With mutual co-operation.

The demand for new medical knowledge, drugs and medicine is growing, which needs to be addressed by both the public and private healthcare systems. Some of the important findings of a recent survey on the corporate hospitals scenario Include: y The national average of proportion of households in the middle and higher middle income group has increased from 14% in 1990 to 20% in 1996. y Private insurance will drive the healthcare revenues. Considering the rising middle and higher middle income group we get a conservative estimate of 200 million insurable lives. y The population to bed ratio in India is 1 bed per 1000, in relation to the WHO norm of 1 bed per 300. y y In India, there exits space for 75000 to 100000 hospital beds. The Indian healthcare industry is worth Rs. 730 bn to-day, and it is expected to grow by around 13% to 15% annually.

India s with health care services industry is poised to become a major driver of economic growth as first-world patients, driven out of their own systems by high costs and crowded conditions, look for cheaper places for medical care. For India, new terms such as such as health tourism, health care outsourcing and medical back office support are suddenly gaining currency. Already, with health care costs having spiraled to prohibitive levels across much of the developed world, the British government, for instance, is contemplating flying its ailing to India to clear up long waiting periods for treatment and surgery in the UK s overcrowded hospitals. India s hospital care and education facilities are rapidly improving after having been freed from the yoke of 50 years of a command economy. Hospitals in Kolkata have ling queues of patients from Bangladesh, waiting for appointments with Indian medical specialist. The opening of bus service between Indian and Lahore has brought Pakistani patients as well.

The statistics are impressive. According to India s ministry of External Affairs, the U$$17 billion Indian health care industry comprises roughly 4 percent of the country s GDP. Hospital services, health care equipment, managed care and pharmaceuticals are poised to grow by 13 percent annually for the next six years. According to the insurance Regulatory and Development Authority (IRDA), India s health care industry could grow exponentially, as have software and pharmaceuticals over the past decade. The government believes that only 10 percent of the market potential has been tapped. With global revenues an estimated $2.8 trillion, health care is the world s largest industry. The industry s growth is being fuelled by the rising purchasing power of the Indian middle class, which is willing to pay more for quality health care. Indeed, health care is becoming steadily more available as the private sector becomes more involved in the industry and hospital management. With the kind of interest in Indian services that is being shown by other countries, industry analysts believe growth could outstrip current calculations. Privatization is the key to the sector s resurgence. A Central Bureau of Health intelligence study indicates that middle and high-income groups have more confidence in health care products and services offered by private hospitals than in government-owned agencies. On average, private service is 60 percent more expensive than government-owned service. Although private health care is a more expensive alternative for domestic residents, it is cheaper for the British government to fly patients over and back after treatment than it is to treat them at home. In fact, the cost-benefit advantage is phenomenal. Open-heart surgery costs run $34,000 to $70,000 in the UK. In the US, routine open-heart surgery as high as $150,000 with complicated problems considerably more. In India, open heart surgery could cost $3,000 to $10,000 in the best of hospitals. Cost differentials therefore could be anywhere from 200 percent to 800 percent to off the chart. Analysts believe effective marketing could divert patients from African and West Asian countries -----who are going to the US or UK for treatment to Indian. -------Another niche area that could be exploited is procedures that are generally no insurance -----covered in advanced countries, like cosmetic and plastic surgeries and other high-end --------treatments such as breast implants. ------quality remains an issue, it seems to be improving in India, with private hospitals increasingly able to import high-tech medical equipment, a situation that should improve further with the Indian government s announcement that import duties on medical equipment are to be reduced as well. In addition, for decades, doctors and other professionals have been fleeing India for more-developed countries where they could practice medicine or other professions profitably. The US Immigration and Naturalization service says a startling 48 percent of H1-B category workers admitted to the

united states- those with advanced degrees, exceptional abilities or professionals with bachelor s degrees or equivalent and skilled workers-are from India. As health care salaries and medical facilities and improve in India, that brain drain should start to reverse, as it has in the information technology industry. A report published by Dr Vinay Kothari, the managing director of ------Hospihealth, a hospital and health care planner and management consultancy, states that a decade ago India was roughly 50 years behind the US. However, the report says, over the last 10 to 15 years ------this gap has begun to close fast, with high-tech super-specialty hospitals coming up all over the country. Most Indian private hospitals are trying to improve quality by employing quality manpower, better salary structure, training and arranging for continuing education for their doctors. It is therefore increasingly likely that Indian health care will be close to global standards in the coming years. According to the Frost & Sullivan Indian health care Industry Forecast 1996-2006, the industry s growth very much depends on India s continuing macroeconomic liberalization, including further tax cuts, a broader tax base and reduced interest rates for borrowers. The forecast says that the introduction of product patents in India is expected to boost the industry by encouraging multinationals to launch specialized life-saving drugs. After liberalization, the situation in the corporate sector is quite encouraging. The salaries of doctors have shot up after liberalization (over 5 lakh per year, plus hoards of perquisites.) Some large Indian corporate are hiring expatriates by giving compensation packages range from $ 250,000-$400,000 p.a. That is Rs. 1025 crore to Rs 2 crores per annum (Cherian, G: 2002). Moreover, in India, they can afford to hire a driver and servants, luxuries they could never afford in the US. The basic living conditions in Indian are also improving rapidly, notes one of the scientists (Business world, 1999: 2127). Secondly, opportunities to conduct research are opening in India, spurred by the prospect of the government introducing product patents. Besides, Indian drug companies are also investing more in research. India can get immense benefit if it can tap the NRIs in this field. It is also observed that Indians in the U.S spend close to 1 $billion on healthcare. If India could provide better facilities and attract them, it will be a tremendous push toward the healthcare development of India.

Source: ICRA, The Indian Pharmaceutical Industry This shows that India spends a higher percentage of its GNP on health than China, Bangladesh ect. This is true of both public expenditure on health, as well as the total (public and private) expenditure on health. Here we can see the poor returns on the resources we spend on setting up

Corporate Hospitals in India Corporate hospitals are going to play a vital role in India in near future. Presently though they are not spread widely all over the country, these hospitals are found mostly in metropolis. They make their impact more in terms of quality medical service in the society. The concept of corporate hospitals in India was pioneered by Dr. Pratap C. Keddy. In India corporate hospitals are the front runners in using all the leading technologies. Corporate hospitals mushroomed in the late eighties. These hospitals with their high-profile and profit-driven approach, are located mainly in urban centers. Another dimension of the urban area is the relatively high incidence of institutional support for an individual s healthcare needs of their employees.