The notion of healthcare provision and financing as an essential component of the role of the
nation state gained ascendancy in many developing and newly-independent countries through
the post-World War II years. In these countries, the welfare-oriented approach fitted well
with developmental-nationalist goals, but was also led and supported by international health
policy, enunciated as the primary health care strategy in the Alma-Ata Declaration of 1978.
Through the 1980s, however, as the welfarist-nationalist project gave way to the neo-liberal
agenda, the private health sector in many countries grew increasingly prominent.
Privatisation of the healthcare sector took many varied forms, but everywhere it was the
primary mechanism by which the neo-liberal agenda took hold. Nowhere is this clearer than
in the emerging market economies of Asia, where private capital is increasingly making
inroads into the healthcare sector, leading to the emergence of a globalising healthcare
industry, seen in the multinational and transnational character of healthcare corporations, the
international movement of skilled personnel (particularly nurses), and the creation of an
international market for medical services.
The transnational character of healthcare provision is reflected in healthcare corporations that
own and manage healthcare facilities and conduct healthcare activities – such as human
resource training and medical referrals -- between countries. For example, a hospital in one
country may refer cases to a sister hospital in another country, or a corporation’s nurses’
training facility in one country may provide the training of its nursing personnel from another
country.