Health Care
Tourists Seek Cheaper Medical Procedures in Asia
Listen to this story... by Fred de Sam Lazaro
All Things Considered, February 14, 2005 · Travel to the developing world has long been associated with health threats and advice on how to avoid becoming ill. But a growing number of tourists are now traveling to certain countries -- among them India, Malaysia and Thailand -- because they want medical care. Fred de Sam Lazaro of Twin Cities Public Television reports on what's being called medical tourism.
Sunday, May 27, 2007
Why Patients Are Flocking Overseas for Operations
Why Patients Are Flocking Overseas for Operations
Hospitals around the world are drawing new patients with topnotch doctors, high-tech equipment and low costs. These 10 are leaders in their fields.
By Joe Cochrane
Newsweek International
Oct. 30, 2006 issue - It's not a stretch to call Jamie Johnson an accidental tourist in Thailand. While touring with a Christian singing group last month, Johnson, a diabetic from the United States, developed an infection in her ankle that shut down her kidneys. She was evacuated by airplane from Malaysia to Bumrungrad International hospital in Bangkok—a facility she had ever heard of in a country she had never been to and in a city she had associated with sex shows in beer bars. "My husband back home was thinking, 'She's going to be in a straw hut'," she says.
Johnson, though, was lucky enough to land in Asia's first internationally accredited hospital and one of the most modern and efficient medical facilities in the world. Last year the hospital treated 400,000 foreign patients—the highest of any hospital in the world—from more than 150 countries, for everything from heart disease to hip replacements to breast implants. The attraction: world-class medicine at developing-world prices. And patients get velvet-glove treatment redolent of a five-star hotel. "We deliver the one thing that people want in health care but don't expect to get—service," says Ruben Toral, the hospital's marketing director.
As medical costs skyrocket—Americans spent 16 percent of GDP on health care last year, according to the OECD, and Europeans aren't far behind—the idea of going abroad to get healthy is becoming more and more attractive. More than 150,000 North Americans and Europeans currently seek medical treatment overseas each year, estimates Josef Woodman, author of the forthcoming "Patients Without Borders." For invasive surgeries, preferred destinations include India, Thailand, Singapore and Malaysia. Large hospitals, such as Bumrungrad and the Apollo chain in India, actively court American, European and Middle Eastern patients. Slick Web sites tout their partnerships with nearby luxury hotels for post-op recovery. Bumrungrad arranges limousines to pick up patients at the airport, and sheiks and princes congregate in the Platinum Lounge of Apollo's Delhi hospital. Abacas International, a leading travel facilitator, reports that medical tourism to Asia could generate up to $4.4 billion by 2012.
Businesses are taking notice. At least 40 corporations have signed on to the overseas plan that United Group Programs, a health insurer in Boca Raton, Florida, began offering six months ago. Sending an employee abroad can save 80 percent of the costs of a procedure; a $50,000 angioplasty in the United States costs less than $6,000 in Mohali, India, according to GlobalChoice Healthcare, a firm that arranges foreign medical procedures.
Bumrungrad officials insist that foreigners come not just for cheap bills and luxury accommodations. The hospital's doctors, they say, have been trained at the best Western medical schools and use the most advanced medical equipment. And the service is eye-opening for patients accustomed to public clinics. Walk-in patients see a specialist in 17 minutes on average. Since 75 percent of hospital revenues are paid by patients directly, health and insurance companies have no say in treatment. Low labor costs allow Thai hospitals to employ more staff.
Some health-insurance companies are embracing medical tourism to reduce costs and make policyholders happy. It is only a matter of time before the phenomenon evolves into medical outsourcing, says Mack Banner, Bumrungrad's CEO. "People are going to leave their country, they're going to go overseas and they're going to get health care," he says. To make room for them, Bumrungrad is building an 18-story outpatient center, which will double the hospital's capacity to 6,000 outpatients per day. That's room for a lot of tourists, accidental or otherwise.
With Barrett Sheridan in New York
© 2007 Newsweek, Inc.
URL: http://www.msnbc.msn.com/id/15365149/site/newsweek/
10 World Leaders
Bumrungrad International Hospital in Bangkok
Buchinger Clinic in Germany
All India Institute of Medical Sciences in Delhi
The Fyodorov Clinics in Russia
A Technology Prescription: Denver Health
Brigham and Women’s Hospital
Sourasky Medical Center in Tel Aviv
Hôpital Edouard Herriot in Lyons
Hospital for Tropical Diseases in London
Mount Sinai Medical Center
TAIWAN WELL QUALIFIED TO DEVELOP MEDICAL TOURISM
TAIWAN WELL QUALIFIED TO DEVELOP MEDICAL TOURISM
2007-05-24 20:34:42
Taipei, May 24 (CNA) Participants in an international seminar on the medical care industry held in Taipei agreed Thursday that Taiwan has good conditions for developing medical tourism.
They said Taiwan can achieve the goal of becoming a world-class medical care center and listed 10 areas in which Taiwan could have a competitive edge.
They are live liver transplant, bone marrow transplant, cardiovascular medicine, microsurgery and cosmetic surgery, breast magnetic resonance imaging and other advanced medical examinations, knee surgery, brain tumor medicine and immunology therapy, Parkinson's disease diagnosis, cost-efficient medical care and high-quality medical teams.
Ho Mei-yueh, chairwoman of the Council for Economic Planning and Development, said the council has listed the medical tourism as one of its flagship projects in its three-year economic development plan.
She said the council will integrate government agencies in charge of medical care, tourism, insurance and visa issuance to attract foreigners to Taiwan for low-cost high-quality medical services.
Ho noted that Singapore attracted 150,000 medical tourists in 2000 and that the number had ballooned to 400,000 by 2005. The medical care industry in Thailand created a production value of US$490 million in 2003, attracting 700,000 visitors seeking treatment, she added.
(By Lilian Wu)
2007-05-24 20:34:42
Taipei, May 24 (CNA) Participants in an international seminar on the medical care industry held in Taipei agreed Thursday that Taiwan has good conditions for developing medical tourism.
They said Taiwan can achieve the goal of becoming a world-class medical care center and listed 10 areas in which Taiwan could have a competitive edge.
They are live liver transplant, bone marrow transplant, cardiovascular medicine, microsurgery and cosmetic surgery, breast magnetic resonance imaging and other advanced medical examinations, knee surgery, brain tumor medicine and immunology therapy, Parkinson's disease diagnosis, cost-efficient medical care and high-quality medical teams.
Ho Mei-yueh, chairwoman of the Council for Economic Planning and Development, said the council has listed the medical tourism as one of its flagship projects in its three-year economic development plan.
She said the council will integrate government agencies in charge of medical care, tourism, insurance and visa issuance to attract foreigners to Taiwan for low-cost high-quality medical services.
Ho noted that Singapore attracted 150,000 medical tourists in 2000 and that the number had ballooned to 400,000 by 2005. The medical care industry in Thailand created a production value of US$490 million in 2003, attracting 700,000 visitors seeking treatment, she added.
(By Lilian Wu)
Medical tourism can be the next goldmine for India: CII
Medical tourism can be the next goldmine for India: CII
Our Bureau
Bangalore , Nov. 26
INDIA can turn medical tourism into its next goldmine, if it rightly projects its competences and improves the healthcare standards, said speakers at the CII-sponsored two-day quality summit on health tourism.
During the current season between now and March 2005 alone, some two million leisure and business travellers are expected into the country compared to 1.3 lakh tourists coming in the past 18 months. This is the time to encash it into a $1-billion medical tourism opportunity, catering to several foreigners who are seeking low-cost, but world-class medical treatment, said Mr Vishal Bali, Summit Chairman and VP, Wockhardt Hospitals.
He said no other country offers the unique mix of seven officially approved systems of medicine ranging from Ayurveda to naturopathy and Tibetan medicine. This industry is growing at 30 per cent annually and could easily add 40 million new jobs too.
"There is no reason why India should not become the healthcare destination of the world" by combining the best of specialty hospitals, hotels and spas, the State Tourism departments and travel agents, he said. South East Asia is the undisputed leader in the area, with Bangkok's famed Bumrungrad Hospital alone attracting 2.7 lakh international patients a year.
According to Mr Utkarsh Palnitkar, Partner, Ernst & Young, medical tourism could be a $30-40-billion proposition worldwide, with spends on hospitalisation rising; the Gulf region led by Saudi Arabia alone spends $20 billion on medical care. However, new entrants were emerging such as South Africa, Croatia and Greece, and "We have to wake up fast" to grab the pie.
Players such as Prestige group's joint venture Angsana Oasis, Dr Isaac Mathai's Soukya International Holistic Health Care Centre at Whitefield (near Bangalore), Ayurveda Gram Heritage Wellness Centre and Kerala-based Casino Group have scented early successes by offering Indian and Western therapies to a large number of foreigners.
According to Dr Mathai, if each of the 40,000 US physicians of Indian origin refers one person to India, the medical tourists could become a huge number. Ayurveda, spirituality, yoga, acupressure and naturopathy can be the unique selling propositions for foreigners who don't hesitate to spend $400 an hour on any of these systems. "If you play up Ayurveda the right way, an unbelievable number of people can come to India" seeking its benefits, said Dr Mathai.
Our Bureau
Bangalore , Nov. 26
INDIA can turn medical tourism into its next goldmine, if it rightly projects its competences and improves the healthcare standards, said speakers at the CII-sponsored two-day quality summit on health tourism.
During the current season between now and March 2005 alone, some two million leisure and business travellers are expected into the country compared to 1.3 lakh tourists coming in the past 18 months. This is the time to encash it into a $1-billion medical tourism opportunity, catering to several foreigners who are seeking low-cost, but world-class medical treatment, said Mr Vishal Bali, Summit Chairman and VP, Wockhardt Hospitals.
He said no other country offers the unique mix of seven officially approved systems of medicine ranging from Ayurveda to naturopathy and Tibetan medicine. This industry is growing at 30 per cent annually and could easily add 40 million new jobs too.
"There is no reason why India should not become the healthcare destination of the world" by combining the best of specialty hospitals, hotels and spas, the State Tourism departments and travel agents, he said. South East Asia is the undisputed leader in the area, with Bangkok's famed Bumrungrad Hospital alone attracting 2.7 lakh international patients a year.
According to Mr Utkarsh Palnitkar, Partner, Ernst & Young, medical tourism could be a $30-40-billion proposition worldwide, with spends on hospitalisation rising; the Gulf region led by Saudi Arabia alone spends $20 billion on medical care. However, new entrants were emerging such as South Africa, Croatia and Greece, and "We have to wake up fast" to grab the pie.
Players such as Prestige group's joint venture Angsana Oasis, Dr Isaac Mathai's Soukya International Holistic Health Care Centre at Whitefield (near Bangalore), Ayurveda Gram Heritage Wellness Centre and Kerala-based Casino Group have scented early successes by offering Indian and Western therapies to a large number of foreigners.
According to Dr Mathai, if each of the 40,000 US physicians of Indian origin refers one person to India, the medical tourists could become a huge number. Ayurveda, spirituality, yoga, acupressure and naturopathy can be the unique selling propositions for foreigners who don't hesitate to spend $400 an hour on any of these systems. "If you play up Ayurveda the right way, an unbelievable number of people can come to India" seeking its benefits, said Dr Mathai.
Medical tourism: Marketing India isn't a good idea
Dateline Mysore: Medical tourism: Marketing India isn't a good idea by G V Krishnan
Dateline Mysore Travelling to get a heart bypass can't be much fun. But then health and tourism ministries are reported to have joined hands to launch an international advt. campaign. A brochure suggests that overseas patients can combine medical treatment with trips to Taj Mahal, the Himalayas, and a host of places of tourist interest.
Dateline Mysore :: GVK's Archived Works :: GVK's Profile :: Email GVK
Head of cardiology at a corporate hospital in Chennai told me once (this was years ago) that they needed to do 12 surgeries a day to be able to maintain three operation theatres, meet loan repayment schedule on equipment, and fulfill dividend expectations of shareholders. He was not merely a reputed cardiac surgeon, but also a hospital management board member – 'I've to take care of the shareholders' interests'.
Specialty hospitals have emerged as good business, a sure-fire foreign exchange earners and have made India a destination for healthcare outsourcing. We hear hospital management circles talking of 'medical tourism', a term I despise. Overseas visitors in need of surgery and concerned companions on medicare trip to India do not exactly fit the definition of 'tourists', a word I would normally associate with vacationers and pleasure-seekers. Travelling to get a heart bypass can't be much fun. But then health and tourism ministries are reported to have joined hands to launch an international advt. campaign. A brochure suggests that overseas patients can combine medical treatment with trips to Taj Mahal, the Himalayas, and a host of places of tourist interest.
Union health minister Dr Anbumani Ramdoss reckons that 150,000 foreigners needing medical treatment visit India in a year and the healthcare tourism market is worth $333 mil. Projected growth is to make it a $2 billion industry by 2012. The idea is to target some 50 million Americans who are not covered by insurance. Most of those making the trip to India are folks who can't afford it in their own country. Heart surgery that costs $200,000 in the UScan be done in India for $10,000.
Hip resurfacing costs in Mumbai $6,000 while the same surgical procedure done in the US would set you back by $25,000. If you don't have insurance cover in the US, and can't raise that kind of money, even the Lord would be reluctant to help. I once met a lady at a Phoenix soup kitchen whose family became homeless, because her husband got pneumonia. His insurance cover had lapsed. And they had to sell their house to pay hospital bills. It was a matter of $11,000.
Thousands of US patients are said to be opting India as healthcare alternative, to take advantage of the cut-rate heart surgery, gastric bypass and hysterectomies. Economics professor Milica Bookman, of Philadelphia St. Joseph's University, was quoted in *People* magazine as saying, "from what we're hearing, the quality of care is certainly as good as what you find in an American hospital". The professor is writing a book on medical outsourcing.
A school bus driver in Lakeville, Minn., who had hip resurfacing done in Mumbai has set up a websiteto share her experience and offer guidance to those looking at healthcare options in India. Healthcare tourism may be good for our private hospitals. But the question is whether it is good idea for our government to promote it in a big way.
I would have thought our corporate health sector needs no government prodding to promote its own interests. Besides, there is a school of thought that believes governments should have no role in promoting healthcare tourism for it impacts negatively the interests of the people in India. The point is made by Prof.Prabhudev Konana, of University of Texas in a op-ed page article in The Hindu.
Five-star hospital services and advanced medical devices raise investment levels; and shareholders expect value for their investment. All this, and an aggressive promotion of healthcare tourism, could price out the middle-class in India from private healthcare facilities in their own country.
Medi-tourism promoters speak of trickle-down effect and say the high paying foreign clientele can subsidize the cost of providing the best of medical treatment to the local population. This sounds sensible, and even feasible on paper. But can we really hope for a well-functioning, subsidy-transfer system in place, working to the best advantage of the needy patients in India? In the prevailing shortage of hospital beds, doctors and trained para-medics aggressive marketing of healthcare tourism would amplify the demand-supply gap in the private healthcare sector,according to Prof. Konana.
Dateline Mysore Travelling to get a heart bypass can't be much fun. But then health and tourism ministries are reported to have joined hands to launch an international advt. campaign. A brochure suggests that overseas patients can combine medical treatment with trips to Taj Mahal, the Himalayas, and a host of places of tourist interest.
Dateline Mysore :: GVK's Archived Works :: GVK's Profile :: Email GVK
Head of cardiology at a corporate hospital in Chennai told me once (this was years ago) that they needed to do 12 surgeries a day to be able to maintain three operation theatres, meet loan repayment schedule on equipment, and fulfill dividend expectations of shareholders. He was not merely a reputed cardiac surgeon, but also a hospital management board member – 'I've to take care of the shareholders' interests'.
Specialty hospitals have emerged as good business, a sure-fire foreign exchange earners and have made India a destination for healthcare outsourcing. We hear hospital management circles talking of 'medical tourism', a term I despise. Overseas visitors in need of surgery and concerned companions on medicare trip to India do not exactly fit the definition of 'tourists', a word I would normally associate with vacationers and pleasure-seekers. Travelling to get a heart bypass can't be much fun. But then health and tourism ministries are reported to have joined hands to launch an international advt. campaign. A brochure suggests that overseas patients can combine medical treatment with trips to Taj Mahal, the Himalayas, and a host of places of tourist interest.
Union health minister Dr Anbumani Ramdoss reckons that 150,000 foreigners needing medical treatment visit India in a year and the healthcare tourism market
Hip resurfacing costs in Mumbai $6,000 while the same surgical procedure done in the US would set you back by $25,000. If you don't have insurance cover in the US, and can't raise that kind of money, even the Lord would be reluctant to help. I once met a lady at a Phoenix soup kitchen whose family became homeless, because her husband got pneumonia. His insurance cover had lapsed. And they had to sell their house to pay hospital bills. It was a matter of $11,000.
Thousands of US patients are said to be opting India as healthcare alternative, to take advantage of the cut-rate heart surgery, gastric bypass and hysterectomies. Economics professor Milica Bookman, of Philadelphia St. Joseph's University, was quoted in *People* magazine as saying, "from what we're hearing, the quality of care is certainly as good as what you find in an American hospital". The professor is writing a book on medical outsourcing.
A school bus driver in Lakeville, Minn., who had hip resurfacing done in Mumbai has set up a website
I would have thought our corporate health sector needs no government prodding to promote its own interests. Besides, there is a school of thought that believes governments should have no role in promoting healthcare tourism for it impacts negatively the interests of the people in India. The point is made by Prof.Prabhudev Konana, of University of Texas in a op-ed page article in The Hindu
Five-star hospital services and advanced medical devices raise investment levels; and shareholders expect value for their investment. All this, and an aggressive promotion of healthcare tourism, could price out the middle-class in India from private healthcare facilities in their own country.
Medi-tourism promoters speak of trickle-down effect and say the high paying foreign clientele can subsidize the cost of providing the best of medical treatment to the local population. This sounds sensible, and even feasible on paper. But can we really hope for a well-functioning, subsidy-transfer system in place, working to the best advantage of the needy patients in India? In the prevailing shortage of hospital beds, doctors and trained para-medics aggressive marketing of healthcare tourism would amplify the demand-supply gap in the private healthcare sector,according to Prof. Konana.
BlueCross BlueShield and BlueChoice HealthPlan Pioneer Global Healthcare Alternative
BlueCross BlueShield and BlueChoice HealthPlan Pioneer Global Healthcare Alternative
February 8, 2007
Contact: Elizabeth Hammond
803.264.4626
COLUMBIA - BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan of South Carolina are streamlining access to medical and surgical treatment at U.S.-accredited facilities overseas. Through BlueCross' Companion Global Healthcare, members will have a single launch point for appointments, information and travel services beginning Feb. 15.
Companion Global Healthcare recently affiliated with JCI-accredited Bumrungrad International Hospital in Bangkok, Thailand, as the first hospital in its overseas network, and with World Access for travel services. The Companion Global Healthcare model is the first of its kind in South Carolina and among the first in the United States.
BlueCross BlueShield and BlueChoice HealthPlan members will have access to the program by clicking on a link on the Discounts & Value-Added page on www.SouthCarolinaBlues.com or www.BlueChoiceSC.com or by calling 1-877-232-0765.
"Including a global healthcare alternative reflects our ongoing commitment to help members seek the services they want at competitive prices," said David Boucher, BlueCross assistant vice president of health care services. "In a flattened world of increased price transparency, an international surgical network is a natural next step for those in our membership who want to travel for medical care."
BlueCross BlueShield and BlueChoice HealthPlan went to great lengths to identify credible, experienced organizations to participate in this program. "Bumrungrad treats over 400,000 international patients annually, including 80,000 Americans in 2006, and has over 150 U.S. board-certified doctors," Boucher said.
Bumrungrad International Hospital (www.bumrungrad.com) is Thailand's premier private medical center, a regional referral center for specialty care and a leader in treating international patients. The hospital is a one-stop medical center with more than 750 doctors and 554 beds. It was featured on CBS' 60 Minutes and recently named by Newsweek magazine as one of the top 10 international destinations for medical services. It is Asia's first and Thailand's only hospital accredited by the Joint Commission International (JCI). JCI is the international arm of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which has accredited over 4,000 U.S. hospitals and over 110 facilities elsewhere.
A leading provider of specialty insurance and assistance, World Access (www.worldaccess.com) will arrange and assist with travel services, including transportation and accommodations, air ambulance, and international claims management. World Access is a member of the Mondial Assistance Group and part of the Allianz family of companies.
BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina are headquartered in Columbia, S.C. BlueChoice HealthPlan of South Carolina is a wholly owned subsidiary of BlueCross BlueShield of South Carolina, and both are independent licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. BlueChoice is a registered mark of the Blue Cross and Blue Shield Association.
February 8, 2007
Contact: Elizabeth Hammond
803.264.4626
COLUMBIA - BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan of South Carolina are streamlining access to medical and surgical treatment at U.S.-accredited facilities overseas. Through BlueCross' Companion Global Healthcare, members will have a single launch point for appointments, information and travel services beginning Feb. 15.
Companion Global Healthcare recently affiliated with JCI-accredited Bumrungrad International Hospital in Bangkok, Thailand, as the first hospital in its overseas network, and with World Access for travel services. The Companion Global Healthcare model is the first of its kind in South Carolina and among the first in the United States.
BlueCross BlueShield and BlueChoice HealthPlan members will have access to the program by clicking on a link on the Discounts & Value-Added page on www.SouthCarolinaBlues.com or www.BlueChoiceSC.com or by calling 1-877-232-0765.
"Including a global healthcare alternative reflects our ongoing commitment to help members seek the services they want at competitive prices," said David Boucher, BlueCross assistant vice president of health care services. "In a flattened world of increased price transparency, an international surgical network is a natural next step for those in our membership who want to travel for medical care."
BlueCross BlueShield and BlueChoice HealthPlan went to great lengths to identify credible, experienced organizations to participate in this program. "Bumrungrad treats over 400,000 international patients annually, including 80,000 Americans in 2006, and has over 150 U.S. board-certified doctors," Boucher said.
Bumrungrad International Hospital (www.bumrungrad.com) is Thailand's premier private medical center, a regional referral center for specialty care and a leader in treating international patients. The hospital is a one-stop medical center with more than 750 doctors and 554 beds. It was featured on CBS' 60 Minutes and recently named by Newsweek magazine as one of the top 10 international destinations for medical services. It is Asia's first and Thailand's only hospital accredited by the Joint Commission International (JCI). JCI is the international arm of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which has accredited over 4,000 U.S. hospitals and over 110 facilities elsewhere.
A leading provider of specialty insurance and assistance, World Access (www.worldaccess.com) will arrange and assist with travel services, including transportation and accommodations, air ambulance, and international claims management. World Access is a member of the Mondial Assistance Group and part of the Allianz family of companies.
BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina are headquartered in Columbia, S.C. BlueChoice HealthPlan of South Carolina is a wholly owned subsidiary of BlueCross BlueShield of South Carolina, and both are independent licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. BlueChoice is a registered mark of the Blue Cross and Blue Shield Association.
Are we ready for medical tourism?
Are we ready for medical tourism?
RUPA CHINAI and RAHUL GOSWAMI
The private healthcare industry is quietly facilitating a revolution to enable India to emerge as a health destination. Yet there are the sceptics.
`Nearly 82 per cent of all health spending in India is private.' World Bank study
PHOTO: VIVEK BENDRE
CONFIDENCE INSPIRING: A patient from West Asia at Mumbai's Jaslok Hospital.
STARK contrasts are no surprise in urban India, and in the healthcare sector, the difference between what is available (world-class techniques and service, at a price) and what the common denominator urgently needs is no less so. In Mumbai, as in New Delhi, Chennai and Hyderabad, private sector healthcare centres are gleaming "islands of excellence", as the industry calls them, all too often surrounded by seas of medical neglect.
These "islands" — the private healthcare industry in India — are quietly facilitating a revolution. Only seven years from now, the most optimistic industry forecast posits, medical tourists hosted by India can pump Rs. 10,000 crores into our economy. An estimated 1,50,000 such visitors a year already spend about Rs. 1,500 crores in India for treatment.
When the mix is just right (support from the government in the form of incentives and tax breaks, international healthcare accreditation standards in place, breakthroughs in insurance coverage for overseas patients, and savvy promotion of India as a tourism-plus-medical tech destination) the sector is certain the numbers will fall into place.
What's more, the beneficiary of such growth will be the country's desperately overburdened public health system, say industry associations such as the Confederation of Indian Industry (CII) and the Federation of Indian Chambers of Commerce and Industry (FICCI), which see medical tourism a mirror of the early years of India's info-tech growth.
The spin-off
Explaining the view, Anupam Verma, honorary secretary of the Medical Tourism Council of Maharashtra and a director of Mumbai's Hinduja Hospital, says, "Look at the possibility of the public hospitals being technologically upgraded to world-class standards with this source of income. Also, with exposure to the paid medical service market, the spirit of competition will germinate in public hospitals ...(to) enhance their efficiency and service delivery levels."
Such optimism apart, India's three-tier public health system — primary health centres (PHC) in villages, district hospitals, and tertiary care hospitals — is increasingly unable to attend to the medical needs of the population.
Government expenditure on public health infrastructure is shrinking. At present, India spends about a per cent of its gross domestic product (GDP) on healthcare, lower than the average of 2.8 per cent of GDP spent by some less developed countries.
Yet, as the National Human Development Report (2001) points out: "There has been a misplaced emphasis on maintenance and strengthening of private health care services ... at the expense of broadening and deepening of a public health care system targeted at controlling the incidence of disease, particularly of communicable diseases, in rural areas."
Private healthcare is indeed expanding rapidly to fill the need for services. According to a World Bank study released in January 2004, nearly 82 per cent of all health spending in India is private.
PHOTO: R.V. MOORTHY
A WIDENING GAP: Can public healthcare catch up?
The study also pointed to health inequities such as the poorest quintile getting only 10 per cent of subsidies, while the richest 20 quintile captures 33 per cent.
Jean Dreze of the Delhi School of Economics calls it a "paradox". Bed capacities in five-star private hospitals remain under-utilised, he has observed, forcing the industry and government to promote health tourism, and "on the other hand, PHCs are suffering due to lack of government patronage".
Dr. Nergis Mistry, scientific researcher with the Foundation for Medical Research, Mumbai, warns against a technology and urban-centred approach to delivering healthcare. "Medical tourism will force us towards the latest expensive technology that is demanded in the West," she says. Mistry believes that a technology-centric approach to healthcare, such as that promoted by the major private hospitals, will inevitably affect the cost of care to the common man.
Given the fiscal imperatives (healthcare is also an industry, after all) how does the private sector in India propose to make services accessible and affordable to the average Indian, and how does the private sector define its responsibility to public health care?
"The role and responsibilities of the government are clearly in the areas of primary healthcare, epidemics, public health and sanitation," says S.K. Venkataraman, chief financial officer of the Apollo Hospitals Group, "whereas the private sector can cater to secondary, tertiary and quaternary care and the increasing burden of diseases due to lifestyle factors, like cancer, cardiac ailments and diabetes."
Dr. Naresh Trehan, executive director of the Escorts Heart Institute and Research Centre, says the private sector can "contribute in small but significant ways given its resource constraints".
Escorts runs a rural healthcare programme under which it deputes specialists to conduct cardiology camps that examine patients free of cost, he says. Villages are "adopted" to "improve their basic levels of sanitation and health and awareness, which goes a long way towards improving the health index", Trehan adds.
But, what does medical tourism promise to deliver and why is the public sector not convinced? The dream of a million medical tourists, establishing India's status as a health hub and boosting an industry to growth rates rivalling that of info-tech, is seen as within reach by the private sector.
In the last two years, international news coverage of India's major private hospitals — Apollo, Asian Heart Institute, Escorts, Fortis, Hinduja, Max Healthcare, Wockhardt and Woodlands among them — has been upbeat and confidence-inspiring. At home, however, the question increasingly being asked by public health practitioners is: how will this affect the country's health indices?
The numbers that the industry can offer are internationally tempting, and not only for United States or United Kingdom-based patients. Heart surgery that would cost $30,000 (or approximately Rs. 12,90,000) in the U.S. or Britain costs approximately $14,000 (or Rs. 6,02,000) in Thailand (a major destination for medical tourists) and around $7,000 (or Rs. 3,01,000) in India. A bone marrow transplant procedure would run up a bill of $2,50,000 (or Rs. 1,07,50,000) in the U.S. or Britain, versus $60,000 (or Rs. 25,80,000) in Thailand and $30,000 (or Rs. 12,90,000) in India.
Despite these numbers, regional competition for medical tourists is fierce. Thailand is currently the Asian leader both in number of foreign patients and revenue. Malaysia and Singapore too have set in motion aggressive plans, with ambitious targets, for the years 2010-12, which is also seen as a defining period by CII and the Indian Health Care Federation (IHCF), an association of about 60 hospitals.
Now, private healthcare groups are lobbying for the adoption of measures they say will encourage growth — some of these are tax allowances for rural doctors, relaxations in the norms for setting up medical colleges, and relaxation in indirect taxes on purchase of equipment, medicines, medical consumables and devices.
"The challenge," says Dr. Trehan, "is to try and match the cost of creation with ability to pay. Thus to incentivise hospitals to come up in rural areas, the government needs to go much beyond this."
S.K. Venkataraman emphasises that the industry urgently needs infrastructure status "with attendant benefits like a tax holiday, concessional utilities and preferential land allotments, in order to create an enabling environment for the healthy growth of this sector".
These demands are questioned by health policy analysts. Ravi Duggal, health researcher with Mumbai's Centre for Enquiry into Health and Allied Themes, points out that private hospitals have obligations for their not-for-profit status under the Public Trust Act to provide healthcare free to the extent of 20 per cent of their resources. "Where is the accountability of this provision?" he asks.
Certainly, the view from ground zero of a public hospital's out-patient's department is uniformly grim. Under-funded, undermanned and under-equipped, Mumbai's severely overburdened public hospitals have borne the brunt of public rage.
`Will make no difference'
Dr. K.C. Ojha, financial director of the Bombay Hospital for 27 years (until 1994) says bluntly: "Medical tourism will not make any difference to Indian healthcare. It will mean greater profits for the private hospital sector and creation of Indian jobs. Hospitals that provide for medical tourism will not create subsidised treatment for Indians."
He is alarmed by symptoms of the widening gap between medical need and service — in the second half of 2004 there were at least seven reported incidents in Mumbai of patient's families assaulting hospital staff, both in State and municipal corporation-run hospitals, and private clinics, because of the perception that they were victims of medical negligence. "Their anger is spilling over in assaults on doctors, unheard of until now in a country where the medical profession is worshipped next to God," says Dr Armida Fernandes, former dean of the State government-run Sion Hospital in Mumbai.
With charges for speciality services steadily rising, healthcare moves out of the reach of the common man, she adds, often propelling them into either indebtedness or to quacks.
Nevertheless, Dr. Nilima Kshirsagar, dean of the King Edward Memorial Hospital in Mumbai, sees the possibility of leveraging the expertise and experience teaching hospitals have in clinical medicine and surgical skill.
"With augmented infrastructure we can provide services to foreign patients and revenues earned can subsidise poor Indian patients," she says, which is a view close to that of the CII and IHCF.
The bottom-line for Kshirsagar however is equity: "People are looking at health as a business. The government has not examined how our patients will benefit from medical tourism or whether they will lose out. The need to benefit Indian patients is the main goal, and medical tourism cannot be at their cost."
World-class care
CHENNAI's Frontier Lifeline Hospital (Dr. K.M. Cherian Heart Foundation) began healing the hearts of international patients on March 1, 2004.
PHOTO: VINO JOHN
ALL'S WELL: In Chennai.
"They were treated free of cost," says Dr. Cherian (in the picture, first row sitting, fourth from right). "That's when the foreign patients started coming in. Chennai is truly the health hub of Asia." Over the course of a year, Frontier Lifeline has seen more than 200 patients from Fiji, Iraq, Kenya, Malaysia, Mauritius, Palestine, Tanzania and Uganda.
In the first year of operations, Dr. Cherian says Frontier Lifeline generated $2,00,000 (or approximately Rs. 86,00,000). "If a small place like this can earn so much foreign exchange, imagine if we built dedicated health hubs with all the facilities."
Surgical procedures that cost upwards of 3,000 (or approximately Rs. 1,68,000) are available for Rs. 10,000 to Rs. 30,000 here. Recently, the hospital used an indigenously created bovine jugular conduit to connect the ventricle and the arteries of a 27-day-old Palestinian boy, Khalid. "These are the same techniques being used in Europe," he says. "The only other manufacturer of this conduit is a German company. We provide world-class treatment at a much lesser cost."
However, Dr. Cherian says, most of the patients are from Asia as India does not have the necessary infrastructure to cater to European and U.S. requirements. "Our roads are dirty, water is bad, even internet connectivity — which people from the West consider a must — is not up to their standards, despite all our claims of IT proficiency."
India has the cost advantage, the technology and clinical expertise and manpower to be an international health destination, but Government support is lacking. He advocates a holistic approach to healthcare, with entire complexes or resorts that provide the medical tourists all the facilities. The St. Gregorios Cardiovascular Centre in Parumala in Alleppey district, Kerala, set up by his institution could become such a holistic centre with the right kind of support. He describes it as a rural area with all the facilities of an urban hospital and just one hour from Kochi. "It's a 30-bed hospital, in one year, we have performed more than 500 angioplasties and 400 open-heart surgeries. It's set in the middle of a village by paddy fields and a river... it's the kind of place that is ideal for surgery, recovery and relaxation," he says.
SHALINI UMACHANDRAN
© Copyright 2000 - 2006 The Hindu
Subscribe to:
Posts (Atom)