A Tale of Two Indias

Recently I had the joy of exploring India for 20 days. Tradition, triumph, squalor and splendor all flow together in a sea teeming with all the variety and richness of humanity. Improbabilities and possibilities abound.

What about health care in the world's largest democracy? In the marvelous paradox of that great nation, it all depends on which India you're in. Traditional India plods on as a new India rises.

Traditional India

The opportunity to receive adequate health care is slim to none for most people. India's government devotes less than 5 percent of its GDP on health care for a population of more than 1 billion people. In rural areas, families spend nearly 27 percent of their income on health care and 35 percent of those who are hospitalized fall below the poverty line. (India Knowledge @Wharton, 2/11/10)

Public health services suffer the same fate as many Indian institutions: overcrowding, crumbling infrastructure and corruption. Private health services are unaffordable, often unregulated and sometimes substandard. Excellent health care is available in urban areas to those who are wealthy. Reform on a massive scale is beyond possibility anytime soon.

The New India

The opportunity to become a global hub for medical tourism, clinical studies and R&D is growing due to highly qualified doctors and scientists, state-of-the-art technology and low costs. India's health care industry is expanding rapidly and generates US$40 billion each year. It is now only second to education as the major service-sector employer in India, providing jobs for about 4.5 million people, directly or indirectly. (India Knowledge @Wharton, 2/11/10)

America's health care reform presents new opportunities for India. New laws will add 32 million Americans to the rolls of the insured and will require the type of back-office outsourced services at which India excels. Studies show that up to 41 percent of health plan costs are administrative. Pressure will intensify to deliver low-cost services for enrollment, database organization, claims processing and other support. India has the answer.

Services that can't be outsourced to India by law will still provide opportunity. Major Indian outsourcing firms Wipro and Tata Consultancy Services have set up operations in Atlanta and Cincinnati. Infosys will soon follow suit in Dallas. (Christian Science Monitor)

People tend to accentuate the shortcomings of India. After my journey, I can attest that there is no shortage of ingenuity and tenacity in India. The wheels of progress can move slowly, but my hope is that the rise of the new India will bring better health and well-being to all.


— Tom DeSanto

Image: Taken by me in Jodhpur, India in March 2010

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