With and Without Borders: Global Regulation of Health and Healthcare

• In Event: 471 - Section on Medical Sociology Paper Session. Global and Transnational Health

Abstract

The globalized world is clearly not simply a world without borders. Although early approaches to globalization (and especially economic globalization), stressed a declining importance of borders, more recent work has instead problematized borders, making the variable effects of borders a topic for investigation. With the dismantling of some barriers, cross border flows of capital, goods, information, and people have increased. In response, though, fresh questions have been raised about what should and should not flow across borders, with states rejecting or modifying some of the boundary dismantling moves of intergovernmental bodies. This process of re­territorialization (not de­territorialization) has brought a differentiation in borders, with distinctions made among different types of borders and between what is and is not permitted to cross and under what conditions. In this more flexible system, borders can be easily traversed boundaries, semi­permeable filters, or impenetrable walls; they can be permeable in one direction or both; they can be permeable for some things but impenetrable for others. To help clarify thinking about the disparate role of borders, we examine in three subparts of healthcare where there are compelling reasons both to dismantle and to strengthen borders. We look at the function of national borders in disease surveillance, medical tourism, and the distribution of pharmaceuticals and medical devices, finding substantial variation in which kinds of borders continue to be important, what purposes they serve, and which actors favor the dismantling and which for advocate the shoring up of boundaries.

Authors

• Carol Heimer, Northwestern University

• Alka Menon, Northwestern University

• Arielle Woloshin Tolman, Northwestern University