One of the world’s most respected journals, The Economist, suggests this week that Medical Tourism is the proverbial tide that lifts all boats. In an article headlined “Importing Competition,” the magazine says the “coming boom in medical travel could help both rich and poor.”

By “rich,” they mean the United States and the developed economies of the west — not wealthy individuals. By “poor,” they mean the Latin American, Asian, Eastern European and African countries that are becoming medical tourism destinations.

The argument in “poor” countries against medical tourism is that providing private medical infrastructure for foreign patients will divert resources from improving health care locally. But The Economist asserts:

But the private sector cannot be blamed for the failings of state-run health bureaucracies in developing countries, which neglected the poor long before medical tourists arrived. And the foreigners’ arrival could improve things in developing countries, for the poor as well as the rich. Although the hospitals that cater to medical tourists will of course employ local staff, they will also create jobs, tempt home émigré doctors and nurses, encourage locals to train as medics, spread know-how and treat local people.

An argument against medical tourism from the point of view of the “rich” is that the United States (for example) needs to focus on cutting costs and improving efficiency of its own healthcare system rather than having patients go overseas. The Economist suggests that medical tourism is part of the solution, not part of the problem:

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Sometimes, you can’t go it alone and get satisfaction. Individual consumers with complaints, however valid, are rarely a match for the sort of colossal indifference that a big corporation or government entity can routinely bring to bear on a problem.

And most medical tourists and travelers go it alone. I know I did, in 2004. I did my research. I talked to other people who had been overseas for healthcare. I vetted my doctor. And I went, and I had a great experience.

But what if something had gone wrong — if I had been unhappy with my treatment or had complications? I like and trust my doctors; I know they would have done everything they could to “make it right.” But I have no way of knowing what would have happened, really.

Earlier this week, the Washington Post ran a story about a patient, Betty Meisel of Portland, Oregon, who went to Thailand in 2005 for plastic surgery and had things go wrong. The hospital, perhaps the best-known destination for international patients, claimed three years later to have not received the email she says she sent back then regarding her terrible surgical outcomes. When contacted by a reporter in April, the hospital did write to Meisel and issued a refund.

Which didn’t make everything OK, of course, though it was something.

Years ago, stories like Betty’s were more the rule than the exception, when reporters wrote about medical tourism. This was not because the medical facilities and doctors overseas were bad, but because reporters didn’t know enough to place a single bad outcome in context. The “news value” would be the oddness of someone going overseas for surgery, and the media treated bad surgical outcomes almost with a “what else would you expect?” kind of demeanor. The media learned, over time, and stopped reporting the small percentage of bad results as the norm. Bumrungrad International, in fact, has a reported complication rate that any U.S. hospital would be proud to match.

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