International Trade in Services.pdf - DSpace at Khazar University

112 International Trade in Services
Mode 4
Imports under Mode 4, if not properly managed, could raise a number of
issues. First, Mode 4 movements of personnel are often confused with permanent
migration. The media has related a number of stories about nurses and,
sometimes, doctors from developing countries who have been exploited while
working on assignments abroad. Foreign temporary employees could be perceived
as a threat by national employees if different labor conditions apply
(including salary). This is, unfortunately, a frequent scenario, and, while it is not
a disincentive for Mode 4 trade, importing countries should make a special
effort to avoid such abuses and more closely regulate the temporary movement
of health personnel.
The Export Side: Trade in Health Services as an
Engine of Export Growth and Diversification
Exports are the focal point of a large segment of the literature on trade. The gains
promised to participants in the global race for medical tourism have caused countries
to enter the race. Long neglected, trade in health services now appears as a
credible engine of export growth and diversification in selected developing countries.
While the benefits could be important, it should be noted that not all countries
have a comparative advantage in the sector, and some forms of export could
have negative effects domestically unless adequate accompanying measures are
adopted.
Global trade and prospects at a glance
Statistics on trade in services are generally scarce and imprecise, in part because
services are intangible and, hence, long considered nontradable. Health is no
exception, and it remains difficult to assess the real size of the global market in
the trade in health services. Estimates vary significantly. For example, a 2004
McKinsey study reported that 150,000 foreigners had visited India for treatment
that year, while a more recent 2008 study by the same consulting firm suggested
that the market is not as large as reported and placed the current market at
60,000 to 85,000 medical tourists a year (Ehrbeck, Guevara, and Mango 2008).
Another consulting firm, Deloitte (2008), estimated the value of the world medical
tourism market at around US$60 billion in 2008 (expected to grow to
US$100 billion by 2010), with more than 1 million medical tourists annually
and 750,000 outbound from the United States alone (the latter expected to
reach 6 million by 2010).