Medical tourism and global health inequality

By many accounts, the numbers of patients from industrialized countries seeking medical treatment in countries like India, Thailand or Cuba are increasing rapidly. Last year, the New York Times issued a piece whose basic theme was that medical tourism is becoming 'normalized', i.e. it is no longer just an option for a small minority seeking cheap nosejobs or teeth-whitening. North Americans and Europeans are now looking to developing countries for highly-invasive and life-extending operations, like heart-valve and hip replacements. That medical tourism is becoming regarded as a solution to the problems of high medical costs and insurance premiums is exemplified by the fact that insurance companies in the US are starting to provide plans that encourage clients to seek some medical interventions abroad. And governments in developing countries are encouraging the trend, for the same reasons they promote more familar forms of tourism.

On the face of it, one could see this as a mutually beneficial transaction: patients from industrialized countries receive medical services at bargain prices, while medical institutions and individuals in developing countries receive much needed revenue. But, as a recent piece in Asia Times emphasizes, the picture is much more complicated. Creating pockets of 'first-world' medical care in developing countries also has a number of ethically untoward effects: internal brain drain of health care professionals from public hospitals to state-of-the-art clinics catering to foreigners, and the creation (or reinforcement) of a strongly two-tiered health care system, with a superior level of care for the rich and an inferior one for the poor. Besides being a source of injustice, medical tourism is also unrealistic as a solution to problems of health care systems in more affluent nations. Even if the numbers of medical tourism has increased, the numbers are still relatively small compared to those staying at home. But the increasing amounts of money spent abroad by medical tourists might have a positive effect, i.e. encourage what should have been a priority in the United States long ago: affordable and high-quality health care.