07/12/2014

APersonalStory:WhatcantheU.S.learnfromIndiashealthcaresystem?|ForbesIndiaBlog

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Health
VijayRamnathJayaraman
ItellstoriesaboutthebusinessofHealthcareinIndiaandtheU.S.
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APersonalStory:Whatcanthe
U.S.learnfromIndias
healthcaresystem?

VijayRamnathJayaraman

VijayRamnathJayaramanisa
healthcaremanagementconsultant.
HehelpshospitalleadersacrossU.S.
andIndiaindealingwithfinancialchallenges.He
isaGlobalShaper,agroupofleadersunderthe
ageof30chargedwithcatalyzingpositivesocial
changeintheirrespectivecommunitiesby
WorldEconomicForum(WEF).Hewasrecently
chosenasa2014CarnegieNewLeaderbythe
CarnegieCouncil,NewYork.Heisalsoa
foundingmemberofanInstituteofHealthcare
Improvement(IHI)chapter.Hehasdegrees
fromGeorgiaInstituteofTechnologyandAnna
University.

09/18/2014|7comments|2004views

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AtForbes,Vijayfocusesintheareasofpolitics,
economics,andthebusinessofhealthcarein
IndiaandU.S.Theviewsexpressedonthissite
arehisownanddonotreflectthoseofhis
employerorclients.
Pleasefeelfreetocontacthimdirectly
@vijayramnath
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Image:Shutterstock

MYRSSFEED

Previously,IwroteaboutIndiashealthcaresystemanditscharacteristics.Thisweek,I
wanttoshareapersonalstoryhighlightingsomequalitativeadvantagesofoursystem
andprescriptivetakeawaysforU.S.healthcare.
InJune2012,Iwokeupat7AMwithaphonecallfromChennai.Itwasfrommy52
yearoldmotherinherbrokenvoicewhisperingTheysayitissurelymalignant.Ihad
http://forbesindia.com/blog/health/apersonalstorywhatcantheuslearnfromindiashealthcaresystem/

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07/12/2014

APersonalStory:WhatcantheU.S.learnfromIndiashealthcaresystem?|ForbesIndiaBlog

noideawhatitmeantthen.Likemany,IcamehomefromworkandGoogledher
diagnosisfortwostraighthourstofindout.ShewasdiagnosedwithStageIIcervical
cancerthatdayatChennaisleadingcancertreatmentcentre.Iwaslatersurprisedto
learnthatthistypeofcanceraffectsnearly300,000womeneveryyeararoundtheworld
anditisalsooneoftheleadingcausesofdeathsforwomeninIndia.

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BeforeIjumpedintoanyconclusionsrightaway,Iwentaheadanddidadetailed
comparisonofIndianandU.S.healthcaresystemsajourneywhichchangedmy
perspectivesonIndiassetup.HereswhatIfound.
StrongSupportSystems
ThesupportsysteminIndiaisincredible.Iwillbesurprisedifanyofthewestern
nationscanevencomeclose.Thedaymymotherwasdiagnosed,shegotallthesupport
neededwitheveryoneinmyfamilyaroundher.Shestillthinksthatthisisthenumber
onereasonforrecoveryandpositiveoutlook.

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InU.S.,unfortunately,familiesareweaklyknit.AccordingtoCensus.gov,aU.S.
governmentwebsitethatcapturesnationalcensusinformation,theaveragefamilysize
inU.S.wasbetween2.61to3.28in2009.Thisiswellbelowthe3.35to5.47forIndia
duringthesameperiod.Similarly,lookingatthetrendsdataonhouseholdsizes,a
numberthathasbeenshrinkingbetween1970and2007intheU.S.,wecansaythat
familiesaredefinitelybeginningtoincludeonlytheparentsandkids,orjustasingle
parentandkids.NograndparentsorextendedfamiliesareapartofmostU.S.families
today.
Ithinkthisisatroublingtrendwhichhastobereversed.TakeforinstanceinTexas,
Medicaid,aninsurancesystemwhichpaysforthepoor,paysforthetransportationof
patientstohospital.Althoughthisseemslikeaniceideaatfirst,itsimplyshowsthekind
ofsupportthatpeopledontreceiveautomaticallyfromtheirfamilyorfriends.Solving
suchalongtermsystemicproblemisgoingtobedifficult.U.S.canlearnaboutthe
benefitsofincludingelderlyparentsinfamiliesasagrassrootslevelfixtosolvingits
longtermdebtandhealthcarecostproblems.
EasyAccesstoCare
Accesstohealthcareisdefinedbyapatientsabilitygettoaprimaryorspecialtycare
hospital.IfyouliveinametropolitancityinIndia,thisisgenerallyreadilyavailable.The
problemcomeswhenyouliveinaruralpartofthecountry.Havingahealthinsuranceis
abigfactorintheU.S.Inaddition,gettinganappointmentforthedoctorofyourchoice
ischallenging.Yourdoctorhastobeinyourinsurancenetwork.Ifnot,youmayendup
payingalot.Evenaftergoingthroughthesehurdles,itisstillhardtogetan
appointmentatyourconvenience.Doctorsdontseeyouontheweekendsandyouneed
tobookanappointmentatleastthreeweeksinadvance.Ifyouneedtoseeadoctorright
away,youhavetobereallysickandvisittheemergencyroomofahospitalonlytofind
outthatyouhavetowaitforfourmorehours.
Gettingyourtestsdoneisanothermonster.Yourinsurancemustcoveralltheseservices
andyouhavetomakeanappointmentwiththehospital.Allofwhichcouldeasilyaddup
toafourweekwaitingperiod.
Now,letsturnourfocustotheIndianscene.ArecentIMSInstitutestudywasquoted
sayingthat60percentofurbanIndiansgetreadyaccesstoproviders.Thisisverytruein
mycase.Allmymothersappointmentsandtestswerescheduledwithintwodaysofher
diagnosisandwerecompletedinlessthanaweek.Thiswouldhavebeenimpossiblein
theU.S.initscurrentsetup.Basicaccesstocareisfragmentedandavailableonlyafter
sortingoutthecomplicatedhealthinsurancestructure.Eventhoughthequalityofcare
mightnotbeuptoU.S.standards,Indiahasdoneagreatjobofmakingroutinethings
easilyavailable.Itiseasytogetanappointment,easytopayforanappointment,and
easytoscheduleyourtests.
PayingforCare
PayingforcareinIndiaisrelativelysimpleIamnotarguingthatitisalways
affordableforeveryone.Ifonecanpayforthecare,thepricesareactuallyvery
transparent.Forthreemonths,acombinedchemotherapyandradiationcostexactly
whatthedoctorsinitiallyestimated.Ourfamilywasneversurprisedwiththefinalbill.
Althoughthatsaysnothingaboutthecostoritseffectiveness,pricewasstilltransparent.
Weroughlyknewwhatweweregettingintobeforeweagreedtothetreatmentplans.
ThereisnowayweknowthepriceoftreatmentsaheadoftimeintheU.S.Costsare
alwayshiddenandvariabledependingonthetypeofinsurancecoverageandyourrisk
profile.Ifyouareemployedandifyouremployerprovidesagoodcomprehensive
insurancepackage,youarecompletelyshieldedawayfromthecostsbecauseyouendup
payingalmostnothing.

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APersonalStory:WhatcantheU.S.learnfromIndiashealthcaresystem?|ForbesIndiaBlog

Comingbacktomyownstory,mymotheriscompletelyfinenow.Inearly2013,she
evenvisitedtheU.S.andspoketoafewphysiciansthere.Theywereallamazedbythe
careshereceivedinChennai.Ithinkallthecreditgoestoherstrongwill,supportfrom
family,thedoctorswhotreatedher,and,mostimportantly,thesystemthatmadeeasy
accesspossibleincities.

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by2016:GoldmanSachs

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Gundlachisreadytobe
coronated

Inconclusion,itisclearthatbothcountrieshavetheirstrengthsandweaknesses.Ifthe
U.S.drawslessonsfromIndiasstrengthssupportivesocialstructure,simplepayment
systemsandcostofcareitcouldactasasteppingstoneintoitsfuture.India,onthe
otherhand,mustconsolidateitsplusesandensurethatitupsitsgametotacklethe
negatives.Alotstillneedstobedone,butIamoptimistic.

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Tags:Accesstohealthcare,cancer,CervicalCancer,Chennai,emergencyroom,health
reform,India,UnitedStates

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sanjaySeptember30,2014at7:44pm

Agree,thehealthcaredeliveryinIndianHospitalsparticularlyinmetroisworldclassand
theproofisthesizablenumberofoverseaspatientsflockingthereestablishments,besides
Socialfactordoplayamajorrole.ButIndiaisnotmetrocitiesalone,perhapstimeto
analysessimilarpatientsdiagnosedinruralpartofthecountry.Inmydiscussionwitha
seniordoctorfrompublichealthIwasinformedthatinsomeregionsofcountrythe
percentageofwomensufferingfromcervicalcancerisashighas1819%withmostinstage
3or4.

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MousumiGhoshSeptember29,2014at12:43pm

Icompletelyagreewithyou.InDecember2013Igotacorneagraphtingdoneherein
Kolkata,Indiamuchagainstpublicpeception.Iamdoingfine.
Reply
VijayRamnathJayaramanSeptember30,2014at7:57pm

Goodtohearyoursuccessstory,Mousumi!
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VasuSeptember26,2014at11:32am

It'sgoodsomeonetalkingaboutgoodIndianHealthSystemandcomparingtoAmerican
HealthSystem.IfI'mtalkingaboutgovernmenthealthsysteminIndiaisverybadbecause
thishealthsystemmeantforpoorpeople.Thereisnocareforpatienttheirrecoveryand
thereisnoguarantyfortherelife.InIndiasuchgoodfacilityavailableforrichpeopleonly.
ThisisrealIndia.

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VijayRamnathJayaramanSeptember26,2014at8:03pm

ThanksforvisitingusVasu!
Reply

NiradSeptember20,2014at12:14am

IsitreallythatBadinUS?Bitsurprisedbythearticle.
Reply

http://forbesindia.com/blog/health/apersonalstorywhatcantheuslearnfromindiashealthcaresystem/

VijayRamnathJayaraman
September30,201419:57pmbyVijayRamnath
Jayaraman

CommentedonAPersonalStory:Whatcan
theU.S.learnfromIndia'shealthcare
system?

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APersonalStory:WhatcantheU.S.learnfromIndiashealthcaresystem?|ForbesIndiaBlog
VijayRamnathJayaramanSeptember20,2014at8:53pm

Goodtohearyoursuccessstory,Mousumi!

IviewtheU.S.healthcareas1)HealthcareProblem:Whichisthecare
receivedbypatientswhichismostlyavailabletoeveryoneintheU.S.
Usuallythecareisalsohighqualityandproducesgoodoutcomesand
2)HealthInsuranceProblem:Thisiswherethebarriersofcareexist.
Unless,youhaveagoodinsurancethroughanemployer/selffunded,
youarelargelyresponsibleforpayingforcostswhichcouldrunupto
thousandsofdollarsresultingindelayedcare.ThanksNirad.

September30,201419:44pmbysanjay

CommentedonAPersonalStory:Whatcan
theU.S.learnfromIndia'shealthcare
system?
Agree,thehealthcaredeliveryinIndian
Hospitalsparticularlyinmetroisworldclass
andtheproofisthesizablenumberof
overseaspatientsflockingthere
establishments,besidesSocialfactordoplay
amajorrole.ButIndiaisnotmetrocities
alone,perhapstimetoanalysessimilarpati...

Reply

September29,201412:43pmbyMousumiGhosh

CommentedonAPersonalStory:Whatcan
theU.S.learnfromIndia'shealthcare
system?
Icompletelyagreewithyou.InDecember
2013Igotacorneagraphtingdoneherein
Kolkata,Indiamuchagainstpublicpeception.
Iamdoingfine.

VijayRamnathJayaraman
September26,201420:03pmbyVijayRamnath
Jayaraman

CommentedonAPersonalStory:Whatcan
theU.S.learnfromIndia'shealthcare
system?
ThanksforvisitingusVasu!
September26,201411:32ambyVasu

CommentedonAPersonalStory:Whatcan
theU.S.learnfromIndia'shealthcare
system?
It'sgoodsomeonetalkingaboutgoodIndian
HealthSystemandcomparingtoAmerican
HealthSystem.IfI'mtalkingabout
governmenthealthsysteminIndiaisvery
badbecausethishealthsystemmeantfor
poorpeople.Thereisnocareforpatienttheir
recoveryandthereisnoguarantyforthere
life...

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