Desired Reforms in Health Services Trade between India and Pakistan
Rabia Manzoor
Research Associate, SDPI, Pakistan
Dr. Vaqar Ahmed
Deputy Executive Director, SDPI, Pakistan
Medical tourism is now commonly pursued by patients seeking high-quality treatment abroad at relatively economical expense (Connell 2011). The quantum and value of medical tourism has grown recently because of high cost of health, long waiting lists (even in advanced economies), ease of transfer of fee and low travel costs (Ibid: 2005). Documented and anecdotal evidence shows that patients from Pakistan are travelling to India for better health facilities particularly for liver and kidney transplant, cardiology and infertility treatment. Potential benefits of health trade across borders are well documented, but there are also constraints in improving and regulating the bilateral health trade between India and Pakistan.
Existing evidence concerning the health services trade between India and Pakistan clearly presents challenges and opportunities for expanding trade in health services. However, there are also significant obstacles that could be resolved. Therefore, there is a need of short-term bilateral agreements and key reforms for the promotion of trade in health services between India and Pakistan.
According to our recent study, one of the core obstacles in advancing health trade under mode (2), “consumption of health services”, with India is the rigid visa regime faced by the patients, accompanying persons and personnel from Pakistan. Lack of inadequate information to access healthcare facilities across India is yet another problem. Medical patients in Pakistan also face difficulties when fulfilling payment requirements for seeking medical treatment in India. Since Pakistani currency cannot be exchanged or used for accessing medical treatment in India, patients travelling to India have to carry up to the maximum limit allowed under Pakistan foreign exchange rules (i.e., USD 5000). This mode of transaction restricts patients’ choice and creates dependency on third parties and informal channels of transactions.
However, there are several ways to push for reforms that improve the health services trade between both countries. In our study, we also found certain desired regulatory and policy reforms in health services and possible entry points that can facilitate expansion of the health services trade between India and Pakistan. For example, there is a need to establish institutional linkages between the best public and private hospitals; health-sector teaching institutions can pave the way for “movement of personnel” across both countries too. Another option is to encourage the private sector to invest in health trade as well as develop formal linkages with private hospitals across both countries.
Furthermore, we should consider formalising the health trade by establishing facilitation desks across major cities. These centres could provide information on visa requirements, different available treatments and a list of hospitals in India. Financial transactions and modes of payment for medical treatment should be made flexible by designating banks in each country for handling financial transactions under medical treatment and consultation.
Finally, there is a need to develop synergies among professional associations; ministries of health, commerce, foreign affairs; and interior, PMDC, provincial departments of health and central banks on both sides. A task force may be set up at the ministerial level to formally or informally initiate the process of crafting a health trade policy. Through these desired regulatory and policy reforms, we can facilitate expansion of the health services trade between India and Pakistan.
Rabia Manzoor
Research Associate, SDPI, Pakistan
Dr. Vaqar Ahmed
Deputy Executive Director, SDPI, Pakistan
Medical tourism is now commonly pursued by patients seeking high-quality treatment abroad at relatively economical expense (Connell 2011). The quantum and value of medical tourism has grown recently because of high cost of health, long waiting lists (even in advanced economies), ease of transfer of fee and low travel costs (Ibid: 2005). Documented and anecdotal evidence shows that patients from Pakistan are travelling to India for better health facilities particularly for liver and kidney transplant, cardiology and infertility treatment. Potential benefits of health trade across borders are well documented, but there are also constraints in improving and regulating the bilateral health trade between India and Pakistan.
Existing evidence concerning the health services trade between India and Pakistan clearly presents challenges and opportunities for expanding trade in health services. However, there are also significant obstacles that could be resolved. Therefore, there is a need of short-term bilateral agreements and key reforms for the promotion of trade in health services between India and Pakistan.
According to our recent study, one of the core obstacles in advancing health trade under mode (2), “consumption of health services”, with India is the rigid visa regime faced by the patients, accompanying persons and personnel from Pakistan. Lack of inadequate information to access healthcare facilities across India is yet another problem. Medical patients in Pakistan also face difficulties when fulfilling payment requirements for seeking medical treatment in India. Since Pakistani currency cannot be exchanged or used for accessing medical treatment in India, patients travelling to India have to carry up to the maximum limit allowed under Pakistan foreign exchange rules (i.e., USD 5000). This mode of transaction restricts patients’ choice and creates dependency on third parties and informal channels of transactions.
However, there are several ways to push for reforms that improve the health services trade between both countries. In our study, we also found certain desired regulatory and policy reforms in health services and possible entry points that can facilitate expansion of the health services trade between India and Pakistan. For example, there is a need to establish institutional linkages between the best public and private hospitals; health-sector teaching institutions can pave the way for “movement of personnel” across both countries too. Another option is to encourage the private sector to invest in health trade as well as develop formal linkages with private hospitals across both countries.
Furthermore, we should consider formalising the health trade by establishing facilitation desks across major cities. These centres could provide information on visa requirements, different available treatments and a list of hospitals in India. Financial transactions and modes of payment for medical treatment should be made flexible by designating banks in each country for handling financial transactions under medical treatment and consultation.
Finally, there is a need to develop synergies among professional associations; ministries of health, commerce, foreign affairs; and interior, PMDC, provincial departments of health and central banks on both sides. A task force may be set up at the ministerial level to formally or informally initiate the process of crafting a health trade policy. Through these desired regulatory and policy reforms, we can facilitate expansion of the health services trade between India and Pakistan.
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