International Trade & Health Equity: Have Benefits of Medical Tourism ‘Trickled Down’ to India’s Poor?

This is the final version of the article. Available from the publisher via the link in this record.In the late 20th century, international trade was projected as a tool for development with regard to global, social and political formations. Traditional political economic models claimed wealth generation through ostensibly maximising ‘comparative advantages’. The free market economy model claims that the whole society will receive material welfare from such international trade, as benefits of economic growth ‘trickle down’ either directly through increased income or indirectly as the increased government revenues are spent on infrastructural development, health, education, etc. Convinced by this theoretical claim, India gradually changed its stance from opponent to proponent of international trade in services during the WTO Uruguay round negotiations. Accordingly, the Indian government’s policy shifted towards capitalising India’s ‘comparative advantage’ in medical tourism, while contending that foreign exchange and revenue earned can be used to subsidise the treatment of poor patients. Thus, promotion of trade liberalisation in hospital services has been viewed as a tool to fulfil the mandate of social justice and promote health equity. However, the present paper argues that, instead, the health inequities have only grown throughout the period of neo-liberal globalisation, while there is no empirical evidence to prove the ‘trickling down’ of any material benefit to the poor resulting from opening up the healthcare sector to privatisation and internationalisation. Moreover, while the Indian health policy shift facilitated the burgeoning of a highly variable private sector, the absence of a comprehensive regulatory framework and a just grievance redress system has resulted in dubious quality and unethical practices in healthcare service provision in both the public and private sectors and inflation in healthcare costs. The paper will conclude with reiterating the importance of healthcare as intrinsic to ‘health capabilities’ imperative for enjoying a meaningful life