MEDICAL TOURISM Sanjiv Malik Chief Executive Health Care

MEDICAL TOURISM Sanjiv Malik, Chief Executive Health Care Dr. Max

Medical Travel • • People traveling across borders for healthcare needs Only ambulatory care can be really linked to tourism. Tourism is recreation linked. Is health recreation linked ? ? Serious ailments e. g Heart Surgery , Joint replacements etc which can be treated in Indian Hospitals without any waiting can not be linked with Tourism

Concept of Medical Tourism / Treatment for Foreign Patients

Historical Perspective Neolithic & Bronze Age Mineral & Hot Spring visits Middle Ages Thermal Springs 16 th century “Fountain of Youth” 17 th/18 th century Spa 19 th century Sea & Mountain Air (TB sanitarium) 20 th century “Health Farms” or “Fat Farms”

Healthcare Business Facts & Figures • Worlds largest after retailing • Global healthcare revenue US$ 2. 8 trillion • India’s healthcare industry worth US$ 17 billion; to grow by 13% • per annum for next 6 years In 2004, India treated 1. 8 Lac patients. This is to grow substantially at the rate 25 -30% in 2005 Contd. .

Healthcare Business Facts & Figures • Medical tourism could account for 3 -5% of the total healthcare delivery market. • India is rated amongst the world’s “must see top ten destination” by Conde Naste (international magazine) • A study by CII Mckinsey estimates that country could earn 5000 -10, 000 crore by 2012 • Health procedures across world show 200 -800% cost difference

Issues for Treatment in Different Countries SAARC , AFRICAS, MIDDLE EAST • No advance care available e. g Afghanistan , Nepal and Bangladesh etc • Limited specialized care WEST • Long waiting - UK • Insurance unaffordable leading to semi insured and uninsured population - US • Private hospitals very expensive

Advantage India (Core Competencies) “First World Treatment at Third World Costs” Quality Large pool of doctors, nurses & paramedics Strength: - Over 650, 000 doctors; - Highly skilled experts, and - Possess English speaking skills Comfort Level • NRI doctors recognized as amongst best in adopted countries (First World) • Usage of English • Indian Nurses increasingly getting international exposure Contd. .

Advantage India (Core Competencies) “First World Treatment at Third World Costs” Value Proposition Quality medical services at 1/10 th costs: • Complicated surgical procedures possible at 1/10 th the cost • Increase in use of Computerized Hospital Information Systems • Software technologists facilitating tech revolution in healthcare • State-of-the-art medical establishments of great repute Contd

Comparative Analysis in USD Procedure US UK Burmungrad Bangkok Max Healthcare Raffles Singapore Angioplasty 30000 2100027000 4000 - 5000 Angiography 2500 3000 2000 1100 400 800 Hip replacement 19000 1300016000 6600 Knee replacement 2700032000 1600018000 6000 CABG 30000 6400 9600 Lasik 22502900 750 400 (Note: all costs in us$)

Advantage India (Core Competencies) “First World Treatment at Third World Costs” Lower Medication cost: • Strong Pharma Sector and gaining world recognition • Fast emerging as major Drug R&D Center • Strong Generic drugs business • Low cost of drug development in India • No waiting Tourist Interest: • 5000 year old civilization • Renowned for Historical, Cultural and Religious diversity • Diverse geographical landmarks; vast coastline • Traditional arts and crafts • Vibrant democracy: Freedom for citizens; empowered women population Contd. .

Advantage India (Core Competencies) “First World Treatment at Third World Costs” Alternative Medicine Proposition: • Ancient Ayurvedic stream of medicines • Rejuvenation alternatives: Kerala’s health retreats • Naturopathy and Yoga

Changing Consumer Patterns • Increased visibility & ease of access to leading hospitals, doctors and surgeons who post their skills & specialties, pricing etc on websites has made available a wide choice of treatment to the overseas patients • Media is showcasing India’s ability to treat overseas patients in a comparable environment

Insurance • India proactively talking to Foreign Insurance companies to treat their beneficiaries in India • Cashless benefits • Hassle Free

CONCERNS Consumer’s Point of View Negative Perceptions Hygiene/Unsanitary Medical Insurance Instability Pollution Inadequate Cover Terrorism Prone Backward & Bureaucratic Underdeveloped Communal Unrest Insurance Frauds Accreditation Connectivity No Global Players No Uniformity No Flights!! Overseas Companies Refuse Reimbursements Bad Roads ISO, CRISIL, ICRA WEST: JCAHO Backward

Industry Issues Doctors § Standardized education in Medical Institutions § Strong regulatory mechanism to curb quacks § No communication and inter-personal skills teaching Nurses & Paramedical Service § Deficient Language skills § Lack of Standardization § Attrition § Hygiene awareness in medical attendants § Unhygienic Food handling §Heterogeneous Pricing of services

PATH FORWARD (Strategy Imperative) APEX BODY POTENTIAL + IMPROVEMENTS SUCCESS GOVERNMENT & INDUSTRY HAND-HOLDING: A MUST

PATH FORWARD (Potential + Improvements) POTENTIAL Doctors & Paramedics Expertise Recognized Cost Advantage Language Skills Vibrant Industries IT Strength Management Skills Pharmaceutical Industry Tourism Potential Service Industry Mindset FUTURE FOCUS Uniform Medical Education Standards Industry Accreditation Standards Mandatory Accreditation of all Colleges & Hospitals Target-oriented Infrastructure Investment More Medical, Nursing colleges and Hospitals Regulatory Bodies with Teeth Government soft loan to Private Players Tax Holiday & Further Duty Roll Back Apex Industry body under Union List Greater Industry & Govt. Interaction Medical Insurance Reforms Seamless Single-Window Facility to Tourists Govt. sell India as Medical Tourism Destination

PATH FORWARD (For Success) SPIN-OFF REALIZED POTENTIAL GDP Growth INDIA EMERGES AS MAJOR MEDICAL TOURISM DESTINATION Employment in Healthcare Sector Employment in Tourism Industry Overall Growth in Commerce Reversal & Arrest of Brain Drain Stimulus to Pharmaceuticals Industry Growth in Insurance Industry Better medical facilities for larger population Catalyzes India to the Club of Global Leaders

Summary Opportunity India Opportunity Max & Others Need to Tap

Thank You