By Dennis Wesley
MEDICAL tourism is now a flourishing industry in several developing economies.
Some Americans find it less expensive to visit India and other Southeast Asian countries in search of timely healthcare.
It is also not a surprise that most of the establishments that cater to “medical tourists” are privately run.
Medical tourism is a complex phenomenon, and it does have its merits. Nonetheless, it is undeniable that the phenomenon also represents the deepening of America’s public health crisis.
The phenomenon also raises several ethical questions: if developing economies cannot guarantee healthcare to their own citizens, is it at all justifiable for these governments to incentivize medical tourism? Would this not amount to a criminal reallocation of already scant resources?
What this does reveal about public planning in developed and developing countries is that healthcare, much like education, is largely viewed from the perspective of neoliberalism.
In other words, access to quality healthcare and education is increasingly predicated on the ability to pay.
Clearly, the neoliberal logic flies in the face of the impulse that drives arguments for universal healthcare, which is predicated on equality of opportunity.
It aims to ensure timely access to healthcare based on clinical need, not ability to pay.
This of course does not mean that healthcare is entirely paid for; rather, it aims to prevent people from incurring financial hardship as a result of expensive healthcare.
Medical tourism is an excellent example to use in public discourse surrounding healthcare. Here’s why: nationalism, in its more zealous forms, also involves opposition to calls for regulation of the private sector.
Proponents argue that public intervention would stifle economic growth.
Usually, these arguments tie individual freedom and the freedom of the private sector, and suggest that regulating one means adversely affecting the other as well.
Yet, it must surely also be a matter of national pride to provide cheap, timely healthcare to Americans without them having to travel halfway across the globe.
In fact, as John Macionis notes in his work on contemporary sociology, discussions involving rights and liberties can only be complete if we also discuss the question of responsibility.
That is, the private sector is within its rights to seek profit, but it is also obligated to contribute to the public good.
Similarly, as mentioned above, the general public is also duty-bound to demand better from the public-private partnership.
To be sure, people do have the right to travel elsewhere in search of cheap, timely healthcare, but that they choose to do so doesn’t mean they don’t mind doing so.
The medical tourism example shows that poor public planning affects those who can and cannot afford clinical care.
This is one of the biggest failures of neoliberalism.
In effect, even the ability to pay does not guarantee timely healthcare for Americans. Medical tourism, therefore, might also be an adaptive preference.
It is also essential to note that the call for universal health coverage does not involve calls for the nationalization of healthcare.
After all, bureaucratic hurdles associated with the public sector also tend to deter people from seeking clinical care.
The universal health coverage model is not based on rigid ideals. It is malleable and draws on multiple strategies. Regardless of the strategies, the model aims to set minimum standards of clinical care. This is not a tall ask, and neither is it undoable.
Today’s healthcare reforms mainly focus on making healthcare more accessible and efficient.
To do so means increasing the efficiency of the public sector and reminding the private healthcare sector of its duties to the general public.
Ultimately, to regulate private healthcare is to think of actionable ways to produce better health outcomes for Americans at lower costs. This means convincing the private sector to lower their profit margins.
This is especially important since the private sector can be an efficient alternative to the bureaucratic and sometimes time-insensitive aspects of public healthcare. However, profit-oriented privatization is not the solution.
Dennis Wesley is an independent educational researcher. His interests include interdisciplinary practices and methods. He mainly writes about mental health, academia, and sustainability. You can follow his personal blog and Twitter here and here respectively.
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