Medical Tourism in Developing Countries

Would You Like a Safari With Your Lasik Surgery? ● 73of medical tourism cannot be neglected by authorities. According to Adamsand Kinnon, “All considerations point to the need for governments to providea strong and effective regulatory framework for the private actorsinvolved in trade in health services. But above all, and especially in developingcountries, they have to be able to reinforce it.” 31Taxation is also an integral component of this environment. Authoritiesmust make decisions as to which economic activity associated with medicaltourism is to be taxed and how much. As discussed in chapters 5 and 7,tax policy must promote taxes that are low enough not to stifle privateactivity and high enough to make a significant addition to public revenue.The public sector can further augment its financial capacity with directpayments by foreigners for use of public health facilities. 32 Foreign patientshave a small number of beds in public hospitals available to them (andlimitless number in private hospitals). By allowing some foreign patientsinto public hospitals, the authorities earn additional income that will alleviatetheir pressure on resources (according to a study of the Australian healthsystem, two or three locals can be treated with the income earned from oneforeign patient 33 ).Finally, it must be stressed that governments seeking to develop themedical tourism industry must foster cooperation within the public sector(as well as with the private sector, as described below). Indeed, the broadnature of medical tourism necessitates the involvement of several publicsector bodies including the Ministries of Health, Trade, Tourism, andTransportation. Offices in charge of migration, immigration, and foreigntravel must also be involved, as well as the central bank. Communicationbetween the Ministries of Health and Trade is crucial since one may be infavor of regulation while the other may lean towards liberalization. Suchcooperation is evident in many developing countries. The Philippine HealthTourism Program relies heavily on the cooperation between the Departmentsof Tourism, Health, and Energy in order to offer cost-effective medicaltreatments combined with the best tourist attractions. 34 In India, given itshighly decentralized political structure, cooperation between federal andstate levels is crucial. Moreover, authorities have started involving thenational airline in medical tourism strategies.However, it is Cuba that has the most extensive cooperation withinpublic sector departments and thus warrants an extended description.According to a WHO study, the success of the Cuban medical tourismmodel is due to the strategy of coordination and collaboration of theMinistry of Health with other institutions in tourism, commerce, and industry.35 In order to coordinate, market, and promote international health care,the Cuban government created the state run monopoly SERVIMED whose