HEALTH care has long seemed one of the most local of all industries. Yet beneath the bandages, globalisation is thriving. The outsourcing of record keeping and the reading of X-rays is already a multi-billion-dollar business. The recruitment of doctors and nurses from the developing world by rich countries is also common, if controversial. The next growth area for the industry is the flow of patients in the other direction–known as “medical tourism”–which is on the threshold of a dramatic boom.
Tens of millions of middle-class Americans are uninsured or underinsured and soaring health costs are pushing them and cost-conscious employers and insurers to look abroad for savings (see article). At the same time the best hospitals in Asia and Latin America now rival or surpass many hospitals in the rich world for safety and quality. On one estimate, Americans can save 85% by shopping around and the number who will travel for care is due to rocket from under 1m last year to 10m by 2012–by which time it will deprive American hospitals of some $160 billion of annual business.
Daily Archives: August 18, 2008
Ancient Midwest
THE earthworks left behind by the long vanished civilizations of the Midwest are harder to spot than the pueblos and kivas of Arizona and New Mexico. For a long time many of them were hidden in plain sight or dismissed as little more than heaps of soil. But the more today’s archaeologists learn about the Midwestern mounds, the more intriguing is the picture that emerges from 1,000 or more years ago: a city with thousands of people just a few miles from present-day St. Louis, a 1,348-foot earthen serpent that points to the summer solstice, artifacts made of materials that could only have arrived over lengthy trade routes.
Looks like a fascinating drive.
The new age of authoritarianism
In 1989, the Berlin Wall fell, democracy was on the march and we declared the End of History. Nearly two decades later, a neo-imperialist Russia is at war with Georgia, Communist China is proudly hosting the Olympics, and we find that, instead, we have entered the Age of Authoritarianism.
It is worth recalling how different we thought the future would be in the immediate, happy aftermath of the end of the cold war. Remember Francis Fukuyama’s ringing assertion: “The triumph of the west, of the western idea, is evident first of all in the total exhaustion of viable systematic alternatives to western liberalism.”
Even in the heady days of 1989, that declaration of universal – and possibly eternal – ideological victory seemed a little hubristic to Professor Fukuyama’s many critics. Yet his essay made such an impact because it captured the scale, and the enormous benefits, of the change sweeping through the world. Not only was the stifling Soviet – which was really the Russian – suzerainty over central and eastern Europe and central Asia coming to an end but, even more importantly, the very idea of a one-party state, ruthlessly presiding over a centrally planned economy, seemed to be discredited, if not forever, then surely for our lifetimes.