Medical Tourism in Developing Countries

Offshore Doctors ● 49the closest facilities, immediately across the border from their homes. Theyalso do not vacation before or after their medical treatment. Their demandis for nonelective medical care, as they have neither the time nor the inclinationfor elective or lifestyle medicine. While all countries under studyhave border medicine, Thailand’s border regions are inundated by poorpatients from neighboring countries. 27 Chile also has ample border medicaltourism and is bracing for more when the international highway connectingnorthern Argentina, eastern Bolivia, and western Brazil is completed.Two clarifications are in order. First, while border medicine tends toattract the poor in neighboring countries, this does not imply that the richin those neighboring countries do not travel to the same destination formedical care. To the contrary, there is evidence of luxury medical travelfrom neighbors of all the countries under study. Indeed, India receivespatients from the Gulf States as well as nearby Bangladesh, Mauritius,Nepal, and Sri Lanka. Chile and Argentina both provide medical servicesto neighboring residents, as their medical systems are more sophisticatedand modern. Most of the demand for first-rate medical centers in Chilecomes from upper income and upper-middle income patients from Boliviaand Peru, and to a lesser extent, from Ecuador. 28 However, the wealthypatients will rarely receive medical care in the border areas, but will insteadbe drawn to the large medical centers that tend to be urban or resortbased.Second, not all border medicine is demanded by residents of developingcountries. A study of trade in health services in Tijuana in 1994 notes thaton average, there were 300,000 health related border crossings per month. 29Only 50,000 were people going to San Diego for health care while theremaining 250,000 went from the United States to Tijuana. In fact, tens ofthousands of California workers get their medical and dental checkups, aswell as major treatment and surgeries, in Mexico, where health care ischeaper. 30 Also, Americans have been going to Mexico for medical servicesand cheap drugs for a long time. 31The Price of Medical Care as a Pull and a PushAs per microeconomic theory, the quantity demanded of medical tourism,just like any other good or service, is determined by price. When foreignerstravel to developing countries to partake of their health-care services, theyhave undoubtedly been lured by low prices. Just how low are these prices?That question is answered below from the point of view of the patient,namely, how much does the patient spend and what does he get for hiscash outlay. In chapter 4, the low prices of medical tourism are studied from