It has long been thought that health care is one of the industries least vulnerable to dislocation from globalization. After all, like many service businesses, health care is normally delivered where it is purchased. However, for some activities and procedures, this is now fast changing. The trend began with certain diagnostic procedures, such as MRI scans. The United States has a shortage of radiologists, the doctors who specialize in reading and interpreting diagnostic medical images, including X-rays, CT scans, MRI scans, and ultrasounds. Demand for radiologists has been growing twice as fast as the rate at which medical schools are graduating radiologists with the skills and qualifications required to read medical images. This imbalance between supply and demand means that radiologists are expensive; an American radiologist can earn as much as $400,000 a year. In the early 2000s, an Indian radiologist working at the Massachusetts General Hospital, Dr. Sanjay Saini, found a way to deal with the shortage and expense—send images over the Internet to India where they could be interpreted by radiologists. This would reduce the workload on America’s radiologists and also cut costs. A radiologist in India might earn one-tenth of his or her U.S. counterpart. Plus, because India is on the opposite side of the globe, the images could be interpreted while it was nighttime in the United States and be ready for the attending physician when he or she arrived for work the following morning. 

The globalization trend has now spilled over into surgery. In the fall of 2008, for example, Adrienne de Forrest of Colorado had hip surgery in Chennai, India, while Texan David Jones had triple bypass surgery in New Delhi. Both patients were uninsured. De Forrest’s surgery cost $8,000, and Jones’ cost $16,000, including travel expenses. Had those 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 750,000 Americans traveled abroad for medical treatment. The consulting company Deloitte is forecasting the numbers to reach 10 million by 2012, which would be worth about $21 billion to those nations where the procedures are performed. 

Some might be worried about 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 in the United States or Britain. The three largest recipient countries of American patients are Mexico (due to its proximity), India (where 450,000 were treated in 2007), and Singapore (where over 400,000 were treated in 2007, and where the local medical schools are considered to be among the very best in the world). Costs in these countries generally run from 20 to 35 percent of those in the United States.

Questions

1. What are the facilitating developments that have allowed health care to start globalizing?

2. Who benefits from the globalization of health care? Who are the losers?

3. Are there any risks associated with the globalization of health care? Can these risks be mitigated? How?

4. On balance, do you think that the globalization of healthcare is a good thing, or not?