Medical tourism and the state in Malaysia and Singapore

A striking feature of the medical tourist industry that has developed in Asia since the late 1990s is the involvement of States in supporting the private sector in marketing healthcare services to foreign patients. Malaysia and Singapore, two of the leading players in this field, have, since the 1980s, embarked on healthcare reforms, resulting in an enlarged private healthcare sector. The Singapore state, moving toward state corporatism, has advanced further in its healthcare reforms, and is therefore able to minimize the gap between government and private health services. The Malaysian state, fragmented and facing greater opposition, has not been able to advance as far in its healthcare reforms, and faces a growing gap between public and private health services. Nevertheless, both countries face a shortage of doctors in the public sector, and rising costs and user charges: problems that are exacerbated by a growing private market in healthcare to which the medical tourist industry contributes. As successful market economies, the cases of Malaysia and Singapore serve to illustrate the potential effects of healthcare reforms and commercialization of healthcare on social policy; particularly salient in the context of an emerging focus on trade in health services as a possible growth engine for countries' economic development.