Medical Tourism in Developing Countries

74 ● Medical Tourism in Developing Countriesfunctions include coordination with tour operators and the national airline.SERVIMED also developed 42 centers—health resorts linked to surroundinghospitals that provide surgical and rehabilitative treatments. 36 Buildingbusiness ventures with hotels and building medical resorts and villages thatserve as “off-shore medical centers,” all required a tremendous amount ofcooperation between departments. Such cooperation enabled Cuba to developa successful export strategy of linking health care with tourism. 37The Private SectorThe active involvement of the public sector in medical tourism maygive the erroneous impression that governments do not encourage the privatesector. With the exception of Cuba, authorities in developing countrieshave realized that private business tends to be dynamic and adaptable; ittends to respond quickly to technological change and financial incentives,both at the level of transnational corporations, as well as at the level ofmicro businesses.The private sector has traditionally been stronger than the public sectorin services, so it comes as no surprise that it dominates in the tourismindustry. The World Bank takes a strong position on the role of the privatesector in tourism, giving it supremacy over the public sector: “While tourismdevelopment is predominantly a private sector activity,” partnershipwith governments must be effective to ensure maximum benefit to the localpopulation. Heeding the World Bank position, numerous countries havetourism policies such as the one announced in India in 2001, namely“government-led, private-sector driven and community-welfare oriented[italics mine].” 38 The governments of southern African countries (with theexception of Angola) have together formulated a tourism policy in whichthe role of the private sector is recognized in financing and implementingfuture developments. 39 In Jordan, the lack of sufficient private sectorleadership is viewed as the principal obstacle to the development of thetourist sector. 40In part, medical tourism services consist of the health sector that hastraditionally been under public control and which, as noted above, is politicallyhighly sensitive. Nevertheless, with the exception of Cuba, economicactivity in medical tourism is currently generated by both private andpublic sectors as all countries under study have parallel private and publichealth-care systems. These include hospitals, clinics, diagnostic centers,treatment centers, and nursing homes. In Malaysia some 80 percent ofhealth care is provided by the public sector. The private sector is growingrapidly, and offers mostly curative and rehabilitation services. It is financed