On Saturday, March 27, 2010 I attended the 14th Wharton India Economic Forum. So I believe the event started in 1996 marking five years of liberalization of Indian economy. There was an impressive list of speakers. You had people from Private Equity, Information and Technology, Social Sector, Healthcare, and Education and Training. There also was panel of woman leaders talking about issues of glass ceiling at workplace.
In the morning, I attended the healthcare panel. I found the Sangita Reddy, (Director, Apollo Hospitals) had the most memorable insights. She pointed out the efficiency of health care services in India by comparing the back office & administrative costs in the two countries; 7 percent in India versus 25 percent in US. I am impressed that India has basically managed to keep the cost of a by-pass surgery stable for 27 years despite the high rate of inflation. She underscored her point by mentioning that Indian doctors were more willing to do a 'Beating Heart Surgery', a very complicated procedure that saves costs and has a greater probability of recovery. Apparently, 97 percent of heart surgeries are beating heart in India versus less than 10 percent in the US. You would think that a country as technologically advanced as the US would have adopted an advanced technique. This underscores the discussions about healthcare that I have with my friends, some of them healthcare professionals. They insist that in India doctors are more efficient and more willing to actually 'treat you'. My take on this has always been that a society with such a high instance of law-suits and 'do no harm' principle causes doctors to cover their backs first with multiple tests, before initiating any treatment. The inefficiency in the system is greater because the payment is made by a third party. Since the money appears to go from the insurance company's pocket, neither doctors nor patients are concerned about efficiency. Remember, your insurance premium is actually a 'sunk cost', money that you have spent anyway.
Bhargav Das Gupta, CEO and MD, ICICI Lombard talked about the new products to finance healthcare in India, especially for really poor people. The low penetration on insurance (less than 5%) is an opportunity for insurers, but the low awareness a huge challenge. Only yesterday I was reading how Indians do not care much about health insurance. There was the perennial subject of drugs patents and generics and branded drugs, and the long winded process to discovery of new drugs. What really stayed on with me was an interesting tit bit about ingenious water filters. Homi Khusrokhan, Advisor to Tata Healthcare explained how the Tata's successfully developed an extremely cheap water filter that removes 99.7% bacteria from water using burnt rice husk and nano silver, without power. On a personal note, I really liked Khusrokhan, the man had a wealth of experience with a really humble Lucknowi demeanor. The composition of the panel was extremely impressive. The organizers had ensured that there were representatives from delivery (Apollo), pharmaceutical (GSK and Excel life sciences) and the payers (Tata Healthcare, ICICI Lombard and GSK Venture), ensuring that all aspects of this complex issue are covered. I hope to write about other panels and speakers in my later posts. In the meantime you can have a look at the complete list of speakers & panel members here
Books Update: I am back to fiction for the time being. Finished 'Memoirs of Geisha' sometime back. Loved the portrayal and discovered few unknown aspects of the traditional Japanese culture
8 comments:
We have this huge hospital called Metro Hospital in Faridabad that has this marketing campaign that says they have conducted about 1000 beating heart surgeries.
And what is interesting is that a very large number of patients getting treated in Faridabad are from middle east and other parts of the world.
Quite insightful - the views of the speakers..Looking forward to read more bits from forum.
About Memoirs of Geisha - haven't read the book,but I got to watch the movie based on this book a few years ago.I loved the kid who portrayed the protagnist's childhood.And what stayed with me from movie was the cherry blossom garden they show in the movie.That day, I told myself that this is one place I want to be at.Lucky I am ,this sunday , I found myself at cherry blossom festival in Seoul surrounded by 1000s of cherry blossom trees.There must be something true in SRK's OSO Kaynat dialogue :)
~Deeksha
http://goldenbuds.wordpress.com
@RV - Yes, I was thinking exactly the same that 'medical tourism' got missed out of the debate somehow. I met this person who was involved with a american hospital chain working on setting up hospitals in UAE because there is a huge demand. Infact looks like people from middle east travel both east (India) and West (Europe/ USA) for treatment. I guess whether you have the oil money or not determines the direction of your travel.
Welcome to my blog Deeksha.
I planned to post more too but got lost in things. About the cherry blossoms, you are lucky. I travelled all the way to DC and still missed them because of the storm. How is your Korean adventure shaping up ?
It is turning out great :).Now, it being my 7th month here,I plan to write extensively about the insights of their culture and lifestyle,but their work style leaves me with no time :(.I 'll share the pics of the cherry blossom festival with you soon :).I happened to have a look on cherry blossom trees of Canada and USA and they look a little more giant than their Korean counterparts,but with a tree full of flowers,more is better :)
~Deeksha
Interesting to know the beating heart surgery part, but I would have no hesitation in reiterating it that Indian medicine is behind (but only a bit) than what is offered in American system. However, you have to remember that the best in US is offered most often than not when you are willing to pay yourself than through the insurance firms.
On another note is the health reforms in India. Although much is being done and has been achieved through National Rural Health Mission (NRHM) and RSBY (Rashtiya Swasthaya Bima Yojana), I still feel that we are emulating the US model and that in my understanding is not the way to go.
Health is more of a right and not a commodity as it is treated in USA.
@Prabhjot - The other point to consider is insurance incentivises preventive care contributing to better overall health. I know enough about the misuse of the insurance sytem & abuse of insurance companies, not that much about the better quality outside the insurance system. Though its logical that you can get better care if you pay yourself because you are charged 3-4 times what an insurance company is. Overall I think there is enough evidence that current American system leads to longer healthier lives inspite of unhealthy lifetyles, even it you call it commoditised.
The problem with health(care) as a right is from the economic angle. Government providing it is highly inefficient and often impossibly costly as some european models show. So if its a right, who pays for it, especially in poor countries where money anyway isnt plenty.
Actually its the opposite. Healthcare as an economic model will be successful when more and more people use it unlike the way we think. The costs borne by some in the higher income bracket offsets the cost of the lower income group. Compare this to insurance where the incentive, as you rightly point out, it not to use the health system at all. Insurance, when incepted, was a system where both the insurer and the insuree did not want the event to occur or hoped it was a remote possibility but feared its consequences. This is ok as long as you are providing insurance for hospialisations which are rare events and as a user you would like to happen. However, when it comes to primary care- or the day to day diseases that just require simple treatment without hospitalisation, its more or less unavoidable and a more certain event. Here insurance companies would always loose and therefore the present problem.
Also, unlike US most european economies spend much less and have still much better health indicators. The problem perhaps lies in the confusion that universal health insurance = universal health care.
Insurance is good, but only as long as it is for a rare event and where the Govt can not step in to provide it. Contrary to most people, actually Govt run hospitals are perhaps the best in India. AIIMS, PGIs, CMC, or even the Govt hospitals in most district centers are much heavily used than the most famous private hospital can ever hope to. The population they may cater to is different, but that is also because the particular health event they are dealing with is separate. A totally market driven health system is definitely not the way to go to cater for such a HUGE population that is presently being served by the Govt systems in India and such a low cost.
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