Observations from the Healthcare Frontlines in India

Posted on 22 September 2011 by Josef Woodman

Fortis Hospital, Gurgaon

Last week, on the long plane ride home from Chennai and Delhi (headquarters of India's two largest healthcare providers Apollo and Fortis), I had time to reflect upon the astounding rate of growth and change on the subcontinent.

Delhi's and Chennai's construction landscape looked more like the Beijing of five years back, with freshly constructed office buildings and cranes dominating the urban landscape. Slums have been razed, and while much of the poverty-ridden population has likely been sent back to the countryside, I witnessed the familiar and ubiquitous terrain of low-income housing replacing the tin and tarp communities of yore.

What does this have to do with healthcare? Plenty. India now boasts a larger middle class population than the US—nearly 300 million souls. Along with access to improved education, automobiles, washing machines, and iPads, newly-affluent Indians are filling public and private hospitals seeking advanced, Western-style medical attention.

Hospitals like Fortis Healthcare, Max, Columbia Asia, Apollo, and Medanta are all running at or beyond capacity, and India's providers are struggling to bridge the gap between the demand for and availability of quality healthcare. They're also facing, for the first time, the mixed blessing of health insurance—nearly 20 percent of the population is now covered, driving provider margins down even as hospitals invest vast sums to improve quality of delivery.

In order to maintain acceptable levels of profitability, Indian specialty hospitals require a healthy flow of international patients, which help balance the books with direct payment for higher margin specialty care. In meetings with Fortis and Apollo executives, I was keenly aware of their concerns about the failings of healthcare systems in developed nations such as the US, Canada, UK and Japan. These providers seek to better manage the evolution of private healthcare in India by streamlining the claims and reporting process, gaining maximum efficiencies from specialty centers, emphasizing preventive care, and adding greater efficiency and common sense into the mix.

I truly hope India can achieve more desirable results than their entrenched counterparts, and in the process perhaps we can learn a thing or two about how to serve patients more efficiently and affordably. Wouldn't that be a twist?