Government Industries

What is Governments Roles in Cross-Border Health?

Medical tourism remains an industry that is predominantly a commercial response to a demand or health care driven by consumers. We use the term ‘medical tourism’ in a somewhat restrictive fashion: the self-selected decision of individuals to seek medical care in a foreign country. We thus exclude from our consideration ill and injured vacationers, ex-pats living much of their time abroad and intermittently needing medical care, and publicly-insured cross-border care initiated or approved by governments, generally due to lack of or undersupply within their own borders. While robust data with regard to medical tourism is hard to come by, the medical tourism industry lays claim to significant growth in recent years and associated with this growth a promise of economic benefit.

This benefit is arguably the key driver of medical tourism on the supply side and is recognized as such by many countries seeking to develop or expand this offshoring sector. Not only are many national governments supportive of medical tourism, but they are also often investors in this sector.

The primary areas in which medical tourism and governmental (public) health care regulation intersect include:

  • Education and regulation of health professionals, with concerns that both of these may be sub-standard in destination countries to those in countries of international patients
  • Changes in a destination country’s accreditation systems to accommodate internationally trained providers working in medical tourism facilities could lower qualification standards
  • Accreditation of health care facilities, with concerns over inadequate governmental standards, or of government oversight of the over 40 private international accreditation bodies
  • Provision of services that are illegal in the international patient’s home country, and/or are unproven or ineffective treatments
  • • The role of unregulated or self-regulated intermediary medical tourism services, such as medical tourism brokers, on-line sites, or specialized training programs or certifications in medical tourism that exist outside of publicly regulated professions
  • Potential lack of legal redress in cases of alleged medical malpractice, where destination countries may have no, or inadequate, means for international patients to pursue claims
  • Lack of requirements for the full sharing of medical files/records, either by the international patient on departure or by the medical tourism provider on the patient’s return
  • Poor oversight of the potential spread of extreme drug-resistant or antimicrobial-resistant infections that international patients may return with, which can then spread to health care facilities in their home country especially if they require follow-up care
  • The intersect between national-level policies and regulations (or lack thereof) and international law, notably core human rights obligations that require governments to ensure that privatization of health markets (including those for medical tourism) or actions of third parties (such as medical tourism brokers) do not interfere with the right of national citizens to health care and health-related services

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