John F.P. Bridges discusses why Americans are paying increased attention to "medical tourism".
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John F. P. Bridges: Medical tourism is kind of like a bit of a new phenomena, but it's part of a wider phenomena in terms of healthcare tourism. And I think where it's coming up at the moment now, a little bit for political reasons is people are worried about changing the monopoly structure of hospitals, and doctors associations and insurance companies also. But I think it's also being used politically at the moment associated with the calls for a national healthcare system or Medicare for all, and people are using the healthcare tourism and medical tourism as a symptom of a disease that's eating away at the healthcare system due to lack of insurance and not as an opportunity. And I see it as an opportunity, because it presents -- you imagine that you don't have a provider access in your area, there is a shortage of doctors and nurses in particular specialties why would we restrict ourselves just to providing care from Americans? Why can't we think about a global market? Global market for training and global market for provision, a global market for communications. This is very important. What are the politics surrounding Medical Tourism? John F. P. Bridges: Certainly, since 9/11 the focus in America moved from importing patients to - I am sorry bringing patients here. So at Cleveland Clinic, main agenda was bringing wealthy foreigners here and treating them. Now, it's harder to get them visas and particularly if you are Muslim, there is some resistance about coming to America maybe. And so now the notion is it might be easier, it might be more comfortable if we go there and work with partnerships in places like Abu Dhabi and Dubai and Singapore, and provide healthcare services there, in one's local environment. Then this got turned around, and kind of like saying well, why don't we export our patients to those countries? I don't think that that's a major issue. Exportation of American patients to South East Asia is a little bit unrealistic, bordering with Mexico and Canada I think that that's much realistic. Internal markets inside America, we really haven't discussed them very well. But the Cleveland Clinic does have offices in Florida and for people who traditionally were living in Cleveland then retired to Florida, they still have continuity of care. As people move around, maybe we have to start thinking about these type of global healthcare networks rather than just a local healthcare network. What impact will Medical Tourism have on the traditional American healthcare system. Depends whether you are going to define it as a healthcare system, a provisionary healthcare system of insurance. Yeah, in terms of provision, some people claim that it's a disruptive technology, and that the cost differences are up to 80% and this is going to really put pressure on Americans, who provide these services. Really, it's just competition, and competition is generally viewed by from an economic point of view is a good thing. Would we just want one type of American cars only and ban all the other types of cars? But the competition is sure put a little bit of financial pressure on the American companies, which will also enforce them to improve their quality. So when all said was done, I think there were some losers because when you are building monopolies, I used to live in Cleveland, so steel monopolies for example. They are not so interested in opening up the trade, but when all is said and done for a nation, I think it's better to be open than to be closed. Will Medical Tourism eventually take off? It's already taken off. It's just that Americans haven't been a major players. 35,000 Indonesians participate in healthcare tourism every year. Indonesia is about the same size as America in terms of population, but they don't have the facilities. They are a whole heap of little islands that sometimes they don't have the facilities. So if you are on an outskirt island and you have to fly to Jakarta to get your healthcare services, the

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