Medical Tourism in Developing Countries

Plastic Surgery is Not Peanuts ● 23emerging distinctions that seemed no less divisive. While chapter 1 brieflydescribed some contemporary issues involved in naming and classifyingdeveloping countries, the descriptions below are more global in perspective.Samuel Huntington, for example, divided countries by culture and proposedthe “big cultural divide.” 11 Robert Kaplan focused on regions with ethnicstrife and those without. 12 Barnett and Gaffney divided the world into thefunctioning core of globalization (including Western democracies, Russia,and Asia’s emerging economies), and the nonintegrating gap (includingcountries that remain disconnected from globalization due to political culturalrigidity, such as the Middle East, or because of poverty, such as CentralAsia, Africa, and Central America). 13 This is similar to Thomas Friedman’sdivision of countries into those that buy into the flat world and those thatdo not. 14 Countries have even been divided according to their membershipin a world trade club (such as Birdsall and Lawrence’s modern trade clubsthat include multilateral associations such as the UNWTO and regional onessuch as NAFTA, MERCOSUR, and APEC 15 ).Each of these post–Cold War concepts of the world share an acknowledgmentof globalization and its tendency to tie countries in a complex setof economic relations. Such globalization entails a large increase in economic,social, and cultural interdependence between countries of theworld. 16 While countries have been linked to the international economy forcenturies (witness the role of global trade in eighteenth century imperialism,dependency relations in the twentieth century, export promotion policies ofthe 1980s and 1990s, etc.), 17 what is new in the current era of globalizationis the volume and the nature of international economic interaction. 18Another new factor in globalization is the predominance of services. Indeed,Prestowitz claims that contemporary globalization is different from previousones because it is less driven by countries or corporations and more bypeople. 19 People are the providers of services. Moreover, the world economicenvironment of the twenty-first century is characterized by the internationaltrade of those services.Globalization, the growing importance of services, and the increasedinternational trade of those services are all discussed below with special referenceto tourism, health care, and medical tourism.GlobalizationIn the twenty-first century, not only has the sheer magnitude of flows ofcapital, goods, services, and labor increased, but the speed, pervasiveness,and impermanence of international transactions have also become apparent.Advances in technology and the spread of information have altered the