Most of us have at least a rough sense of what globalization means when it comes to cars, movies, vegetables, and information technology. But what does it mean when it comes to health care?
A Google search on “health care” and “globalization” mostly leads to articles that focus on medical tourism, which is when patients travel—sometimes across the world—to receive treatments. When patients travel for care, sometimes at the urging of large employers or whoever is paying for the service, it’s typically to receive treatment at a discount from what it would cost near their homes, though sometimes it’s to receive treatments that aren’t available locally, or that in some way aren’t delivered as well.
But as I’ve written here in this blog and elsewhere, medical tourism isn’t the big trend it’s been anticipated to be, and it will likely become even less important. That’s because we’ll see the worldwide gaps in health care prices, availability and quality start to shrink, as countries with advanced health care systems grapple to control their costs, and other countries improve quality and access. The result is that more people will be able to get the treatment they need more locally at costs that aren’t terribly out of line with other places in the world. This is a very good thing, because people who need medical treatment shouldn’t have to add the burden of travel to their already challenging situations.
Also turning up on Google under search results for health care globalization, but in a distant second place, is the idea that physicians, nurses and technicians will move to other countries to work. That is, health care professionals are to some extent becoming exports via immigration or expatriation. That’s a trend that’s been going on for a long time, and will likely continue for the foreseeable future, given mismatches in various countries’ health care demands, labor costs, employment levels, and training availability, among other factors. But whether it’s a good representation of globalization is another question.
Health care globalization will ultimately be about the more fluid flow of services, expertise and information across borders. That particular interpretation of health care globalization is scarce among the Google search results. A small exception is the World Health Organization’s website, which while it more prominently cites medical tourism and immigrant/expat health care labor as examples of globalization in health care, also includes these three lines as defining the trend:
The increase in private companies, including foreign companies, which provide health services and health insurance schemes.
The use of new technologies, such as the Internet, to provide health services across borders and to remote regions within countries.
....Openness to foreign goods, services, ideas and policies, and people.
Buried in those few words is a world of opportunity to improve health care around the planet, and one that could go far beyond sending patients to other countries for hip replacements or importing nursing staff. Therein lies the future of health care globalization: Collaborations between private health care organizations, insurers, NGOs, government agencies, academic centers, investors and others, coming together across borders to sustainably expand and improve health care systems.
Those collaborations can involve the flow of experts who visit to help design and develop hospitals and clinical programs, of procedural and physical tools that enable improvements, of telemedicine that augments local capabilities, of private investment to support new projects, and of managers who can teach others how to keep things running smoothly. We at Johns Hopkins Medicine International have been helping to provide and orchestrate these sorts of collaborative services in dozens of major health care projects all over the world for two decades, and more and more of our fellow academic medical centers and other organizations are joining in.
Yes, we’re also involved in helping patients who travel internationally for treatment, and in bringing in staff who come from other countries to work at our hospitals and projects. Sure, that’s part of globalization. But health care globalization at its best will be about bringing a vast range of international resources to bear on comprehensive local solutions. It has been exciting for us at JHI to help pioneer that trend, and I look forward to watching it grow in the coming decade.No Comments