In today’s New York Times, there is a lengthy and fascinating piece detailing a rapidly increasing byproduct of India’s economic boom times – and we’re not talking about GDP. As the article says:
In a changing India, it seems to go this way: make good money and get cars, get houses, get servants, get meals out, get diabetes.

You want a sobering stat? Here you go, “In 20 years, projections are that there may be a staggering 75 million Indian diabetics.” Who is a prime target for this dreaded disease? I’ll give you a hint – it’s not farmers…
In Chennai, workers in the software industry rank among the envied elite. Doctors worry about their habits — tapping keys for exercise, ingesting junk food at the computer. Dr. C. R. Anand Moses, a local diabetologist, sees a steady parade of eager software professionals, devoured by diabetes. “They work impossible hours sitting still,” he said.

S. Venkatesh, 28, a thick-around-the-middle programmer, knows the diabetes narrative. Much of his work is for Western companies that operate during the Indian night. So he works in the dark, sleeps in the day. “The software industry is full of pressure, because you are paid well,” he said. “In India, if you work in software, your hours are the office.” His sole exercise is to sometimes climb the stairs. A year and a half ago, he found out he had diabetes.

So, once again, as with the post I put up a while back dealing with pollution, globalization results in a vast array of consequences – some good, some bad. Some of these results happen in the West, while others happen half a world away.

Read the whole article…then get your blood levels tested!

This week in India, a strike by thousands of doctors and medical students who work at hospitals across the country caused significant delays of much-needed medical services. In Bangalore, for example, hundreds of medical and engineering students marched in the streets.

So, what exactly are these folks protesting?

Well, the protests center around an issue we here in America have been struggling with for the last forty years or so – “affirmative action.” Over here, just using that phrase makes some people quite agitated, and even downright angry.

And so, this always contentious issue in the US has now become a source of much heated debate in India, since a government proposal was recently introduced calling for half of the jobs at government hospitals and half the seats at medical schools to be reserved for lower-caste and other disadvantaged Indians.

And fears of a growing push for affirmative action across ALL industries in India, especially those involved in the incredibly important and lucrative field of outsourcing, have raised some valid concerns among private business leaders and watchers.

In a story in the New York Times today (subscription required), Partha Iyengar, vice president for research at the Indian operations of Gartner, Inc. is quoted as saying:

“If affirmative action is enforced in the outsourcing industry, for instance, it will lead to resource turbulence,” said Mr. Iyengar, who feels challenges like language and culture would reduce the employable pool of candidates for companies.

“Resource Turbulence” – what a wonderful phrase! It conjures up all sorts of images of a potentially bumpy, uneasy flight – which India could argubaly be in for if this affirmative action push gathers more momentum and results in widespread, government-enforced labor rules.

So, should the Indian government try and undo the past and current injustices of its country’s caste system through affirmative action legislation? Or should it allow India’s private industry, arguably a far more efficient mechanism, to lead the way to better equality and increased opportunity? Or perhaps a combination of public and private plans is once again the best path to follow?

No matter what, changes that allow more “have-nots” in India to become “haves” can’t be looked at by anyone as anything but a good thing, in and of itself. But in the process, will the growing pains involved in creating a more equitable Indian workforce irreparably harm the country’s well-earned place in the world as a leading provider of highly-skilled, highly-efficient labor?

Like I said – in the months and years ahead, it could get quite “bumpy” for India as this issue gets sorted out…

Thoughts?

Posted by Paul Orefice

In the May 29, 2006 issue of Time magazine, you can read all about Wayne Steinard, a general contractor from Winter Haven, FL, who had a clogged artery that needed to be taken care of right away. But Wayne couldn’t afford medical insurance, and so he obviously also couldn’t afford the $60,000 it would cost in the US to have the artery cleared and a stent installed.

So, what did Wayne do? Well, along with his daughter, he got on a plane to New Dehli where he was checked in to Max Healthcare’s Devki Devi Heart & Vascular Institute. And, once there, it turned out Wayne needed much more than just a simple stent – his artery was 90% blocked and he required immediate double bypass surgery.

The surgery was a success, and here’s the kicker: Steinard’s total bill from the hospital in New Dehli came to $6,650 – less than a tenth of what it would have cost in the US!

The so-called “medical tourism” phenomena – where patients who lack adequate medical insurance and the money for high-cost, often-life-saving surgical procedures opt to travel from the US to countries like India, Thailand, Singapore, Mexico, etc. – is an example of a booming outsourcing niche. And it’s only going to get bigger from here.

One of the most intriguing aspects to the story in Time discusses how small business owners in the US are just beginning to explore ways to offer their employees the option to head overseas for much less expensive medical procedures – heart bypass, hip replacement, spinal fusion, etc. – as a way to combat medical coverage costs that have simply spiraled out of control. An entire industry of global private hospital networks, consultant companies, and medical accreditation organizations have sprung out of seemingly nowhere in the past several years to handle the booming need for their services.

For small and medium size companies in the US and elsewhere, is this a truly viable solution for a huge and growing part of their bottom line expenses? There are many pros and cons to weigh, for sure, but it does appear to be a new outsourcing trend that is here to stay.

What are the implications of the medical tourism trend for US hospitals, and the US health-care system, overall? Nothing too good, I believe – at least in the short-run. But perhaps it’s time they wake up to global competition, like everyone else in the US has had to do.

Thoughts?