Professor talks global health care



A renowned Harvard professor discussed the global nature of health care and the need to balance personal rights with the greater good in a lecture Wednesday.

Professor I. Glenn Cohen met with students for a talk titled “The Globalization of Health Care, Global Justice, and Global Law” at noon yesterday in the Maurer School of Law.

His appearance was the latest in the George P. Smith, II, Distinguished Visiting Professorship-Chair lecture series.

Cohen, faculty director of the Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics at the Harvard Law School, cited the expenditure on health care to be $3.207 trillion in 2015, “roughly $10,000 per person.”

Health care expenses made up 17.5 percent of the United States’ GDP as of 2014 and is only expected to grow, he said.

Cohen said the fraction of our income being spent on health care is shrinking despite attempts to fix it.

“One possible solution is globalization,” he said.

Most products the public consume come from a global supply chain, and it is natural that health care should follow that trend, Cohen said.

The three kinds of globalization he addressed were medical tourism, medical migration and medical repatriation.

Medical tourism is “the travel of patients from one country, the home country, to another country, the destination country, for the primary purpose of securing care,” he said.

Websites that act as travel agencies for those wishing to partake in medical tourism try to sell the idea of glamour, and often offer the patients a vacation package with their desired procedure.

It is impossible to accurately measure the number of travelers participating in medical tourism because these trips are often taken to escape the legal confines of the home country, and are usually undocumented, which leaves a minimal paper trail.

Insurance companies often try to send patients overseas to undergo cheaper procedures.

Even with travel expenses and covering the cost of the procedure, companies “can still make a healthy profit,” he said.

“All the numbers in the industry are soft,” 
Cohen said.

He showed a chart that listed the cost of a mastectomy, a routine procedure, at about $40,000 in 
America and only $7,500 in India.

Medicine in many other countries of the world is done as if in an assembly line compared to medicine in the U.S., he said.

Every part of the line is cheaper, and therefore the procedure as a whole will be cheaper.

The second type of globalization is medical migration.

This is when doctors leave their home countries to study and live in developed countries.

“The U.S. depends very heavily on foreign-trained doctors in their health care system,” he said.

Though this is often viewed as a negative for the home countries of the health professionals, Cohen said it is important to consider the human aspect of the decision.

“Don’t we all want to choose our own career paths?” he said. “What about our rights to travel?”

The right to leave one’s home country and even change nationalities has long been defined as a basic human right, 
Cohen said.

The final category of globalization is medical repatriation: “the transfer of usually uninsured alien patients with significant long-term care needs,” 
Cohen said.

The majority of patients who fall into this category are undocumented, so there is not a lot of data available, he said.

Cohen used the example of a Mexican native who obtained a visa to work in America and was left comatose from serious injuries he sustained in a car 
accident.

Because the man had no health insurance and his family had no means of covering the expenses, it was decided he would be deported back to Mexico against the will of his family members.

“The driving force of this desire of sending people back has to do with the gap in our social safety net,” he said. “Most immigrants pay into health care and social services more than they take out.”

Harvard professor talks about global health care

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