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

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 16th century “Fountain of Youth” 17th/18th century Spa 19th century Sea & Mountain Air (TB sanitarium) 20th 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) Quality Comfort Level “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) Value Proposition “First World Treatment at Third World Costs” Value Proposition Quality medical services at 1/10th costs: Complicated surgical procedures possible at 1/10th 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 21000-27000 4000 - 5000 5000 Angiography 2500 - 3000 2000 1100 400 800 Hip replacement 19000 13000-16000 6000 6600 Knee replacement 27000-32000 16000-18000 CABG 6400 9600 Lasik 2250-2900 750 (Note: all costs in us$)

Advantage India (Core Competencies) No waiting Tourist Interest: “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) Alternative Medicine Proposition: “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 Hygiene/Unsanitary Pollution Negative Perceptions Hygiene/Unsanitary Pollution Backward & Bureaucratic Medical Insurance Inadequate Cover Underdeveloped Insurance Frauds No Global Players Overseas Companies Refuse Reimbursements Instability Terrorism Prone Communal Unrest Connectivity No Flights!! Bad Roads Backward Accreditation No Uniformity ISO, CRISIL, ICRA WEST: JCAHO

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

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

(Potential + Improvements) PATH FORWARD (Potential + Improvements) FUTURE FOCUS POTENTIAL 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 Doctors & Paramedics Expertise Recognized Cost Advantage Language Skills Vibrant Industries IT Strength Management Skills Pharmaceutical Industry Tourism Potential Service Industry Mindset

PATH FORWARD (For Success) REALIZED POTENTIAL SPIN-OFF INDIA EMERGES AS MAJOR MEDICAL TOURISM DESTINATION GDP Growth 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