Introduction
The health sector throughout the world is in a process of transformation and restructuring. Citizens have the right to quality health services and the government is expected to be the facilitator in the discharge of such services. However, excluding few developed countries, governments of most of the countries are seen failing to manage or provide the requisite health services to the citizens owing to budgetary constraints and cost escalations (UNCTD, 1997). This reduction in government spending and health insurance coverage in a way created scopes for international trade in health services. Many countries are now trying to take advantage of the new trade opportunities in the health sector. This motivated entry of private players in the international health business and this, in turn, saw a reduction in entry barriers and implementation of various agreements like the GATS, TRIPS, etc. This chapter presents the current scenario of the global health trade with a particular focus on the role of foreign private clinics.
The Private Sector in Health Care Services
Over the past two decades, the private health sector has grown and played an increasingly important role in the financing and delivery of healthcare services. However, information about the private health sector is limited and there has been a little systematic collection of data on the private health sector (Marzolf, 2002). The difference between the public and private provision of healthcare services and products in Indonesia is not so clear. The majority of healthcare professionals engage in the delivery of both public and private services. Some public facilities have been used to deliver private or international services and some state-owned enterprises are incorporated as private firms even though the sole shareholder is the government.
Almost in all less developed and developing countries, the private sector is the most likely source of growth of health care, yet policy remains largely focused on the public system. The under-funded public system is stretched thin; the private health sector is not filling the gap, and neither system works all that well. It is estimated that huge funds would be required to refurbish, renovate, and reequip the public health system in such countries and as such private involvements are encouraged.
Many countries further made commitments to target available funds to curative treatment for the poor and on “public goods”. The transition from focusing on infectious diseases to an emphasis on chronic illnesses associated with an aging population calls for a significantly different profile of facilities, treatments, and personnel. Current allocations for public health care are insufficient to implement this strategy. This transition, combined with population growth and aging of the population would require huge expenses in healthcare investment over the next 15 years to provide minimally adequate services to the population.
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