Global competition in health care

American managed care companies begin to look for international markets

Your software may come from the United States, your computer from Singapore, your car from Germany or Japan, and your wine from Chile, but no matter where you are reading this your health care is probably provided from your own country. That may be about to change, particularly if you live in the developing world.

Earlier this month the leaders of United States managed health care plans met in Mexico City to look at the opportunities for doing business internationally. The meeting was organised by the American Association of Health Plans and the Academy for International Health Studies. As one delegate said, the rhetoric may have been about learning from other countries but most of the Americans at the meeting were interested in selling. Workshops looked at “market opportunities” in Israel, Korea, Venezuela, Canada, Mexico, Russia, France, Singapore, Brazil, New Zealand, Puerto Rico, Australia, South Africa, and Argentina. Britain was probably absent from the list because its financially constrained health care system provides little room for profit and because many of the methods of managed care are already being used.

The meeting began by looking at general economic trends, and the main development at the end of the 20th century is that global competition is becoming the …