Global Health and Foreign Policy

Feldbaum, Harley; Lee, Kelley; Michaud, Joshua

Countries also increasingly trade in health services, traditionally regarded as nontradable, as a result of advances in information and communication technologies, increased international mobility of service providers and patients, and growing participation by the private sector in health care (64) . Under the World Trade Organization's General Agreement on Trade in Services, trade of health services is categorized under 4 modes: cross-border delivery of samples or services, consumption of health services abroad, establishment of health facilities by a foreign-based concern, and movement of health personnel across borders (65, 66) . While the extent to which trade occurs varies across these modes, there is a general trend towards increased trade in health services (67, 68) . There are potential opportunities arising from such trade, including efficiency, specialization and quality gains, public sector cost savings, expansion of service provision, export revenues and remittances, transfer of technology and skills, and increased patient choice. The risks concern distributive consequences for domestic patients and the possible ''brain drain'' of health professionals from resource-scarce countries (69).