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Mercosur is the fourth largest economic community in the world and represents the regional integration of the South American countries Argentina, Brazil, Paraguay, and Uruguay as full members, as well as Bolivia and Chile as associate members. This free-trade zone, encompassing most product categories, provides a competitive opportunity for companies that understand how to exploit it. By setting up local subsidiaries or joint ventures with local players in the region, foreign manufacturers can take advantage of lower taxes and duties, local labor rates and free access to Mercosur countries.
Argentina is a strong supporter of healthcare. Its healthcare industry sales for 2004 totaled more than $50 million. Despite present economic woes, Argentina represents future opportunity for U.S. companies as its economy recovers.
Brazil ranks among the 10 largest healthcare markets in the world. The public and private health sectors in Brazil generate an estimated revenue of $50 billion per year, which amounts to almost 5% of the country’s GDP. A strong private health network that often competes with the public health system provides health assistance to about 25% of Brazil’s population of 160 million. It is expected to grow significantly over the next 10 years.
Brazil was recently reported to have 2744 health-related companies, 7811 hospitals (some 6000 of them private), 550,000 hospital beds, and 15,327 institutions for complementary diagnosis (clinics and laboratories). Public and nonprofit hospitals—defined as private hospitals supplying a minimum of 60% of their services to the poor under government Medicare fees—are not subject to import duties or value-added taxes. In order to take advantage of this tax-free status, hospitals generally import directly, or do so with the assistance of an import agent. Import agents usually receive their commission directly from the foreign supplier.
Chile. The 1997 US-Canada-Chile Free Trade Agreement eliminated tariffs for the majority of US and Canadian products exported to Chile. Certainly there are opportunities for foreign companies to assume leadership in the Chilean industry and work with native companies to build capacity within existing organizations. The 2004 Chilean health industries market had an estimated value of $4.6 billion. And in the 2002 laboratory equipment market, Chile imported $95.9 million worth of goods; within this sector, imports of reagents reached $22.6 million.
Mexico. As a result of the North American Free Trade Agreement (NAFTA) of 1994, Mexico is the largest Latin-American trading partner of the United States and Canada. The country has a population above 100 million and, with a GDP of more than $900 billion, offers exporters interesting opportunities in the health industries, a Mexican economic sector that has experienced considerable recent growth. The healthcare market was $690 million in 2004, of which 90% was imported products.
Mexico has some 3700 hospitals and about 2170 private institutions offering inpatient facilities. These institutions are the primary purchasers of healthcare products. Most of the private facilities, about 80%, are small centers with 15 beds or fewer. Public healthcare services are increasingly being supplemented by private-sector providers as more and more middle-class Mexicans seek the higher-quality care offered by private institutions. Private facilities saw approximately 21 million users in 2000. As many as 2.5 million Mexicans are covered by private health plans. The private and public healthcare systems run parallel to each other with very little integration.
Andean Community. The Andean Community, formerly called the Andean Group, is another South American economic organization, and consists of Bolivia, Colombia, Ecuador, Peru, and Venezuela. For almost 20 years, its goal of economic growth and the creation of a regional common market floundered. The Andean Community finally achieved a free-trade agreement in 1991, and by 1993 the free-trade zone was complete. Intraregional trade has subsequently increased tremendously. At the end of 2002, exports among the member states amounted to $5.3 billion.
The Andean Community has set an ambitious external agenda that includes the establishment of closer links with other Latin American and Caribbean countries and with the United States and Canada. It also involves the joint participation of the Andean countries in the World Trade Organization and, in particular, negotiations surrounding the Free Trade Area of the Americas. However, it is in the negotiation of a free-trade agreement with Mercosur that the Andean Community seeks to achieve results in the short term. These negotiations have raised great expectations. Once the desired agreement is fully implemented, the landscape of Latin American economic integration may indeed change.
A borderless Caribbean economic region was established in 1965 to give its small constituent nations the strength of collective resources and opportunities. This Caribbean Community, Caricom, agreed to impose no import duties on goods of community origin. The Caricom entity has signed other trade agreements with the Dominican Republic and Venezuela. This could be a major incentive for manufacturers to introduce their goods to a market of more than 12 million people in the Caribbean.
In most of Central America and the Caribbean, the state is a major provider of healthcare, in addition to financing healthcare. Budgets for care-providing institutions are based on historical data rather than actual needs, and are funded through a detailed line-item budget submitted to the health ministry. These countries have a mix of public and private providers and commonly share health services and facilities.
An effort to unite the economies of the Western Hemisphere into a single free-trade zone began at the Summit of the Americas held in December 1994 in Miami. The heads of state and government of the 34 democracies in the region agreed to construct a Free Trade Area of the Americas, whose acronym FTAA (ALCA in Spanish) will become better known. FTAA would progressively eliminate barriers to trade and investment. The signatories intend to complete negotiations for the agreement by 2005. Although not yet in effect, this broad free-trade agreement represents a large near-term opportunity for exporters.