Chapter 7: Health Tourism: The Costs
Both the importing and the exporting side derive benefits from trade in health. As well as the gains there are also the risks. This chapter shows that it would be a mistake to assume that the balance will necessarily end up in the black. 7.1 THE COUNTRIES THAT BUY In the importing countries there is a danger that the exit option will put off the solution of the underlying problem. The uninsured and the uninsurable seek treatment abroad because America cannot guarantee them affordable medical care at home. The well-heeled and the anxious buy shorter waits in foreign countries because Britain is not satisfactorily reducing the queues in its National Health. The middle classes who can pay get the prime cut. The poor who cannot pay get what they are given. It is the dual standard all over again. Globalisation is privatisation. Privatisation is life-chances shaken up. A refuge for the educated and the mainstream, the market creams off some of the most vocal spokesmen for higher standards and better amenities. It is unlikely that the old, the disturbed and the deprived will be able to lobby as effectively for themselves if the middle classes opt out into an apartheid of their own construction. It was precisely this kind of stratified separation, Titmuss writes, that Britain’s NHS in 1948 had been created to destroy: ‘The middle-classes, invited to enter the Service in 1948, did so and have since largely stayed. . . . Their continuing participation, and their more articulate demands for improvements,...
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