If it takes 15 hours to see you, perhaps they would be better off in India.
Surgeries, Side Trips for 'Medical Tourists'.... Washington Post, 10/21/04
NEW DELHI -- Three months ago, Howard Staab learned that he suffered from a
life-threatening heart condition and would have to undergo surgery at a cost
of up to $200,000 -- an impossible sum for the 53-year-old carpenter from
Durham, N.C., who has no health insurance.
So he outsourced the job to India.
Taking his cue from cost-cutting U.S. businesses, Staab last month flew
about 7,500 miles! to the Indian capital, where doctors at the Escorts Heart
Institute & Research Centre -- a sleek aluminum-colored building across the
street from a bicycle-rickshaw stand -- replaced his balky heart valve with
one harvested from a pig. Total bill: about $10,000, including round-trip
airfare and a planned side trip to the Taj Mahal.
"The Indian doctors, they did such a fine job here, and took care of us so
well," said Staab, a gentle, ponytailed bicycling enthusiast who was
accompanied to India by his partner, Maggi Grace. "I would do it again."
Staab is one of a growing number of people known as "medical tourists" who
are traveling to India in search of First World health care at Third World
prices. Last year, an estimated 150,000 foreigners visited India for medical
procedures, and the number is increasing at the rate of about 15 percent a
year, according to Zakariah Ahmed, a health care specialist at the
Confederation of Indian Industries.
Eager to cash! in on the trend, posh private hospitals are beginning to
offer services tailored for foreign patients, such as airport pickups,
Internet-equipped private rooms and package deals that combine, for example,
tummy-tuck surgery with several nights in a maharajah's palace. Some
hospitals are pushing treatment regimens that augment standard medicine with
yoga and other forms of traditional Indian healing.
The phenomenon is another example of how India is profiting from
globalization -- the growing integration of world economies -- just as it
has already done in such other service industries as insurance and banking,
which are outsourcing an ever-widening assortment of office tasks to the
country. A recent study by the McKinsey consulting firm estimated that
India's medical tourist industry could yield as much as $2.2 billion in
annual revenue by 2012.
"If we do this right, we can heal the world," said Prathap C. Reddy, a
physician who founded Apollo Hospitals, a 6,400-bed! chain that is
headquartered in the coastal city of Chennai and is one of the biggest
private health care providers in Asia.
The trend is still in its early stages. Most of the foreigners treated in
India come from other developing countries in Asia, Africa or the Middle
East, where top-quality hospitals and health professionals are often hard to
find. Patients from the United States and Europe still are relatively
rare -- not only because of the distance they must travel but also, hospital
executives acknowledge, because India continues to suffer from an image of
poverty and poor hygiene that discourages many patients.
Taken as a whole, India's health care system is hardly a model, with barely
four doctors for every 10,000 people, compared with 27 in the United States,
according to the World Bank. Health care accounts for just 5.1 percent of
India's gross domestic product, against 14 percent in the United
States.
On the other hand, India offers a growing num! ber of private "centers of
excellence" where the quality of care is as good or better than that of
big-city hospitals in the United States or Europe, asserted Naresh Trehan, a
self-assured cardiovascular surgeon who runs Escorts and performed the
operation on Staab.
Trehan said, for example, that the death rate for coronary bypass patients
at Escorts is 0.8 percent. By contrast, the 1999 death rate for the same
procedure at New York-Presbyterian Hospital, where former president Bill
Clinton recently underwent bypass surgery, was 2.35 percent, according to a
2002 study by the New York State Health Department.
Escorts is one of only a handful of treatment facilities worldwide that
specialize in robotic surgery, which is less invasive than conventional
surgery because it relies on tiny, remote-controlled instruments that are
inserted through a small incision.
"Our surgeons are much better," boasted Trehan, 58, a former assistant
professor at New York University ! Medical School, who said he earned nearly
$2 million a year from his Manhattan practice before returning to India to
found Escorts in 1988.
Although they are equipped with state-of-the-art technology, hospitals such
as Escorts typically are able to charge far less than their U.S. and
European counterparts because pay scales are much lower and patient volumes
higher, according to Trehan and other doctors. For example, a magnetic
resonance imaging (MRI) scan costs $60 at Escorts, compared with roughly
$700 in New York, according to Trehan.
Moreover, he added, a New York heart surgeon "has to pay $100,000 a year in
malpractice insurance. Here it's $4,000."
In addition to patients from other developing countries, top Indian
hospitals derive a significant share of foreign business from people of
Indian origin who live in developed countries but maintain close ties to
their homeland. But the same hospitals now are starting to attract
non-Indian patients from industri! alized countries, and especially from
Britain and Canada, where patients are becoming fed up with long waits for
elective surgery under overstretched government health plans.
"If you can wait for two years for a bypass surgery, then you don't need it
or you're dead -- one of the two," Trehan said. "Similarly, if you're
wobbling on your frozen joints for two years because of a waiting list, it's
a human tragedy."
One such patient is Tom Raudaschl, an Austrian who lives in Canada and earns
his living as a mountain guide. Suffering from osteoarthritis in his hip,
Raudaschl last year decided to undergo "hip resurfacing," a relatively new
procedure that involves scraping away damaged bone and replacing it with
chrome alloy. He learned he would have to wait as long as three years if he
wanted to have the operation under Canada's national health plan, a delay
that would have cost him his job, Raudaschl said. In the United States, the
procedure would have cost $21,000, he said.
So this month, Raudaschl flew from Calgary to Chennai, on India's east
coast, where a surgeon at Apollo Hospital performed the operation Wednesday
for $5,000, including all hospital costs, Raudaschl said by telephone from
his hospital bed.
"As soon as you tell people that you're going to India, they frown,"
Raudaschl said. But he said he could not be more pleased with the service.
"They picked me up at the airport, did all the hotel bookings, and the food
is great, too," said Raudaschl, whose private room was equipped with
Internet service, a microwave and a refrigerator. Most important, Raudaschl
said the surgeon told him he would be "skiing again in a month."
To cope with its backlog of cases, Britain's National Health Service has
begun referring patients for treatment to Spain and France, although for
now, the health service limits referrals to hospitals within three hours'
flying time, according to Anupam Sibal, a British-trained pediatrician ! and
Apollo's director of medical services.
"Nobody even questions the capability of an Indian doctor, because there
isn't a big hospital in the United States where there isn't an Indian doctor
working," he said.
Before they would admit him for surgery, Staab, the heart patient, said
hospital officials at Durham Regional Hospital asked for a $50,000 deposit
and warned that the entire cost of treatment could run as high as $200,000.
Katie Galbraith, a hospital spokeswoman, confirmed in an e-mail that
hospital costs in such cases typically are in the neighborhood of $100,000;
the surgeon's bill, which is charged separately, would have added tens of
thousands more. Patients such as Staab who do not qualify for charity care
often are offered a payment plan, she said.
Staab was discharged from the Indian hospital Monday and was recuperating at
a nearby hotel. He planned to return to Durham after visiting the Taj Mahal. |
