This is from today's WSJ.
Mr. Salo, a former commercial fisherman, faced a wait of a year or more for free care from Canada's national health service but the pain had become unbearable. Before airfare and other expenses, he paid $4,500 for the surgery at Apollo Hospitals Enterprises Ltd., a quarter of the cost for similar treatment in Europe and the U.S.
"People need to know that there are other options out there," says Mr. Salo, 54 years old, who was swinging golf clubs a month after the operation.
Mr. Salo is one of 60,000 foreign patients who were treated at Apollo Hospitals over the past three years. Since its start as a single hospital in 1983, Apollo has grown to 37 hospitals with more than 6,400 beds, making it one of the largest private hospital chains in Asia. Apollo's emergence as a global health-care provider in many ways tracks India's economic trajectory over the past three decades. The company has capitalized on the high cost of health-care administration in the U.S. and demands of patients elsewhere, for fast, inexpensive treatment.
Hundreds of Apollo's data processors work late-night shifts providing billing services and processing insurance claims for U.S. hospitals and insurers. Apollo laboratories perform clinical trials for Western drug companies, such as Pfizer Inc. and Eli Lilly & Co. Apollo even remotely evaluates X-rays and CAT scans.
Apollo's range of medical services -- from the back office to the operating room -- highlights the contradictions of the global outsourcing debate. In seeking to provide a wide range of services at a large discount to Western competitors, Apollo is yet another Indian company threatening jobs in the U.S. and other countries. On the other hand, Apollo's relatively inexpensive medical services have benefited patients from numerous countries. It also has helped India's overburdened health-care system. India has fewer than one hospital bed per 1,000 people, compared with more than seven in developed countries.
...But the core of its business is a fast-growing class of Indians who have the money to forego free treatment at state-owned hospitals. Of India's one billion people, roughly 250 million are considered middle- class. Complete checkups typically cost about $90 to $180. That is affordable to India's growing numbers of call-center workers and engineers -- though still out of reach for the very poor, estimated at about 300 million.
For the first three quarters of the fiscal year ended March 31, Apollo posted net income of the equivalent of $6.4 million, more than the $6.2 million it earned in the full prior fiscal year. Its revenue totaled about $84 million for the nine months, compared with $75 million during the same nine months of the year before. Nearly 62% of Apollo's revenue came from its core hospital business during the 2003 fiscal year; 36% came from pharmacies, and the balance from the newer outsourcing businesses.
The company expects the number of patients to grow about 20% per year over the next decade, and Dr. Reddy anticipates the outsourcing businesses will soon make up 25% of total net profit.
"The globalization of health care is changing service rapidly, and Apollo has been among the most aggressive in pursuing these opportunities," says Ofer Carmel, senior assistant to the director general of Maccabi Healthcare Services, a top Israeli health-care provider in Tel Aviv. Mr. Carmel says Maccabi is seeking to replicate some Apollo strategies.
...In another room on the campus, 30 Apollo staffers pored over medical bills and insurance claims, some of the 400 data processors who move in and out of the information-technology wing each day. They have memorized hundreds of codes that correspond to different medical procedures. The unit's manager, Miriam Mamta Edwards, punched numbers for radiological procedures into her computer. On her cubicle hangs a sign: "I Came, I Saw, I Coded."
In another room, Apollo executive Divya Sehgal met with American health-care executives who had flown in to look at how Apollo is handling their company's remote billing operations. To accommodate more billing and claims operations, a floor has been cleared in the complex for 300 more workers.
Meanwhile, pathologist Shyamala Sesikeran was overseeing clinical trials for half a dozen Western pharmaceutical companies. Over the past year, her staff has studied the effects of antibiotics, cancer drugs and heart treatments on local residents.
"More people will come to India" for treatment, says Saif Salim Sulieman al-Ziyuti, who was at the complex with his cousin, Salim Ali Salim al-Ziyuti, for annual check-ups. They had traveled from their home in the United Arab Emirates, three hours away by air. "They take good care of you," says the white-robed Mr. Saif. The cousins say their medical care at home is first-rate, but a scheduling backlog means weeks of waiting.
Apollo's example is important. It is almost one of its kind in India (as far as I know). However, I have heard stories of people dreming on the same lines. Healthcare is supposed to be a booming industry for some decades to come. I am going to find out more about this one.
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