Telemedicine is the exchanging of patient information through the Internet or cybertechnology. Telehealth and teleconferencing have been used extensively for consulting with other professionals as well as reaching patients who live in rural or remote areas. The most popular direction globalization has taken is in the area of medical tourism. Countries such as India, Singapore, and Thailand provide care such as cardiac surgery, joint replacements, and reconstructive surgery at significant differences in cost.
Along with the medical care provided, these locations offer a vacation-like atmosphere. Another feature that encourages the use of medical tourism is the availability of medications and technologies that may be experimental in some countries but readily available in others. Because of the cost differential, some private insurers also offer incentives to utilize medical tourism as a means of accessing health care services.
Although medical tourism has led to knowledge development on a worldwide scale, concerns remain as to quality and liability. However, despite these concerns, entities such as medical tourism have the potential to increase awareness of illness and disease processes.
And How It Hurt America
This knowledge could be empowering to developing countries. Since the early s, over 48 million people have been displaced due to the environmental crisis and its health related impact Toole, HIV rates are increasing both in the US and abroad, infecting nearly 25 million people. Other diseases such as tuberculosis and cholera have developed into drug-resistant strains proven difficult to treat, thus increasing the disease transmission rates. Poverty has been found to be a leading predictor of health disparities. This economic burden results in decreased access to necessary and affordable healthcare.
Economic globalization has been the fundamental force behind the overall process of globalization over the last two decades. It has been characterized both by a dramatic growth in the volume of cross-border flows and by major changes in their nature.
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- WTO, Globalization and China’s Health Care System | SpringerLink.
- WTO, Globalization and China's Health Care System | Xiao-Wan Wang | Palgrave Macmillan.
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International trade has grown at an accelerated pace—nearly 8. However, this transformation has largely by-passed low-income countries, most of which remain critically dependent on aid flows Woodward et al. Global does not mean international, as international may connote what is happening between as little as two nations. It does not mean a health issue that is local and spreads to the rest of the world geographically and it does not mean that which is happening everywhere.
Labonte is quick to point to the danger of focusing on the global economy as a natural, logical system when it is actually an outcome of political and economic interaction.
China, Globalization, and the IMF -- Address by Eduardo Aninat
As a counterpoint, it is also not productive to balance either the political or economic components. To do so, would diminish the impact of either or both. Rennen and Martens have suggested a definition of globalization that is perhaps more acceptable, as it conveys all these dynamic ingredients. The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system.
As they give us their model on evaluating globalization impact on health, Huynen et al. Each one of them interacts within itself and with one or more of the others determining to a major degree, beyond the impact of genetics, proximally and distally, the health outcomes of a nation or a people. Institutional determinants consist of infrastructure, health policy, health-related policy, governance structure, political environment, system of law, regulation, all impacting on health services. The economic determinants, which are occupational structure, tax system, and markets, interact or determine the economic infrastructure, economic development and trade.
The socio-cultural determinants include culture, such as religion, ideology, customs, population structure, size, and geographical distribution.
In addition, knowledge, social organization, social security, insurance system, mobility communication, and social interactions, are socio-cultural determinants that have an impact on social environmental lifestyle. Finally, the environmental determinants refer to ecological setting, climate, ecosystem stability, goods and services, interacting with the physical environment such as food and water.
All of these have an impact on social lifestyles and environmental conditions. These determinants are always present and may interact and necessarily impact population health and the services available and accessible for the maintenance of a sound public health system.
Consequently, the establishment of a sound public health system entails constant surveillance of the determinants named above and their impact, as man tries to prolong life and improve its quality on earth. Used this way, global health focuses on elements such as water, sanitation, environment, inequality, malnutrition, HIV, tuberculosis, malaria, mental illness, health policy, behavioral health, and maternal mortality, research, education, and practice, linked to the basic human health rights.
WTO, Globalization and China’s Health Care System
Along with global health and the attempt to provide a framework for analysis, the determinants of health occupy a prominent role in any discussion. We proceed now to examine this issue as it relates to global public health. Given that the nature of social determinants of health are many and consistently interact and impact health, no one discipline can unravel the total complexity of health and health care.
As noted by Labonte and Schrecker:. Globalization comprises multiple, interacting policy dynamics or processes the effects of which may be difficult if not impossible to separate. Pathways from globalization to changes in social determinants of health are not always linear, do not operate in isolation from one another, and may involve multiple stages and feedback loops. It is reasonable to surmise that only a multi-disciplinary or trans-disciplinary approach to health and globalization can produce an objective body of knowledge.
One mistake common to many globalization approaches is to portray the economy as the primary or sole measuring stick of the process itself, while relegating the impact of globalization on health to a secondary role. The World Trade Organization WTO has also presented insurmountable obstacles to the social programs of the developing world. The third consideration is the status of vectors for globalization which are often a multiplicity of bilateral and multilateral agreements among the richer and the poorer nations, with the appearance that they are being signed to promote human rights, and protect the environment, and the rights of women and children.
Even though desirable in specific cases, quite often the agreements are not properly enforceable.
This aspect makes it difficult for governments to control their exchange markets in an effort to stabilize currencies, manage their economies, and maintain fiscal autonomy UNDP, There are binding rules and sanctions mainly emanating from the World Trade Organization established in The size of transnational corporations, such as Mitsubishi in South Africa and Poland in , quite often larger than the nations in which they operate, as measured through their gross domestic product GDP , is choking many developing countries.
However, the more powerful countries often find ways to refuse to accept or enforce the regulations, and proceed, for example, to subsidize their own agricultural enterprises. Woodward et al.
Hertz , a critic of globalization, wrote:. In the Third World we see a race at the bottom: Multinationals pitting developing countries against each other to provide the most advantageous conditions for investment, with no regulation, no red tape, no unions, a blind eye turned to environmental degradation.
Even though this approach seems more normative than evidence-based practice, it provides an excellent common-sense framework that very few individuals can argue against. The defenders of globalization argue that knowledge and technology through trade and investment help wipe out epidemics through more advanced surveillance systems, treatment and more effective prevention. However, others argue that under the agreements of the World Organization for Animal Health, it is easier to stop the spread of certain diseases on the planet.
The detractors of this argument note that often because of the costs involved, there is no consistent enforcement of the agreements across continents and among countries. The other major argument in favor of globalization is that it spurs economic growth through foreign investment, liberalization, and competition, both of which contribute to higher incomes, reduction of poverty, and better health care, leading to desirable change in the determinants of health Levin Institute, b. The globalization processes may have positive and negative health consequences on the population they are supposedly intended to help.
These include increasing health care and education access, legislation designed to protect human and labor rights, restriction on exposure to hazardous drugs and products, such as tobacco, environmental waste, and environmental protection. In fact, there has been evidence that globalization has resulted in higher tobacco consumption, notably in poorer countries WHO, and higher alcoholic consumption, particularly among the young Kuo et al.
Normally, poorer countries have been able to provide services, such as education, health, and sanitation, through taxation and domestic subsidies. However, liberalization has meant the elimination or reduction of tariffs which, ultimately, are designed as a mechanism to reduce poverty and assist the poor. Liberalization may, indeed, result in price increase or price reduction, lower wages, or risks to the farmers. Lower prices may mean that the farmer will have to work more hours to be self-sustaining.
Studies in Rwanda, Zambia, Kenya, Malawi, Sierra Leone, the Gambia, the Philippines, Guatemala, Papua New Guinea, and India found that globalization had mixed results, as a great effort was mounted to move from subsistence agriculture to agricultural commercialization. Even though, in some countries, the health results were promising, in others, such as Zambia that tried to move from subsistence corn production to commercialized corn output, the health conditions deteriorated more for children from commercialized than from subsistence households.
These findings stress the need for gender analysis when the impact of globalization on household health is considered. Free trade as a part of globalization, even though it may have contributed to the provision of food to many countries, has also led to food insecurity in many, leading the International Covenant on Economic, Social and Cultural Rights to declare in that food security was a right of all peoples, which the World Food Summit endorsed that same year.
Obviously, the protection of our ecosystem is paramount in the preservation and improvement of public health. Ecosystems provide us with the basic human needs like food, clean air, clean water, and clean soils and prevent the spread of diseases throught biological control. Finally, ecosystems provide us with medical and genetic resources, which are necessary to prevent or cure diseases. However, profitability goals often take precedence over ecosystem concerns. The impact of globalization on social services and employment has been detrimental to health and access to quality health care for most people of the world.
Whether or not there is a U.S.-China deal, the global trade system is changing - Barron's
Once a government eliminates tariffs, export taxes, and agricultural and industrial subsidies, as the World Trade Organization has mandated, supported by such major loan corporations and institutions as the World Bank, the International Monetary Fund, and the Paris Club, it also reduces its revenue.
For example, in Latin America, unemployment increased by 50 percent during the s, and, in Sub-Saharan Africa, North Africa, and Asia, by 74 percent, 43 percent, and 62 percent, respectively, even though overall GDP social services budgets remained the same World Bank, In many cases, there may be a temporary economic growth but, almost always, economic sustainability is not maintained without further assistance through grants and loans by wealthier and technologically more advanced institutions and nations, continuing to maintain a state of dependence on donors. Zambia is a good example of where liberalization policies led to unemployment and further poverty, as a result of the World Bank and International Monetary Fund loans during the s, which encouraged this country to open its borders to cheap textile imports Azevedo, This and the introduction of user-fees for school led to an increase in dropouts and illiteracy rates.
The government was forced to eliminate the newly-imposed school fees and health care co-payments and to re-introduce subsidies to agriculture and domestic industries. Domestic products gave preference to imported luxury goods. As a consequence, the local entrepreneurship was severely weakened, resulting in higher unemployment and a lowered tax base for the government for social programs, such as health care. Liberalization of coconut and rubber products, as dictated by the WTO, led to a drop in prices.
Experts predicted that Kerala would also abandon its food subsidy, which would have tragic consequences for the nutrition of its people.