Medical Tourism in Developing Countries

38 ● Medical Tourism in Developing Countriesbe used for nonessential health care. The evidence of demand for nonemergencymedicine is clear, much of it directed at elective surgery such asplastic surgery, bunion reduction, knee replacement, Lasik eye surgery, andporcelain teeth caps (discussed in chapter 3). Traveling to LDCs for theseservices and adding a tropical vacation at the end is an increasingly appealingoption for those with rising discretionary income. Therefore, if incomestagnates in the West, income growth in developing countries will continueto provide a market for global medical tourism.Foreign patients are also sensitive to price. In fact, the primary reasonwhy tourists travel to developing countries has to do with price considerations.If those prices rise, demand would undoubtedly fall off as otherconsiderations (cost of travel, being away from home for medical care, etc.)come into play. Moreover, there is variety within medical tourism as not allmedical services have the same price elasticity (as health economist ChristinaRennhoff pointed out, people are more price sensitive in the case of dentalwork and mental care than, for example, in the case of gastrointestinalproblems 66 ).Together, income and price elasticity of demand for medical tourismsuggests that the terms of trade in exporting countries will not be as unfavorableas if the export in question were cashews, or, for that matter, nonmedicaltourism. The instability of export earnings for both cashews andleisure tourism is high, given its dependency on factors such as volatiledemand, seasonal changes, and fashion. Those factors are not relevant formedical tourism. Still, despite its difference from cashew nuts, medicaltourism is nevertheless dependent on international markets, albeit in ageneric way, the way that all export industries are. While scholars haveargued that depending on the export of raw materials is less conducive togrowth than depending on the export of television sets, no one has yetcompared TVs with medical tourism in terms of the growth that is generatedby tourism. In this book, it is argued that for some destination countries,medical tourism has phenomenal potential, presently even exceedingmanufacturing industries.Moreover, medical tourism in developing countries might introduce newforms of dependency. It might result in reverse dependency relationships inwhich the West may increasingly depend on developing countries to provideits medical care and alleviate the pressures on its medical system. 67Indeed, when the debt-ridden British National Health Service sends bloodsamples to India for analysis and has the results returned through e-mail,is this not an indication of dependency? 68 A similar reversal in dependencyroles might take place on the micro level, between patient and doctor.Power relations are different in medicine, and a German patient under the