationalexchange based on deteriorating terms of trade. These one-waydependency relationships were the focus of the Dependency Theories of the1970s. In this chapter, it is argued that medical tourism does not fostersuch dependency. Indeed, depending on the export earnings of a cash cropsuch as peanuts is very different from attracting consumers to high-techservices that are unavailable or inaccessible in their home countries. In thisway, medical tourism stands apart from tourism in general, and so, it hasunique implications for economic development.Medical Tourism Takes Off: The InternationalEnvironment as EnablerWith the conclusion of the Cold War and its bipolar division of countries,scholars rushed to describe the international environment that followed itsdemise. Despite the initial buzz created by Fukuyama’s idea that history died,and with it, the divisions among countries, others disagreed and identified