The Henry Fords of Healthcare: …Lessons the West Can Learn from the East by Sanandaji Nima;

Author:Sanandaji, Nima;
Language: eng
Format: epub
Publisher: London Publishing Partnership
Published: 2020-03-11T12:38:18+00:00

Exporting healthcareTravelling abroad to receive healthcare is not an entirely new phenomenon. The ancient Greeks constructed temples in honour of their god of medicine, Asclepius. These became some of the world’s first health centres. People travelled far to these temples in order to seek cures for their ailments. That people can travel to get the best available healthcare is in fact a good idea, at least for specialised treatments and those patients who are able to travel. However, the modern welfare systems of Western countries have been built upon the principle that health services should be provided in local hospitals. Patients seldom go to other regions, and even more rarely to other countries, to receive higher-quality specialist care.

The health sectors of Western countries are not completely closed to the idea of trade in healthcare. As an illustrative example, the small country of Iceland has a deal with the public health system in Sweden. Each year a small number of patients are flown from Iceland to Sweden to get specialised care. And the European Union has a scheme enabling citizens of member countries who work in or travel to other member countries to get treatment abroad. The member country pays the healthcare bill to the country in which the treatment is given. On the whole, however, health trade is not a major phenomenon in Western health sectors.

The reason is not necessarily that those in charge of public-sector health systems are against the idea of health trade. Their administrators have long flirted with the idea of selling health services to other countries, perhaps driven by the notion that their model of health delivery is superior to those of neighbouring countries. However, as is the case for other goods and services provided by the state, publicly financed and organised healthcare has not successfully been internationalised. There are some examples of specialised hospitals in the West. One example in the UK is Moorfields Eye Hospital, a specialist NHS eye hospital in London run by a Foundation Trust. Such hospitals do attempt to attract foreign patients but their ability to do so is limited. The organisation and financing of healthcare in European welfare states does not encourage trade in health. As a result of the lack of trade, even within regions in the same country, Western healthcare has a relatively low level of specialisation. Local hospitals often have to provide nearly all treatments that can be demanded. This lack of specialisation, and therefore economies of scale, reduces efficiency. An analogy can be made with restaurants which have such a broad menu that they fail to excel in any particular category.

Globally, however, health trade is growing in importance. The OECD explains that healthcare provision has undergone a process of globalisation in recent decades, giving rise to new patterns of consumption and production. Patients increasingly cross borders in the pursuit of medical treatments, a phenomenon commonly termed ‘medical tourism’ (Lunt et al. 2011; OECD 2014). Some European countries, such as Luxembourg, import a significant share of health services from their neighbours rather than producing all services themselves.

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