India's Growing Presence in Health Services Trade? Challenges and Policy Options

崛起中的印度醫療服務貿易：挑戰與政策選擇

10.30392/TJWTOS.201109_(20).0001

德巴喜斯•查卡拉鮑迪(Debashis Chakraborty)；阿努吉•狄爾瓦瑞亞(Anuj Dilwaria)

印度 ； 貿易政策 ； 醫療服務出口 ； 勞工移動 ； India ； Trade Policy ； Labour Mobility ； Medical Service Exports

Taiwanese Journal of WTO Studies

20期（2011 / 09 / 01）

1 - 45

英文

自從1991年啓動結構調整計畫（structural adjustment program，縮寫爲SAP）以來，身爲世界主要發展中國家之一的印度就一直維持著令人印象深刻的成長率。尤其是服務業的成長最引人注目。近期雖然印度服務業的各項出口都有增無減，但是醫療服務的出口卻佔有特殊的地位。各種形式的醫療服務出口此期間都一直維持增長的趨勢。本文主旨是試圖從未來的挑戰與選擇來檢視印度醫療服務出口的模式。結論是印度醫療服務的出口在可預見的未來可能將會持續，國內的改革、多邊協商與晚近印度所簽署的區域貿易協定（Regional Trade Agreements，簡稱RTAs）將會扮演關鍵的角色。

India, one of the major developing countries in the world, has shown an impressive growth trajectory since initiation of the structural adjustment program (SAP) in 1991. The growth of the service sector in particular has been quite impressive. While service sector exports from India have increased on various categories in recent period, the export of medical services holds a special position. The medical service exports from the country have increased in all the modes over the period covering categories like tele-medicine, tele-diagnostics, medical transcriptions, medical tourism, investments abroad and movement of Indian doctors, midwives and nurses to foreign countries etc. The current paper attempts to review India's export pattern under this category, keeping in mind the future challenges and options. It concludes that export of medical services from India is likely to continue in coming future. The domestic reforms, multilateral negotiations and India's entry into a number of RTAs in recent would play a key role in this regard.

1. Kalam, APJ Abdul (2011), 'Evolution of New India', Address to the members of Indo-American Center Chicago, April 23, available at: www.abdulkalam.com (last accessed on May 20, 2011).
2. Government of India, 'India: Revised Offer', WTO Document No. TN/S/O/IND/Rev.1 (dated 24 August 2005)..
3. Hindustan Times (2009), 'Health is Hot: 4 new Firms Soon', September 7, New Delhi.
4. Jha, Lalit K. (2011), 'Americans need not visit India for cheap health care: Obama', PTI, April 20, available at: http://in.news.yahoo.com/americans-not-visit-india-cheap-health-care-obama-063100035.html (last accessed on May 20, 2011).
5. Hindustan Times (2010c), 'Malaysia scraps visa on arrival for Indians', August 3, New Delhi.
6. Outsourcing Professionals (undated), 'Medical Transcription Outsourcing', available at: http://www.outsourcingprofessionals.com/medical-transcription.php (last accessed on May 20, 2011).
7. Hindustan Times (2010a), 'Japan opens visa door to Indians', October 25, New Delhi.
8. (1998).International Trade in Health Services: A Development Perspective.Geneva:UNCTAD.
9. Medical Tourism Export (2010), 'Inflow of Foreign patients', Issue 35 available at: http://archive.constantcontact.com/fs037/1102570284699/archive/1103662410739.html (last accessed on 19 May, 2011).
10. Indian Express (2011), 'MCI gives nod to 21 new colleges, adds 1,800 seats', July 1, Mumbai.
11. Empower (undated), 'JCAHO Compliance Training (Joint Commission)', available at: http://www.empowerbpo.com/JCAHO_Compliance_Training.html (last accessed on May 20, 2011).
12. Hindustan Times (2007), 'UK tightens entry norms', April 20, New Delhi.
13. Hindustan Times (2010b), 'UK shuts door on Indian docs', September 10, New Delhi.
14. Jain, Neha and Sandeep Sinha (2009), 'Wn DC.hite Paper on Healthcare Sector', T.A. Pai Management Institute, available at: http://tapmiblogs.files.wordpress.com/2010/03/white-paper-on-healthcare-sector.pdf (last accessed on May 20, 2011).
15. Todd, Stephen (undated), 'Heart Surgery Costs – Why You Should Consider India', available at: http://www.healtharticlebank.com/Article/Heart-Surgery-Costs---Why-You-Should-Consider-India/1438 (last accessed on May 20, 2011).
16. Ministry of Commerce, 'India's Submissions to Trade partners', Government of India, accessible from www.commerce.nic.in (last accessed on May 20, 2011).
17. Taneja, Nisha, Arpita Mukherjee, Sanath Jayanetti and Tilani Jayawardane (2004), 'Indo-Sri Lanka Trade in Services: FTA II and beyond', Working Paper No. 145, New DelhiTaneja, Nisha, Arpita Mukherjee, Sanath Jayanetti and Tilani Jayawardane (2004), 'Indo-Sri Lanka Trade in Services: FTA II and beyond', Working Paper No. 145, New Delhi,未出版
18. Medical Council of India (undated), 'Annual Reports' (various issues) available at http://www.mciindia.org/AboutMCI/AnnualReports.aspx (last accessed on 19 May, 2011).
19. Government of United Kingdom, Department of Health (2004), 'Code of Practice for the international recruitment of healthcare professionals', available at: http://www.dh.gov.uk/assetRoot/04/09/77/34/04097734.pdf.", London.
20. Hindustan Times (2011a), 'Lanka scraps visa on arrival for Indians', May 27, New Delhi.
21. Mediminds (undated), 'Opportunities in Indian Healthcare Industry', available at: http://www.mediminds.com/files/Indian%20Healthcare%20Industry%20Presentation.pdf (last accessed on May 20, 2011).
22. Ministry of External Affairs (2005), 'India's Foreign Relations Documents 2005', available at: http://meaindia.nic.in/staticfile/meapublication/foreign%20relations%202005.pdf (last accessed on May 20, 2011).
23. Hindustan Times (2011b), 'Foreign Faculty in Med Colleges soon', May 26, New Delhi.
24. Cosmetic Plastic Surgery Costs (undated), 'Cosmetic Plastic Surgery Costs', available at: http://www.cosmeticplasticsurgerystatistics.com/costs.html (last accessed on May 20, 2011).
25. India Law Offices (undated), 'Indian Healthcare Sector', available at: http://www.indialawoffices.com/pdf/healthcaresector.pdf, (last accessed on May 20, 2011).
26. Dawson, Sarah and Keith Pollard (2007), 'Guide to Medical Tourism', available at: http://www.doctorinternet.info/medical-travelguide/comparing-the-costs/ (last accessed on May 20, 2011).
27. European Union, 'Communication from the European Communities and its Member States: Conditional Revised Offer, WTO Document No. TN/S/O/EEC/Rev.1 (dated 29 June 2005)..
28. Amnesty International(2006).Caring for human rights: Challenges and opportunities for nurses and midwives.London:Amnesty International.
29. Arunanondchai, Jutamas,Fink, Carsten(2007).World Bank Policy Research Working PaperWorld Bank Policy Research Working Paper,未出版
30. Athukorala, Prema-Chandra.Outward Foreign Direct Investment from India.Asian Development Review,26(2),125-153.
31. Bach, Stephen(2004).Migration patterns of Physicians and Nurses: Still the same story?.Bulletin of the World Health Organization,82(8),624-625.
32. Buchan, James(2007).Asia Research Institute Working Paper SeriesAsia Research Institute Working Paper Series,Singapore:National University of Singapore.
33. Buchan, James,Jobanputra, Renu,Gough, Pippa,Hutt, Ruth(2006).Internationally recruited nurses in London: a survey of career paths and plans.Human Resources for Health,4(14)
34. Buchan, James,Kingma, Mireille,Lorenzo, F. Marilyn(2005).International migration of nurses: trends and policy implications.Geneva:International Council of Nurses.
35. Buchan, James,Seccombe, Ian(2006).Worlds Apart? The UK and International Nurses.London:Royal College of Nursing.
36. Cattaneo, Olivier(2009).World Bank Policy Research Working PaperWorld Bank Policy Research Working Paper,Washington DC:.
37. Chaisse, Julien,Chakraborty, Debashis,Nag, Biswajit(2011).A Note on India's Recent Involvement in Trade Blocs (2003-2009): Regionally Sharpening the Multilateral Agenda?.Connecticut Journal of International Law,26(2)
38. Chakraborty, Debashis(2009).Trade in Health Services: The Case of Cross-Border Movement of Nurses and Midwives.Gender and Trade Newsletter,9(3)
39. Chanda, Rupa(2001).ICRIER Working PaperICRIER Working Paper,New Delhi:.
40. Chanda, Rupa(2011).India-EU relations in health services: prospects and challenges.Global Health,7(1)
41. Chanda, Rupa,WHO India Country Office(2007).Foreign Investment in Hospitals in India: Status and Implications.New Delhi and WTO Cell, Ministry of Health and Family Welfare, Government of India.
42. Clark University(2010).Investing In India: A Guide to U.S. Investors.Worcester, MA:Graduate School of Management.
43. Economist(2005).African migration: Home, sweet home - for some.Economist,August,37-38.
44. Editorial(2007).Gregorian.Lucknow:King George Medical College.
45. Ganguly, Debjani(2005).ICRIER Working PaperICRIER Working Paper,New Delhi:.
46. Gootiiz, Batshur,Mattoo, Aaditya(2009).World Bank Policy Research Working paperWorld Bank Policy Research Working paper,Washington DC:.
47. Herrick, Devon M.(2007).NCPA Policy ReportNCPA Policy Report,Dallas:National Center for Policy Analysis.
48. High Commission of India, Colombo(2011).India-Connects.The Economic and Business Newsletter,2(2)
49. Kinfu, Yohannes,Poz, Mario R. Dal,Mercerb, Hugo,Evans, David B.(2009).The health worker shortage in Africa: are enough physicians and nurses being trained?.Bull World Health Organ,87,225-230.
50. Kumar, Pranav,B, Simi T..,未出版
51. Ministry of Health and Family Welfare(1983).National Health Policy.New Delhi:Government of India.
52. Ministry of Health and Family Welfare(2002).National Health Policy.New Delhi:Government of India.
53. Mishra, S. K.,Kapoor, L.,Singh, I. P.(2009).Telemedicine in India: current scenario and the future.Telemedicine and e-health,15(6),568-575.
54. Mukherjee, Arpita,Mody, Aditi,Taneja, Nisha,Sachdeva, Ruchika(2003).ICRIER Working PaperICRIER Working Paper,New Delhi:.
55. News Report(2007).Pranab Mukherjee launches pilot projects of PAN.Africa Quarterly,47(2),8.
56. Pittman, Patricia,Folsom, Amanda,Bass, Emily,Leonhardy, Kathryn(2007).U.S.-Based International Nurse Recruitment: Structure and Practices of a Burgeoning Industry.Washington DC:AcademyHealth.
57. Planning Commission(2008).Report of the High Level Group on Services Sector.New Delhi:Government of India.
58. Prime Minister''s Office(2004).National Common Minimum Programme.New Delhi:Government of India.
59. Robinson, Vaughan,Carey, Malcolm(2000).Peopling Skilled International Migration: Indian Doctors in the UK.International Migration,38(1),89-108.
60. Shet, Arun S.(2008).Physician migration: Trends and long term perspectives.The National Medical Journal of India,21(5),246-247.
61. Stevens, P.(ed.),Chakraborty, D.(ed.)(2009).Towards a Healthy Future? Indian and Global Experiences.New Delhi:Bookwell.
62. Stokes, Bruce(2007).Bedside India.National Journal,May
63. World Health Organisation(2006).Poverty, Trade and Health: An Emerging Health Development issue.Geneva:World Health Organisation.
64. Yamagata, Tatsufumi(2007).Institute of Developing Economies Discussion PaperInstitute of Developing Economies Discussion Paper,Tokyo:Japan External Trade Organization (JETRO).