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Health Equity in a Globalizing EraPast Challenges, Future Prospects$
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Ronald Labonté and Arne Ruckert

Print publication date: 2019

Print ISBN-13: 9780198835356

Published to Oxford Scholarship Online: May 2019

DOI: 10.1093/oso/9780198835356.001.0001

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Global flows

Global flows

Health workers and patients on the move

(p.192) Chapter 9 Global flows
Health Equity in a Globalizing Era

Ronald Labonté

Arne Ruckert

Oxford University Press

Health systems rely upon two groups of people: health workers and patients. In recent decades both groups have been on the move globally, with the creation of internationalized labour market opportunities (the hunt for skilled labour in the case of health workers) and private investments in high-end health care on lower-cost developing countries (one of the key incentives for patients seeking care outside of their own country, for uninsured or under-insured services). Both flows raise a number of health equity concerns. Health worker migration can pose undue hardships on low-resource, high-disease burden countries who lose their workers to richer nations, creating a ‘perverse subsidy’ of poor to rich. With medical tourism, private, fee-paying foreign patients in poorer countries could ‘crowd out’ access to care for domestic patients in those countries, while potentially returning with drug resistant infections or complications burdening their home country’s health systems.

Keywords:   health worker migration, health worker shortages, push/pull, perverse subsidy, remittances, medical tourism, transplant tourism, health care privatization

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