Name: Simon Sebastian Peñaloza Alvarez - 428771 Topic: Export of services

Subject: Foreign trade regime Teacher: Jorge Luis Bejarano Martinez

Export of Services

Modality

"Under the General Agreement on Trade in Services (GATS), services can be supplied
internationally in four distinct ways, known as 'modes of supply'. Mode 4 refers to services
supplied by persons of a WTO Member through their presence in the territory of another
Member. It covers employees of service companies and self-employed service providers."
(WTO, 2017)
The export of health services is a form of tourism, based on the search for medical
solutions outside the country of residence, either to reduce costs, seek a better
technology and specialty in treatments or even to combine it with recreational activities.
Finding that this is an excellent opportunity for Colombia since it has potential to exploit
this new form of business.
It should also be noted that Colombia is a regional leader in the export of health services,
the Colombian health sector is a reference worldwide for its achievements in 25 years of
implementation of the General Social Security System in Health, created by Law 100 of
1993. Among the most outstanding advances are the extensive coverage of the Health
Benefits Plan. and the expansion of health coverage, which, according to data from the
Comprehensive Social Protection Information System, in 1993 reached only 23.5% of the
population and today covers 96.6%. The country is making progress in offering specialized
medical services for foreign citizens. A review of the main achievements of this sector.
In recent years this sector has been strengthened and is constantly growing, since
Colombia is a main destination for the realization of medical treatments. On the other
hand, the country has 23 hospitals in the ranking of the 58 best Latin American hospitals,
of which five of them have Joint Commission International accreditation. ✓ The quality of
the surgeons, the low costs and the wide range of health services have positioned the
country as one of the top 20 medical tourism destinations worldwide along with nations
such as: USA, Thailand, Italy and Japan. Among the patients who are most operated on in
the country are Colombian nationals living in the United States, Spain and Mexico.
Followed by Venezuelans, Cubans and Argentines living outside their country and, to a
lesser extent, Americans, Germans or Swiss.

Enterprise
Health Export
Logo

Slogan
We go where you are to improve your life.
Strategic management
Strategies
These are the promotion mechanisms that Colombia is carrying out through strategic
alliances, inclusion in the Health Cluster, obtaining international certifications, among
others, contribute to the growth of exports of health services, although it has not yet been
achieved that the Health Sector can attract patients from international markets in a
representative way; therefore, it is convenient on the one hand to support the
government to take advantage of the negotiations and generate strategies that allow it to
do so, and on the other hand, to strengthen its own efforts in favor of it.

Strategic direction

MISSION To effectively and efficiently meet the health care needs of the international
community. Provide the best medical care based on scientific evidence and ethical
content, accompanying the patient and his family.

VISION
Create and sustain a comprehensive private health system, which offers a space for
growth and professional development focused on excellence and warmth in the care of
patients and their families.

VALUES
Equity: In the use of the resources and services of the institution without distinction of
age, gender, social group, ideology and creed, state of health or disease.
Responsibility: Build tasks aimed at achieving the best results. Assume an active role in
the daily work both in the clinic and within society.

Efficiency: Achieve objectives using processes and working methods that optimize
performance with the best use of resources.

Competitive advantage
• Colombia has four (4) accredited health service provider institutions, while Ecuador has
one institution accredited by the Joint Commission International (Joint Commission
International, 2014).
• During the time in which this research was carried out, the Pablo Tobón Uribe Hospital
was carrying out the corresponding procedures to be accredited, this process was
completed and from 2015, it obtained the Joint Commission International's Gold Seal of
Approval (Pablo Tobón Uribe Hospital, 2015), which represents the quality and
commitment that the organization has towards the service it offers to its patients. This
type of accreditation contributes to providing improvements in the areas of personal
education, good practices, quality and patient safety.
• THE HPTU has certifications that accredit it of high quality such as the NTC ISO 14001:
2004 standard, member of the Global Network of Green and Healthy Hospitals, ICONTEC,
ISQUA accreditation and the improvement of its position within the Ranking of the 10
hospitals with the highest percentage of doctors with sub-specialty (Central Intelligence
Agency, 2014).
• The number of foreign patients treated at the headquarters of the Pablo Tobón Uribe
Hospital in the city of Medellín in the last two years has increased by 40% (Pablo Tobón
Uribe Hospital, 2014). • In Colombia, the costs for performing medical procedures are
cheaper (Medical Tourism, 2013). The city of Medellín has been preparing in order to
receive tourists in health, patients and companions in such a way that they can benefit
from complete tourist packages (lodging, transportation, food, local tourism, etc.)
(PROCOLOMBIA, 2014).5. Synergistic effect

Target market
In many parts of the world, health systems have deficiencies, whether in quality,
accessibility, technology or waiting times. "In countries such as the United States of
America, health services are very expensive, in Canada waiting times are very high, in
Europe the aging population reduces the level of income, in Africa there are problems of
availability and low quality of services, in Japan there is overstay in the hospitalized
population and in the Caribbean there is little technological availability and low care
capacity." ( Procolombia, 2011)
So it's these countries that we're going to focus on or our export company is going to run:
United States
The United States does not have a universal insurance system, as do many European
countries. There are three state programs: Medicare, which covers retirees and the
disabled, Medicaid, which covers the homeless, and military programs. Most other citizens
approximately 68% of the population have Private Insurance, usually offered by their
employers, (who pay part of the costs) or product of direct purchase. In this category
there is no minimum package that they must offer. They can reject people with "pre-
existing conditions," which usually occurs in patients with 23 chronic diseases. They can
also refuse reimbursements for services already provided, if inconsistencies are found in
the information provided by the beneficiary in the application formats, even if the
erroneous information has nothing to do with the health problem. Americans have sought
alternatives such as Health Tourism. So much so that in the world patients who travel
looking for lower costs for non-critical acute procedures (procedures that do not require
emergency interventions) that are performed with a standard protocol, similar to that of
their country of origin; come almost entirely from the U.S.
TENDENCY:
Currently, foreign consumers of domestic medical services are mostly Colombian citizens
residing in the United States. In the second instance, Latinos or Spanish speakers who
have a relationship with Colombia (either by familiarity or sympathy). Colombia competes
with neighboring countries (Costa Rica, Panama and Mexico, among others) in the vast
majority of procedures. Consumers take into account measures related to patient safety
and international accreditations of hospitals.
DISTRIBUTION CHANNEL:
For procedures of low complexity (dental, ophthalmological or plastic surgeries) the
decision is made by recommendations or publicity. In the case of complex operations,
there are companies dedicated to intermediating between consumers and health service
providers that provide a comprehensive service, from the facilitation of preoperative
consultations and travel logistics for the patient and his family. These facilitators advertise
online and participate in social networks to disseminate testimonials.
Canada
The Government of Canada takes a comprehensive approach to its bilateral relations with
Colombia through its political, trade, development, and peace and security programming.
The relationship includes: expanding trade and investment; a frank dialogue on human
rights; development cooperation; support for Colombia's efforts for justice, security and
peacebuilding; increasing mobility between our two countries (tourism, studies, business,
immigration). "Canada and Colombia enjoy a dynamic and increasingly diversified
bilateral trade relationship, facilitated by the 2011 Free Trade Agreement. This includes
significant Canadian investment in various sectors, such as infrastructure, energy, mining,
oil and gas, financial services, engineering services, agri-food and education, and more
than 100 Canadian companies with a presence in Colombia" (Government of Canada,
2022)
And for the service sector there are also quite significant advantages:

 Opportunities were created that will allow Colombia to become an export platform for
cross-border services to the Canadian market.

 Generation of commercial opportunities for individuals and / or companies that can sell
their services from Colombia without having to move or settle in Canada. Some sectors
that can benefit are consulting services, telemedicine, call centers, online translation, data
processing services, computer services and other services related to software,
telecommunications and design services, among others.

 Opportunity to increase the export potential of Professional Services. It creates the

possibility of negotiating mutual recognition agreements for the professional services
sectors. In addition, the possibility of issuing temporary licences of professional service
suppliers of the other Party is granted. In this regard, the respective national engineering
agencies of Colombia and Canada have initiated an exchange of information on this
subject.

Explain how the currency will be returned for the service caused.

Change is made through the exchange rate regime

The exchange rate regime: is the set of rules that regulate aspects of international
changes. International exchanges can be defined as all transactions abroad that involve
payment or transfer of currencies or securities representative thereof. 
According to the Colombian exchange rate regime, there are two markets:

 Regulated market
 Free market
The DIAN exercises control over the operations carried out with the currencies whose
negotiation must not be carried out compulsorily through authorized intermediaries,
which are understood to be freely held, possessed and negotiated within the limitations
indicated by the exchange regime.
Entry or exit of foreign currency by travelers.
Those received by tourism agencies and hotels for goods and services sold to foreign
tourists.
The sale of foreign currency and traveler's checks in a professional manner exercised by
the residents in the country.
Operations between residents in the country in foreign currency.
And they can be done through these intermediaries:

o Commercial bank
o Mortgage bank
o Finance Corporation
o Trade Finance Company
o The National Energy Finance -FEN-
o Banco de Comercio Exterior de Colombia S.A. -BANCOLDEX-
o Financial cooperative
o Brokerage company
o Foreign exchange intermediation and special financial services companies.

Bibliographies

https://www.international.gc.ca/country-pays/colombia-colombie/relations.aspx?lang=spa

http://tangara.uis.edu.co/biblioweb/tesis/2014/155561.pdf

https://www.wto.org/spanish/tratop_s/serv_s/mouvement_persons_s/
mouvement_persons_s.htm

https://www.andi.com.co/Home/Noticia/7356-colombia-lider-regional-en-la-exportacio

https://www.dian.gov.co/atencionciudadano/infoconsulta/Paginas/ControlCambiario.aspx