Medical Tourism in Developing Countries

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CHAPTER 4Would You Like a Safari WithYour Lasik Surgery? The Supply ofMedical TourismIn the 1970s, tourists from Europe and Japan traversed long distancesto be treated by Tony Agpaoa, a Philippine faith healer. To facilitate themedical transactions, Mr. Agpaoa put his patients up at his own hotelin Baguio City. Patients were saved the trouble of seeking accommodationsand while there, were able to partake in Philippine food and culture in anexotic landscape. While the twenty-first century medical tourism offered inLDCs differ in scope, breadth, and technology from what Mr. Agpaoaoffered, in their essence the transactions are the same: medical services arebeing packaged according to their particular setting. Be it the King HusseinCancer Center in Jordan, or Cira Garcia Clinic in Cuba, or even Mr. Agpaoa’ssomewhat rustic facilities in the Philippines, medical tourism entails thesupply of health services marketed so as to reach the demand source thatsustains them. To enhance the medical experience, tie-ins are offered totourist services. All in all, both Tony Agpaoa and large modern hospitalsshare commercial opportunities and management challenges of the medicaltourism industry.Supply is the focus of this chapter. While chapter 3 examined whichservices are in demand (such as invasive and diagnostic procedures, lifestylemedicine, luxury, high-tech medical tourism, border services, and traditionalmedicine, as well as all the hospitality services associated with thetravel and tourism industry such as transportation, accommodation, food,and beverage), the focus here is on how those services are supplied andpromoted. The chapter begins with an analysis of the respective roles of thepublic and private sectors. The former, heavily involved in economic developmentas well as health care and tourism, promotes medical tourism
66 ● Medical Tourism in Developing Countriesthrough a variety of efforts discussed below. The private sector pursues itsprofit interests by attracting foreign patients. Neither sector alone canachieve their goals without the participation of the other. This necessarycooperation is analyzed with an eye on the best way to ensure that medicaltourism takes off. The private and public sectors in developing countriesare then placed into the global context, as they both function within aframework set by international organizations, and they both tap foreign—physical and human—resources that are governed by international laws andregulations. Finally, the nature and rationale of medical tourism’s tie-ins tothe tourist industry are described.The Public SectorThe role of the state in medical tourism must be viewed against the broaderrole of the state in economic development, in health care, and intourism.With respect to the former, Meier and Rauch have divided the literatureon the role of the public sector in economic development into three categories.1 The most optimistic view says that the state is a benevolent leader indevelopment, a force that maximizes social welfare. The pessimistic viewstates that the government is an obstacle to development because it representsthe interests of a narrow group and acts against the majority. A thirdview says that there is a wide possible range of relationships between thestate and development, and each case must be assessed as to whether thestate can formulate and implement policy without corruption. It is thismiddle road that many scholars have supported, and in so doing, they havefound that there is indeed a role for the state in economic development.This role has waxed and waned over time, being high in the aftermath ofWorld War II (or LDC independence), dropping somewhat in the marketoriented 1980s, and rising once again in the twenty-first century. As PeterCalvert noted, the role of the state was under attack during the 1980s and1990s when the Washington Consensus orthodoxy reigned, according towhich the role of the government should be kept to a minimum. 2 Due tofrequent market failures, the state is being brought back in. 3This re-emergence of government has been highlighted by scholars.Sinclair and Stabler noted that, “in contrast to traditional neoclassical theory,new growth theory provides a possible role for government.” 4 Mittelman andPasha also identified the role of the state, especially with respect to capitalaccumulation in the less developed countries. 5 Similar views have beenvoiced outside scholarly circles, from international organizations and policymakers. According to the UNWTO, “It is widely recognized that the market
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List of AcronymsAIDS Acquired Immun
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2 ● Medical Tourism in Developing
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10 ● Medical Tourism in Developin
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12 ● Medical Tourism in Developin
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116 ● Medical Tourism in Developi
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188 ● NotesTreatment Abroad Could
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190 ● Notes60. Emerging markets i
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192 ● Notes21. Woodward et al.,
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194 ● Notes57. Economist, July 31
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196 ● Notes25. New York Times, De
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198 ● Notes73. Rupa Chanda, “Tr
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200 ● Notes16. Peter Schofield,
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202 ● Notes56. Thomas Friedman, T
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204 ● Notes99. Chanda, “Trade i
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206 ● Notes21. Marvin Cetron, Fre
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208 ● Notes71. Chanda, “Trade i
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210 ● Notes116. Cited in Rashmi B
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212 ● Notes2. Simonetta Zarrilli,
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214 ● Notes30. Joint Commission I
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216 ● Notes65. Mattoo and Rathind
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218 ● Notes102. It is a problem i
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220 ● Notes29. Larry Solomon, “
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224 ● Selected BibliographyBower,
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226 ● Selected BibliographyJohans
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228 ● Selected BibliographyRoffe,
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232 ● Indexbrain drain/gain 105-9
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234 ● Indexdestination countriesa
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236 ● Indexhealth careon airplane
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238 ● IndexJJohanson, Misty 44, 9
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240 ● Indexmedical tourism (conti
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242 ● Indexpublic health (continu
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244 ● Indextourism sectormarket s
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Medical Tourism in Developing Countries

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