medical tourism

medical tourism, also called health tourism, surgical tourism, or medical travel,  international travel for the purpose of receiving medical care. Many patients engage in medical tourism because the procedures they seek can be performed in other countries at relatively low cost and without the delay and inconvenience of being placed on a waiting list. In addition, some patients travel to specific destinations to undergo procedures that are not available in their home country. Examples of such procedures include stem-cell transplants and sex-change operations.

History and growth of medical tourism

Throughout history people have traveled long distances for health care. In ancient Greece, for example, worshippers of Asclepius, the Greco-Roman god of medicine, would make pilgrimages to his temple in Epidaurus, where they would undergo healing through “incubation rituals,” which were rooted in prayer, fasting, and ceremony. Likewise, spas and public baths have long been popular destinations for those seeking medical cures. In the 17th century the emergence of spa towns in appealing settings like the Pyrenees attracted wealthy people from all over Europe. In later centuries, as travel and tourism increased, spas and health resorts in countries worldwide often attracted clientele from overseas. In addition, the establishment of facilities such as the nonprofit Mayo Clinic in Rochester, Minn., provided new opportunities for patients in need of treatments and surgical procedures not available elsewhere.

The practice of traveling internationally for surgery, however, is a relatively recent phenomenon. For example, Costa Rica experienced an influx of foreigners seeking cosmetic and dental surgery in the 1980s. By the 1990s physicians there actively worked to attract foreign patients, offering various types of plastic surgery, from face-lifts to liposuction, at low cost. Near the end of the first decade of the 21st century, an estimated 20,000–25,000 medical tourists visited Costa Rica, representing a significant increase over previous years. That growth appeared to parallel the worldwide boom in medical tourism that took place in the early 21st century. In 2010, for example, nearly 1.5 million Americans traveled outside their country for medical care—nearly twice the number from just three years earlier.

Destinations and services offered

Medical tourists may be citizens of developed or developing countries, although affluent individuals from the United States, Canada, and the United Kingdom account for a large proportion of the consumer base. Popular destinations for medical tourism include Brazil, Costa Rica, India, Mexico, Panama, Singapore, South Africa, and Thailand. The types of health and medical clinics that cater to medical tourists are often state-of-the-art facilities and are staffed with physicians who possess advanced medical degrees. Medical tourism Web sites and travel agencies typically offer package deals, with recuperation from surgery advertised as vacation-like. Services offered range from cosmetic, cardiac, eye, dental, or orthopedic surgeries to psychiatric services and procedures such as sex-change operations that may be socially or culturally unacceptable and hence unavailable in other countries.

Social and ethical issues in medical tourism

Inconsistency in quality of care is a major source of criticism for the medical tourism industry. One of the primary mechanisms implemented for the standardization of international health care is accreditation. Accreditation attempts to ensure that medical tourism facilities meet basic safety standards, are staffed with trained personnel, and have appropriate medical equipment to perform the procedures offered. Among the major accreditation organizations for international hospitals are the Joint Commission International (JCI), a branch of the U.S.-based Joint Commission Resources; Accreditation Canada International; and the Australian Council on Healthcare Standards International. Those organizations charge fees to clients who want to have their facilities surveyed for accreditation, and each organization maintains a list of accredited hospitals to help persons wishing to travel internationally for health care select a facility that will meet their needs.

Another issue in medical tourism concerns the illegal trafficking of organs. Countries with indigent or vulnerable populations frequently have a greater availability of organs for medical use, since members of these populations are often tempted to risk their health and give up an organ with the promise of monetary compensation. Combined with the lack of adequate resources for donor care, the practices surrounding organ obtainment have been targeted as an aspect of medical tourism in need of greater regulation and oversight. Likewise, the exploitation of medical procedures for which efficacy is unproven or for which safety is unknown is a point of discussion for standardization and regulation.

In addition, in all countries, medical tourism could polarize national health care policy, creating or furthering disparities in health care services made available to citizens versus foreigners. Because the latter bring money into countries and hence bolster national economies, they often enjoy greater access to doctors and medical resources than do the actual citizens of the country.

Kara Rogers

Seoul vows to strike origin, command posts of N.K. attacks

The South Korean military notched up its defense posture on Wednesday and vowed stern punishment against North Korea’s provocations after Pyongyang warned of retaliation for imminent U.N. Security Council sanctions and Seoul-Washington joint military drills.

North Korea’s military leadership late Tuesday threatened to launch “nuclear strikes,” annul the inter-Korean truce, close its office in the border village of Panmunjom, and cut off its military hotline with the United Nations Command.

 “The drills are, as the North was informed, annual South Korea-U.S. joint exercises for the defense of the Korean Peninsula,” said Maj. Gen. Kim Yong-hyun, the Joint Chiefs of Staff’s head of operations, at a news conference at the Defense Ministry in Seoul.

“If North Korea nonetheless pushes ahead with provocations that would threaten the lives and safety of our citizens, our military will strongly and sternly punish the provocations’ starting point, its supporting forces and command. We are making it clear that all preparations are completed.”
The heightened threat was carried in a statement by the Supreme Command of the (North) Korean People’s Army and announced by Kim Yong-chol, the hard-line chief of North Korea’s Reconnaissance General Bureau. He was lately reinstated to a four-star general three months after being demoted to two-star rank.

 The RGB is believed to have masterminded a series of attacks against the South including the sinking of the corvette Cheonan and the shelling of Yeonpyeong Island, both in 2010, and a 2011 cyber attack that paralyzed the National Agricultural Cooperative Federation’s banking system for several weeks.

In New York, the U.N. Security Council will approve its fourth batch of sanctions as early as Thursday in punishment of Pyongyang for its nuclear test on Feb. 12. The newest measures are expected to include asset freezes, tighter cargo inspection, travel bans for core individuals and restrictions on the transfer of bulk cash.

Seoul and Washington started their Foal Eagle field training program on March 1 for a two-month run and are scheduled to launch 10-day computer-simulated drills named Key Resolve on Monday.

The North is also predicted to stage a nationwide military exercise next week, mobilizing a standing army and backup forces including laborers and farmers.

Late last month, Pak Rim-su, the North Korean military representative at Panmunjom, sent a telephone message to U.S. Forces Korea Commander Gen. James Thurman and warned against “a war of aggression by staging the reckless joint military exercises.”

“When the war exercises reach their main phase after March 11, the Korean War armistice agreement, which has existed in its name only, will come to an end,” the KPA statement reads.

To better cope with escalating tensions, Cheong Wa Dae said it will hold a chief secretary meeting every morning under Chief of Staff Huh Tae-yeol.

Concerns are rising over President Park Geun-hye’s ability to handle the high-stake issue with the much-touted national security office still not in place amid festering partisan disputes over her overall government reshuffle plans and an ensuing administrative vacuum.
The Tuesday meeting took place without Kim Jang-soo, a former defense minister who was named to steer the organization. He is being separately briefed on the situation and related developments, government sources said.

“We are under abnormal conditions in which Kim is unable to attend the senior secretary meeting because of delays in passing the government reform bill,” presidential spokesperson Yoon Chang-jung told reporters early in the day.

“But the National Security Office is substantively examining and responding to the situation in close cooperation with the administration including the Defense Ministry and military.”

By Shin Hyon-hee (heeshin@heraldcorp.com)

U.N. approves new sanctions against North Korea

The U.N. Security Council voted unanimously Thursday for tough new sanctions to punish North Korea for its latest nuclear test, and a furious Pyongyang threatened a nuclear strike against the United States.

The sanctions drafted by North Korea's closest ally, China, and the United States send a powerful message that the international community condemns Pyongyang's ballistic missile and nuclear tests _ and repeated violations of Security Council resolutions.

“Adoption of the resolution itself is not enough,” China's U.N. Ambassador Li Baodong said. “We want to see full implementation of the resolution.” Li also urged calm and a resumption of the stalled six-party talks aimed at denuclearizing the Korean peninsula.

“The top priority now is to defuse the tensions, bring down heat ... bring the situation back on the track of diplomacy, on negotiations,” Li said.

North Korea's nuclear test in February was the first since the country's young new leader, Kim Jong Un, took charge amid questions of whether he would steer the country on a different course. The North's threats sharpened Thursday with the first reference to a preemptive nuclear attack.

Immediately before the vote, an unidentified spokesman for Pyongyang's Foreign Ministry said the North will exercise its right for “a preemptive nuclear attack to destroy the strongholds of the aggressors” because Washington is “set to light a fuse for a nuclear war.”

The statement was carried by the North's official Korean Central News Agency, which issued no immediate comment after the Security Council vote.

In Pyongyang, Army Gen. Kang Pyo Yong told a crowd of tens of thousands that North Korea is ready to fire long-range nuclear-armed missiles at Washington, which “will be engulfed in a sea of fire.”

The White House responded by saying the U.S. is fully capable of defending itself against a North Korea ballistic missile attack.

Although North Korea boasts of nuclear bombs and pre-emptive strikes, it is not thought to have mastered the ability to produce a warhead small enough to put on a missile capable of reaching the U.S. It is believed to have enough nuclear fuel, however, for several crude nuclear devices.
The United States has long been concerned that North Korea could eventually pose a missile threat to U.S. territory. The Defense Department first began to operate a ground-based missile defense system in late 2004 with such a potential threat in mind.

“North Korea must wake up from its delusion of becoming a ... nuclear weapons state and make the right choice,” said South Korea's U.N. Ambassador Kim Sook said. “It can either take the right path toward a bright future and prosperity, or it can take a bad road toward further and deeper isolation and eventual self-destruction.”


(AP)

N. Korea says will sever hot-line with Seoul, nullify

North Korea will sever its hot-line with Seoul and nullify non-aggression agreements between the countries, the state-run news agency said Friday amid escalating tensions over the North's nuclear test last month.

"The DPRK abrogates all agreements on nonaggressions reached between the North and the South," the North's Committee for the Peaceful Reunification of Korea, a propaganda organ against the South, said in a statement.

"The DPRK will close the Panmunjom liaison channel between the north and the south," said the English statement carried by the North's Korean Central News Agency. DPRK is the short for the country's official name Democratic People's Republic of Korea.

The statement came hours after the United Nations unanimously adopted a resolution to punish the communist country for its internationally-condemned underground nuclear test on Feb. 12.
(Yonhap News)