International Trade in Services.pdf - DSpace at Khazar University

110 International Trade in Services
trained in specialties that are sometimes not available locally. In turn, this contributes
to facilitating technology and knowledge transfers.
The flexibility of Mode 4 also allows some countries to remedy shortages
among the health care providers in remote or underserviced areas (see, for example,
Canada). In many countries, the attribution of visas to health personnel is
subject to economic needs tests.
Risks associated with increased trade or aversion to opening
Domestic health markets are significantly regulated and are often characterized by
a high level of protection against imports. The motives underlying some regulation
and protection may be legitimate, although a number of measures help mitigate
the risks and maximize the benefits of opening. A distinction should be made
according to the mode of service supply and according to whether the service is
provided or consumed domestically or abroad.
Mode 1
So far, trade in health services under Mode 1 has remained limited mostly for
technological reasons. At the current level of technological development, Mode 1
does not appear to be cost efficient. For other services ancillary to health, such as
back-office or transcription services, the argument may not prevail; however,
these activities could be a challenge for regulators, for example with regard to
securing the confidentiality of medical information.
In general, Mode 1 imports could fall through the cracks of domestic regulation.
How does one ensure that a doctor operating abroad meets all the qualification
criteria or respects applicable medical ethics rules Mode 1 trade in health
services could increase the risks of malpractice unless an adequate regulatory
framework is put in place.
Mode 2
Mode 2 and trade in general should not become a substitute for domestic reforms.
In the case of Oman, government-sponsored medical travel is supplemented by
domestic reforms aimed at limiting imports under Mode 2 (see box 4.1). Between
1990 and 2006, the number of Omani seeking treatment abroad was cut in half;
investment in an oncology center meant that the number of patients seeking such
treatment abroad dropped by 92 percent. In Abu Dhabi in the United Arab
Emirates, government-funded medical travel for cardiology decreased by 55 percent
from 2004 to 2006 after a surgery team specialized in cardiology and with significant
international experience was set up in the city (Ehrbeck, Guevara, and
Mango 2008). Mode 2 imports are only second best and should remain a temporary
solution awaiting domestic capacity building. 3