Working Paper

Trade in Health Services - An Analytical Framework

The present paper deals with a topic that pertains to Health Economics as well as to Trade Theory

– Trade in Health Services. It is intended to deliver an analytical framework for the assessments

of this new sector of international trade which takes into account both the ‘general

welfare aspects’ and the effects for the achievement of general ‘health system goals’. While to

former will be scrutinized by the subcategories allocation, accumulation and location effects,

the latter is aligned with the OECD Health System Performance Framework which mentions

three major health system goals that are ‘Health Improvement & Outcome’, ‘Responsiveness &

Access’ and ‘Financial Contribution & Health Expenditures’. For this purpose trade in Health

Services is split up according to the four modes of service supply introduced by the General

Agreement of Trade in Services (GATS). For each mode examples are enclosed and the current

level of trade is analysed. It is also examined what are the major obstacles for trade in these

modes and what liberalization perspectives are given. The subsequent discussion and plausibility

considerations of how each mode may contribute to improve efficiency as well as equity in

national health systems is a systematic starting point for further research. It provides a first

insight in how trade in Health Services could help to overcome resource constraints in national

health systems as well as allude to the potential risks of which sight shouldn’t be lost.


Patricia Waeger


Publication Date