I hadn’t given medical tourism or outsourcing much thought until a few months ago, when I was at the Narayana Hrudayalaya (NH) Hospitals in Bangalore with Devi Shetty, the founder of the medical complex and a pediatric cardiothoracic surgeon.
Shetty told me bypass surgeries cost his patients $2,000 to $5,000, a tenth of what it would cost in the United States. As a U.S.-educated doctor, I wasn’t sure whether I should feel threatened by or marvel at Shetty’s setup. But I was curious, so I asked him how he was able to realize such savings.
His formula was simple: Focus on the process and on volume. “If you are investing heavily in the process, the product naturally will be good,” he told me. Just as Wal-Mart capitalizes on the power of bulk purchasing, Shetty has applied process and volume principles to his hospitals, using innovation and well-tested surgical techniques developed in the United States.
Devon Herrick, a policy expert at the National Center for Policy Analysis, a think tank based in Dallas, identified other factors that make foreign hospitals less expensive: lower labor costs certainly, but also fewer third-party payments, price transparency, limited malpractice liability and fewer regulations.
As I spoke with Shetty, I was reminded of the epiphany Tom Friedman experienced when he conceived his book “The World Is Flat” after meeting with the founder of Infosys. Could health care become globalized and a level playing field, much like the software industry? Shetty’s hospitals are just a stone’s throw away from the high-tech, oasis-like campus of Infosys, an information technology company with more than $5 billion in annual revenue.
American health-care dollars are bound to be a prime target for providers overseas. But I was worried about the quality of health care in a developing country where the tap water is unsafe for drinking.
Shetty, 54, wearing a surgical cap and sea-blue scrubs, had me drape on a cotton gown and surgical shoe covers for a tour of his ICU. He told me that the Joint Commission International — a U.S.-based organization that establishes standards for and inspects health-care providers — was coming for a review in two weeks.
I asked him a litmus-test question about quality of care delivered to critically ill patients: “What is your ICU nurse-to-patient ratio?”
Without hesitating he said, “One to one.” The same as ours in the United States, I told him. He sent me an e-mail in February: “We got JCI with flying colors.” More than 220 medical sites outside the United States are JCI-certified.