The Globalization of Health Care Iebad long been thoughe chat health cave is one of the isdustres east vulnerable to diskscation from globaliza- tion. After all, lke many service businesses, health care snomally delivered where itis purchased. However, for some activities and procedures, chis is now fast chang- ing. The trend beganwith oxtain diagnostic procesures, such as MRI scans The United States has a shortage of radiologists, the doctos who specialize in eading and interpreting diagnostic medical images, including Xcrays, CT sean, MRI scars, and ulersounds Demand for radiologists has been growing twice asfastas the rate at which medical schools ate geaduating radiologists with the sills and qualifications required to read medi- cal images. This mia ance berwee nsupply and demand means that radiblogiss are expensive: an American ra diologist can earn as much as $400,000 a year. In the carly 2000s, an Indian radiologist working at the Massachusetts General Hospital, Dr. Senjay Saini, found 2 way to deal with the shorage and expeme—send im- ages over the [nternet to India, where they could be in- temreted by raliologise. This would reduce the workload on Americdbimdislogstiand also cur costs. A radiologist #n India might eam one-tenth of his or her USS. counterpart. Plus, because India is on the opposite side ofthe globe, che images could be interpreted while it was nighttime in the United States and be ready for the attending physician when he orshe arrived for work the following marning. “The globalization ted has now sp dled over into sur- gery. In the fall of 2008, for example, Adrienne de Forrest of Colorado had hip surgery in Chennai, India, whie Texan David Jones had tiple bypass surgery in New Delhi. Both patients were unissused. De Forrest's surgery cost $8,000, arc Jones's cost $16,000 including travel expenses. Had chose operations been done in the United States, they would have cost $45,000 and $250,000, respectively. Forrest and Jones are not alone: in 2007 some 750000 Americans traveled abioad for ‘matical wentment. The company Deloize is the number co reach 10 million by 2012, which would be worth about $21 billion tw those ma- dons where the procedures are performed. ‘Some might be worried ahout the quality of medical care in other countries, but medical tourists typically go to new hospitals, most of which are private, where highly skilled physicians treat them, many of whom trained inthe United Statesor Britain, The three lagest recipient counties of American patients ate Mexico (due tw its proximity), India (where 450,000 were treated in 2007), and Singapore (where more than 400,000 were teated in 2007, ard whese the local medi: fal schools ae considered to be among the very best in. the word). Costs in these countries generally run from 20 0035 percencof thosein the United Scares ‘A number of factors are driving the globalization trend. Fist there is the high costof medical care in the United States, which is the source of che lamest umber of patients. Then these is the fact that over 45 million Americans are uninsured and many more are “underinsured” and face high copayments for expensive procedures (although recent legislation in. the United States should change this over the next five year). Many of these people find ie far cheaper w fly absoad wo get treatment. Thind is the emergence of high-quality private hospital chains in places much as India and Singapore. Fourth, the rising coots of insur- ing their workforces are starting to permiade some large Americancompanies tolook sbecad. Asd finaly some insurance companies are experimenting with payanent for foreign treatment at internationally aceredited how pitas. In 2008, for example, Aetna, a lange insurer, launched a pdor scheme in partnesbip with Singapar- ean hospitals. Aema stared wo give Americans the op- ton whave procedures costing $20,000 or more in the United States performed in Singapore, where the com- pany reckon that the quality of care is better chan at the average American hospital! Case Discussion Questions 1. What ae the facditating developments thathave allowedhealth care to star globaliing? 2 Who benefits from the globalisation of health care? Who ae the loser? 3. Arethereany sche asoc ated with tbe globalica- tion of health care? Can these risks hemnieigated? Hout 4. On balance, db you think that the globalization of health care is good thing, or noe? Soure 'G. Calvin, “Think YourJob Gant Be Sent tw nda Forme, December 15, 2004,p. 80 A. Pollack, “Whois Reading Your We." Phe New York Times, Novembxs 16, 2008, pn 1.5: ‘Ancrypnous, “Sun, ond and sealpek, The Eaomt, March teh, 2007, page 2 Anomooun, “Operaing Profit, The Economist, Aupat L62h, 2008, 9p 74-76.R. Bade. “Hise ‘Abo, Ream, May 1009, gage 14