Health Affairs, 25, no. 2 (2006): 357 doi: 10.1377/hlthaff.25.2.357 © 2006 by Project HOPE	New Online   Pay Cuts For Medicare Docs   Access To Care Woes   Public Coverage More Efficient   Empowering Consumers

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Insurance

PROLOGUE

Facets Of Insurance Coverage Worldwide

Although considerable variation exists in the number of service sectors member nations are willing to submit to the purview of these governing principles, the sheer magnitude of the multi-trillion-dollar trade in health care services is likely to continue to compel robust exploration and expansion of attempts to lure domestic health care sectors into the global marketplace. Not surprisingly, such interest has multiplied the vehicles through which global trade in health care services manifests itself, including foreign direct investment in health services ventures and transnational migration of health professionals. Among the most storied examples is the steady growth in medical tourism: the movement of residents of largely developed countries to developing countries capable of providing high-quality health care procedures at a fraction of their home-country cost. In 2003 the number of patients traveling to Cuba, India, Jordan, and Southeast Asia alone exceeded 350,000. Beyond the direct progeny of trade in health care services, such as medical tourism, however, lies the equally important, indirect implications of such globalization: the free flow of ideas. A potentially powerful incarnation of such intellectual migration can be seen in efforts to explore the feasibility of applying private health insurance concepts to developing countries.

The papers that follow lend insight into both such direct and indirect manifestations of the growing trade in health care services. First, Aaditya Mattoo and Randeep Rathindran attempt to quantify the sizable cost savings possibly accruing to the U.S. health care system from the strategic travel of U.S citizens abroad for certain health care services and procedures, and they identify the myriad obstacles inhibiting realization of such savings inherent to the existing health insurance infrastructure. Next, Mark Pauly and colleagues relate analysis flowing from a 2005 Wharton School conference convened to discuss potential effiencies to be had from application of private health insurance to developing-country contexts—particularly those with high rates of out-of-pocket medical spending—and factors inhibiting the emergence of this application.

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