Working Paper

Trade in Health Services - An Analytical Framework

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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


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