By Claudia Tanner
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For decades, patients seeking world-class specialist care often traveled to a small cluster of Western medical capitals. But while North American and European hospitals remain prominent, leading institutions are increasingly emerging in Asia, the Middle East and elsewhere.
This shift is driven by distinct economic models across different regions, according to Margaret E. Kruk, professor of health systems and medicine at Washington University. “Countries like India, Singapore, Thailand and South Korea have embraced medical tourism as an economic strategy,” Kruk said. “They are providing advanced services for neighboring lower-income countries, where the demand for quality services is growing faster than their health systems can improve.”
Global health expert Professor Enis Barış of the University of Washington says that for countries that once sent complex cases overseas, investing at home makes sense. “The money spent sending patients abroad could instead endow world-class institutions at home, retain the spending, train a workforce and, in time, reverse the flow by attracting foreign patients,” Barış said.
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Saudi Arabia, through its Vision 2030 government initiative, has modernized its health care system. “Instead of relying exclusively on the gradual expansion of physical facilities, the kingdom strategically prioritized advanced digital infrastructure,” Associate Professor Yazed Sulaiman Alruthia, a health economics researcher at King Saud University in Riyadh, said. He pointed to the Seha Virtual Hospital, which links over 240 hospitals nationwide to provide remote specialist consultations and intensive care monitoring.
“Saudi Arabia has effectively leapfrogged traditional stages of health care development,” he said.
However, Barış noted that research ecosystems, training pipelines and cultures of safety and teamwork cannot simply be purchased. “Institutions are slowly built over decades,” he said. “So long as there is awareness of what can be bought and what needs to be developed locally with patience and perseverance, the leapfrog becomes a crucial first step.”
But there is a crucial distinction between building an exceptional hospital and building an exceptional health care system. While many established Western hospitals face aging infrastructure and tightening budgets, emerging hubs risk deepening existing inequalities in access.
Kruk points to India and Thailand, where high-end private hospitals can offer substantially better care than that available to most citizens. Mishal S. Khan of the London School of Hygiene and Tropical Medicine highlights the risk that scarce, highly qualified doctors become concentrated in hospitals serving wealthier patients and medical tourists.
Indeed, the World Health Organization projects a global shortage of 11 million health workers by 2030.
The emerging global map of specialist care, then, tells two stories at once: countries can increasingly build world-class hospitals, but spreading high-quality care across entire populations remains far harder.
As Barış put it: “It is often easier to globalize ‘vertically’ than ‘horizontally.’”
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