How health insurance inhibits trade in health care

Health Affairs

Volumn 25, Issue 2, 2006, Pages 358-368

  Mattoo, Aaditya ^a   Rathindran, Randeep ^b  

^a WORLD BANK   (United States)

^b HDR/HLB Decision Economics Inc   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

COMMERCIAL PHENOMENA; COST CONTROL; DEVELOPING COUNTRY; ECONOMICS; ETHNOLOGY; HEALTH CARE COST; HEALTH CARE DELIVERY; HEALTH INSURANCE; HEALTH SERVICE; HUMAN; INSURANCE; INTERNATIONAL COOPERATION; REVIEW; TRAVEL; UNITED STATES;

COMMERCE; COST SAVINGS; DEVELOPING COUNTRIES; HEALTH CARE COSTS; HEALTH EXPENDITURES; HEALTH SERVICES; HEALTH SERVICES ACCESSIBILITY; HUMANS; INSURANCE COVERAGE; INSURANCE SELECTION BIAS; INSURANCE, HEALTH; INTERNATIONALITY; TRAVEL; UNITED STATES;

EID: 33645676896     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.25.2.358     Document Type: Review

References (27)

1. J. Moorhead, "Sun, Sea, Sand, and Surgery," Guardian (London), 11 May 2004.
2. Compiled from sources such as the British Medical Journal, Tourism Authority of Thailand, Singapore Health Ministry, Malaysian Department of Statistics, Confederation of Indian Industry, South Ask Network of Economic Research Institutes, Jordan Times, and Cuba Travel USA. Also see J. Arunanondchai and C. Fink, "Trade in Health Services in the ASEAN Region" (Unpublished paper, World Bank, 2005).
3. American Medical Association, Physician Characteristics and Distribution in the U.S. (Chicago: AMA, 2004).
4. G.T. McMahon, "Coming to America - International Medical Graduates in the United States," New England Journal of Medicine 350, no. 24 (2004): 2435-2437.
5. M. Liu and H. Yamagata, "Trends among Foreign Graduate Faculty at U.S. Medical Schools," Analysis Brief 3, no. 1 (Washington: Association of American Medical Colleges June 2000).
6. B. Brush, J. Sochalski, and A. Berger, "Imported Care: Recruiting Foreign Nurses to U.S. Health Care Facilities," Health Affairs 23, no. 3 (2004): 78-87.
7. J. Lancaster, "Surgeries, Side Trips for 'Medical Tourists': Affordable Care at India's Private Hospitals Draws Growing Number of Foreigners," Washington Post, 21 October 2004.
8. U.S. Census Bureau, Income, Poverty, and Health Insurance Coverage in the United States: 2003, Current Population Reports P60-226 (Washington: U.S. Government Printing Office, 2004).
9. AMA, Current Procedural Terminology, CPT 2004, Professional Edition (Chicago: AMA, 2004).
10. Airfares were obtained online from Expedia.com and averaged, over peak and off-peak rates.
11. If 5 percent of U.S. patients were to go overseas, the savings would be about $692 million. If 20 percent of U.S. patients were to go overseas for these surgeries, the savings would be more than $2.7 billion.
12. T.N. Srinivasan, "Information Technology Enabled Services and India's Growth Prospects," in Offshoring White-Collar Work-Issues and Implications, ed. L. Brainard and S.M. Collins (Washington: Brookings Institution, 2005).
13. Medicare Payment Advisory Commission, "Medicare Physician Payment Rates Compared to Rates Paid by the Average Private Insurer, 1999-2001" (Washington: MedPAC, 2001).
14. Through our discussions with insurers such as Vanbreda, we have learned that there are insurance laws in some countries, such as Belgium, that prohibit making the insured person richer than he or she was before purchasing insurance.
15. A California Blue Shield health maintenance organization (HMO) covers all of its members for nonemergency care in Mexico. See S. Geis, "Passport to Health Care at Lower Cost to Patient," Washington Post, 6 November 2005. The difference can translate into more affordable premiums for U.S. businesses. According to HealthNet company officials, the cost of insuring a family of four whose treatment was covered in the United States is $631 a month, but only $306 a month if they used physicians in Mexico.
16. It is reported that in Texas, legislators explored the possibility of allowing HMOs to operate also in Mexico, but physicians in South Texas lobbied against the changes, arguing that local doctors could not compete with the lower costs in Mexico. Geis, "Passport to Health Care."
17. The absence of an explicit restriction was confirmed by the NAIC.
18. D. Warner, ed., NAFTA and Trade in Medical Services between the U.S. and Mexico (Austin: University of Texas, 1997), chap. 6.
19. See M. Gaynor, D. Haas-Wilson, and W.B. Vogt, "Are Invisible Hands Good Hands? Moral Hazard, Competition, and Second-Best in Health Care Markets," Journal of Political Economy 108, no. 5 (2000): 992-1005.
20. D. Warner and L. Jahnke, "Toward Better Access to Health Insurance Coverage for U.S. Retirees in Mexico," Salud Publica de Mexico 43, no. 1 (2001): 59-66.
21. A. Mattoo, "Can No Competition Policy Be Better than Some Competition Policy?" International Journal of Industrial Organization 19, no. 1-2 (2001): 55-77.
22. J.D. Birkmeyer et al., "Hospital Volume and Surgical Mortality in the U.S.," New England Journal of Medicine 346, no. 15 (2002): 1128-1137
23. J. Hibbard, J. Stockard, and M. Tusler, "Does Publicizing Hospital Performance Stimulate Quality Improvement Efforts?" Health Affairs 22, no. 2 (2003): 84-94.
24. Warner, ed., NAFTA and Trade in Medical Services.
25. R. Chanda, "Trade in Health Services," Bulletin of the World Health Organization 80, no. 2 (2002): 158-163.
26. A. Gross, "Regulatory Update on Malaysia's Medical Markets," Pacific Bridge Journal, June 1999, http://www.pacificbridgemedical.com/ publications_Malaysia2.html (accessed 17 January 2006).
27. Chanda presents evidence of several specialty corporate hospitals that are being built in India in collaboration with foreign companies, including a $40 million cardiac centre set up under a consortium between Australia, Canada, and India. Chanda, "Trade in Health Services." Corporate hospitals in developing countries are also establishing commercial presence overseas.