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Medical Tourism, Access to Health Care, & Global Justice
I Glenn Cohen
Medical tourism – the travel of patients from
one (the “home”) country to another (the “destination”) country for medical
treatment – represents a growing business. A number of authors have raised the
concern that medical tourism reduces access to health care for the destination
country’s poor and suggested that home country governments or international
bodies have obligations to curb medical tourism or mitigate its negative
effects when they occur.
This article is the fi rst to comprehensively
examine both the question of whether this negative eff ect on access to health
care occurs for the destination country’s poor, and the normative question of
the home country and international bodies’ obligations if it does occur. I draw
on the work of leading theorists from the Statist, Cosmopolitan, and
Intermediate camps on Global Justice and apply it to medical tourism. I also
show how the application of these theories to medical tourism highlights areas
in which these theories are underspecified and suggests diverging paths for
filling in lacunae. Finally,
I discuss the kinds of home country, destination
country, and multilateral forms of regulation this analysis would support and
reject.
I. Preface
II. Introduction
III. Kinds of Medical Tourism, Kinds of
Ethical Concerns
IV. The Empirical Claim
V. The Normative Question
A. Self-Interest
B. Cosmopolitan Th eories
C. Statist Th eories
D. Intermediate Theories
1.
Cohen, Sabel & Daniels
2.
Pogge
VI. Convergence, Divergence & Policy
Prescriptions
VII. Conclusion: From Medical Tourism to Health Care Globalization