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2. 1. World Health Organisation (2010) Health systems financing: The path to universal health coverage. World Health Report.
2. Ibid.
3. All WHO Member States have signed up to the declaration of World Health Assembly resolution 58.33 in 2005 and have tasked WHO to develop an action plan to implement the 2010 World Health Report.
4. Millennium Development Goals 2015, United Nations
5. http://www.who.int/health_financing/UHC_ENvs_BD.PDF
No one knows precisely when humans started using cash in exchange of goods or services – history claims it
was 5000 BC. Are we going to keep using it until the next 7 millenniums?
Spoken truth, limited action -
Healthcare around the world is
unaffordable for millions of people,
and the cost of the medical
treatments continues to prevent
those with limited buying power
from seeking care. In parallel, this
condition pushes the many into
poverty each year after having the
access to the right care.
Globally, and especially in most of
developing countries – where
healthcare infrastructure is not well
built and fitting to the national
community, hardships due to the
costs spent on the medical needs, a
family financial situation can change
almost in a blink of an eye: assets
are sold, savings are emptied,
children are forcefully taken out of
school for not being able to cover
the tuition fee, family members give
up employment to provide care, and
social networks are strained due to
unpaid loans and repeated requests
for help.
Every year, catastrophic health
costs push millions of families into
intergenerational cycle of poverty1.
Only one of five people has social
security protection that will cover
lost wages in the event of illness2
.
Given the fact, countries are
responsible for standardizing and
delivering universal access to
healthcare systems according to
their legal commitments for every
layer of economy their citizens are
positioned. However, many have
failed to understand that this is only
possible if they develop sustainable
health financing mechanisms and
infrastructure to support strong and
equitable national health systems.
Whilst the universal health coverage
holds the role as an instrument to
realise the healthcare rights for
every individual and promote social
consistency, equitable (even) health
financing systems contribute to
progress across all areas of
development. Those are the tasks
for the governments and world
leaders to carryon by prioritising
equitable health financing to deliver
health for all. Making progress
towards universal access to health
services is fundamental to go
beyond the globalisation to fulfil the
healthcare rights and to accelerate
social and economic growth.
In 1978, at the International
Conference on Primary Health Care,
world leaders promised to deliver
health for all3
, and continue
pursuing targets related to global
health to achieve the health
Millennium Development Goals by
20154
.
All efforts combined will continue to
fail unless they provide transparent
leadership and efficient health
financing and equitable health
services, ensuring that every
individual, especially the vulnerable
groups, are protected from costs
and risks.
What is universal health coverage?
Universal health coverage for health
is when all people have access to
health services (promotion,
prevention, treatments and
rehabilitation), without fear of
falling into poverty5
.
When talking about health or
medical coverage, one cannot go
too far from the cost-perspective of
the care services given to the
patients. However, it is not the only
factor that matters. The financing
mechanism that is being used to
pay, direct users fees, insurance,
tax, crowd funding, or other
mechanism that may apply for
specific community. The availability
of health services, the quality of
care and predictability of costs that-
will be incurred also influence
health care coverage.
Thus, in order to develop the
universal access to healthcare, the
international community must
support developing countries to
raise funds for health, reduce
dependence on out of pocket
payments, especially through the
elimination of user fees, and
promote risk pooling in the form of
an increased proportion of public
financing for health spent more
efficiently and equitably.
Believing that healthcare is the
most critical human right that
effects every layer of economy,
government and the environment,
our digital hospital concept, MEDx
eHealthCenter, is combining the
power of technology and analytics
to improve the healthcare delivery
across the developing countries
through its seven care services
available on its online platform,
www.medx.care.
Health Coverage
Through Digital Healthcare

3. 1 Glinos, I. A., Baeten, R., Helble, M. & Maarse, H. (2010), A typology of cross-border patient mobility. Health & Place.
2 Timmermans, K. (2004), Developing countries and trade in health services: which way is forward? Int J Health Service.
3 Ramírez de Arellano, A. B. (2007), Patients without borders: the emergence of medical tourism. International Journal of Health Services.
4 Turner, L. (2007), 'First World Health Care at Third World Prices': Globalization, Bioethics and Medical Tourism.
5 https://medx.care/about
Eindhoven, the Netherlands – the
global growth in the medical world
specifically, as well as medical
technology across national borders
have been developed into new
patterns of productions and
consumptions over the past
decades.
“A new trend has surfaced. A
growing trade in healthcare,
involving the movement of patients
choosing to cross the borders in the
pursuit of medical treatment and
health; a phenomenon called
‘medical tourism‘.” – MEDx Care
Medical tourism is an act when care
seekers opt to travel to different
countries, intending to receive –
based on personal belief or
information sought – ‘better’
medical treatment. The treatments
received may span the full range of
medical services, but most
commonly includes dental care,
cosmetic surgery, elective surgery,
and fertility treatment. Setting the
boundary of what is health, within
this range of treatments, not all
would be included within health
trade. Cosmetic surgery for
example, would not be considered
within the health boundary.
Medical tourism and the
globalisation
Medical tourists, when being
questioned of the reason behind
their choice to travel abroad to
receive treatments, gave answers
that can be based on economic,
social, cultural and technological.
Domestic health systems in many of
the emergent and growth countries,
for instance, are undergoing
significant challenges and strain –
tightened eligibility criteria, waiting
lists, non-transparent
infrastructures and shifting priorities
for health care have mostly direct
impact on the care seeker decision
making. Others, however, are driven
by their stronger purchase power
and therefore forms consumerism.
The storm of open information era
and development of diverse
providers competing on quality and
price now provide for all demands.
Unlike other forms of patient
mobility where decisions on behalf
of the patient are made by the
medical practitioners (doctors or
physicians), medical tourism
involves individuals acting as a
consumer and making their own
decisions regarding their health
needs, how these can best be
treated by the most appropriate
provider.
There are five driving factors behind
the rise of medical service overseas
phenomenon found by Glinos et al.,
(2006): familiarity, availability,
cost, quality and bioethical
legislation (international travel for
abortion services, fertility
treatment, and euthanasia
services)1
.
In terms of familiarity, expatriates
often have medical care on their
visits back to their home country,
which would also show up as
medical tourism, for example, the
large Indian Diaspora in the UK.
Some treatments may not be
available or may be subject to a
wait in the home country
(availability), this may include
latest technology and techniques
that require more funds to be spent
(cost and quality). Or else,
treatments that may not be legal in
the country of origin (bioethical).
Different origin and destination,
same purpose
Some places may be simultaneously
acting as countries of origin and
destination in the medical tourism
marketplace. High-income countries
may service overseas elites from
‘less developed’ countries, driven
by the price and quality. Treatments
may often be available in their
origin countries and equal to the
international healthcare standard
within the private sector, but at
greater cost – often referred as
“better developed countries’
medical services are less worrisome,
more trusted”. In parallel, the
citizens coming from richer, more
developed nations choose to travel
as medical tourists to Lower and
Middle Income Countries for
treatments due to lower-cost
treatments. This section focuses on
the implications for countries from
the perspective of them being an
origin or source of medical tourists.
Example of Medical Tourism advertisement in
India. Picture credit to peachealthcare.net
There are, though, financial impacts
on individuals and their families.
Some families may fall into debt to
fund treatments. It is also the case
that not all medical tourism may
consume considerable family
resources. All in all, benefits and
risks from the medical tourism are
applicable to both of origin and
destination countries.
Most countries that engage in
delivering care to medical tourists
do so to increase the level of direct
foreign exchange earnings coming
into their country; to improve their
balance-of-payments position
(Timmermans, 20042
, Ramírez de
Arellano, 20073
, Turner, 20074
) . To
some extent this might be income
thought of as accruing directly to
the health system. For instance,
foreign patients purchase health
care services, and hence provide an
income that can be used within
hospitals to cross-subsidise care for
domestic patients, or could be used
The Pursuit of
Medical Treatments Abroad

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to help fund capital investment,
such as MRI scanners, that are then
used by all patients in the hospital.
It is therefore possible that some
countries may seek foreign patients
in order to develop facilities to
better serve local patients.
On the other hand, this practice has
helped the care seekers mostly in
the emergent countries, exposing
themselves that there are actually
other chances for them to be
treated (more) appropriately – the
only concern is that not everyone
has the privilege to elect their
preferred treatments.
Current and potential risks from
medical tourism
Medical tourism as a trend creates
risks to the local medical
practitioners of the origin countries
with more competition of the price,
quality of treatments and services,
and to the nation’s healthcare
credibility. At the same time,
international patients also puts
more pressure to the destination
countries’ medical services with
expectations and the limited space
available – which was primarily
designated for the local patients.
Other risk at social level which has
been increasing and becoming the
governments’ of the destination
countries concern nowadays is that
patients are refusing to go back to
their home countries, claiming their
human rights from the perspective
of healthcare, and trying to become
“permanent residents” to gain equal
rights as the local citizens.
Combining the phenomenon and
what it means to the international
society, MEDx Care, as the pioneer
in the digital hospital market,
provides the care seekers with first
and/or second opinion from medical
professionals across the border3
,
without actually spending extra
pennies to seek for the treatment
abroad – unless advised the
otherwise.