Remember ME - You Me and Dementia

Wednesday, March 12, 2008

Medical tourism and its impact on Indain GDP

AFTER INFORMATION Technology (IT) and Information Technology enabled Services (IteS), which are currently good contributors to our nation’s GDP, the next big thing happening (already begun!!!) could be ‘medical tourism’, which has enormous potential, if rightly tapped, to make great contributions to the nation’s GDP. The following will illustrate a few valid points by way of expert’s questions vs opinions offered, current statistics available with future projections and a few suggestions for making best use of medical tourism towards the development of the country’s economic prosperity.

Sharing of a wonderful experience by a foreign national:

For thousands of medical tourists like George Marshall, this debate is invisible. In 2004, a heart bypass was recommended for the 73-year-old British citizen, which would have cost him up to £20,000. “I had to wait for over three months to see the cardiologist and potentially a further six months for the operation,” he said. Instead, he paid £4,400 to Wockhardt Hospitals for the operation. Airfare and travel insurance cost extra, and he paid with his own money, as insurance couldn’t cover his outsourcing of medical needs.

Existing offers available for medical tourists:

Currently, the offers available today for similar patients are specialised services ranging from cardiology and cardiac surgery (angioplasty, bypass, valve replacement), to oncology and onco-surgery, organ transplants (liver and kidney), bone marrow transplants, joint replacements, eye surgery and in-vitro fertilisation. The cost differential is significant, as it was for Marshall, for the patients.

Reason for going in for medical tourism:

Medical tourism is attracting people from all over the industrialised world, from countries with relatively poor healthcare infrastructures and, in case of the US, places with exorbitantly expensive health care systems.

Medical tourists from the US are usually those seeking procedures not covered by their insurers, those seeking necessary procedures and who are provided with incentives to find lower cost options, and those who cannot secure medical insurance where they depend on the procedures and the physicians. Cosmetic procedures are easily found in South America, while complex heart and orthopedic procedures are found in India, Thailand and Singapore, and specialised in-vitro fertilisation can be found in South Africa, Israel and Spain.

In the global medical tourism industry, from cosmetic surgery to complex oncology, bargain prices can be found at a medical centre somewhere in the world. Time and money provide the incentives for seeking healthcare outside country. In the case of public health systems with long delays, such as Britain, time is the motivation.

Accredited hospitals are potential winners in wooing medical tourists:

Quality is a concern for potential medical tourists and what are now being called ‘offshore hospitals’ address their concern by seeking and obtaining accreditation from bodies such as Joint Commission International (JCI), a subsidiary of the Joint Commission on Accreditation of Healthcare Organisations (JCAHO), which offers accreditation to hospitals in the US. Several other hospitals that are offering medical tourism in India meet or exceed the standards of care of the finest hospitals located in US.

Some advantage in availing this service:

The lower cost structure of these hospitals allows them to be more generous with resources for their well-paying clients. Nurse-to-patient ratios are higher, private rooms are readily available and family members are often included in the trip and made comfortable in luxury facilities that resemble five-star hotels.

Dr Milica Bookman, professor of economics at St. Joseph’s University in Philadelphia, US, is author of the book Medical Tourism in Developing Countries. According to her research on the economic impact of medical tourism, 750,000 Americans are expected to have travelled abroad for treatment in 2007 and over six million will be doing by 2010.

Some findings done through a study report by a global agency:

According to a study by global accounting and consulting firm Ernst and Young and the Federation of Indian Chambers of Commerce and Industry (FICCI), private hospitals in India earned Rs 62,000 corer in fiscal 2006 and revenues from the sector are expected to rise up to Rs 130,000 crores (at current prices and exchange rates) in 2012, which represents an annual revenue growth rate of about 19 per cent a year.

Our Finance Ministry’s projections on GDP:

The Finance Ministry’s Investment Commission emphasises that healthcare delivery is already one of the largest service-sector industries in India, and expects the industry to grow and contribute up to five per cent of GDP (at around Rs. 240,000 crores) by 2010.

Comments offered by lead hospital spokesperson:

“The sector is getting focused from an investment perspective,” said Vishal Bali, chief executive of Wockhardt Hospitals, who plans to double its hospitals to 30 from 15 in time span of two years. “The drivers for the future are falling in place.” At the same time, Dr Pratap C Reddy, chairman of the Apollo Hospitals Group, explained: “We need to invest $60-70 billion over the next five years in hospitals and healthcare education to expand this sector and reach out to masses as soon as possible.”

Comments offered by other professionals in this field:

Ravi Duggal, a researcher with the Mumbai-based policy analysis group, Centre for Enquiry into Health and Allied Themes, explained, “The problem starts when a developing country, which has 75 per cent of its population either poor living at subsistence level, collaborates in promoting medical tourism when it cannot meet the basic healthcare needs of a majority of its citizens.” Medical tourism creates a climate of inequitable services that undermine the goal of health for all, in the view of Dr Nergis Mistry, scientific researcher with the Foundation for Medical Research, Mumbai. Mistry warns against a technology and urban-centred approach to delivering health care: “It raises the cost of healthcare for the local population because it forces the use of expensive technology and drugs.”

Number of people having visited India for as medical tourists:

India now hosts and treats an estimated of 50,000 medical tourists a year and the catalytic CII-McKinsey report of 2002 projected that medical tourism could contribute up to Rs 10,000 crores in revenue by the year 2012.

Existing guidelines seem to be inadequate:

In the major states, health departments issue guidelines to private hospitals specifying their obligation to provide beds, treatment and services to the public patient, and to return a portion of revenues from medical tourism into serving the public health overburden, but neither are these hospital held to account on these points by their respective state governments, nor does a standard country-wide regulatory system exist to ensure such compliance.

Benefits are accruing only to private sectors:

A signal of state-directed change however comes from Tamil Nadu, Karnataka and Andhra Pradesh. “As of now, it is only the private sector that is reaping the benefits of medical tourism in Tamil Nadu,” said health secretary VK Subburaj, “while the government sector remains out of this loop so far: We have been focusing on public health. However, with the concept of ‘pay wards’ coming up in government hospitals for certain field segments; we can expect this trend to change.”

State wise preparation in progress:

Karnataka is now preparing to promote premier government institutions as medical tourism destinations. “The department of Tourism with the Health and Family Welfare department has identified centres of excellence in the government health sector — such as Jayadeva Institute of Cardiology and the Kidwai Institute of Oncology — which will be promoted abroad as places for specialised treatment at affordable costs,” said health commissioner Basavaraju.

Moreover, what is now being called the Andhra Pradesh model stems from the provision of universal health insurance in three districts, and AP chief minister YS Rajasekhara Reddy has called for bids in six other districts.

Thus, as Dr Pratap C Reddy of Apollo Hospitals emphasised, insurance cover and accessibility can drive change. “In Aragonda, Andhra Pradesh, with a contribution of a rupee a day a constable’s son was able to have a bone marrow transplantation done at the best facility. Nobody can afford to pay for major illnesses, and we need a mechanism to make hospital procedures cashless. That is possible only with insurance.”

After going through the above, what could be the wish list of a common man for making medical tourism a big success for India? Some of these are summarized below:
Let there be an identical agency like NAASCOM for medical tourism to periodically come out realistic reports for bettering the services in the days to come.

Why only private sector gains - why not public sector too, from the earnings of medical tourism - a thorough study need to be done by involving the experts.

The rates charged or services offered could be further subsidised so that people from different parts of the country throng to our hospitals for getting timely, immediate and quality care all at an affordable cost so that at least by word of mouth the message gets well spread across different sections of the societies.

ESI hospitals too can join this race by selectively opening up their doors so that their income gets a big boost, which could be optimally utilised for bettering the services from all angles benefiting the registered care seeker.

Let our foreign consulate offices act as ambassadors for promoting medical tourism to get this business a big boost.

Let there be innovative schemes by targeting medical tourists so that they return back with great feeling of comfort, satisfaction and joy.

Let there be more and more infrastructure avenues opened up so that consultants can join the fray for bringing in world class quality treatment facilities, all under one roof.

Let our doctors who are serving out of India and willing to come back be encouraged to the fullest for doing their best to give a big push to this trade.

More and more top class colleges are set up in the country, with foreign collaboration, so that aspiring students lovingly join this profession to earn their degree (doctorate) for serving the society and mankind.

Before, concluding, let’s hope our country’s overall infrastructure moves fast on issues like good quality roads, international airports, best of the five star /three star hotels at affordable rates, best pick up and return conveyance, sight seeing points made more visible and attractive and customer care from start to finish is of the highest order.

Lastly, let’s hope our GDP do get a boost of at least 5 per cent and more in the near future so that the economy keeps growing at a fast rate.

By Vishnu Mohan


Forget yourself for others, and others will never forget you.

No comments: