The Problematization of Medical Tourism: A Critique of Neoliberalism

Abstract

The past two decades have seen the extensive privatisation and marketisation of health care in an ever reaching number of developing countries. Within this milieu, medical tourism is being promoted as a rational economic development strategy for some developing nations, and a makeshift solution to the escalating waiting lists and exorbitant costs of health care in developed nations. This paper explores the need to problematize medical tourism in order to move beyond one dimensional neoliberal discourses that have, to date, dominated the arena. In this problematization, the paper discusses a range of understandings and uses of the term 'medical tourism' and situates it within the context of the neoliberal economic development of health care internationally. Drawing on theory from critical medical anthropology and health and human rights perspectives, the paper critically analyzes the assumed independence between the medical tourism industry and local populations facing critical health issues, where social, cultural and economic inequities are widening in terms of access, cost and quality of health care. Finally, medical tourism is examined in the local context of India, critiquing the increasingly indistinct roles played by government and private sectors, whilst linking these shifts to global market forces.

Health Equity Impacts of Medical Tourism in the Caribbean: the Need to Provide Actionable Guidance Regarding Balancing Local and Foreign Interests

“…It has been suggested that medical tourism Medical Tourism in the Caribbean can positively impact public healthcare through increased access to medical technology (21), a trickle down from foreign exchange that will be re-invested into public health systems (4), and the increased availability of specialists (18). Conversely, negative impacts may include a diminishing attention to public healthcare as a result of optimism toward the high-tech medicine industry, seen as being associated with development and first-world medical practices (21), the growth of a two-tiered health system (18), strain on health human resources (16), and the need to increase public healthcare capital in order to provide higher salaries to retain workers (17).…”

Power, potential, and pitfalls in global health academic partnerships: review and reflections on an approach in Nepal

“…Many articles reveal the ethical dilemmas and potential unintended consequences – as well as the blurred definitional and operational boundaries – of short-term medical missions [24,25], global health electives [26,27], and medical volunteer trips [28–32]. Others seek to delineate qualities of effective global health partnerships [33], create principles and codes of ethical engagement [19,34–39] that may guide the creation of ethically sound and successful partnerships, or facilitate the improvement of existing ones [40].…”

Medical tourism by Indian-South Africans to India: an exploratory investigation

“…The apartheid government, who came into power in 1948, considered healthcare a private responsibility, with the exception of those who could not afford it (Coovadia et al, 2009). By 1960, approximately 80% of the white population had invested in medical aid schemes (Söderlund et al, 1998). The demand for high quality healthcare, over and above the basic primary services offered at public hospitals, resulted in the development of a large private medical sector.…”

“…Asia currently boasts the top three major global medical tourism destinations, namely, India, Singapore and Thailand (Crush, 2012). More specifically, the development of medical tourism as an economic development strategy in India is argued to have resulted from neoliberalisation of the economy and related efforts to reduce public expenditure and to open the Indian economy for foreign investment (Chee, 2010;Smith, 2012). From the early 1980s, India developed policies to actively promote the transition from a public healthcare system to the current predominantly privatised system (Chaudhry et al, 2004).…”

“…From the early 1980s, India developed policies to actively promote the transition from a public healthcare system to the current predominantly privatised system (Chaudhry et al, 2004). One of the objectives of the pre-1980 welfare policies was to provide comprehensive healthcare services across the socio-economic spectrum of Indian citizens (Smith, 2012). This was gradually downgraded with the implementation of structural adjustments from the 1980s (Kirk, 2011), where poorer classes were limited to public healthcare services available at a minimal service-fee, while more expensive services were restricted to private institutions, and thus became less accessible to the local populace.…”