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.

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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 website to 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.