Some critical reasons for growth in medical tourism
A few years ago one frequently heard of patients from the middle east coming to India for quality medical treatment, but of late there seem to be a lot of people from developed countries like the US, UK and Canada coming here. Countries known for their excellent hospitals and medical care. At first I thought it was all about cost, and while that does seem to play a role in driving medical tourism to poorer countries…to my surprise I found out that there are other complex reasons…
Patients in Canada (Canada has a free government run health system, something which India can only dream of) have to wait even for an x-ray or an MRI!! I couldn’t quite believe it because here, even though we are a poorer nation, people can can get an MRI almost instantly, if they can afford it. And for an operation a Canadian might have to wait for about 18 weeks. As its free, everyone has to wait, money or not. However Canada’s dental health system runs on private insurance and patients generally get faster treatment.
The Americans feel their system is better because it runs on private health insurance. But its been exposed to some extent by Michael Moore’s documentary Sicko. The film shows how “middle-class families cannot afford medical care and profit-driven insurance giants go to extraordinary lengths to limit payments.” He has also detailed the number of people without insurance and partial insurance and also deaths due to delays in treatment or lack of treatment.
But this is the system that India is heading for! Private health insurance companies here are struggling to keep their head above water and are being finicky about payments. Seeing America’s plight, I wonder what the future holds for us. Right now industry analysts here are saying that once the system stabilizes and more people join the health schemes (few people can afford private health insurance in India) then the insurance companies will make money and everything will be alright.
But if what’s happening in America is anything to go by, its that part of the US medical system that is government run (Medicare – for the elderly and disabled or Medicaid for the very poor) which works. In fact its said to be working better than the government run system in Canada as its better funded. America’s Medicare system however has long waiting times. Here it says that waiting periods can be as long as two years.
But overall, critics feel that Sicko, which tears the American health system apart, has not given the complete picture. Those who hold down jobs (companies pay for the insurance then) have good health care and medicare takes over in old age. Others believe that Moore has exaggerated the figures on uninsured people, has not talked about those who deliberately choose not to insure themselves even when they can afford it and has not mentioned the free emergency care available for all. A business week article gives a balanced picture. Their take on Moore’s portrayal of America’s health-care:
In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems… If you find a suspicious-looking mole and want to see a dermatologist, you can expect an average wait of 38 days in the U.S., and up to 73 days if you live in Boston…Got a knee injury?…the average time needed to see an orthopedic surgeon ranges from 8 days in Atlanta to 43 days in Los Angeles. Nationwide, the average is 17 days.
As for Britain, about 50,000 people left the country for medical treatment in 2006 and this is set to increase because of “lengthening waiting lists.” Britain’s public health service (NHS) is not able to meet the demand.
Thats what it is about finally. Supply verses demand. Not enough doctors…and too many patients.
But ironically India which is providing medical care to those leaving their own country, has the same problem! Not enough doctors and too many patients!! The only difference is that people (those who suffer are at the bottom of the economic pyramid) can do nothing about it. Why, many can’t even afford to travel (or are too sick to travel) from their remote village to the town which does have the doctor they need. And even if they manage to to go there, they cannot afford the fees. And if they can afford the fees, they cannot afford the treatment or the hospital bed. Its not uncommon for private hospitals here to refuse to release cured patients or even dead bodies unless bills are paid. Patients who cannot afford private hospitals can always try the public health system (but one has to pay for the medicines) – if a hospital bed is available. Our public health system (used mainly by the poor) is over-crowded. So much so in fact that a lot of the lower middle classes prefer the smaller private clinics which have mushroomed everywhere…even if the treatment burns a hole in their pocket and the doctor’s treatment is suspect. The majority of Indians do not have health insurance. Worse, the laws in place against medical negligence do not always work, not the least because the courts are slow.
One of the reasons why this medical tourism thing never impressed me is because elitism makes me uncomfortable, at least where healthcare is concerned. Thats why I think the Canadian system is ideal…if only it worked! But medical tourism aside, the idea that the rich can monopolize doctors is something which is already happening in India. At least the patients who are coming from abroad are adding to our exchequer. About 200,000 people came to India in 2006 for medical treatment and this number is set to increase. The medical tourism industry in India will be worth Rs 100 billion by 2012.
And we are still luckier than them I think…because middle class people here get doctors’ appointments the very next day, can get a knee surgery done in a few weeks…why, even a working class person here can manage to cough up enough money for a minor operation. And he can get it done quickly. And as for major operations, when my mother in law was diagnosed with breast cancer, the biopsy was done in 48 hours and an operation in the next 8 days! If we had had to wait for say 3 months, it would have risked her life…not to mention the tension of waiting.
In this scenario I think the recent attempts by the US and British governments to discourage their citizens from coming to India because of travel hazards aren’t going to work. Not as long as people are suffering.
(Photos are for representative purposes only and copyrighted to me)
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