TL and Medical Tourism

[Pope Uncommon the Dainty]

Originally Posted by SteveS

Meanwhile, people in Cancun who depend on the national health care get the sort of care one might expect in a country on the border between developed and third world. It's probably much better than the care a poor person in the US gets, but far short of what wealthy or well-insured people in the US get, or what one can get in the medical tourism hospital.

This. One of the most gameable and sad realities about tourism is the massive inequalities that it creates and engenders, as well as the cultural hegemony it can then exert. The people who live in a tourist destination often make far less money than is needed to pay the prices aimed at the wealthy tourists, and (worse, perhaps) the only way they can come close is by working for the resorts or whatever that attract the tourists. Things only get worse when there's a 3-TL (frex) difference between the two groups, and the tourism is medical. You could run an entire campaign (either single-system or circuit hospital ship) telling these kinds of stories, including everything from natives begging tourists to pay for their children's or elder's healthcare to theft and sabotage by the lower classes to out-and-out class warfare. And where do the various nobles involved stand on these issues?

***

As a transwoman (genderqueer, but transwoman works as well as anything else does), this also brings to mind the phenomenon of transfolk going to Thailand (most famously) to get their gender-affirming surgery. Obviously, it's because of cost and it's same TL, but it's also because of inherent prejudice in our culture, society, economy, and insurance system. Play around with all of those, maybe mix and match them. Any spaceship with a doctor might find itself asking what it should do when a local celebrity, politician, or religious figure of a world without the technology to perform gender-affirming surgery beyond a sharp knife shows up at the spaceport, asking them to do the surgery. Does their answer change if the planet's culture is very accepting of trans identities?

***

I also think of the brain GAIN Cuba has experienced for some time. It's because they built one of the best medical education systems in the world ~ and, like true communists, offered to allow at least a good chunk of the tuition to be paid in labor. Sure, embargoes meant that you had outdated, inadequate, or just very little equipment while you did the two years guest labor to pay off your schooling, but it meant you were top of your field globally. Imagine that happening on one of the lower-TL planets in your subsector. They can't provide the whizbang tools, but they've managed to scrape together enough money for databases and virtual holographic teachers and direct skill download from the higher-TL planets that their medical education system is the best in the subsector, but you have to work for them for 4 years to pay for that schooling. Northern Exposure in the Third Imperium, anybody? A character who took the training and ran from the labor? Wars developing as the planetary noble, desperate to keep his edge faces losing one of the suppliers of educational materials?

[swordtart]

Originally Posted by ravenfish

Does the phenomenon of people traveling from a developed to a less developed country in search of cheaper health care occur in countries other than the United States?

We chose to have specialist treatment done privately in Germany rather than the UK for a number of reasons.

The UK National Health System (NHS) though excellent value for routine medical care(IMHO) isn't really suited to unusual medical conditions, due to resource constraints (they can't afford to have a specialist in obscure medical conditions on stand-by just in case). As a result specialist treatment is available state-paid but there are often long waiting lists. Alternatively you can pay to have it done privately within a much reduced time-frame. Once you have decided to go private you may as well shop around.

Germany had a world renowned specialist and whilst there were some specialists in the UK, they didn't have the same international reputation. The best in the world has to live somewhere, why wouldn't you travel to the best in the world (or galaxy) if you could afford it.

As someone else pointed out, it is not just the treatment, there is also recovery to consider. In our case the total cost of the treatment plus a few days locally in a hotel so that daily monitoring could occur was less in Germany than London. Favourable exchange rates and the fact that you can find European hotels that are less expensive than London hotels meant we could spend a long weekend in Hamburg for the price of 2 nights in London and could therefore have a few days decompressing. For me as a Brit, a few days in Hamburg is more fun than a few days in London anyway. There was the psychological benefit of thinking of the trip as a "holiday" to Hamburg plus some treatment compared to thinking of it as going to London for treatment.

Our one experience of a German hospital was that it seemed to be better equipped, maintained and run than the UK hospitals we have been to in the past. It should be remembered however that this was a private hospital and we have only been in NHS hospitals (and you only tend to dwell on the bad things about hospitals). A positive medical experience (in terms of feelings rather than any treatment) can generate psychological (placebo) recovery benefits.

[The Colonel]

Originally Posted by swordtart

We chose to have specialist treatment done privately in Germany rather than the UK for a number of reasons.

The UK National Health System (NHS) though excellent value for routine medical care(IMHO) isn't really suited to unusual medical conditions, due to resource constraints (they can't afford to have a specialist in obscure medical conditions on stand-by just in case). As a result specialist treatment is available state-paid but there are often long waiting lists. Alternatively you can pay to have it done privately within a much reduced time-frame. Once you have decided to go private you may as well shop around.

I've heard plenty of reference to people going a lot further than Germany to get work done - apparently there's plenty of places in South Asia that can do good quality work at low prices.