Medical Tourism in Developing Countries

28 ● Medical Tourism in Developing Countriesenough to make a dent in public health-care provision. Over time, however,tax revenue might be significant enough to be siphoned back into the localequipment and services and infrastructure. Under those circumstances,medical tourism might subsidize local patients who have no money to payfor services. It just might make a difference for the 6 million people whodie every year from AIDS, malaria, and tuberculosis, as well as the 7 millionchildren who die from curable infectious diseases. 34Economic GrowthMany economists have argued that participation in the global economy ispositively related to economic growth. 35 Whether it occurs through tradeof goods and services or through financial flows, such participation oftenstimulates domestic production, increases employment, stimulates growthpromotingcompetition, increases tax revenue, increases the flow of foreigncurrency, and, as Dollar and Kray point out, reduces poverty in developingcountries. 36 In the short run these effects might not occur, and then countrieserect trade barriers, restrict the flow of foreign investment, curtail theactivities of multinational organizations, restrict immigration and emigration,and limit exposure to foreign cultures by restricting tourism. However,the long run growth experience in countries such as Hong Kong, Taiwan,Singapore, and South Korea has reignited the hope that foreign investmentand export-oriented policies are a panacea for LDCs. 37 Many of thesecountries are hoping trade in tourist and medical services will do the samefor their economies for the reasons discussed below.International Trade in Health and Tourism ServicesMost sales in the tourist and medical sectors are made within domesticborders. While those sales are significant in size, they do not generate foreigncurrency income. In both sectors, revenue in foreign currency is earnedby cross-border exchange, namely, through international trade. Foreign currencyis precisely the reason these services are traded, as Gupta noted in astudy of Indian health care. 38What exactly is traded in tourism and medicine in order to bring foreigncurrency into local hands?In the former, foreigners buy transportation, accommodations, restaurantmeals, and entertainment. They rent cars and tennis rackets, they hiretour guides and travel agents, they have a massage, and they watch a localdance performance. According to the World Bank, such services are importantas visitor expenditure outside their hotels can range from half to nearly