International Trade & Business (PMM5363)

International Trade & Business (PMM5363)
Prof. Abdul Hamid Mohamed

Global Business Today 6e
by Charles W.L. Hill McGraw-Hill/Irwin Copyright © 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Introduction In the world economy today, we see
a shift away from self-contained national economies with high barriers to cross-border trade and investment a move toward a more integrated global economic system with lower barriers to trade and investment about $3 trillion in foreign exchange transactions taking place everyday over $12 million of goods and some $3 trillion of services being sold across national borders the establishment of international institutions Internet Extra: The U.S. Census Bureau contains monthly statistics on trade between the United States and its trading partners. The web site is { Click on 2008, then on Total Trade, Next, click on Surplus, and then on Deficit. Who is the top trading partner for the U.S.? What is the top destination for U.S. goods? What country exports the most to the U.S.?

Introduction The effects of this trend can be seen
in the cars people drive in the food people eat in the jobs where people work in the clothes people wear in many other ways

What Is Globalization? Question: What is globalization?
Globalization refers to the trend towards a more integrated global economic system Two key facets of globalization are: the globalization of markets the globalization of production Country Focus: Outsourcing American Healthcare Summary This feature explores the practice of outsourcing medical work to other countries. In recent years, pressures to cut costs in the medical industry have led to the practice of outsourcing. Today, not only is paperwork outsourced to countries such as India, but also the reading of x-rays. In some cases, patients, in an effort to curb costs, are now choosing to have medical procedures conducted in foreign countries. Suggested Discussion Questions 1. A decade ago the idea that medical procedures might move offshore was unthinkable. Today it is a reality. What trends have facilitated this process? Is the globalization of health care good or bad for the American economy? Discussion Points: Advances in technology are a primary key to making the outsourcing of medical work possible in recent years. In particular, the Internet makes it possible to quickly transmit large amounts of data to countries such as India where the information can be processed and returned. In addition, the high cost of medical care in countries like the U.S. is prompting people to consider cheaper alternatives. The cost to repair a leaky heart valve in India is about $10,000 including airfare, while in the U.S. the same surgery could cost $60,000. So, when considered from a strictly economic perspective, the globalization of health care should result in a more efficient industry. Prices in the U.S. should fall as countries like India offer their services as an alternative to higher-priced American ones. It would follow then, that Americans should have more disposable income which could then be spent in other part of the economy. 2. Is the globalization of health care good or bad for patients? Who might benefit from the globalization of health care? Who might lose? Discussion Points: This is a difficult question. Some students might argue that the outsourcing of medical procedures to nations where salaries of medical professional are lower clearly benefits consumers. However, other students might suggest that the level of care in countries such as India may not be up to the standards found in the United States, and that the process takes some control out of the hands of the consumers. Certainly, health care professionals in the United States see the outsourcing trend in a negative light, however, medical insurance companies view any means of cutting costs as a positive move. Most students will probably agree that the current trend to outsource medical procedures is just the beginning. The rising cost of health care is likely to continue to put pressure on the industry to find cheaper alternatives to handling not only direct patient care, but also the paperwork involved. Most students will probably agree that outsourcing to cut costs in the paperwork end of the process makes sense, but may draw the line at the outsourcing of medical procedures. Others however, might point out that the care being offered by some hospitals in countries like India is on par with American hospitals, indeed many of the doctors are American trained. Teaching Tip: To learn how heath insurance companies are using outsourcing to cut costs, go to {

Classroom Performance System
The trend away from distinct national economic units and toward one huge global market is known as Internationalization Economic integration Globalization Privatization Classroom Performance System Answer: c

The Globalization of Markets
The globalization of markets refers to the merging of historically distinct and separate national markets into one huge global marketplace In many markets today, the tastes and preferences of consumers in different nations are converging upon some global norm Examples of this trend include Coca Cola, Starbucks, Sony PlayStation, and McDonald’s hamburgers

The Globalization of Production
The globalization of production refers to the sourcing of goods and services from locations around the globe to take advantage of national differences in the cost and quality of factors of production (labor energy, land, and capital) The goal for companies is to lower their overall cost structure or improve the quality or functionality of their product and gain competitive advantage Examples of companies doing this include Boeing and Vizio

The Emergence of Global Institutions
Several global institutions have emerged to help manage, regulate, and police the global market place promote the establishment of multinational treaties to govern the global business system

Notable global institutions include the World Trade Organization (WTO) which is responsible for policing the world trading system and ensuring that nations adhere to the rules established in WTO treaties In 2008, 151 nations accounting for 97% of world trade were members of the WTO the International Monetary Fund (IMF) which maintains order in the international monetary system Internet Extra: To learn the status of current trade issues, “hot” areas of international trade, and the responsibilities of the WTO, go to { Click on Current News. Review the issues that are currently at the top of the agenda for the WTO. Do they affect developed countries or developing countries? What are their implications for global trade? Go to Trade Topics. Click on Disputes Gateway. Explore the disputes currently under review. How do you think they will be resolved? Why?

the World Bank which promotes economic development the United Nations (UN) which maintains international peace and security, develops friendly relations among nations, cooperates in solving international problems and promotes respect for human rights, and is a center for harmonizing the actions of nations

Drivers of Globalization
Question: What is driving the move toward greater globalization? There are two macro factors underlying the trend toward greater globalization declining trade and investment barriers technological change

Classroom Performance System
Coca-Cola, Sony Playstations, and McDonald’s hamburgers are all examples of American products Global products Industrial products National products

Declining Trade and Investment Barriers
International trade occurs when a firm exports goods or services to consumers in another country Foreign direct investment (FDI) occurs when a firm invests resources in business activities outside its home country During the 1920s and 1930s, many nations erected barriers to international trade and FDI to protect domestic industries from foreign competition

After WWII, advanced Western countries began removing trade and investment barriers Under GATT (the forerunner of the WTO), over 100 nations negotiated further decreases in tariffs and made significant progress on a number of non-tariff issues Under the WTO, a mechanism now exists for dispute resolution and the enforcement of trade laws, and there is a push to cut tariffs on industrial goods, services, and agricultural products

Lower trade barriers enable companies to view the world as a single market and establish production activities in optimal locations around the globe This has led to an acceleration in the volume of world trade and investment since the early 1980s

Growth in World Merchandise Trade and Production,

The Role of Technological Change
The lowering of trade barriers made globalization of markets and production a theoretical possibility, technological change made it a tangible reality Since World War II, there have been major advances in communication, information processing, and transportation

The development of the microprocessor has lowered the cost of global communication and therefore the cost of coordinating and controlling a global organization Web-based transactions have grown from virtually zero in 1994 to $250 billion in 2007 in the U.S. alone, and Internet usage is up from fewer than 1 million users in 1990 to 1.3 billion users in 2007 Commercial jet aircraft and super freighters and the introduction of containerization have greatly simplified trans-shipment from one mode of transport to another

Question: What are the implications of technological change for the globalization of production? Lower transportation costs make a geographically dispersed production system more economical and allow firms to better respond to international customer demands

Question: What are the implications of technological change for the globalization of markets? Low cost communications networks have helped create electronic global marketplaces Low cost transportation have enabled firms to create global markets, and have facilitated the movement of people from country to country promoting a convergence of consumer tastes and preferences

The Changing Demographics of the Global Economy
In the 1960s: the U.S. dominated the world economy and the world trade picture the U.S. dominated world FDI U.S. multinationals dominated the international business scene about half the world-- the centrally planned economies of the communist world-- was off limits to Western international business Today, much of this has changed. Country Focus: India’s Software Sector Summary This feature explores the growth of India’s software industry. Starting from nothing just twenty-five years, the industry now generates revenues of nearly $40 billion, and exports of $31.3 billion. With global spending on information technology expected to be some $260 billion in 2009, Indian companies are primed to capture a significant share of the pie, forcing their Western counterparts to make changes to their strategies. Suggested Discussion Questions 1. What factors have contributed to the growth of India’s software industry? Discussion Points: Four key factors have contributed to the growth of India’s software industry. First is the huge number of engineers in India. Some 400,000 engineers graduate from Indian universities every year. A second factor is India’s low wage structure. Indian engineers make about 12 percent of what an American colleague might make. Third, coordination between Western firms and Indian firms is facilitated by the large number of English-speaking Indians. Finally, because of the differences in time zones, Indian firms operate while American firms are closed. 2. How has India’s software industry changed in recent years? What are the implications of these changes for American companies like IBM and Microsoft? Discussion Points: There has been a gradual shift in the Indian software industry in recent years. Initially, Indian firms focused on the low end of the industry to supply basic software development and testing services to Western firms. Today however, many companies have moved into higher end services to compete for large software development projects, business outsourcing contracts, and information technology consulting services. This new competitive threat is forcing American firms like IBM and Microsoft to rethink their global strategies. Some Western companies are now investing in India with the goal of capturing some of the cost advantages Indian companies like Infosys and Wirpro enjoy. Teaching Tip: The economic slowdown in the United States is beginning to have an effect on India’s information technology sector. To learn more, go to {

The Changing World Output and World Trade Picture
In the early 1960s, the U.S. was the world's dominant industrial power accounting for about 40.3% of world manufacturing output By 2007, the U.S. accounted for only 20.7% Other developed nations experienced a similar decline

Rapid economic growth is now being experienced by countries such as China, Thailand, and Malaysia Further relative decline in the U.S. share of world output and world exports seems likely Forecasts predict a rapid rise in the share of world output accounted for by developing nations such as China, India, Indonesia, Thailand, and South Korea, and a decline in the share by industrialized countries such as Britain, Japan, and the United States So companies may find both new markets and new competitors in the developing regions of the world

The Changing Demographics of World GDP and Trade

The Changing Foreign Direct Investment Picture
The share of world output generated by developing countries has been steadily increasing since the 1960s The stock of foreign direct investment (total cumulative value of foreign investments) generated by rich industrial countries has been on a steady decline There has been a sustained growth in cross-border flows of foreign direct investment The largest recipient of FDI has been China

Percentage Share of Total FDI Stock,

FDI Inflows,

The Changing Nature of the Multinational Enterprise
A multinational enterprise is any business that has productive activities in two or more countries Since the 1960s, there has been a rise in non-U.S. multinationals there has been a rise in mini-multinationals Management Focus: China’s Hisense – An Emerging Multinational Summary This feature examines the growth of Hisense which began in 1969 as a state-owned factory with just 10 employees. Over the years, the company emerged as one of China’s leading makers of television sets. In 1994, China relaxed its hold on the company and Zhou Houijan was appointed CEO. Under Zhou’s leadership Hisense has become as one of China’s premier manufacturers of consumer appliances and telecommunications equipment. Suggested Discussion Questions 1. What makes Hisense different from other manufacturers of consumer electronics? What factors have contributed to its success? Discussion Points: The success of Hisense can be attributed to not only its low cost structure, but also the company’s skill in product innovation. In fact, Hisense believes that its main strength is its rapid production innovation. The company feels that to be successful in the highly competitive consumer electronics industry, it must be on the cutting edge of innovation. Consequently, the company’s strategy is to continuously launch advanced, high quality, and competitively priced products. 2. Why has Hisense established multiple R&D centers? How do these R&D centers fit into the firm’s global strategy? Discussion Points: In 1994, Hisense established its first R&D center in China. Since then, the company has also established R&D centers in South Africa and Europe, and is scheduled to open an R&D center in the United States in the near future. Being innovative is central to Hisense’s strategy. Having multiple R&D centers allows Hisense to be closer to its markets, and should help the company better serve customer needs and preferences. Teaching Tip: To learn more about Hisense go to {

The globalization of the world economy has resulted in a decline in the dominance of U.S. firms in the global marketplace In 1973, 48.5 % of the world’s 260 largest MNEs were U.S. firms By 2006, just 24 of the world’s 100 largest non-financial MNEs were from the U.S., 13 were from France, 12 from Germany, 12 were from Britain, and 9 were from Japan, and 7 of the world’s largest 100 MNEs were from developing economies

While most international trade and investment is conducted by large MNEs, many small and medium-size firms are expanding internationally The Internet has made it easier for many smaller companies to build international sales

The Changing World Order
Today, many markets that had been closed to Western firms are open The collapse of communism in Eastern Europe has created a host of export and investment opportunities Economic development in China has created huge opportunities despite continued Communist control Free market reforms and democracy in Latin America have created opportunities for new markets and new sources of materials and production

The Global Economy of the Twenty-First Century
A more integrated global economy presents new opportunities for firms, but it can also result in political and economic disruptions that may throw plans into disarray

The Globalization Debate
Question: Is the shift toward a more integrated and interdependent global economy a good thing? Many experts believe that globalization is promoting greater prosperity in the global economy, more jobs, and lower prices for goods and services Others feel that globalization is not beneficial

Antiglobalization Protests
Question: What are the concerns of critics of globalization? Anti-globalization protesters now turn up at almost every major meeting of a global institution Protesters fear that globalization is forever changing the world in a negative way

Globalization, Jobs, and Income
Critics of globalization worry that jobs in advanced economies are being lost to low-wage nations Supporters of globalization disagree, claiming that the benefits of free trade outweigh its costs While some jobs may be lost, the economy as a whole is better off Supporters argue that free trade will result in countries specializing in the production of those goods and services that they can produce most efficiently, while importing goods and services that they cannot produce as efficiently, and that in doing so, all countries will gain Country Focus: Protesting Globalization in France Summary This feature describes the anti-globalization protests going on in France. The protests, led by activist Jose Bove, started when the U.S. retaliated against EU bans on beef imports by imposing a 100% tariff on some EU products. Bove and his associates targeted McDonald’s, and also California winemaker Mondavi as symbols of their opposition to American investments. Still, despite the protests, foreign investment in France is at record highs, and ironically, so are French investments abroad. Suggested Discussion Questions 1. Consider the trade war that initiated the protests led by Bove. The EU instituted restrictions on the import of hormone treated beef because it was feared that the product might lead to health problems. The WTO stated that the restrictions were prohibited under WTO agreements and ordered the EU to lift the restrictions or face retaliatory measures. In your opinion, did the WTO act appropriately? Should a government be permitted to make decisions as to what products are or are not available to consumers? Should the WTO? What do you think would have happened if the WTO had ruled in favor of the EU? Discussion Points: Many students will probably argue that the European Union’s restrictions against hormone treated beef were nothing more than thinly veiled protectionism. Accordingly, students will probably feel that the World Trade Organization was justified in its ruling. Some students however, may suggest that the European Union was looking out for its citizens when it instituted the bans, and that therefore the World Trade Organization was overstepping its bounds. 2. Why was McDonald’s chosen as the target for anti-globalization protests? How can companies like McDonald’s protect themselves from the actions of protesters like Bove? Discussion Points: Students will probably recognize that as an icon of the United States, McDonald’s is a symbol of America and as such was a natural target for protesters. The fact that its menu is based on beef was probably an added bonus. Many students will note that companies that are actively involved in local communities are less likely to attract negative feeling than those that are not. Students might recommend that companies like McDonald’s work to ingratiate themselves with the host country through charitable programs, social activities, and so on. Lecture Note: For more on this case, see Chapter 6’s Country Focus: Trade in Hormone-Treated Beef. Teaching Tip: To learn more about ongoing WTO disputes, go the WTO’s homepage: { Video Note: Protesting against globalization is not uncommon. The iGlobe Environmental Activist Questions the Goals of Globalization also explores the negative effects of globalization.

Globalization, Labor Policies, and the Environment
Critics of globalization argue that that free trade encourages firms from advanced nations to move manufacturing facilities offshore to less developed countries with lax environmental and labor regulations Supporters of free trade point out that tougher environmental regulation and stricter labor standards go hand in hand with economic progress and that as countries get richer as a result of globalization, they raise their environmental and labor standards Free trade does not lead to more pollution and labor exploitation, it leads to less

Globalization and National Sovereignty
Critics of globalization worry that economic power is shifting away from national governments and toward supranational organizations such as the WTO, the European Union (EU), and the UN Supporters of globalization argue that the power of these organizations is limited to what nation-states collectively agree to grant The organizations must be able to persuade members states to follow certain actions Without the support of members, the organizations have no power

Globalization and the World’s Poor
Critics of globalization argue that the gap between rich and poor has gotten wider and that the benefits of globalization have not been shared equally Supporters of free trade suggest that the actions of governments have made limited economic improvement in many countries Many of the world’s poorest nations are under totalitarian regimes, suffer from endemic corruption, have few property rights, are involved in war, and are burdened by high debt

Managing in the Global Marketplace
Question: What does the shift toward a global economy mean for managers within an international business? Managing an international business (any firm that engages in international trade or investment) differs from managing a domestic business in four key ways

Managing in the Global Marketplace
Countries differences require companies to vary their practices country by country Managers face a greater and more complex range of problems International companies must work within the limits imposed by governmental intervention and the global trading system International transactions require converting funds and being susceptible to exchange rate changes

Critical Discussion Question
1. Describe the shifts in the world economy over the last 30 years. What are the implications of these shifts for international businesses based in Great Britain? North America? Hong Kong? Answer: The world economy has shifted dramatically over the past 30 years. As late as the 1960s, four stylized facts described the demographics of the global economy. The first was U.S. dominance in the world economy and world trade. The second was U.S. dominance in the world foreign direct investment picture. Related to this, the third fact was the dominance of large, multinational U.S. firms in the international business scene. The fourth was that roughly fifty percent of the world - the centrally planned economies of the Communist world - was off-limits to Western international businesses. All of these demographic facts have changed. Although the U.S. remains the world's dominant economic power, its share of world output and world exports have declined significantly since the 1960s. This trend does not reflect trouble in the U.S. economy, but rather reflects the growing industrialization of developing countries such as China, India, Indonesia, and South Korea. This trend is also reflected in the world foreign direct investment picture. As depicted in Figure 1.2 in the textbook, the share of world output (or the stock of foreign direct investment) generated by developing countries has been on a steady increase since the 1960s, while the share of world output generated by rich industrial countries has been on a steady decline. Shifts in the world economy can also be seen through the shifting power of multinational enterprises. Since the 1960s, there have been two notable trends in the demographics of the multinational enterprise. The first has been the rise of non-U.S. multinationals, particularly Japanese multinationals. The second has been the emergence of a growing number of small and medium-sized multinationals, called mini-multinationals. The fall of Communism in Eastern Europe and the republics of the former Soviet Union have brought about the final shift in the world economy. Many of the former Communist nations of Europe and Asia seem to share a commitment to democratic politics and free market economies. Similar developments are being observed in Latin America. If these trends continue, the opportunities for international business may be enormous. The implications of these shifts are similar for North America and Britain. The United States and Britain once had the luxury of being the dominant players in the world arena, with little substantive competition from the developing nations of the world. That has changed. Today, U.S. and British manufacturers must compete with competitors from across the world to win orders. The changing demographics of the world economy favor a city like Hong Kong. Hong Kong (which is now under Chinese rule) is well located with easy access to markets in Japan, South Korea, Indonesia, and other Asian markets. Hong Kong has a vibrant labor force that can compete on par with the industrialized nations of the world. The decline in the influence of the U.S. and Britain on the global economy provides opportunities for companies in Hong Kong to aggressively pursue export markets.

2. "The study of international business is fine if you are going to work in a large multinational enterprise, but it has no relevance for individuals who are going to work in smaller firms." Evaluate this statement. Answer: People who believe in this view, and the firms that they work for, may find that they do not achieve their full potential (at best) and may ultimately fail because of their myopia. As barriers to trade decrease and state of the art technological developments take place throughout the world, new opportunities and threats exist on a worldwide basis. The rise of the mini-multinationals suggests there are global opportunities even for small firms. But staying attuned to international markets is not only important from the perspective of seeking profitable opportunities for small firms; it can also be critical for long-term competitive survival. Firms from other countries may be developing products that, if sold internationally, may wipe out small domestic competitors. Scanning international markets for the best suppliers is also important for small firms, for if a domestic competitor is able to tap into a superior supplier from a foreign country, it may be able to seriously erode a small firm's competitive position before the small firm understands the source of its competitor's competitive advantage and can take appropriate counter actions.

3. How have changes in technology contributed to the globalization of markets and of production? Would the globalization of production and markets have been possible without these technological changes? Answer: Changes in technology have contributed to the globalization of markets and of production in a very substantive manner. For instance, improvements in transportation technology have paved the way for companies like Coca-Cola, Levi Strauss, Sony and McDonalds to make their products available worldwide. Similarly, improvements in communications technology have had a major impact. The ability to negotiate across continents has been facilitated by improved communications technology, and the rapidly decreasing cost of communications has lowered the expense of coordinating and controlling a global corporation. Finally, the impact of information technology has been far reaching. Companies can now gain worldwide exposure simply by setting up a homepage on the Internet. This technology was not available just a few short years ago. The globalization of production and markets may have been possible without improvements in technology, but the pace of globalization would have been much slower. The falling cost of technology has made it affordable for many developing nations, which has been instrumental in helping these nations improve their share of world output and world exports. The inclusion of these nations, such as China, India, Thailand, and South Korea, has been instrumental in the globalization of markets and production. In addition, improvements in global transportation and communication have made it relatively easy for business executives from different countries to converse with one another. If these forms of technology, including air-travel, fax capability, , and overnight delivery of packages were not available, it would be much more difficult for businesses to conduct international trade.

4. "Ultimately, the study of international business is no different from the study of domestic business. Thus, there is no point in having a separate course on international business." Evaluate this statement. Answer: This statement reflects a poor understanding of the unique challenges involved in international business. Managing an international business is different from managing a purely domestic business for at least four reasons. These are: (1) countries are different; (2) the range of problems confronted by a manager in an international business is wider and the problems themselves more complex than those confronted by a manager in a domestic business; (3) an international business must find ways to work within the limits imposed by government intervention in the international trade and investment system; and (4) international transactions involve converting money into different currencies. As a result of these differences, there are ample reasons for studying international business as a specific field of study or discipline.

5. How might the Internet and the associated World Wide Web affect international business activity and the globalization of the world economy? Answer: According to the text, the Internet and World Wide Web (WWW) promise to develop into the information background of tomorrow's global economy. This improved technology will not only make it easier for individuals and companies in different countries to conduct business with one another, but will also further decrease the cost of communications. These improvements will undoubtedly hasten the already rapid pace of globalization. Another distinct attribute of the Internet and the WWW is that they act as an equalizer between large (resource rich) and small (resource poor) firms. For instance, it does not cost any more for a small software firm to gain visibility via the WWW than it does for a large software company like Microsoft. As a result, the WWW helps small companies reach the size of audience that was previously only within the reach of large, resource rich firms.

6. If current trends continue, China may emerge as the world's largest economy by Discuss the possible implications of such a development for: The world trading system. The world monetary system. The business strategy of today's European and U.S. based global corporations. Global commodity prices. Answer: The world trading system would clearly be affected by such a development. Currently China enjoys a somewhat privileged status within the World Trade Organization as a “developing” country. Such a rise to eminence, however, would clearly force it to become a full and equal member, with all the rights and responsibilities. China would also be in a position to actively affect the terms of trade between many countries. On the monetary front, one would expect that China would have to have fully convertible and trading currency, and it could become one of the “benchmark” currencies of the world. From the perspective of Western global firms, China would represent both a huge market, and potentially the home base of some very capable competitors. Finally, commodity prices would probably fall.

7. Read the Country Focus “Outsourcing American Healthcare,” then answer the following questions: a) A decade ago the idea that medical procedures might move offshore was unthinkable. Today it is a reality. What trends have facilitated this process? b) Is the globalization of health care good or bad for patients? c) Is the globalization of health care good or bad for the American economy? d) Who might benefit from the globalization of health care? Who might lose? e) Do you think that the U.S. government should restrict the outsourcing of medical work to developing nations? What if physicians in those countries are certified by U.S. medical institutions? Answer: a) Advances in technology are a primary key to making the outsourcing of medical work possible in recent years. In particular, the Internet makes it possible to quickly transmit large amounts of data to countries such as India where the information can be processed and returned. In addition, the high cost of medical care in countries like the U.S. is prompting people to consider cheaper alternatives. The cost to repair a leaky heart valve in India is about $10,000 including airfare, while in the U.S. the same surgery could cost $60,000. b) This is a difficult question. Some students might argue that the outsourcing of medical procedures to nations where salaries of medical professional are lower clearly benefits consumers. However, other students might suggest that the level of care in countries such as India may not be up to the standards found in the United States, and that the process takes some control out of the hands of the consumers. Certainly, health care professionals in the United States see the outsourcing trend in a negative light, however, medical insurance companies view any means of cutting costs as a positive move. c) When considered from a strictly economic perspective, the globalization of health care should result in a more efficient industry. Prices in the U.S. should fall as countries like India offer their services as an alternative to higher-priced American ones. It would follow then, that Americans should have more disposable income which could then be spent in other part of the economy. d) Most students will probably agree that the current trend to outsource medical procedures is just the beginning. The rising cost of health care is likely to continue to put pressure on the industry to find cheaper alternatives to handling not only direct patient care, but also the paperwork involved. Most students will probably agree that outsourcing to cut costs in the paperwork end of the process makes sense, but may draw the line at the outsourcing of medical procedures. Others however, might point out that the care being offered by some hospitals in countries like India is on par with American hospitals, indeed many of the doctors are American trained. e) The answer to this question may depend on the nationality of the student. Students from countries that have national heath care may already feel that since the government already controls the medical industry, issues related to the outsourcing of medical work is out of their hands. Students from countries with private health care such as the United States may believe that the government has a certain responsibility to protect its citizens, and that the issue of outsourcing of medical procedures may fall into this realm of protection. In either case, it would appear that restrictions to limit the practice would almost certainly raise costs further.

International Trade & Business (PMM5363)

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