International legal regulation of trade in medical services: doctrinal approaches and the problem of terminological certainty

Globalization has transformed cross-border trade in medical services into a fully developed large-scale industry. Roughly 14 million individuals seek medical care outside their home country on an annual basis, and the worldwide market for this practice is valued at close to 40 billion USD. Nevertheless, neither international law nor domestic legal systems provide a legally codified definition of “international medical services,” leading to terminological ambiguity and legal risks when qualifying the relevant legal relationships. The article synthesizes existing doctrinal perspectives and, based on theirintegration,formulates an original authorial definition ofinternational medicalservices.It examines the four modes of supply under GATS, explores the tension between trade liberalization and states’ obligations to uphold the right to health, and highlights legal uncertainty in interpreting the governmental services exception. The study substantiates a presumption that public services fall outside the scope of GATS. Practical recommendations are offered for Kazakhstan. These include revising its WTO commitments, strategically employing specific commitment categories, and involving public health authorities in international negotiations. The findings may assist the country in shaping its national position regarding trade in international medical services.

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