Based on a year of ethnographic fieldwork, this dissertation explores the development of the global medical tourism industry in Costa Rica and the social, ethical, and ideological implications that its growth may have for the existing socialized health care system. This study seeks to understand the ways in which medical tourism, as a model of global neoliberal health care, affects how Costa Ricans think about delivery of and state responsibility for health care. The research draws deeply on the social, economic, political, and cultural contexts in which medical tourism is unfolding. It addresses the ideological tensions and contradictions that surround medical tourism, as the line between conceptions of health care as local and global, socialist and capitalist, public and private, blurs to accommodate this emerging industry. Rather than emphasizing the view of medical tourism from the top, the focus is on local perceptions, understandings and engagements with medical tourism. Grounded in the experiences of Costa Rican health care providers, educators, policy makers and citizens, this paper tells the story of a system in flux.
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