Gareth+-Memo+9+Structuring+a+Project


 * __MEMO 9- Structuring a Project__**


 * Regulatory (legal and political)**
 * Formation of international healthcare accreditation organizations
 * Shift away from national healthcare/welfare state, move to prominent broadly defined ‘neoliberal’ governmentality
 * Expansion of regulatory allowance for broadly defined ‘globalization’
 * Ongoing history of Medicaid/Medicare reforms equaling rollback of benefits.
 * Increased openness of immigration laws in some countries.


 * Economic**
 * Development/Free Trade Treaties and Organizations gain prominence and enable transnational industry (WTO, GATT, NAFTA)
 * Increasing cost of malpractice insurance and increasing deregulation of health insurance in the US and Western Europe
 * Global economic crisis, especially US national credit crisis / recession
 * Increased economic acceptance of outsourcing/offshoring, and expansion of the successful model from manufacture to IT to other industries.
 * Recent years- availability of credit allowed those without money to travel for care despite need for COD.


 * Technological**
 * Improved infrastructure for travel by air, and balance of economic model for lower airfare despite raising fuel prices.
 * Communication technology allows formation of online communities, and legitimation by sharing personal stories.
 * Increasing visibility of biomedical technologies and decreased cost makes them available as a realistic industry form in new contexts.
 * Highspeed communication infrastructure allows pre- and post-operative care to be cooperative with home doctor in ideal cases.

Socio-Cultural
 * Shift to emphasis on personal choice.
 * Diminished demand for healthcare as an entitlement/right in wealthy nations.
 * Pluralism, Migrant Communities maintain ties with home countries.
 * Concept of biomedicine as universal.
 * Prestige technologies, and symbolic value of some forms of biomedicine balance for exoticism of locations.
 * Increased demands on time encourage combined vacation time and medical treatment, even when treatment is close to home.
 * 30 year history of public movement to shift health responsibility to the individual
 * World system in flux and recent shifts in economy have changed the apparent status of Asian and Developed world nations.

Institutional
 * Increase in number and visibility of Transnational NGOs
 * Boutique travel agencies and other small batch businesses (i.e. eco tourism) provides template.
 * Scarcity/ differential distribution of experts and infrastructure

Natural
 * Arguably the phenomenon termed ‘time space compression’ and the shrinking world
 * Higher populations
 * Bodies