Paper Summary:

This paper explains that the GATS (General Agreement on Trade in Services) defines four modes for trading in the health care industry: (1) Cross-Border Trade in which trading takes place from one country to another, (2) Consumption Abroad in which the medical services are used abroad by the consumers, also called 'medical tourism', (3) Commercial Presence in which a service supplier crosses the borders to establish and provide heath services, such as hospitals, clinics and nursing homes, in other countries and (4) Movement of Natural Persons in which health personnel such as doctors, technicians and administers cross country borders. The author points out that, in the past, the bulk of healthcare infrastructure in India has been provided by the public sector, but the large-scale entrance of Third Party Administrators (TPAs), corporate hospitals and information technology are creating an organized delivery system of healthcare facilities. The paper stresses that India is ready for large-scale global trade in medical services to augment the domestic tele-medicine network in all areas and to integrate the domestic facilities with the global tele-medicine network. Many graphs and tables.

Table of Contents
Overview of Global Healthcare Trade
Cross-border Trade (Mode 1)
Consumption Abroad (Mode 2
Commercial Presence (Mode 3)
Movement of Natural Persons (Mode 4)
Implications of Trade in Healthcare
The Current Indian Health Scenario
Future Trends, Scope of Foreign Collaboration and Policy Environment
Mode 4 Trade in Medical Care
Institutionalizing Effective Alternatives to Fee-for-Service Primary Care
Reinstating or Creating Cross-Subsidy
Increasing Private Purchasing of Health Services by Government Facilities
Evolution of a Mixed Healthcare Model in India

From the Paper:

"In India, approximately 60% of the total health expenditure comes from self-paid category as against Government's contribution of 25-30%, while contributions from insurance companies are negligible. However, opening up of the insurance sector to private players will make healthcare affordable to a large number of people. Currently, in India only 0.2% of the total population is covered under Mediclaim, whereas in developed nations like USA, about 75% of the total population is covered under such insurance schemes. One reason could be the lack of awareness and marketing. Moreover, agencies like GIC take 6 months to process claims and to reimburse customers after they have paid out of their own pockets."

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