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NEW DELHI, INDIA, October 21, 2004: Three months ago, Howard Staab leaned that he suffered from a life-threatening heart condition and would have to undergo surgery at a cost of up to US$200,000–an impossible sum for the 53-year-old carpenter from Durham, N.C., who has no health insurance. So he outsourced the job to India, begins this article. Staab last month flew to the Indian capital, where doctors at the Escorts Heart Institute & Research Centre replaced his balky heart valve. The total bill was about $10,000, including round-trip airfare and a planned side trip to the Taj Mahal. “The Indian doctors, they did such a fine job here, and took care of us so well,” said Staab.



Staab is one of a growing number of people known as “medical tourists” who are traveling to India in search of First World health care at Third World prices. Last year, an estimated 150,000 foreigners visited India for medical procedures, and the number is increasing at the rate of about 15 percent a year, according to Zakariah Ahmed, a health care specialist at the Confederation of Indian Industries. The trend is still in its early stages. Most of the foreigners treated in India come from other developing countries in Asia, Africa or the Middle East, where top quality hospitals and health professionals are often hard to find. Top Indian hospitals also derive a significant share of foreign business from people of Indian origin who live in developed countries but maintain close ties to their homeland. But the same hospitals now are starting to attract non-Indian patients from industrialized countries, and especially from Britain and Canada, where patients are becoming fed up with long waits for elective surgery under overstretched government health plans.



India’s health care system is hardly a model, with barely four doctors for every 10,000 people, compared with 27 in the United States, according to the World Bank. On the other hand, India offers a growing number of private “centers of excellence” where the quality of care is as good or better than that of big-city hospitals in the United States or Europe, says Naresh Trehan, a cardiovascular surgeon who runs Escorts and performed the operation on Staab. Trehan said, for example, that the death rate for coronary bypass patients at Escorts is 0.8 percent. By contrast, the 1999 death rate for the same procedure at New York Presbyterian Hospital, where former president Bill Clinton recently underwent bypass surgery was 2.35 percent, according to a 2002 study by the New York Sate Health Department. Although they are equipped with state-of-the -art technology, hospitals such as Escorts typically are able to charge far less than their U.S. and European counterparts because pay scales are much lower and patient volumes higher according to Trehan. Moreover, he added, a New York heart surgeon “has to pay $100,000 a year in malpractice insurance. Here it’s $4,000.”

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