A research paper dealing with various elements such as how American companies
function abroad this will be presented as a background using the readings provided abroad and
also my personal research on how American companies operate abroad. Also it will contain the
effects that it has on consumers. The main goal being to understand the effects of medical
tourism to American businesses, how they are conducted in America and also around the world
and hoe this in turn relates to the companies and their consumers. And mainly is the main
concept of medical tourism.
Firstly, we will start with an abstract, currently health services are being
advertised in the worldwide markets. Medical processes such knee and hip replacements, cardiac
and cosmetic surgeries, ophthalmologic practices, transplants of organs and even cell and stem
injections can all be purchased now in the market place for global health services. According to
Turner (p. 443-467), Companies associated with medical tourism are currently marketing sun
and surgery facilities and are making use of international hospitals in Costa Rica to arrange for
the packaged medical care they advertise. India, Mexico and Costa Rica are among the countries
being used too. The same way textile manufacturing and automobile production moved away
from America, Americans travelling overseas to seek facilities that are cheap in order to benefit
from the competitive advantage that is currently present in the world marketplace.
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There is an argument according to Turner (p. 443-467), from the proponents of healthcare
tourism that consumer choices will be promoted by a global market in the healthcare services, it
will also step up competition among health centers and hospitals and also enable patients to be
able to gain full access to high quality health care facilities that are available worldwide.
However there is a growing concern on the quality of patient care from the skeptic’s side. Also
the authenticity of information that is availed to the patients, legal redress in instances where
patients are harmed while undergoing healthcare at international health centers.
The emergence of worldwide markets for medical services will have a significant effect
upon medical insurance in America. According to Turner (p. 443-467), Medical service delivery
will also be affected as well as the relationships between medical practitioners and their patients.
According to Ganesh the whole concept of medical travel is not new to the global
marketplace. This is because historically it has involved the wealthy people travelling across the
world in order to seek the best medication for their illnesses. This was mainly practiced by
individuals from developing countries where the health facilities there were not advanced enough
to treat their illnesses hence they travelled to developed countries in search of proper medication
for their facilities. However (Ganesh) sees that a new type of medical travelers has come up.
They were referred to as medical tourists that consist mainly of typical of middle class families
from developing countries travelling to seek proper healthcare abroad.
According to (Ganesh) medical tourism can also be referred to as crossboader healthcare
or wellness tourism and the industry has been evolving at quite a high rate. The whole concept of
medical tourism currently is widely referred to as the act of a person not preferring medical
facilities from his country of origin and opting to travel overseas to undeveloped countries in
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order to seek the same facilities but at a lesser cost compared to their own homeland. The
increased popularity among middle class people has been the biggest contributor to the
increment in interests of medical tourism because costs of domestic health care have risen to
unprecedented levels and also due to the fact that it is the working class that is bearing the
burden of increments in insurance costs. Therefore to free themselves of such burdens the
citizens opt for medication overseas and this in turn affects heavily businesses in America like
the insurance companies because if people are not taking up premiums then the profits from
health insurance covers will reduce. Also the hospital revenues will reduce since the number of
patients admitted will be reduced.
This conditions have made more people to opt for foreign destinations for healthcare
facilities. According to (Ganesh), it that in this world full of increased globalization, it is crucial
for any citizen to understand the contributing factors to these trends and the effect that this trend
has on the citizens and foreign countries and foreign companies as well. This paper will try and
identity some of these causes and effects of medical tourism on various variables in our society.
The medical care sector is quickly changing a worldwide economy. Healthcare providers in the
USA are in stiff competition from the international sector. They are competing for patients with
countries mainly from Asia like India and Thailand. This is because patients now travel overseas
to these countries to seek medical assistance in processes such as cardiac surgery orthopedic
processes because the countries offer them at lower costs and lower waiting time. This has
affected doctors in America due to the medical care sector being transformed from what was
formally a domestic industry where domestic doctors in the united states of America used to
compete with other for patients residing in America to a worldwide affair where the actual
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competition now takes place more in the global healthcare industry as Laura Dyrda stated
(Beckers spinereview).
This has affected both doctors’ and medical health care providers in the United States of
America a lot. For example it costs in the united states of America $40000 to replace a hip while
overseas in India the same process costs only $3000, to get a heart bypass in America can cost up
to $250000 while overseas in Bangladesh the same process costs only $2000. India it costs
around $15000. Not only that but the hospitals in these nations have got international
accreditations which allegedly prove that their standards are more like the same with the
hospitals here in the united states of America. They also have adopted modern high quality
technology facilities for complex medical processes like heart transplants also by passes.
According to Ms. Nachum (Beckers spinereview) some of these hospitals offer accommodation
for families that came with their patients, others have even gone a knot higher by providing
facilities where the patients recover.
This has really affected businesses in America in respect to health facilities compared to facilities
abroad. The revenue in this sector has really declined while overseas the revenue has really
appreciated. For example according to a report by IMTJ through medical tourism it is anticipated
that a $3billion revenue to be generated by the hospital in Thailand as listed in the Thailand
stock exchange alone and the income earned has registered a 15% increment over the years. This
shows just how strong the medical industry in these Asian countries is flourishing at the expense
of the local American healthcare industry. Hospitals such as Apollo group of hospitals are now
expanding even more by the day. They currently operate almost 55 branches in the global
market, the hospital headquarters are in India. All this is showing how the medical trends are
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forming at the expense of various hospitals in the United States of America. All this applies
pressure on the costs of medical health care and also the take up rate of medical health care
insurance here in the United States of America. Various transformation in America are supposed
to happen in order to justify the high operational costs that are present in the country.
According to IMTJ the impact on physicians has also been felt to some extent owing to the fact
that the pressure on costs leads to low wages in America too for the physicians who paid a lot in
terms of tuition for their studies in college. Those makes most of them have a lot of money to
pay back the student loans they took up in order to finance their college educations these loans
cannot be paid in time if the salaries doctors are paid are below the required standards. This
applies a lot of pressure on medical doctors’ especially those with families to bring up,
mortgages to pay, and food to provide among other basic needs. Therefore the medical tourism
industry has a very huge impact both on the medical doctors and medical facilities in America
through the stiff competition it provides and this impact is increasingly being felt as the years go
by.
Currently an approximate of 5.7 million Americans in America are on part time jobs
although they prefer full time employment that is according to (The economist), hence if these
companies are returned to the united states of America then the part time employed citizens will
be able to secure full time employment while the little un employed also will get job
opportunities.
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This assumes that by taking back the companies from overseas back to America jobs
would be returned back to American as well but now, will Americans be willing to accept the
same low wages paid to workers overseas, if not so then the returning of these companies to the
united states of America will also carry a cost that might have a bigger side effect as highlighted
by (TheBalance). This is because if the locals don’t accept lower wages this would increase the
price of commodities in order to give the citizens their required wages and hence it will increase
the standards of living and some of them might not be able to afford those prices.
Also there is another assumption they are basing upon. The assumption that the
unemployed have the competency needed which necessarily might not be true they may not be
competent enough hence may not benefit much when these farms are returned back to the united
states of America since they will still be left unemployed if they don’t qualify to work in the
companies as explained by (TheBalance). Donald Trump however has vowed that his
administration would renegotiate trade treaties such as NAFTA. He also said that he will add
tariffs on commodities that are imported from china and Mexico. This would increase the prices
of commodities made in those countries and hence in turn will benefit the companies that are
currently producing their goods in America since the prices of foreign produced commodities
will be higher relative to those that are produced locally.
On the other point of discussion on medical tourism, according to (news-medical), it
refers to citizens of a given nation travelling to a foreign country in search of medical facilities
but nevertheless the main reason why the name tourism has been attached there is the fact that
after the treatment process is complete the patients normally opt to stay in the foreign countries
for a bit longer in order to take part in the normal traditional tourism practices like visiting
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historical sites, sightseeing and also by taking day trips to different parts of the foreign country.
Industry concerned with medical has grown steadily for quite some time now. Studies suggest
over 70000 people of the tourists that travel across the world do so for medical purposes. The
best medical destination for these tourists are countries like India, Singapore, Thailand and
Mexico. But is the entire process of medical tourism safe for consumers in America? Becomes a
question in need of an urgent research based answer
The doubt in medical tourism safety is obvious, according to (medicaltourism). When a
person decides to seek medication from a foreign destination a lot of questions arise that require
accurate immediate answers. An example being what are the possible side effects of undergoing
the treatment process. Does the patient have assurance that the medication sought will be
successful? What is the level of trust that the patient has in the agents used to source for this
treatment. Also what are the qualities of these medical centers? Do they meet the required
standards that the patient consider to be appropriate? This are the types of questions that the
patient needs to answer before embarking to a foreign destination in search of treatment.
Nevertheless a significant number of people travel for treatment overseas in destinations
that are proven and also the cost of operations in those countries is relatively cheap compared to
their own countries. (Imtj). For treatments with proof, the clinics, doctors can provide the agents
accreditation documents from the ministry of health in those countries as an effort to assure the
patient of their competency, the patient can also be provided with proof of medical qualifications
of the practitioners employed in the hospitals. Some of these hospitals and medical centers
normally go a step further to provide the patient with historic outcome data of the medical
activities undertaken by the clinic such as surgeries in order to prove their competency. This
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normally answers questions like, "does the patient have an assurance that the medical facilities
sought for actually work?" And also the questions about the qualities of these medical standards
among many other that arise.
Unfortunately some countries lack national health standards. Therefore all the crucial
information needed that has been provided above is not available. In this case it becomes very
risky for the consumer to seek treatment from such facilities. Normally in this cases the patients
are left with no option but to trust the claims made by the practioners in these medical centers
without solid proof. (Imtj). Not even accreditation at the international level by bodies such as JCI
is a quality guarantee for medical facilities. Nor is this an assessment to find out how competent
is a hospital in delivering its medical facilities to its consumers. So medical travel for American
consumers for activities that are delicate such as cosmetic surgeries, elective surgeries and even
dental surgeries is not safe as such since there is a lot of work that still needs to be done in these
destinations in order to upgrade their medical services to assure quality and effectiveness for
American consumers is same or high than in the united states of America.
A bigger question on matters concerning safety of foreign medical destinations comes
when a person decides to travel overseas to seek medical treatment on treatments that are yet to
be approved in the United States of America (TheBalance). A good example for such a case is
multiple sclerosis treatment. Liberation therapy is one which aims to increase blood supply go
the brain and it does so by increasing the size of the neck veins, they open them up. Some
medical practioners believe that this process can increase locomotive abilities of a person and
also reduce MS attacks from occurring. This treatment process however still does not have back
up from extensive medical research, therefore it is yet to be approved to be carried out by any
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national medical system in the United States of America. Although there have been success on
the above process and also legit testimonials as well testifying to the effectiveness of the process,
there have been failures as well.
An example of a failure is the recent death a Canadian patient which made the headlines
of many media houses, the patient had travelled all the way to cost Arica in search of the
liberation therapy treatment. (Imtj). Doctors in Canada commented about this by saying that this
was a cautionary scenario for patients who opt to travel to international destinations to seek
treatment of unproven experiments. While the process has not yet been subjected to trials in the
United States of America. Multiple patients that have been seeking treatment for such procedures
have spent thousands of dollars for the procedure in countries like Poland and India.
Much of the work concerning the above process has been conducted by an Italian
professor that goes by the names Paulo Zamboni who concluded that the treatment process is still
in its assessment stages. (Imtj).Here they are trying to internalize the relevance of the whole
process and also its appropriate audience.
But there is a key factor which undermines the entire process of safety measures and
standards regulatory bodies from resulting travelling agents from advertising the foreign
destinations that offer such facilities and that is the availability of a ready highly profitable
market which is very tempting as explained by (Imtj).
Therefore very many travel agencies have been set up because see the process an income
generating one and some of these agencies are even yet to be accredited here in America bit still
advertise their facilities in the underground market away from the eyes of the American
regulatory board as shown in (Imtj). For example the NS stated above alone has an approximate
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of about 2.5 million patients. The cost of the treatment is an estimated $10000. This shows just
how highly profitable the market is hence making the work very tough on American law
enforcement agencies.
To wind up is that American firms are moving overseas and the main reason for this is
due to the high cost of production in their own country that is the United States of America. They
operate using various systems like the mergers and choosing of foreign domiciles in order to cut
down their expenses and to increase profits. This process affects both the consumer and The
Company in the sense that the consumer gets goods at relatively lower prices compared to the
locally made ones while the company increases its profits. Medical tourism on the other hand is a
key issue that is coming up and the safety of the destinations here is questionable owing to the
health standards in the foreign countries in respect to America hence citizens have to be very
cautious when choosing their foreign medical destinations.
Also to add is the fact that when tourists leave America for foreign destinations in such of
health facilities, it affects American businesses as we have seen in the sense that there will be a
decrease in consumption expenditure in form of patients taking up medical insurance covers will
reduce in America since most of them prefer foreign destinations. Also most private hospitals
offering facilities will be paralyzed because of the consumer choice preference that is making to
travel abroad. Hence making the overseas insurance companies and hospitals to flourish.
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The economist. How American firms operate overseas, 2017,
www.economist.com/blogs/economist-explains/2015/08/economist-explains-9 .
Accessed 2017.
The Balance. Effects of American companies transferring their operations abroad. 2017.
https://www.thebalance.com/how-outsourcing-jobs-affects-the-u-s-economy-3306279 .
Accessed 2017.
News-medical. Explanation on the concept of medical tourism. 2010.
www.news-medical.net/health/What-is-Medical-Tourism.aspx .
Accessed 2017.
Medicaltourism. Safety measures of medical tourism. 2017.
www.medicaltourism.com/blog/how-safe-is-medical-tourism/
Accessed 2017.
Imtj. A proper understanding of the reasons for medical tourism its effects. 2017.
https://www.imtj.com/blog/can-patient-ever-be-sure-treatment-will-work/
Accessed 2017.
Medicaltourism CDC. The market nature of the medical tourism industry. 2017.
https://www.cdc.gov/features/medicaltourism/ . Accessed 2017.
Thebalance. The effect of foreign American companies on domestic consumers and on the
companies themselves. 2017.
https://www.thebalance.com/how-outsourcing-jobs-affects-the-u-s-economy-3306279
Accessed 2017.
Turner, Leigh. “Medical Tourism” And the Global Marketplace in Health Services: U.S.
Patients, International Hospitals, and the Search for Affordable Health Care". International
Journal of Health Services, vol 40, no. 3, 2010, pp. 443-467.
Ganesh Maniam. “Medical tourism as a result of rising American healthcare costs in the context
of healthcare globalization.” International journal of health services. Accessed 2017.
Beckers spinereview. Effects of medical tourism on american doctors and health facilties. 2015.
Beckers spinereview. Effects of medical tourism on American doctors and health facilities. 2015.
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www.beckersspine.com/orthopedic-spine-practices-improving-profits/item/27350-how-
the-global-healthcare-economy-will-impact-us-providers-5-key-trends.html