1. World Health Organisation (2010) Health systems financing: The path to universal health coverage. World Health Report. 2. Ibid. 3. All WHO Member States have signed up to the declaration of World Health Assembly resolution 58.33 in 2005 and have tasked WHO to develop an action plan to implement the 2010 World Health Report. 4. Millennium Development Goals 2015, United Nations 5. http://www.who.int/health_financing/UHC_ENvs_BD.PDF

No one knows precisely when humans started using cash in exchange of goods or services – history claims it

was 5000 BC. Are we going to keep using it until the next 7 millenniums?

Spoken truth, limited action -

Healthcare around the world is

unaffordable for millions of people,

and the cost of the medical

treatments continues to prevent

those with limited buying power

from seeking care. In parallel, this

condition pushes the many into

poverty each year after having the

access to the right care.

Globally, and especially in most of

developing countries – where

healthcare infrastructure is not well

built and fitting to the national

community, hardships due to the

costs spent on the medical needs, a

family financial situation can change

almost in a blink of an eye: assets

are sold, savings are emptied,

children are forcefully taken out of

school for not being able to cover

the tuition fee, family members give

up employment to provide care, and

social networks are strained due to

unpaid loans and repeated requests

for help.

Every year, catastrophic health

costs push millions of families into

intergenerational cycle of poverty1.

Only one of five people has social

security protection that will cover

lost wages in the event of illness2.

Given the fact, countries are

responsible for standardizing and

delivering universal access to

healthcare systems according to

their legal commitments for every

layer of economy their citizens are

positioned. However, many have

failed to understand that this is only

possible if they develop sustainable

health financing mechanisms and

infrastructure to support strong and

equitable national health systems.

Whilst the universal health coverage

holds the role as an instrument to

realise the healthcare rights for

every individual and promote social

consistency, equitable (even) health

financing systems contribute to

progress across all areas of

development. Those are the tasks

for the governments and world

leaders to carryon by prioritising

equitable health financing to deliver

health for all. Making progress

towards universal access to health

services is fundamental to go

beyond the globalisation to fulfil the

healthcare rights and to accelerate

social and economic growth.

In 1978, at the International

Conference on Primary Health Care,

world leaders promised to deliver

health for all3, and continue

pursuing targets related to global

health to achieve the health

Millennium Development Goals by

20154.

All efforts combined will continue to

fail unless they provide transparent

leadership and efficient health

financing and equitable health

services, ensuring that every

individual, especially the vulnerable

groups, are protected from costs

and risks.

What is universal health coverage?

Universal health coverage for health

is when all people have access to

health services (promotion,

prevention, treatments and

rehabilitation), without fear of

falling into poverty5.

When talking about health or

medical coverage, one cannot go

too far from the cost-perspective of

the care services given to the

patients. However, it is not the only

factor that matters. The financing

mechanism that is being used to

pay, direct users fees, insurance,

tax, crowd funding, or other

mechanism that may apply for

specific community. The availability

of health services, the quality of

care and predictability of costs that-

will be incurred also influence

health care coverage.

Thus, in order to develop the

universal access to healthcare, the

international community must

support developing countries to

raise funds for health, reduce

dependence on out of pocket

payments, especially through the

elimination of user fees, and

promote risk pooling in the form of

an increased proportion of public

financing for health spent more

efficiently and equitably.

Believing that healthcare is the

most critical human right that

effects every layer of economy,

government and the environment,

our digital hospital concept, MEDx

eHealthCenter, is combining the

power of technology and analytics

to improve the healthcare delivery

across the developing countries

through its seven care services

available on its online platform,

www.medx.care.

Health Coverage

Through Digital Healthcare

1 Glinos, I. A., Baeten, R., Helble, M. & Maarse, H. (2010), A typology of cross-border patient mobility. Health & Place.

2 Timmermans, K. (2004), Developing countries and trade in health services: which way is forward? Int J Health Service.

3 Ramírez de Arellano, A. B. (2007), Patients without borders: the emergence of medical tourism. International Journal of Health Services.

4 Turner, L. (2007), 'First World Health Care at Third World Prices': Globalization, Bioethics and Medical Tourism.

5 https://medx.care/about

Eindhoven, the Netherlands – the

global growth in the medical world

specifically, as well as medical

technology across national borders

have been developed into new

patterns of productions and

consumptions over the past

decades.

“A new trend has surfaced. A

growing trade in healthcare,

involving the movement of patients

choosing to cross the borders in the

pursuit of medical treatment and

health; a phenomenon called

‘medical tourism‘.” – MEDx Care

Medical tourism is an act when care

seekers opt to travel to different

countries, intending to receive –

based on personal belief or

information sought – ‘better’

medical treatment. The treatments

received may span the full range of

medical services, but most

commonly includes dental care,

cosmetic surgery, elective surgery,

and fertility treatment. Setting the

boundary of what is health, within

this range of treatments, not all

would be included within health

trade. Cosmetic surgery for

example, would not be considered

within the health boundary.

Medical tourism and the

globalisation

Medical tourists, when being

questioned of the reason behind

their choice to travel abroad to

receive treatments, gave answers

that can be based on economic,

social, cultural and technological.

Domestic health systems in many of

the emergent and growth countries,

for instance, are undergoing

significant challenges and strain –

tightened eligibility criteria, waiting

lists, non-transparent

infrastructures and shifting priorities

for health care have mostly direct

impact on the care seeker decision

making. Others, however, are driven

by their stronger purchase power

and therefore forms consumerism.

The storm of open information era

and development of diverse

providers competing on quality and

price now provide for all demands.

Unlike other forms of patient

mobility where decisions on behalf

of the patient are made by the

medical practitioners (doctors or

physicians), medical tourism

involves individuals acting as a

consumer and making their own

decisions regarding their health

needs, how these can best be

treated by the most appropriate

provider.

There are five driving factors behind

the rise of medical service overseas

phenomenon found by Glinos et al.,

(2006): familiarity, availability,

cost, quality and bioethical

legislation (international travel for

abortion services, fertility

treatment, and euthanasia

services)1.

In terms of familiarity, expatriates

often have medical care on their

visits back to their home country,

which would also show up as

medical tourism, for example, the

large Indian Diaspora in the UK.

Some treatments may not be

available or may be subject to a

wait in the home country

(availability), this may include

latest technology and techniques

that require more funds to be spent

(cost and quality). Or else,

treatments that may not be legal in

the country of origin (bioethical).

Different origin and destination,

same purpose

Some places may be simultaneously

acting as countries of origin and

destination in the medical tourism

marketplace. High-income countries

may service overseas elites from

‘less developed’ countries, driven

by the price and quality. Treatments

may often be available in their

origin countries and equal to the

international healthcare standard

within the private sector, but at

greater cost – often referred as

“better developed countries’

medical services are less worrisome,

more trusted”. In parallel, the

citizens coming from richer, more

developed nations choose to travel

as medical tourists to Lower and

Middle Income Countries for

treatments due to lower-cost

treatments. This section focuses on

the implications for countries from

the perspective of them being an

origin or source of medical tourists.

Example of Medical Tourism advertisement in

India. Picture credit to peachealthcare.net

There are, though, financial impacts

on individuals and their families.

Some families may fall into debt to

fund treatments. It is also the case

that not all medical tourism may

consume considerable family

resources. All in all, benefits and

risks from the medical tourism are

applicable to both of origin and

destination countries.

Most countries that engage in

delivering care to medical tourists

do so to increase the level of direct

foreign exchange earnings coming

into their country; to improve their

balance-of-payments position

(Timmermans, 20042, Ramírez de

Arellano, 20073, Turner, 20074) . To

some extent this might be income

thought of as accruing directly to

the health system. For instance,

foreign patients purchase health

care services, and hence provide an

income that can be used within

hospitals to cross-subsidise care for

domestic patients, or could be used

The Pursuit of

Medical Treatments Abroad

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to help fund capital investment,

such as MRI scanners, that are then

used by all patients in the hospital.

It is therefore possible that some

countries may seek foreign patients

in order to develop facilities to

better serve local patients.

On the other hand, this practice has

helped the care seekers mostly in

the emergent countries, exposing

themselves that there are actually

other chances for them to be

treated (more) appropriately – the

only concern is that not everyone

has the privilege to elect their

preferred treatments.

Current and potential risks from

medical tourism

Medical tourism as a trend creates

risks to the local medical

practitioners of the origin countries

with more competition of the price,

quality of treatments and services,

and to the nation’s healthcare

credibility. At the same time,

international patients also puts

more pressure to the destination

countries’ medical services with

expectations and the limited space

available – which was primarily

designated for the local patients.

Other risk at social level which has

been increasing and becoming the

governments’ of the destination

countries concern nowadays is that

patients are refusing to go back to

their home countries, claiming their

human rights from the perspective

of healthcare, and trying to become

“permanent residents” to gain equal

rights as the local citizens.

Combining the phenomenon and

what it means to the international

society, MEDx Care, as the pioneer

in the digital hospital market,

provides the care seekers with first

and/or second opinion from medical

professionals across the border3,

without actually spending extra

pennies to seek for the treatment

abroad – unless advised the

otherwise.