Globalization: the key challenge facing health economics in the 21st century.

摘要

Over 1 million people travel to Asia each year to receive healthcare, contributing some USdollar2 billion to the region's economy. Over 30% of the UK's health workforce is of foreign origin. Over 50% of the doctors trained in Ghana emigrate. Cuba is a regional hub for tele-radiology services. Private companies from India, Singapore and elsewhere invested more than USdollar1 billion last year in establishing hospitals or other ventures abroad (Smith et al., 2007).As the global movement of goods, services, capital and people grows, what will be the impact on health systems and population health? What will be the implication of increased economic liberalization in other sectors on the health sector and on population health? What impact do health issues, such as infectious disease or obesity, have on non-health sectors? How well placed is health economics to address such questions? What advice would health economists give to policymakers facing these issues? In contrast to economists working in other sectors, health economics curricula and research predominantly concern micro-economic analysis within the health sector (notwithstanding some important cross-sectoral work on the determinants of health, and cross-country appraisal of health systems). This editorial argues that such a narrow methodological and geographic focus will be insufficient for health economics to remain relevant to health policy in the 21st century. It is suggested that globalization has, and will increasingly have, significant effects on health and healthcare, and that the challenge facing health economics is to engage with the issues this raises.