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07/12/2014

APersonalStory:WhatcantheU.S.learnfromIndia’shealthcaresystem?|ForbesIndiaBlog

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|Sunday,December7,2014|4:00:28PM Follow BLOGS / Health VijayRamnathJayaraman

ItellstoriesaboutthebusinessofHealthcareinIndiaandtheU.S.

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APersonalStory:Whatcanthe

U.S.learnfromIndia’s

healthcaresystem?

09/18/2014|7comments|2004views Tweet 25 Share Like 236
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Tweet 25 Share Like 236 +Commentnow 18 19 Image: Shutterstock Previously,Iwroteabout

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Previously,IwroteaboutIndia’shealthcaresystemanditscharacteristics.Thisweek,I

wanttoshareapersonalstoryhighlightingsomequalitativeadvantagesofoursystem

andprescriptivetakeawaysforU.S.healthcare.

InJune2012,Iwokeupat7AMwithaphonecallfromChennai.Itwasfrommy52­

year­oldmotherinherbrokenvoicewhispering“Theysayitissurelymalignant.”Ihad

Advertisewithus>> VijayRamnathJayaraman VijayRamnathJayaramanisa

VijayRamnathJayaramanisa healthcaremanagementconsultant. HehelpshospitalleadersacrossU.S. andIndiaindealingwithfinancialchallenges.He isaGlobalShaper,agroupofleadersunderthe

ageof30chargedwithcatalyzingpositivesocial

changeintheirrespectivecommunitiesby WorldEconomicForum(WEF).Hewasrecently

chosenasa2014CarnegieNewLeaderbythe

CarnegieCouncil,NewYork.Heisalsoa

foundingmemberofanInstituteofHealthcare

Improvement(IHI)chapter.Hehasdegrees

fromGeorgiaInstituteofTechnologyandAnna

University.

AtForbes,Vijayfocusesintheareasofpolitics,

economics,andthebusinessofhealthcarein

IndiaandU.S.Theviewsexpressedonthissite

arehisownanddonotreflectthoseofhis

employerorclients.

Pleasefeelfreetocontacthimdirectly

@vijayramnath

@vijayramnath TWITTER MYRSSFEED

07/12/2014

APersonalStory:WhatcantheU.S.learnfromIndia’shealthcaresystem?|ForbesIndiaBlog

noideawhatitmeantthen.Likemany,Icamehomefromworkand“Googled”her diagnosisfortwostraighthourstofindout.ShewasdiagnosedwithStageIIcervical cancerthatdayatChennai’sleadingcancertreatmentcentre.Iwaslatersurprisedto

learnthatthistypeofcanceraffectsnearly300,000womeneveryyeararoundtheworld

BeforeIjumpedintoanyconclusionsrightaway,Iwentaheadanddidadetailed

comparisonofIndianandU.S.healthcaresystems–ajourneywhichchangedmy

perspectivesonIndia’sset­up.Here’swhatIfound.

StrongSupportSystems

ThesupportsysteminIndiaisincredible.Iwillbesurprisedifanyofthewestern

nationscanevencomeclose.Thedaymymotherwasdiagnosed,shegotallthesupport

neededwitheveryoneinmyfamilyaroundher.Shestillthinksthatthisisthenumber

onereasonforrecoveryandpositiveoutlook.

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InU.S.,unfortunately,familiesareweaklyknit.AccordingtoCensus.gov,aU.S. governmentwebsitethatcapturesnationalcensusinformation,theaveragefamilysize

duringthesameperiod.Similarly,lookingatthetrendsdataonhouseholdsizes,a

numberthathasbeenshrinkingbetween1970and2007intheU.S.,wecansaythat

familiesaredefinitelybeginningtoincludeonlytheparentsandkids,orjustasingle

parentandkids.NograndparentsorextendedfamiliesareapartofmostU.S.families

today.

Ithinkthisisatroublingtrendwhichhastobereversed.TakeforinstanceinTexas,

Medicaid,aninsurancesystemwhichpaysforthepoor,paysforthetransportationof

patientstohospital.Althoughthisseemslikeaniceideaatfirst,itsimplyshowsthekind

ofsupportthatpeopledon’treceiveautomaticallyfromtheirfamilyorfriends.Solving

suchalong­termsystemicproblemisgoingtobedifficult.U.S.canlearnaboutthe

benefitsofincludingelderlyparentsinfamiliesasagrassrootslevelfixtosolvingits

long­termdebtandhealthcarecostproblems.

EasyAccesstoCare

Accesstohealthcareisdefinedbyapatient’sabilitygettoaprimaryorspecialtycare

hospital.IfyouliveinametropolitancityinIndia,thisisgenerallyreadilyavailable.The

problemcomeswhenyouliveinaruralpartofthecountry.Havingahealthinsuranceis

abigfactorintheU.S.Inaddition,gettinganappointmentforthedoctorofyourchoice

ischallenging.Yourdoctorhastobeinyourinsurancenetwork.Ifnot,youmayendup

payingalot.Evenaftergoingthroughthesehurdles,itisstillhardtogetan

appointmentatyourconvenience.Doctorsdon’tseeyouontheweekendsandyouneed

tobookanappointmentatleastthreeweeksinadvance.Ifyouneedtoseeadoctorright

away,youhavetobereallysickandvisittheemergencyroomofahospitalonlytofind

outthatyouhavetowaitforfourmorehours.

Gettingyourtestsdoneisanothermonster.Yourinsurancemustcoveralltheseservices

andyouhavetomakeanappointmentwiththehospital.Allofwhichcouldeasilyaddup

toafour­weekwaitingperiod.

Now,let’sturnourfocustotheIndianscene.ArecentIMSInstitutestudywasquoted

sayingthat60percentofurbanIndiansgetreadyaccesstoproviders.Thisisverytruein

mycase.Allmymother’sappointmentsandtestswerescheduledwithintwodaysofher

diagnosisandwerecompletedinlessthanaweek.Thiswouldhavebeenimpossiblein

theU.S.initscurrentset­up.Basicaccesstocareisfragmentedandavailableonlyafter

sortingoutthecomplicatedhealthinsurancestructure.Eventhoughthequalityofcare

mightnotbeuptoU.S.standards,Indiahasdoneagreatjobofmakingroutinethings

easilyavailable.Itiseasytogetanappointment,easytopayforanappointment,and

easytoscheduleyourtests.

PayingforCare

PayingforcareinIndiaisrelativelysimple–Iamnotarguingthatitisalways

affordableforeveryone.Ifonecanpayforthecare,thepricesareactuallyvery

transparent.Forthreemonths,acombinedchemotherapyandradiationcostexactly

whatthedoctorsinitiallyestimated.Ourfamilywasneversurprisedwiththefinalbill.

Althoughthatsaysnothingaboutthecostoritseffectiveness,pricewasstilltransparent.

Weroughlyknewwhatweweregettingintobeforeweagreedtothetreatmentplans.

ThereisnowayweknowthepriceoftreatmentsaheadoftimeintheU.S.Costsare

alwayshiddenandvariabledependingonthetypeofinsurancecoverageandyourrisk

profile.Ifyouareemployedandifyouremployerprovidesagoodcomprehensive

insurancepackage,youarecompletelyshieldedawayfromthecostsbecauseyouendup

payingalmostnothing.

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07/12/2014

APersonalStory:WhatcantheU.S.learnfromIndia’shealthcaresystem?|ForbesIndiaBlog

Comingbacktomyownstory,mymotheriscompletelyfinenow.Inearly2013,she

evenvisitedtheU.S.andspoketoafewphysiciansthere.Theywereallamazedbythe

careshereceivedinChennai.Ithinkallthecreditgoestoherstrongwill,supportfrom

family,thedoctorswhotreatedher,and,mostimportantly,thesystemthatmadeeasy

accesspossibleincities.

Inconclusion,itisclearthatbothcountrieshavetheirstrengthsandweaknesses.Ifthe

U.S.drawslessonsfromIndia’sstrengths—supportivesocialstructure,simplepayment

systemsandcostofcare—itcouldactasasteppingstoneintoitsfuture.India,onthe

otherhand,mustconsolidateitsplusesandensurethatitupsitsgametotacklethe

negatives.Alotstillneedstobedone,butIamoptimistic.

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Agree,thehealthcaredeliveryinIndianHospitalsparticularlyinmetroisworldclassand theproofisthesizablenumberofoverseaspatientsflockingthereestablishments,besides Socialfactordoplayamajorrole.ButIndiaisnotmetrocitiesalone,perhapstimeto analysessimilarpatientsdiagnosedinruralpartofthecountry.Inmydiscussionwitha seniordoctorfrompublichealthIwasinformedthatinsomeregionsofcountrytheAllcommentsaremoderated PostComment Comment

percentageofwomensufferingfromcervicalcancerisashighas18­19%withmostinstage

sanjaySeptember30,2014at7:44pm

3or4.

sanjay September30,2014at7:44pm 3or4. Reply

Icompletelyagreewithyou.InDecember2013Igotacorneagraphtingdonehereinsanjay September30,2014at7:44pm 3or4. Reply MousumiGhosh September29,2014at12:43pm

MousumiGhoshSeptember29,2014at12:43pm

Kolkata,Indiamuchagainstpublicpeception.Iamdoingfine.

Kolkata,Indiamuchagainstpublicpeception.Iamdoingfine. Reply VijayRamnathJayaraman September30,2014at7:57pm

VijayRamnathJayaramanSeptember30,2014at7:57pm

Goodtohearyoursuccessstory,Mousumi!

Goodtohearyoursuccessstory,Mousumi! Reply Vasu September26,2014at11:32am

VasuSeptember26,2014at11:32am Vasu

It'sgoodsomeonetalkingaboutgoodIndianHealthSystemandcomparingtoAmerican

HealthSystem.IfI'mtalkingaboutgovernmenthealthsysteminIndiaisverybadbecause

thishealthsystemmeantforpoorpeople.Thereisnocareforpatienttheirrecoveryand

thereisnoguarantyfortherelife.InIndiasuchgoodfacilityavailableforrichpeopleonly.

ThisisrealIndia.

ThisisrealIndia. Reply VijayRamnathJayaraman September26,2014at8:03pm

VijayRamnathJayaramanSeptember26,2014at8:03pm

ThanksforvisitingusVasu!

September26,2014at8:03pm ThanksforvisitingusVasu! Reply IsitreallythatBadinUS?Bitsurprisedbythearticle. Nirad

IsitreallythatBadinUS?Bitsurprisedbythearticle.September26,2014at8:03pm ThanksforvisitingusVasu! Reply Nirad September20,2014at12:14am Reply

NiradSeptember20,2014at12:14am

Nirad September20,2014at12:14am Reply 'GovernmentMustImproveCold 10

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VijayRamnathJayaraman'sActivityFeed AllActivityFeed VijayRamnathJayaraman September30,201419:57pmbyVijayRamnath

VijayRamnathJayaraman

September30,201419:57pmbyVijayRamnath

Jayaraman

07/12/2014

APersonalStory:WhatcantheU.S.learnfromIndia’shealthcaresystem?|ForbesIndiaBlog

VijayRamnathJayaraman September20,2014at8:53pm

VijayRamnathJayaramanSeptember20,2014at8:53pm

IviewtheU.S.healthcareas1)HealthcareProblem:Whichisthecare

receivedbypatientswhichismostlyavailabletoeveryoneintheU.S. Usuallythecareisalsohighqualityandproducesgoodoutcomesand

2)HealthInsuranceProblem:Thisiswherethebarriersofcareexist.

Unless,youhaveagoodinsurancethroughanemployer/self­funded,

youarelargelyresponsibleforpayingforcostswhichcouldrunupto

thousandsofdollarsresultingindelayedcare.ThanksNirad.

thousandsofdollarsresultingindelayedcare.ThanksNirad. Reply Goodtohearyoursuccessstory,Mousumi!

Goodtohearyoursuccessstory,Mousumi!

September30,201419:44pmbysanjay

September30,201419:44pmbysanjay

Agree,thehealthcaredeliveryinIndian

Hospitalsparticularlyinmetroisworldclass

andtheproofisthesizablenumberof

overseaspatientsflockingthere

establishments,besidesSocialfactordoplay

amajorrole.ButIndiaisnotmetrocities

alone,perhapstimetoanalysessimilarpati

September29,201412:43pmbyMousumiGhosh

September29,201412:43pmbyMousumiGhosh

Icompletelyagreewithyou.InDecember

2013Igotacorneagraphtingdoneherein

Kolkata,Indiamuchagainstpublicpeception.

Iamdoingfine.

Kolkata,Indiamuchagainstpublicpeception. Iamdoingfine. VijayRamnathJayaraman September26,201420:03pmbyVijayRamnath
Kolkata,Indiamuchagainstpublicpeception. Iamdoingfine. VijayRamnathJayaraman September26,201420:03pmbyVijayRamnath

VijayRamnathJayaraman

September26,201420:03pmbyVijayRamnath

Jayaraman

ThanksforvisitingusVasu!

September26,201411:32ambyVasu

September26,201411:32ambyVasu

It'sgoodsomeonetalkingaboutgoodIndian

HealthSystemandcomparingtoAmerican

HealthSystem.IfI'mtalkingabout

governmenthealthsysteminIndiaisvery

badbecausethishealthsystemmeantfor

poorpeople.Thereisnocareforpatienttheir

recoveryandthereisnoguarantyforthere

life

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