Globalization in health care: is international standardization of quality a step toward outsourcing?

Editorial Globalization in health care: is international standardization of quality a step toward outsourcing? Though different in many respects from other types of services, health care services are also impacted by globalization. For example, some countries, especially developing ones, can attract customers by offering high quality health care at a lower cost than is available in their home country. And although this practice is relatively uncommon at the present time, our hypothesis is that, within a short time, this practice will greatly expand, partly due to the development of global standards of quality and the rise of processes of accreditation, both in health care and medical education. Globalization is characterized by the circulation of goods and services between countries in response to criteria of efficiency. Such multilateral agreements between countries, unfortunately, often function to the detriment of the countries with less developed economies. Nevertheless, trade can also benefit developing countries. Outsourcing is one situation in which developing countries that are able to adopt standards, processes, and language of developed countries can benefit from the liberalization of the movement of goods and services. By undertaking some or all components of production or service provision for clients/consumers in the developed country, some economic benefits may occur to the developing country where the 'outsourced' service is provided. But what, we might ask, is the impact of the process of globalization generally and outsourcing more particularly in the health care sector? The movement of professionals in general tends to be detrimental to poorer countries. There are two aspects to this. The most classic is the settlement of young professionals, originally from less developed countries, in more developed countries from which they have graduated with professional credentials. A second phenomenon is the policy of some rich countries, who because they lack doctors and nurses, try to recruit recently trained graduates from poorer countries. The movement of professionals in this way is facilitated by systems that recognize degrees internationally. This issue has arisen recently, for example, in light of the ascension of Poland and the Czech Republic to the European Union and the mutual recognition of medical degrees that accompanied that integration [1]. Another emerging phenomenon is the development, in less developed countries, of medical curric-ula that have been adapted to North American or Western European standards and are offered in English, allowing such programs to negotiate a higher level of recognition worldwide and to provide …