Sucheta Dalal :A Passage to Indian Health Care
Sucheta Dalal

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A Passage to Indian Health Care  

May 23, 2005

By Val MacQueen 

Published   05/12/2005

We know that it is routine for x-rays and many diagnostic tests to be interpreted overnight by medical professionals in India. In a fairly new development, though, it's not just the tests that are headed off to the subcontinent for diagnosis, but the patients themselves -- and they're going in droves.

Medical tourism to India started fairly recently when NRIs (non- resident Indians -- those living and working in the West) began to go "home" to India seeking not just their roots, but root canals. They returned with killer smiles and tales of the staggering savings in costs -- even factoring in airfares -- and excellence of treatment. NRIs, aware from their families of India's state-of-the-art technology and the level of surgical skill, also head off "home" for more critical treatment, like kidney transplants, hip replacements and open heart surgery. Indeed, India's 20 million diaspora returning to the US and Britain after successful treatment are India's best ambassadors.

Britons plagued by their socialist and inefficient National Health Service waiting lists (people diagnosed with cancer or degenerative heart disease can wait for an operation for a year or even more) and Americans who didn't keep up their health insurance after retiring --or never had any -- are now choosing their hospitals and surgeons on the internet and booking their flights to India. And to make it even easier, there are medical tourism companies in India who will take care of all these details for them.

Now, some enterprising hospitals offer greet-and-treat services with an all-inclusive health-tourist package, including the desired medical procedure, hotel, air travel, bookings and admissions to popular tourist attractions. And India has the overwhelming advantage being Anglophone.

A full cycle of IVF treatment followed by a bracing vacation amid the majesty of the Himalayas! Or get your mouth completely redesigned, your teeth recapped by a dentist employing the latest technology and pop over to the exotic pink city of Jaipur in Rajasthan to practice your new smile … all at a fraction of the cost of the medical procedure alone in the West.

If you need more serious treatment, you can have your kidney transplant or spinal surgery in a hospital that is as hygienic and well-equipped as most hospitals in the West -- and a good deal better than some. Hip replacement recuperation may not include a hike to the base camp of Mount Anapurna, but you'll be well attended by skillful and qualified people and you'll return home with the same results you would have achieved in the West for around a quarter of the cost - or sometimes much less.

What kind of cost savings are we talking about? A fairly dependable rule of thumb is, if you're an uninsured American, you'll have paid approximately 25 percent, or less, of the cost you'd have forked out for identical treatment in the US. If you're British, you'll have avoided a National Health waiting list that may have kept you inline for two years. Of course, many British nationals with urgent health problems are opting for private treatment, but it is pricey. Again, costs in India for identical procedures are roughly 25percent of private treatment in Britain. Some procedures in India cost as little as one-tenth what they cost in the West.

Access to open heart surgery in India is immediate, and it will cost, without complications, around $10,000 - against around $50,000in America or privately in Britain. A biopsy for a brain tumor will cost around $1,000 and surgery around $6,000. Hip replacements using the newest techniques cost in the neighborhood of $6,500, with no waiting lists. There are hospitals specializing in nothing but spinal and joint surgery.

Kidney treatment runs around $45 per dialysis using technology identical to that in the West, against $300 or more per dialysis in the US. A full range of sophisticated kidney treatment is available at specialized kidney clinics. A kidney transplant will cost around$7,000.

Regarding above-mentioned IVF treatment, Dr. Hrishikesh Pai, an infertility specialist, notes, "Our technology is only about six months behind that of the West." (Or perhaps not; there may have been no substantial new developments in six months or a year.) An invitro fertilization cycle in a reputable Indian fertility clinic with highly qualified specialists will cost the visitor around$1,200 with the same treatment in the US costing $6,000 per cycle.

Medical tourism is set to become an important contributor to India’s economy and is predicted to earn $2 billion in foreign revenues by the year 2012. After that, I suspect it will be Katy-bar-the-door as people become more frequently exposed to friends and colleagues who’ve been treated to their satisfaction in India.

Most British and Americans are accustomed, anyway, to being treated by expatriate Indian doctors. And now, even the South Americans are finding it more economical to have their cosmetic surgery done in India than at home. Most big Indian cities have several hospitals that are on the A list by any reckoning. Even Hyderabad, a big city, but not one of India's famous tourist destinations, has around 10 world-class hospitals. The BBC notes, about a hospital visit in Bombay, "Walking in from the frenetic streets of Bombay, the Hinduja hospital is certainly a surprise. Its spotless corridors and state-of-the-art equipment could be those of the best hospitals in London or New York."

Even England's cranky, leftwing Guardian newspaper has reported on India’s success as an alternative to dying-while-u-wait on the British National Health. It cites 73-year-old George Marshall, a violin repairer who was diagnosed with coronary disease and told he would have a six month wait for an operation. He considered private treatment, but it would have cost £19,000 (approx. $35,000). Instead, he flew to Bangalore, "where surgeons at a specialist hospital and heart institute took a piece of vein from his arm to repair the thinning arteries of his heart." The cost was $9,000,including the flight. Marshall said he would not hesitate to comeback.

From the US, 64-year-old San Francisco real estate consultant Robert Walter Beeney, who had been unable to walk due to a stiff hip, underwent a successful hip replacement surgery using an anatomic surface replacement at an Apollo hospital. Despite the fact that the device used was manufactured in the US, its use hadn't yet been cleared by the FDA. Beeney had considered going to Britain or Belgium for treatment, where it had been cleared for use, but the costs were too high. The cost for this advanced treatment was $6,600. Had he been in a clinical trial for the not-yet-approved procedure, he would have paid $24,000.

Zakariah Ahmed, an analyst who helped compile a report for the Confederation of Indian Industry and McKinsey Consultants, says last year some 150,000 foreigners visited India for treatment, with the number rising by 15 percent a year.

The Indians are very aware that the infrastructure of some of their larger cities does not inspire technological or hygienic confidence - - despite the fact that inside a modern hospital is a million miles from the chaos on the sidewalks outside. As The Hindu, one of India’s major daily papers, notes, writing from Chennai (Madras) "Atask force comprising representatives from the Health and Tourism Ministries and the Confederation of Indian Industry is accrediting hospitals and spas, which will figure on India's health tourism map", the Union Minister of State for Tourism, Renuka Chowdhury said today. He added, "The accredited hospitals and spas would be rated on quality to ensure that patients from other countries had a reliable system to put their money in."

E.M.Najeeb, writing in India's travel business magazine, makes similar points. And Dr D. Premachandra Sagar, vice-chairman and CEO of Bangalore's Sagar Apollo Hospital, told India Daily that "there is not one medical procedure that cannot be done in our hospital which is done abroad. And the success rate of cardiac bypasses is of98.7% in India, as opposed to only 97.5% in the United States." Yet, he admitted that India's image as a high tech health destination needs more public relations work.

The implications are mind-boggling. Already, it is being suggested in Britain that the National Health Service send patients to India for cataract and hip-replacement surgeries. Again, it is possible that once this catches on, which is happening at the speed of light, insurance giants in the West will soon funnel patients to India for, say, bypass operations or organ transplants. A sign of both quality and acceptance is the fact that already, Blue Cross and Blue Shield will insure patients treated at some groups of Indian hospitals. The British health insurer BUPA also insures treatment at the same chain. Finally, I quote a letter in London's The Telegraph from a prominent consulting surgeon commenting on the National Health Service’s inevitable vulnerability to political opportunism (the Labour government wants to reduce the time taken to train a surgeon to just four years). He closed with, "For my part, if I need major surgery in the future, I will go to India, whence many of my best trainees have qualified and returned."

Originally published by the Tech Central Station

-- Sucheta Dalal