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GATS has several implications on various aspects of social development, especially in the health and education sectors:
Health:
The health sector has a high degree of government involvement in the developing countries, as it is an area of immediate social concern.
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Progressive liberalisation of this sector has both benefits and problems. For example when one looks at the prospect of cross-border exports of health services, it is pointed out that through telemedicine the health care provider can serve the need of the remote and un-served segments of population.
However, it may address the need of selected segments only in view of the prevalent digital divide within the country itself. Following the “consumption abroad mode”, the developing countries can generate foreign exchange by providing healthcare services to other countries. However, there may a contradiction. High quality service may be exported, while low quality is produced for local markets.
Through “commercial presence”, the developing countries can generate additional resources for health care service, generate employment opportunities, reverse the brain-drain, reduce the burden on the government, etc. However, such a possibility would need large foreign direct investment in the health sector.
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As the dual system emerges, better-qualified doctors will flow from the public to the corporate sector. Under the “movement of natural persons” the source country can get more remittances, upgrade skills and standards, and promote exchange of knowledge among health professions as providers of service. The host country, on the other hand, can meet the shortage; improve quality by getting service from the providers.
However, permanent outflows adversely affect the equity and quality of health services in the source countries. “Indeed the bulk of cross-border flows of health care professionals take the form of permanent migration. An estimated 10,000 health professionals emigrated from South Africa between 1989 and 1997. Again a dark side of this human flow from the source countries’ point of view is that it imposes high cost, leads to shortage of trained manpower and loss of public resources. One study estimated that South Africa lost 67.8 billion Rand in human capital investment in health care sector in 1997 (calculated from the training cost of Rand 600,000 per physician), a loss only partly offset by the remittances arising from such outflows”.
Education:
In recent years, the processes of commercialisation of higher education and foreign collaboration therein have increased. The GATS commitment to education services has both the positive and the negative sides. These sides are more or less similar to those of health services.