Medical tourism — the travel of patients from one (the “home”) country to another (the “destination”) country for medical treatment — represents a growing business. A number of authors have raised the concern that medical tourism reduces access to health care for the destination country’s poor and suggested that home country governments or international bodies have obligations to curb medical tourism or mitigate its negative effects when they occur.

This Article is the first to comprehensively examine both the question of whether this negative effect on access to health care occurs for the destination country’s poor, and the normative question of the home country and international bodies’ obligations if it does occur. I draw on the work of leading theorists from the Statist, Cosmopolitan, and Intermediate camps on Global Justice and apply it to medical tourism. I also show how the application of these theories to medical tourism highlights areas in which these theories are underspecified and suggests diverging paths for filling in lacunae. Finally, I discuss the kinds of home country, destination country, and multilateral forms of regulation this analysis would support and reject.

Numerous critics question the legitimacy of international investment law and investor-state arbitration, arguing that this field of law and dispute resolution presents a threat to foundational principles of domestic public law, including democracy and the rule of law. Many of these critics therefore demand institutional reform, and some states follow suit, by recrafting international investment treaties and restricting investor-state arbitration.

In response to this backlash, this Article proposes to react to the challenges international investment law poses for domestic public law values in a more constructive fashion. Instead of demanding the recrafting of international investment law, or even the abolishment of investor-state arbitration, in order to vindicate public law values, this Article recommends an expansion of public law thinking within the existing structure of investment treaty arbitration itself. To this end, it outlines the conceptual and methodological foundations of a new public law approach to international investment law, which arguably has the potential to enhance the acceptance and legitimacy of international investment law as a whole. The Article suggests that international investment law and investment treaty arbitration should be conceptualized as public law disciplines and integrated into a public law model that transcends territorial borders. Investment treaties should be interpreted, investor-state disputes resolved, and system-internal reform proposed by recourse to public law thinking and a specific public law method, namely comparative public law. Accordingly, problems arising in investment treaty arbitration should not be treated in isolation, but rather by drawing on solutions and concepts adopted in other public law systems at the domestic and international level.

This Article develops the framework of comparative institutional analysis for assessing the implications of judicial interpretation in the World Trade Organization (WTO). The analytical framework offers an improved means to describe and assess the consequences of choices made in treaty drafting and interpretation in terms of social welfare and participation in social decision-making. The analysis builds on specific examples from WTO case law. Our framework approaches treaty drafting and judicial interpretive choices through a comparative institutional lens — that is, in comparison with the implications of alternative drafting and interpretive choices for social welfare and participation in social decision-making processes. By deciding among alternative interpretations, the judicial bodies of the WTO effectively determine which social decision-making process decides a particular policy issue. That decision, in turn, can have profound domestic and international implications. While this Article focuses on the WTO, the framework developed here has general relevance for understanding the interpretation of international and domestic legal texts from “law and economics” and “law and society” perspectives.