Cosmetic Tourism Healthcare Policy Analysis Paper

This is a healthcare policy analysis paper. The purpose of a health policy analysis report is to find and define a health care problem, research it and recommend policies to resolve the problem. It is designed to define a PROBLEM that you want to solve through policy recommendations based on data and research studies.The umbrella topic is Medical Tourism, and the subtopic I am working on is cosmetic surgery abroad, aka. cosmetic tourism. Cosmetic tourism is someone who goes abroad (outside the U.S. in my case) to get a cosmetic procedure performed in regions like Central and South America, Asia and Europe.I have attached my literature review regarding this topic, so you may familiarize yourself.
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5 Step Method for a
Writing Policy Analysis
1. Problem Statement
2. Background
3. Landscape
4. Options
5. Recommendation
6. Conclusion
Problem Statement
? Defines the problem
? Written in the form of a question
? Be succinct and specific!
? Needs & concerns of your client
Which one is a better policy statement?
? Should the senator’s top priorities include drafting
legislation regarding the need to address homelessness
and mental illness?
VS.
? What type of legislation should the senator draft for his
top priority of reducing homelessness among the mentally
ill?
Narrow or Broad but NOT Vague
? Narrow statements = less background & landscape info., do
not capture big picture
? Broad statements = more background & landscape info.,
capture big picture
? Vague = unfocused rambling paper. Use limitations such as
geography, time, or numerical boundaries
How can this problem statement be
focused?
What is the best use of the CDC’s resources to
improve the health status of our citizens?
How is this better?
What preventable health issue should
be the top priority for the Centers for
Disease and Control in the next year?
Ask yourself:
Can you imagine 3 to 5 potentially
viable options to address your
problem?
Problem Statement
? Concise & precise
? All other sections relate directly to your
problem statement
? Can always revise problem statement
Background
? Provides factual information to understand
the problem
? Informational only
? Keep your audience in mind
? Facts
? Preamble to policy analysis
Background
? Write to your client and his/her level of
understanding.
? If your client doesn’t have background
knowledge of mental illness, provide
details.
? Create a complete picture.
Background
What type of legislation should the senator draft for his top
priority of reducing homelessness among the mentally ill?
? If your client doesn’t have background
knowledge of mental illness, provide
details.
Landscape
? Reviews the various stakeholders & concerns
? I.D. key stakeholders (beyond the client)
? I.D. Key Factors (political, economic, practical,
legal factors)
Landscape
? Provides overall context
? Organize by stakeholders OR key factors
? Stakeholder 1 and address the key factors
? Key factor and address the stakeholders
? Tone is neutral and objective
Options
? Describe & Analyze 3-5 options to address
the problem
? Analysis of each option
? Pros and cons
? Equal analysis of each option (no favoritism)
? Develop 3-5 criteria for pro/con analysis
? Cost, ROI, political feasibility
? See table 13-2, pg. 261 in reading
Options
? Consider your client’s powers and values
when determining which 3-5 options to
detail.
? Maintaining the status quo can be an option.
? Address the pros and cons.
? Must flow from Problem Statement
Identify, Analyze & Assess Options
?
?
?
Gather information
? Background info.
? Review the literature
? Collect new data
? Survey best practices
? Interview stakeholders
Consider health, feasibility, finances, budget, infrastructure, potential
partners, and the needs and concerns of the stakeholders (all of them!).
Come up with 3-5 potential policies and assess them.
¦ List of criteria (rubric) for analysis – table option
¦ Note pros and cons of each option
Options
? Headings
? Bullets
? See Box 13.2 in your reading
? Side-by-side table
? Descriptive or analytical
? Supplemental to your text
? Table 13.1 & 13.2
Recommendation
? Offer 1 option as the best solution
? Why was it chosen?
? How was it reached?
? Consider client’s values and power
? Drawbacks of the option
? How can drawbacks be handled?
Conclusion
? Be Concise
? Summarize your findings
? Conclude with a persuasive statement
References & Appendices
? APA – use your manual!
? In-text citations need to match your
reference list and vice versa!
Running head: MEDICAL TOURISM
Literature Review: Medication Tourism
1
MEDICAL TOURISM
2
Evolution of Medication Tourism
The U.S. established itself as a world power because of its thriving economy, growing
population, and powerful military. However, one sector that the U.S. can’t take pride in is the
cost of medicine. It is no secret to the average American that prescription drug costs are higher
than in other developed nations (Kesselheim, Avorn, & Sarpatwari, 2016). In turn, the notion of
affordable prescription drugs abroad has enthralled Americans to explore the industry of
medication tourism. American patients, outlined as medication tourism, are traveling to foreign
nations so they may purchase prescription drugs at a fraction of the price they would have been
charged in the U.S. For instance, the remedy for Hepatitis C is usually treated by Sofosbuvir,
which is also available in 91 developed nations, but the price tag for a month supply in the U.S.
is $30,000 and in South Asia it’s only $300 (Baker, 2014). Additionally, Whalen (2015),
mentioned that of the top 40 name brand medications, U.S. consumers paid 93% more than
buyers in the European nation of Norway. This new business enterprise, enclosed under the
umbrella of medical tourism, is having a tremendous impact on the U.S. economy. Roughly $20
billion dollars annually are spent abroad, a figure that is projected to keep increasing (Baker,
2014). In turn, such loss in the U.S. became a gain for the Asian pharmaceutical market,
specifically, in the countries of Thailand, Singapore, Malaysia, and India, who had a combined
revenue of $4.4 billion due to medication tourism (Wong Kee, 2012). Overall, the business of
medication tourism in Asia is forecasted to have a revenue of over $14 billion in the next four
years (“Asia Medical Tourism Market and Forecast”, 2017).
Implications of Medication Tourism
Patients engaging in medication tourism usually do not consider the repercussions this
has domestically on the market price of medication. To begin with, pharmaceutical companies
MEDICAL TOURISM
3
are constantly analyzing their revenue, so if a drug manufacturer observes that less consumers
are purchasing their medication, to reconcile their loss, they increase the price(s) of such drug(s)
(“The Real Costs of Medical Tourism”, 2013). Drug developers, shielded by the authority
granted by legal patents, increase costs knowing that users will pay premium prices so they can
maintain and/or treat their condition. Consequently, individuals who aren’t traveling abroad for
prescriptions are then burdened with paying higher prices. Drug companies have the legal right
to increase prices, since there is no federal regulation to deter them; however, in developed
nations like Norway, prices are government controlled (Whalen, 2015). Therefore, similar
measures, such as in those of Norway, must be taken mirrored by the U.S. government to
regulate control the cost of pharmaceutical Otherwise, cost will keep rising for consumers, as it
has for the past three consecutive years (Tuttle, 2016). The U.S. government can achieve this
goal through negotiating the cost of medication with drug manufactures, which can reduce the
annual expenditure on medical services. Individuals that are clients of medication tourism have a
higher risk of having adverse effects from medications obtained abroad. At first, medication
tourism has a certain panache to it, but upon further examination, hazards such as being sold
counterfeit, fake, or altered drugs without any knowledge are exposed (“The Real Costs of
Medical Tourism”, 2013). For insistence, in 2006, over 300 people in Panama had kidney failure
because of a counterfeit drug from Asia that substituted an ingredient found in the brand name
medication for antifreeze, causing 100 deaths (Bogdanich & Hooker, 2007). The cost to treat and
care for those individuals came out of the Panamanian healthcare system, not the country who
supplied the medication, consequently raising the expenditure for medical services in that given
year. Now, the Asian pharmaceutical market may be increasing their revenues, but eventually
this business will impact the needs of people in that region. Medication tourism will eventually
MEDICAL TOURISM
4
affect prescription drug costs for the locals of these destinations because the value of a good is
usually calculated from the domestic demand. The market for pharmaceutical tourism isn’t
expected to slow down in Asia and the influx of prescription drug tourists paying with their
foreign currency, such as dollars or euros, can potentially drive drug prices to increase. In turn,
this can create access and care issues for natives who pay for their medicine in local currency.
Also, most prescription drug tourists render their products from private institutions, while locals
are dependent on public assistance, such as the people of Thailand who have universal healthcare
funded by the government (NaRanong & NaRanong, 2011). At some point, less money will be
invested into the public sector and that will spawn slower growth, poor management of
resources, and infrastructure shortfalls (Jagyasi, 2010).
Conclusion
The exodus in search of affordable treatment represents a major deficiency for the U.S.,
both from a societal standpoint as well as a financial perspective. Medical tourism does seem
great from the outside looking in, but the reality is that this multibillion-dollar industry is
impacting the healthcare system. The literature provides the insights necessary to derive what
patients/consumers are looking for and what caused them to pursue medical tourism. Having
more than a basic understanding of consumer’s behavior, their triggers, and their motives are
necessary for developing a comprehensive policy; future policies must transcend the
metaphorical ‘light bandaging of the hemorrhaging’ which current policies accomplish, as the
alternative of outsourcing all care and procedures is not ethical (Crooks et al, 2013). The benefit
of having established guidelines regarding the practice of medical tourism is that it will create a
standard of practice, as well as alleviate the toll on local and foreign healthcare systems and
economies. At this point, given the fact that healthcare is evolving rapidly just like medical
MEDICAL TOURISM
5
tourism, all literature utilized in the analysis weighs in heavily in designing a policy that is not a
mere quick fix.
MEDICAL TOURISM
6
References
Asia medical tourism market and forecast to 2022 Report 4301782. (2017, June). Research and
Markets. Retrieved from
https://www.researchandmarkets.com/research/gpnqcn/asia_medical
Baker, D. E. (2014). Has the time come for “medication tourism”? Hospital Pharmacy, 49(11),
999–1000. doi: 10.1310/hpj4911-999.
Bogdanich, W., & Hooker, J. (2007, May 6). From China to Panama, a trail of poisoned
medicine. The New York Times Company. Retrieved from

Crooks, V. A., Turner, L., Cohen, I. G., Bristeir, J., Snyder, J., Casey, V., & Whitmore, R.
(2013). Ethical and legal implications of the risks of medical tourism for patients: A
qualitative study of Canadian health and safety representatives’ perspectives. British
Medical Journal Open, 3(2), 1 – 9. doi:10.1136/bmjopen-2012-002302
Jagyasi, P. (2010, October). Medical tourism impact it’s more than obvious. Medical Tourism
Magazine. Retrieved from http://www.medicaltourismmag.com/medical-tourism-impactitaes-more-than-obvious/
Kesselheim A.S., Avorn J., & Sarpatwari A. (2016). The high cost of prescription drugs in the
United States: Origins and prospects for reform. Journal of the American Medical
Association, 316(8), 858–871. doi:10.1001/jama.2016.11237
NaRanong, A., & NaRanong, V. (2011). The effects of medical tourism: Thailand’s experience.
Retrieved from Bulletin of the World Health Organization:
http://www.who.int/bulletin/volumes/89/5/09-072249/en/
MEDICAL TOURISM
The real costs of medical tourism. (2013, November). InsuranceQuotes.org. Retrieved from
7
http://www.insurancequotes.org/health/the-real-costs-of-medical-tourism/
Tuttle, B. (2016, July). Prescription drug prices in America are rising like no other industry. Time
Inc. Retrieved from http://time.com/money/4406167/prescription-drug-prices-increasewhy/
Whalen, J. (2015, December). Why the U.S. Pays more than other countries for drugs. The Wall
Street Journal. Retrieved from https://www.wsj.com/articles/why-the-u-s-pays-morethan-other-countries-for-drugs-1448939481
Wong Kee, M. (2012). Medical tourism in Asia: Thailand, Singapore, Malaysia, and India. In
C.M. Hall (Ed.), The Ethics, Regulation, and Marketing of Health Mobility (pp. 167-186).
Retrieved from
https://www.researchgate.net/publication/259486257_Medical_Tourism_in_Asia_Thaila
nd_Singapore_Malaysia_and_India
Running head: MEDICAL TOURISM
Literature Review: Medication Tourism
1
MEDICAL TOURISM
2
Evolution of Medication Tourism
The U.S. established itself as a world power because of its thriving economy, growing
population, and powerful military. However, one sector that the U.S. can’t take pride in is the
cost of medicine. It is no secret to the average American that prescription drug costs are higher
than in other developed nations (Kesselheim, Avorn, & Sarpatwari, 2016). In turn, the notion of
affordable prescription drugs abroad has enthralled Americans to explore the industry of
medication tourism. American patients, outlined as medication tourism, are traveling to foreign
nations so they may purchase prescription drugs at a fraction of the price they would have been
charged in the U.S. For instance, the remedy for Hepatitis C is usually treated by Sofosbuvir,
which is also available in 91 developed nations, but the price tag for a month supply in the U.S.
is $30,000 and in South Asia it’s only $300 (Baker, 2014). Additionally, Whalen (2015),
mentioned that of the top 40 name brand medications, U.S. consumers paid 93% more than
buyers in the European nation of Norway. This new business enterprise, enclosed under the
umbrella of medical tourism, is having a tremendous impact on the U.S. economy. Roughly $20
billion dollars annually are spent abroad, a figure that is projected to keep increasing (Baker,
2014). In turn, such loss in the U.S. became a gain for the Asian pharmaceutical market,
specifically, in the countries of Thailand, Singapore, Malaysia, and India, who had a combined
revenue of $4.4 billion due to medication tourism (Wong Kee, 2012). Overall, the business of
medication tourism in Asia is forecasted to have a revenue of over $14 billion in the next four
years (“Asia Medical Tourism Market and Forecast”, 2017).
Implications of Medication Tourism
Patients engaging in medication tourism usually do not consider the repercussions this
has domestically on the market price of medication. To begin with, pharmaceutical companies
MEDICAL TOURISM
3
are constantly analyzing their revenue, so if a drug manufacturer observes that less consumers
are purchasing their medication, to reconcile their loss, they increase the price(s) of such drug(s)
(“The Real Costs of Medical Tourism”, 2013). Drug developers, shielded by the authority
granted by legal patents, increase costs knowing that users will pay premium prices so they can
maintain and/or treat their condition. Consequently, individuals who aren’t traveling abroad for
prescriptions are then burdened with paying higher prices. Drug companies have the legal right
to increase prices, since there is no federal regulation to deter them; however, in developed
nations like Norway, prices are government controlled (Whalen, 2015). Therefore, similar
measures, such as in those of Norway, must be taken mirrored by the U.S. government to
regulate control the cost of pharmaceutical Otherwise, cost will keep rising for consumers, as it
has for the past three consecutive years (Tuttle, 2016). The U.S. government can achieve this
goal through negotiating the cost of medication with drug manufactures, which can reduce the
annual expenditure on medical services. Individuals that are clients of medication tourism have a
higher risk of having adverse effects from medications obtained abroad. At first, medication
tourism has a certain panache to it, but upon further examination, hazards such as being sold
counterfeit, fake, or altered drugs without any knowledge are exposed (“The Real Costs of
Medical Tourism”, 2013). For insistence, in 2006, over 300 people in Panama had kidney failure
because of a counterfeit drug from Asia that substituted an ingredient found in the brand name
medication for antifreeze, causing 100 deaths (Bogdanich & Hooker, 2007). The cost to treat and
care for those individuals came out of the Panamanian healthcare system, not the country who
supplied the medication, consequently raising the expenditure for medical services in that given
year. Now, the Asian pharmaceutical market may be increasing their revenues, but eventually
this business will impact the needs of people in that region. Medication tourism will eventually
MEDICAL TOURISM
4
affect prescription drug costs for the locals of these destinations because the value of a good is
usually calculated from the domestic demand. The market for pharmaceutical tourism isn’t
expected to slow down in Asia and the influx of prescription drug tourists paying with their
foreign currency, such as dollars or euros, can potentially drive drug prices to increase. In turn,
this can create access and care issues for natives who pay for their medicine in local currency.
Also, most prescription drug tourists render their products from private institutions, while locals
are dependent on public assistance, such as the people of Thailand who have universal healthcare
funded by the government (NaRanong & NaRanong, 2011). At some point, less money will be
invested into the public sector and that will spawn slower growth, poor management of
resources, and infrastructure shortfalls (Jagyasi, 2010).
Conclusion
The exodus in search of affordable treatment represents a major deficiency for the U.S.,
both from a societal standpoint as well as a financial perspective. Medical tourism does seem
great from the outside looking in, but the reality is that this multibillion-dollar industry is
impacting the healthcare system. The literature provides the insights necessary to derive what
patients/consumers are looking for and what caused them to pursue medical tourism. Having
more than a basic understanding of consumer’s behavior, their triggers, and their motives are
necessary for developing a comprehensive policy; future policies must transcend the
metaphorical ‘light bandaging of the hemorrhaging’ which current policies accomplish, as the
alternative of outsourcing all care and procedures is not ethical (Crooks et al, 2013). The benefit
of having established guidelines regarding the practice of medical tourism is that it will create a
standard of practice, as well as alleviate the toll on local and foreign healthcare systems and
economies. At this point, given the fact that healthcare is evolving rapidly just like medical
MEDICAL TOURISM
5
tourism, all literature utilized in the analysis weighs in heavily in designing a policy that is not a
mere quick fix.
MEDICAL TOURISM
6
References
Asia medical tourism market and forecast to 2022 Report 4301782. (2017, June). Research and
Markets. Retrieved from
https://www.researchandmarkets.com/research/gpnqcn/asia_medical
Baker, D. E. (2014). Has the time come for “medication tourism”? Hospital Pharmacy, 49(11),
999–1000. doi: 10.1310/hpj4911-999.
Bogdanich, W., & Hooker, J. (2007, May 6). From China to Panama, a trail of poisoned
medicine. The New York Times Company. Retrieved from

Crooks, V. A., Turner, L., Cohen, I. G., Bristeir, J., …
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