Insights and Opportunities for the Philippine Medical Student in the ASEAN CommunityAlbert Francis E. Domingo, MD, MSc5 Feb 2016 | San Beda College Mendiola

Outline

1. Trade and HealthChanges in the market for health

servicesGlobal interactions and local

effects2. ASEAN Economic Cooperation

Politics, economics, and cultureRegional Trade Agreements

3. Implications and InsightsWhat to expectWhat to do

1.TRADE AND HEALTH

At the interface of two national interests

Changes in the marketfor health services

From: GBD 2013 Risk Factors Collaborators (2015)

From: WHO (2015)

Framework Agreements for Regional Trade Agreements

▷Market access and national treatment

▷Investment▷Integration of labour markets▷Government procurement▷Reciprocal recognition of

foreign licenses and qualifications

Trade in health-related services

1. Cross-border supplyTelemedicine, e-Health

2. Consumption abroadForeign patients

3. Commercial presenceForeign service provider (e.g.

hospital)4. Movement of natural persons

Health care professionals temporarily work abroad

“Countries are allowed to make legally binding commitments

pertaining to trade and investment in health services

and to formulate such commitments in accordance with domestic health policy

objectives.

2.ASEAN ECONOMIC

COOPERATIONEasier said that done, but it’s happening

From: www.mb.com.ph

From: asean101forjuan.wordpress.com

Recent Timeline

▷1995: ASEAN Framework Agreement on Trade in Services

▷2012: Eight packages of commitments, including some coverage of health care

▷2015: Integration

Process

▷Liberalization commitments are complemented by:

Mutual recognition agreementsCooperative mechanisms

▷Is there real and concrete mutual recognition to facilitate the movements of patients and/or health professionals?

3.IMPLICATIONS AND

INSIGHTWhat to expect; what to do

“As the global movements of

goods, services, capital, people and ideas grow, what

will the impact on health systems and population

health be?

Increased trade in services

▷Historically the focus of trade has been on goods, not people

▷Technology (e.g. Internet) and travel has allowed for cross-border movement of patients and health professionals

“Health policy-makers need

to pay attention to the respective negotiation and implementation processes with a view to achieving health policy objectives.

“Benefits are not automatic, and liberalization needs to

be properly paced and sequenced within the

development of an adequate regulatory, institutional and

policy framework.

From: gov.ph

“Services liberalization is

considered to be more easily negotiated at the regional level, as opposed to the

multilateral level, as RTAs often include countries with

geographic proximity, cultural ties, and similar levels of economic development.

Trade in health-related services

1. Cross-border supplyTelemedicine, e-Health

2. Consumption abroadForeign patients

3. Commercial presenceForeign service provider (e.g.

hospital)4. Movement of natural persons

Health care professionals temporarily work abroad

Main ReferenceWHO. (2015) Trade and Health: Towards building a National Strategy. Geneva: World Health Organization.

Thanks!Any questions?You can find me at:@AlbertDomingoFacebook.com/aedomingoAlbertDomingo.com

Credits

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