more specifically, suppose there is a cruise liner under Chinese flag a few miles off New York harbor, in international waters, and there are a bunch of nice Chinese doctors/dentists there, all licensed to practiced on Chinese soil but not on American one. Patients can be brought in by fast boat or helicopter (I know, they probably need a passport to get back). Medical personnel get Chinese style salaries, i.e. they are pretty cheap. There are no expensive hospital administrators, unpaid emergency room bills and so forth to cover from the paying customers’ pocket.
I am not sure how the language issue is handled, but basically you can either use translators (possibly remote ones ) or just perform things that don’t require any interaction with the patient at all, like some dental procedures.
Patients are supposed to pay in cash, so presumably this would be targeting the uninsured of whom there should be a fair number nowadays. Then again, maybe eventually such an outfit could make a deal with some of the insurance companies as well.
Ok, anyway, you get the idea. So how does this picture stack up against the law, maritime practices etc? If tomorrow such a ship does in fact show up, what would the authorities do?
maybe my terminology is a bit off. Suppose this cruise liner is positioned on the 13th nautical mile, presumably outside the territorial jurisdiction. Frankly, the Chinese flag would make it foreign territory even within territorial waters, but perhaps keeping it out would make more sense in terms of taxation etc.
I am more interested in the larger question here. Would that scenario violate any existing regulation? If not, then why don’t we see such things being done already?
As for this question, I think the answer is the cost of equipping and staffing a ship as a hospital. Medical tourism already exists, with people flying overseas for surgery and other medical procedures. It’s a lot easier to build and equip a hospital in a foreign country than to do so on a ship. (Plus I’m not sure how you’re going to deal with the ship rocking from the waves, and how that affect the ability to perform delicate operations.)
yes, I agree about medical tourism. I guess this cruise linear approach would make the most sense for relatively, brief, low cost procedures where you don’t want to spend $400 plus quite a bit of time to fly to Mexico and back. In fact, I think the dental procedures especially would fall into this category.
The OP’s example isn’t just a hypothetical: there’s the Dutch group, Women on Waves, which runs the “abortion boat” - which travels to countries where abortion is illegal or highly restricted, takes on women and sails into international waters where they provide the RU-486 pill, and then takes them back to their home countries.
The legality of the practice depends on Dutch law. Under the Labour government, it was allowed (see this Times article from 2007), but under the current right-leaning government, the law has been changed and the practice would not be legal under Dutch law (see this more recent article).
Gionis, Thomas. “Paradox On The High Seas: Evasive Standards Of Medical Care – Duty Without Standards Of Care; A Call For The International Regulation Of Maritime Healthcare Aboard Ships.” 34 J. Marshall L. Rev. 751 (2001) (noting lack of regulation of medicine on the high seas)
There could be other related problems with offshore treatment. Not sure a prescription written by a doctor not licensed in this country will be any good here. Trying to pursue a malpractice claim, if necessary, would be complicated, as well.
) or just perform things that don’t require any interaction with the patient at all, like some dental procedures.