Jun
29
ExpatHealth.org International Health Round-Up – June 2011
Filed Under Healthcare, Technology, USA Health Insurance | Leave a Comment
June saw an E. coli outbreak in Europe and a fresh round of bird flu cases in Egypt, as well as the release of insightful research on both medical error and dengue fever. A key theme across health issues remains weighing the long-term benefits of preventative care (or systemic reform) against up-front costs. That the United States showed the highest error rate among seven developed nations does nothing to enhance the rep of its notoriously cost-inefficient health system – worth bearing in mind as the debate over health reform heats up once more.
Here are some of the top international health stories of the past 30 days:
E. coli ravages Europe
The top story in June was undoubtedly a deadly E. coli outbreak in Germany. Cases were initially reported in May but escalated sharply in June – as of June 28 around 4,000 people had been sickened and total fatalities stood near 50. German authorities identified bean and seed sprouts as the vehicle for the outbreak. While the number of new cases reported in Germany continues to decline (the total is still rising as a result of delayed reporting), late June brought the emergence of 8 cases in France. These too were linked to consumption of raw sprouts. French and German authorities are in the process of determining whether the bacteria had a common source.
For the latest on this story, click here.
USA and Australia show highest medical error rates
Patients who received poorly coordinated medical care or were unable to afford basic medical costs were much more likely to report errors in their medication or treatment, according to a study published in the International Journal of Medical Practice. Researchers from the USA and Australia used data from the Commonwealth Fund International Health Policy Survey to identify the key risk factors behind the errors reported by patients from Canada, USA, the Netherlands, UK, Germany, Australia and New Zealand. 11% of the 11,910 people surveyed said they had suffered a medication or medical error in the last two years. Patients in the USA and Australia reported the highest rates of medical/medication error: 13%. Germany and the UK reported the lowest at 9%.
For more on this story, click here.
WHO finds dengue fever costly as it is deadly
The World Health Organization (WHO) released its latest Dengue Bulletin (PDF Link), a special issue devoted to 10 studies on the cost of dengue fever and various prevention strategies. In an age where many diseases are on the decline dengue continues to pose a serious health threat all over the world. In Brazil, for example, the number of cases increased 6.2% and deaths 12% from 1999-2009. Dengue fever is a mosquito-borne virus common in tropical climates, including popular expat destinations such as India, Thailand and Malaysia. Studies estimate the annual cost of treating it to be in the hundreds of millions of dollars in the latter two countries. For India the figure is in the billions.
For more on this story, click here.
5 new cases of avian influenza in Egypt
WHO reported 5 new cases of avian influenza (or “bird flu”) in Egypt, 3 of which were fatal. The cases were scattered across the country, and are believed to have resulted from exposure to infected poultry. They were confirmed by the Egyptian Central Public Health Laboratory. To date the country has seen 149 cases and 51 deaths from the disease. While avian influenza poses little threat to tourists visiting Egypt on holiday, a spike in cases would do nothing for the country’s image. Revenues from tourism were down 46% in the first quarter of 2011 in the wake of the recent revolution.
For more on this story, click here.
Be sure to check back on this space for more updates in July.
About ExpatHealth.org
ExpatHealth.org offers a one-stop source for international best practices in expatriate health care, expat trends and regulatory changes impacting the health industry. The site covers both global and regional health issues. http://expathealth.org
Jun
10
Nicotine Shows Promise as Weight Control Method
Filed Under Health Insurance, Healthcare, Technology | Leave a Comment
For many years it has been common knowledge that smoking is an extremely harmful habit, with smokers presenting an increased risk for a host of medical conditions including Cancer, Cardiovascular Disease, and infertility, to name but a few. However, a recent study published in Science has highlighted a potential positive effect in Nicotine, a key chemical contained in tobacco products.
It has long been known that smoking suppresses appetite, and that individuals who quit smoking are prone to significant weight gain. The research presented in Science has shown exactly why smoking, and consequently nicotine, is able to control hunger urges. This has lead the researchers involved in the study to become hopeful about some potential future uses of the Nicotine compound, and are also hoping to use the study in order to help individuals attempting to quit tobacco products control their weight after they have ceased smoking.
So how does this process of weight control actually work?
The easy version is that the human brain has a large number of nicotine receptors, spread throughout the tissue. While not all nicotine receptors have an impact on hunger researchers found that the α3β4 nicotinic receptor, located in the hypothalamus, suppresses an individual’s appetite when activated by nicotine.
The news of nicotine’s ability to influence weight gain follows a study published in Science Daily during May 2010 which found that smokers have a decreased risk of developing Parkinson’s disease, a serious degenerative condition of the central nervous system. In this study researchers found that active smokers, who had smoked for more than 40 years, were up to 46 percent less likely to develop Parkinson’s disease than people who had never smoked. Individuals who had smoked for between 30 – 39 years were 35 percent less likely to develop the condition than their non smoking counterparts, while persons who had smoked between 1 and 9 years had reduced their risk of developing Parkinson’s by 8 percent.
However, researches noted that the decreased risk of developing Parkinson’s disease was due to the length of time that an individual had smoked, and that the risk did not change based on the number of cigarettes that were smoked in a single day. The study also noted that in the event that an individual had already developed Parkinson’s symptoms smoking would not retard the progression of the disease, and that treating Parkinson’s with nicotine was not a viable option.
Chemicals in the Tobacco plant are coming under more scrutiny as global health initiatives to encourage people to give up smoking become more prevalent. However, with the news that there are some potentially beneficial effects of this incredibly harmful activity it can be expected that scientists will continue to build on their knowledge of this substance.
One projected line of inquiry into the new knowledge of the nicotine compound is as a weight loss aid for individuals suffering from chronic obesity. Obesity is a rapidly growing issue in many developed nations, especially the USA, and a non-invasive method of controlling appetite outside of drastic stomach surgery or a complete overhaul in lifestyle choices could be a welcome sight for many individuals around the world.
However, there are some key concerns with using nicotine as a form of medical treatment, not in the least is that the substance is highly addictive and that most forms of tobacco use carry the previously mentioned, severe health risks. Using a pure form nicotine pill of some type, nicotine gum, or even the patch could be possible treatment methods but researchers have yet to come to a full understanding of how these options will impact conditions like obesity.
Additionally this could cause a range of issues with regards to medical insurance and life insurance coverage. Smokers and tobacco users will typically receive higher premiums than non-smokers when obtaining health insurance in many parts of the world. In fact, many life insurance policies will check for the presence of Cotinine, a byproduct of nicotine found in the blood of smokers, and impose higher premiums on those who test positive for the molecule. If scientists and doctors find a way to use nicotine as a legitimate treatment option for conditions such as obesity and Parkinson’s disease then a simple test to check for the presence of Cotinine may not be sufficient to calculate the risk presented by a specific individual. However, any development in this direction will be at least a few years off, giving insurers around the world time to prepare for new forms of treatment.
May
23
Cost of Long Term Care to Double by 2050
Filed Under Healthcare | 6 Comments
Aging populations will cause global spending on long-term care to double or even triple by 2050, according to a new analysis report issued by the Organization for Economic Cooperation and Development (OECD), which will be presented in Paris this week.
The report, titled “Help Wanted?: Providing and Paying for Long-Term Care” reveals that half of all people who require long term care are those over 80 years old. The share of the population in this age group throughout the 34 OECD member countries is projected to reach nearly one in ten by 2050, a sharp rise from the one in 25 average measured in 2010 and less than 1 percent in 1950. This percentage of elderly citizens by 2050 will be highest in Japan and Germany, with 17 and 15 percent of their populations respectively.
Spending on long-term care, currently 1.5 percent of GDP on average across the OECD, will rise in conjunction with the ageing population. Currently Sweden and the Netherlands spend the most, at 3.5 and 3.6 percent respectively of their GDP, while Portugal, the Czech Republic and the Slovak Republic spend the least.
Angel Gurría, OECD Secretary-General, remarked on the findings: “With costs rising fast, countries must get better value for money from their spending on long-term care.”
“The piecemeal policies in place in many countries must be overhauled in order to boost productivity and support family carers who are the backbone of long-term care systems,” she added.
Edward Whitehouse, OECD head of pension policy analysis, singled out the UK as a country projected to have “among the highest long-term care expenditures by 2050”, saying “I don’t think that future governments will be able to afford that, which brings us on to how we are going to pay for that system,”. Mr. Whitehouse continued, “The money has got to be found from somewhere. It is going to have to be higher taxes or cuts in public spending on other programs.”
The significant ageing of all OECD nations comes as traditional family ties and social support structures are breaking down. The pool of potential family carers will continue to shrink as families become smaller and more women enter the work force. Furthermore, most social policies will no longer support early retirement, meaning the elderly will have to stay in work longer and save more towards their own private pensions. The need for community involvement and resources to care for frail and disabled senior citizens is growing and will continue to do so more rapidly in OECD countries
OECD governments have a difficult task on their hands: finding a balance between providing accesses to good-quality healthcare and ensuring their systems remain financially sustainable. The report presents several opportunities to begin a transition towards a more cost-effective system. For example, around 70 percent of long-term care patients currently receive their services at home, but spending in institutional care takes in 62 percent of total long term healthcare expenditure. Correcting this inefficiency, encouraging part-time work for the elderly, and paying benefits to family care workers can all be productive policies, helping to reduce the demand for expensive institutional care.
The report further claims that major reforms will be needed to ensure there are enough qualified care workers in the future to meet demand. Currently, less than 2 percent of the total OECD workforce is employed in long term care provision. The OECD report suggests that countries should look be looking to attract more migrant labor as they have thus far supplied a substantial share of long-term care workers in many countries. Around one in four long term care workers in Australia, the UK and US have migrant roots while the ratio is as high as one in two in Austria, Greece, Israel and Italy. The report further claims that there is not only a need for more long-term care workers, but to increase their salaries; as the current low wage environment generates excessive turnover in vital care workers.
Private insurance schemes could be used to ameliorate long-term healthcare expenses in some countries but, according to the report, they are more likely to remain a niche market product unless made compulsory. In the largest private insurance markets in the OECD, the United States and France, currently only 5 and 15 percent respectively of people aged over 40 have long-term care policies in force.
The report concludes that in the face of rising costs, seeking better value for money in long-term care will be a priority. Efficiency discussions regarding long-term care expenses have thus far received relatively little attention and better evidence and proactive action based upon what works and under what conditions is urgently required..
May
3
Many Expat Residents No Longer Able to Afford Rising Healthcare Costs in Dubai
Filed Under Expat Insurance, Health Insurance, Healthcare, Medical Insurance, Middle East, UAE Insurance | 5 Comments
In Dubai, public healthcare costs are rising at a significant rate, which has become a major concern for expatriates, especially those without private health insurance.
Dubai residents can apply for health cards that are supposed to grant them access to public health facilities at a discounted rate. However, with the rising costs of treatment, those health cards essentially offer no discounts now. Treatment costs in government hospitals are now about the same as those of private hospitals, with a consultation costing around 250 Dhs to 400 Dhs (US$ 75 to US$ 120), and a one night stay in the Intensive Care Unit costing around 3100 Dhs (US$ 845).
There has been discussion of passing a legislation that would make health insurance mandatory for all expatriate employees that would be paid for partially by their employers. Abu Dhabi currently already has a similar law in place, which has led to around 98 percent of workers being insured. However, after years of talks in Dubai, expat residents are still waiting to see whether a mandatory health insurance scheme materializes.
To exacerbate the situation, the Dubai Health Authority (DHA) has recently announced that they will start charging expatriate patients for chemotherapy sessions. This announcement was made 2 weeks ago, and is due to be in effect in 1 week.
A staff from the Oncology Department of Dubai Hospital announced, “From May 3rd, patients will have to pay for their chemotherapy injections, the cost of which will depend on the medications.”
The vast majority of expat residents will not be able to afford these costs out-of-pocket. One session of chemotherapy can cost around 8000 Dhs (US$ 2,177), and around 14 – 16 treatments are needed in one year.
Many physicians, authorities, and patients have criticized the DHA for the short notice that it gave patients, and the lack of consideration for patients who have already begun a course of treatment and cannot afford to stop.
For many expat patients, they cannot wait to go back to their home country to seek treatment because it may take a while for the paperwork to be processed before they can start receiving treatment. The delay in treatment can drastically change the outcome of their recovery. It is also too late for these expat cancer patients to apply for and get private health insurance because no private insurer will agree to cover cancer treatment costs once the patient already has cancer.
Other costs, aside from chemotherapy, are also on the rise. Expats, B. Joseph and his wife, had a baby in Dubai in 2000, said, “We paid just Dh 100 for the delivery then. The health card is of no use now” Eleven years later, they have to pay 12,000 Dhs (US$ 3,266) for the same delivery package.
A DHA representative stated, “The card has no specific benefits. It only gives you access to government hospitals and clinics.”
Currently, treatment is still free for Emirati nationals. Emergency treatment for expats is also free until the patient’s condition stabilizes. At that point, they will be billed for all other treatment received outside of the emergency ward.
For example, an Arab woman, who was stabbed during a robbery, was billed 285,000 Dhs (US$ 77,589) for her treatment costs after her situation stabilized. She cannot afford the bill, and felt that the burden of the bill should not be on her. She complained to the Dubai Police Chief Lieutenant General Dahi Khalfan Tamin, and has started a discussion in the Emirate about who should be responsible for treatment costs for crime and traffic accident victims.
The DHA has responded to criticisms of cost cutting measures and rising costs by saying, “As a vital service provider, we take into account ethical and moral requirements. We are always aware that the field involves the life and death of patients and keep in mind the oath all doctors have taken – to treat all patients no matter what race, religion, or social standing – leading to the fact that all patients coming to the hospitals, especially emergency cases, need to be treated immediately regardless of their capability of paying or not. However, taking into account the rapid increase in the population of Dubai and the spiraling costs in running health organizations, there should be a mechanism in place to at least cover the costs of such services.”
He goes on to add, “We believe that most of the issues, if not all, will be resolved with the introduction of a universal mandatory health insurance scheme, whereby every resident of Dubai is covered for certain health services. Dubai is moving forward in that direction.”
However, many Dubai expat residents are skeptical about whether the scheme will ever come into effect. The DHA has said in the past that the scheme was originally to be introduced in January 2009.
According to a month-long Dubai Household Health Survey performed by the DHA, 75 percent of workers in Dubai have no health insurance. This creates a chain of consequences that results in reduced interest and investment in Dubai healthcare services as well as escalating bills.
Dr. Haider Al Yousuf, Director of Health Funding at the DHA said, “Limited access reduces utilization; this does not provide enough volume to maintain a high quality of services provided, allow specialized centers of excellence nor promote medical tourism.”
Ram Lachhan Raj, a laundry worker, ran up a bill of 44,000 Dhs (US$ 11,978) in one week after he was diagnosed with leukemia and renal failure. Neither him nor his employer can afford the costs.
“As good residents, we would like to pay, but just cannot afford it,” said Somsun S, a small business owner, who is left with a bill of 45,000 Dhs (US$ 12,250), after an employee was paralyzed after a fall.
In the past, hospitals have been understanding and have waived the bills for many people. NGOs and other organizations have contributed to treatment costs, but this solution is no longer sustainable as the amounts involved have become much too high.
Patients and hospitals are also trying to organize charity drives by holding garage sales and markets to raise money for patients who cannot afford the costs, but many experts believe that the only permanent solution is mandatory insurance.
Others have pointed out that it is not as simple as passing a law that makes health insurance mandatory. Albert Rodrigues, the Managing Director of Millenium Insurance Brokers noted, “It is not easy. The challenge for the health authorities is to find the right formula that would satisfy all the stakeholders – medical providers, employers, insurance companies, and the general public who include both Emiratis and expatriates. Most employers do not have the margins to cater to the new equipment”
Deteriorating economic conditions are another contributing factor to the delay in implementing the mandatory health insurance scheme. Sanjay Tolani, Director of Goodwill Insurance Brokers expressed, “After the financial crisis, some multinationals have sized down employee covers, while others have begun to share premium costs with the employees.” Tolani also said that to compromise, many large employers have opted for Health Management Offices (HMOS), where employees can have discounts at a network of predetermined clinics and doctors.
Until employers, health authorities, and insurance companies reach a deal, the situation continues to worsen with hospital bills continuing to escalate.
According to the World Health Organization (WHO), the UAE expenditure on health per capita is 3,607 Dhs (US$ 982). Comparatively, this is much lower than many Western countries. However, since the UAE is a tax-free country, medical care costs are becoming more difficult for the government to carry entirely on their own.
Apr
19
Putin Talks Russia Healthcare Reform
Filed Under Healthcare | 1 Comment
Speaking last week at the All-Russian Forum of Medical Workers, Russian Prime Minister Vladimir Putin addressed the country’s continued health care problems and outlined the substantial investments required in the health system to improve outcomes.
The crisis in Russia’s healthcare system has been a persistent problem for many years. Despite an elaborate hospital network and an ample staff of trained health professionals, the medical system has remained unable to provide most citizens with acceptable levels of health care services. The quality and accessibility problems have been principally due to the continued lack and uneven distribution of funds, medical equipment and supplies in the healthcare infrastructure in Russia. These factors coupled with ineffective governance and the poor health and lifestyle choices of many Russians, has resulted in health standards that trail below Western European standards.
The All-Russia Medical Worker Forum, held for the first time at the Russian cardiology research and production center, was called to asses development initiatives involving the Russian healthcare sector, including improving medical workers’ contribution and education, regional healthcare modernization programs and the implementation of medical insurance schemes. Prime Minister Vladimir Putin, alongside several other government ministers, headlined the event and offered a thorough analysis of Russia’s health status in the premier’s address.
Mr. Putin first acknowledged that the demographic crisis, in which Russia lost 700,000 to upwards of a million people annually throughout the nineties, had abated but there was still much work yet to be done. “We have curtailed the destructive trends…But despite all our painstaking efforts, the population in the country has shrunk by 500,000 people over the past five years: these are serious figures,” Putin said.
Life expectancy in Russia has increased from 65.3 to 68.9 in the period of 2005–2010. The birth rate increased 19 percent while the death rate dropped over 11 percent during the same period. In recent years thousands of Russian medical institutions and ambulatory services have received new updated medical equipment and vehicles, cutting both waiting times for diagnostic tests and emergency response time by over half. There has also been a substantial one-third decrease in infant mortality due to improved concentration on maternity care. Despite these positive trends, Mr. Putin remarked that Russia was still too far behind Europe in their health outcomes: “We have spoken about some positive trends in the healthcare system and we have something to show for it. Yet the average lifespan in our country is 8-10 years lower than in neighboring European countries, the death rate from cardiovascular diseases is 4-5 times higher,” Putin said.
The Prime Minister then went into detail describing the poor condition of many hospitals in the country, highlighting that almost a third had no running hot water, let alone up-to-date and clean medical equipment. “A quarter of all the medical facilities in the Russian Federation are in need of overhaul,” Putin said.
An additional deterrent to improving healthcare quality in Russia has been the paltry salaries offered towards medical workers, which Putin admits “are barely above the subsistence minimum.” The tendency has been towards rewarding seniority and this has resulted in excessive management staff and a shortage of necessary primary care workers operating in the healthcare sector. This inadequacy needs to be fixed in order to better allocate resources and improve efficiency in health provision.
In the second half of his address, Mr. Putin put forth his solutions for the healthcare system. The Prime Minister argued for improved and decentralized healthcare funding, culling the oversized management staff, improving conditions for young doctors and modernizing Russia’s medical information systems through the introduction of electronic databases.
First and foremost, considerable investment has been promised to the healthcare sector. Mr. Putin remarked that the government now has the necessary framework to ensure that positive effects of increased health spending will be widespread. “I am 100% sure that we made the right decision in creating a financial basis for the regional programs. Over the next two years, we are now able to continue to invest in the healthcare system – that is, over and above current financing to the substantial tune of 460 billion rubles (US $16 billion) – in order to reinvigorate the network of medical institutions in Russian towns and villages.” Under this extensive spending plan, over 40 percent of federal and municipal medical facilities will be repaired and upgraded. The healthcare system, as a whole, will receive more than 100,000 units of modern medical equipment. The funds will be reportedly be covered by the recent rise in insurance premiums from 3.1 to 5.1 percent.
The government has earmarked 788.7 billion rubles (US $28 billion) for the ‘Healthcare National Project’ which will run through to 2013. The initiative was launched in 2005 to improve Russian health outcomes and measure the quality of medical services in the country. Since its inception, the project has overseen the construction of 7 high-tech medical facilities and 11 maternity clinics across the country, which have provided care for over a million Russians.
To encourage regional responsibility in local healthcare development, the government is in the process of establishing a 30 billion rubles (US $1 billion) incentive fund. Mr. Putin proposed an additional medical system monitoring mechanism through the introduction of an annual ratings project, whereby medical institutions and insurance companies would be judged by customers and agencies for the quality service they provide. “I think that the information about the real state of affairs in medical institutions and the results on studying citizens’ complaints should be open,” Putin said, adding that “it is absolutely inadmissible to conceal unpleasant facts and mistakes.” The process of modernization in the Russian healthcare system will be faster, if more comprehensive and objective information is obtained, Putin claimed.
Mr. Putin was adamant that the excessive number of healthcare executives and their inflated salaries would need to be tackled. The salaries available to valued medical staff are often dependent on the number of managers and directors present. There were 28,000 medical superintendents and deputies in the Russian system last year, salaries account for over 15 billion rubles ($530) annually. “Quite a few medical superintendents have up to 10 deputies on top of aides, personal assistants, you name it… At the same time we witness an unjustifiably large gap between the salaries of a medical institution’s directors and its medical specialists. In some regions, it’s a five- to seven-fold difference,” Putin said.
There will have to be a reduction in healthcare officials and executive staff, bringing the number down into compliance with the real needs of the industry. Putin identified that doctors, paramedics and nurses constitute the core of the healthcare system, and “we should base our payroll decisions on this understanding.” Putin further stated that doctor’s work should be made more efficient through the introduction of comprehensive electronic patient database systems, at the expense of the current arduous paperwork process, which delays treatment. Health Minister Tatyana Golikova confirmed that a relevant law, necessitating electronic tracking integration, had been drafted and sent for the government’s deliberation.
In his closing statement, Vladimir Putin remarked that the road to comprehensive reform would be demanding but that Russia must overcome these obstacles to guarantee their future prosperity:
“The accessibility of high-quality health services, doctors’ and nurses’ living and labor conditions, and the way they do their jobs all have a lot to do with the lives of specific patients and their families, and with Russia’s future in general. The price of the purported reforms is very high, but the hopes and expectations of millions of Russian people have an even higher price. Our common goal is to live up to these expectations and the trust of the Russian people. I think we are in a position to achieve this goal.”
Russia is far from the only country currently embarking on substantial healthcare initiatives and reform. The American healthcare system is structured in a fundamentally different manner from Russia’s system. In the United States, health care is predominantly offered through the private insurance companies while public sector facilities provide primary care for the poor. The US system however has encountered problems of its own as more and more US citizens remain uninsured and the disparity of medical services and health outcomes widen along income lines. The 2010 US Health Reform law mandates that by 2014, American citizens must have health insurance coverage or otherwise pay a US$695 annual fine. It is projected that the Health Reform Law will reduce the number of the uninsured Americans from 19 percent in 2010 to 8 percent by 2016.
Although different from the United States, Russia’s healthcare problems are not exceptional. Countries that traditionally have relied on a state healthcare system tend to suffer from shortages and misallocation of resources, declining quality, and as a result: waning health standards. Health care reform in Russia will have to take into account both local expertise and international experience in improving their healthcare system.
Apr
13
Qatar’s National Health Strategy
Filed Under Healthcare, Uncategorized | 2 Comments
On April 3rd, 2011, Qatar unveiled their ambitious National Health Strategy 2011-16 (NHS). The six year plan is designed to transform Qatar’s existing medical infrastructure into a comprehensive and integrated world-class healthcare system, accessible to all, that will generate the positive health outcomes set about in the development plan named Qatar National Vision 2030. The strategy was the result of comprehensive year-long consultation and was officially endorsed in December 2010 by Qatar’s Supreme Council of Health (SCH). The Qatari government has set aside QR 608 million (USD 167 million) for the NHS’s management operations.
Qatar’s healthcare system currently faces several major challenges, which the national health strategy needs to address. Qatar’s reported healthcare spending has quintupled since 2001 to QR 4.33 billion (USD 1.2 billion). Spending per capita has risen from QR 1,581 (USD 434) in 2001 to QR 4,383 (USD 1204) in 2007, demonstrating that there is a mismatch between the population’s healthcare needs and the current system. There is no unified regulatory framework, health policy or medical performance oversight in Qatar. The current care model is imbalanced towards providing acute tertiary care. This is reflected in Qatar’s public health morbidity and mortality statistics, which record that the majority of deaths are being caused by chronic diseases, injuries, and illness linked to lifestyle and behavior factors that are largely preventable. Shortages in quality healthcare professionals across the health sector are pronounced and efforts to recruit, particularly for private practice, have not thus far succeeded. In addition to this shortage in experienced personnel, the rapid growth and aging of the population is placing an increasing burden on the existing healthcare infrastructure, leading to longer waiting times or treatment and growing dissatisfaction with Qatar’s medical providers.
The NHS has outlined several principal goals in reforming the healthcare system, with 35 individual development projects drafted to achieve the goals. As illustrated in the NHS’s executive summary, primary healthcare will be made the foundation of the new strategy, shifting from the predominantly hospital-based curative care system into a more integrated community-based model. Primary care centres will develop into the first medical point of contact within the Qatari healthcare system. When treatment is required, primary care centers will provide appropriate quality service and better direct and coordinate the patient’s other options in the healthcare system.
Health provision in Qatar will become truly comprehensive and better integrate physical and mental curative and preventive healthcare, differentiating between the different medical needs or men, women and children. Hospital services will become better delineated and optimized within a new clinical services framework. To continue to meet the acute care needs of the population, several hospitals, including Heart, Dukhan, Wakra Hospital and Hamad Medical City, are set to be opened within the next few years. The projected increase in hospital beds, from 2.4 to 4.4 beds per thousand people, will reduce waiting times and prevent cancellation and postponement of surgical treatment.
According to the NHS, a more integrated system for healthcare services in Qatar should establish a stronger focus on improving quality of service. This would be done through standardization, the implementation of advanced technological management programs, such as disease supervision projects, e-health systems and medical data tracking, and further developing strategies to encourage private sector involvement in Qatari healthcare. The SCH will take on more advisory responsibility in the healthcare sector, ensuring that all public health facilities meet clinical guidelines based on international best practices, refined for the local environment. Innovation and quality of health service execution will be better recognized. The level of service for local medical service businesses will be more frequently evaluated and published to allow the public to make informed decisions when selecting healthcare providers.
To address the shortage in healthcare professionals in Qatar, the NHS recommends improving compensation benefits and packages for recruits and to also consider adopting more flexible working arrangements. Although the NHS is interested in increasing its domestic workforce, Qatar continues to depend on expatriate medical staff and therefore must engage in aggressive recruitment in the international market. Only 5 to 10 percent of employees in the medical sector are Qatari. The NHS is looking to improve and expedite the professional licensing and immigration process to enable more dynamic movement into the healthcare sector. Further human resource legislation will be amended to enable professional development and increase retention opportunities for expatriates. So far, human resource laws capping public health salaries and requiring certain administrative positions are filled by Qataris have only made developing a quality workforce more difficult in the country and must be adjusted to remain competitive.
To maintain a high standard of professional healthcare recruits, the NHS will help develop a centralised human resources program. The Qatar Council for Health Practitioners (QCHP) will be administered under the SCH to regulate health professionals and processes, including education and health promotion, registration and licensing, appraisal, and disciplinary action
The Qatari healthcare system will remain affordable through a new healthcare-specific budgeting process. The plan will develop a comprehensive multiyear budgeting program for public health sector spending that includes activity-based costing, which will enable must tighter scrutiny of cost data. Attached to this will be a centralized healthcare infrastructure master plan and a committee tasked with keeping a check on public spending. Without proper oversight, it has not been possible to adequately compare costs between health providers or identify best practices. The NHS also calls for more efficient management and compensation of treatments done abroad and to negotiate volume contracts to control cost.
To further control costs, the NHS will help lay the foundations for Qatar’s national insurance scheme. Several other GCC nations have introduced public health insurance schemes and Qatar has been developing their own. Once initiated, the payment and reimbursement mechanisms put in place to support a compulsory health insurance system will increase transparency with regard to health expenditures throughout the system.
Finally, in addition to this pronounced focus on infrastructure development, Qatar will prioritize advanced medical research, with the goal of shifting from a knowledge-borrowing nation into becoming a knowledge-producing one. The NHS will establish a unified government research body to develop better coordination and sufficient funding in many different medical fields and to enable the capacity for world class research in Qatar..
Mar
31
Maternity Tourists Strain Healthcare Services
Filed Under China, China insurance, Healthcare, Hong Kong | 7 Comments
Hong Kong, this week, has again raised the issue of so-called “maternity tourists,” and is questioning how to best fix the strain that an influx of Chinese mothers seeking to give birth in the city is placing on the SAR’s healthcare system. Following hot on the heels of the announced closure of a Maternity House in San Gabriel California, Hong Kong authorities are looking for options which would allow them to further control the flow of pregnant PRC nationals into the city.
Recent figures from the Hong Kong Hospital Authority and Department of Health have revealed that mainland mothers accounted for approximately 40,000 births in Hong Kong during 2010; roughly 46% of the city’s 88,000 total. This is a massive increase from the “few hundred” births from 2004 – 2005, and is set to rise even further in 2011 and again in 2012, with healthcare officials projecting the numbers at 92,000 and 100,000 respectively.
In 2007 the Hong Kong government introduced legislation which prevents women past the 28th week of pregnancy from entering the city without providing proof of a booking at a local hospital. In addition to this, the government later introduced mandatory pricing for non-resident mothers seeking to give birth in one of the city’s public hospitals; and while these initiatives were initially successful at stemming the tide, China’s recent, and explosive, economic success has again seen the numbers move upwards.
For Chinese nationals there are a number of reasons for giving birth outside of the People’s Republic, not in the least of which is the country’s notorious “One Child Policy.” The legislation severely penalizes families who have more than one child, and in the case of Guangzhou the fines associated with having a second baby can be as much as RMB 180,000 (US$ 27,450). In order to avoid the fines, while still being able to have a second, or even third child, many mainland parents are simply choosing to travel abroad to give birth.
However, while laying the blame at the feet of the “One Child Policy” may be conveniently easy, there are a number of more in-depth social factors which may be playing a role in the rapid development of the Chinese Maternity Tourism trend. One of these is to do with the way that the PRC’s education system is structured.
In China, as elsewhere around the world, there is high concern from many parents regarding their child’s education. Due to the way in which the PRC’s school system is set up, if the child has a Chinese passport and/or residency in certain districts or states, the standards they need to reach in order to access the top schools is prohibitively high – they will need to score extremely well on both the middle and high school entrance exams. It is important to bear in mind the fact that China has a population of approximately 1.3 billion people, and as such competition for the best schools in the country is extremely stiff.
However, one of the major loopholes to this system is through the child possessing a foreign passport, or official residency outside of China, in this case Hong Kong. If the child is not a Chinese passport holder, and does not have official residency in China, then the standards of entry into the country’s most prestigious educational facilities are dramatically lowered. In this case the child is treated as an “international” student, rather than a local one; although the family must pay the high fees associated with this status. In fact, some Chinese families have gone on record saying that they will raise their infant in China until the child reaches high school age, and then send them to Hong Kong to continue their education.
Outside of the Hong Kong healthcare system, the potential strain on the city’s educational services is highly concerning. As with healthcare, Hong Kong has a public education system through which the children all permanent residents are allowed to receive their schooling. While competition for places at Hong Kong schools may be less stiff than across the border, the city has been experiencing severe issues with increasing class sizes and a lack of spaces for secondary students.
One option then is that the Chinese maternity tourists will send their children to private educational institutions within the city, and when looking at the costs involved with a non-resident mother giving birth within Hong Kong, this may not present as much of a significant financial challenge as one may think.
According to one recent interviewee, the Chinese husband of a PRC Maternity Tourist, he paid HK$ 80,000 (US$ 10,272) for a C-Section maternity package at a private hospital in Hong Kong. The package included antenatal medical checkups in the city. The source is quoted as saying that, even were the HKSAR government to impose further restrictions on public hospitals within the city, this would not pose a problem at private maternity hospitals, such as the Matilda, Sanatorium, or Baptist; primarily due to the fact that local Hong Kong mothers vastly prefer the services offered through the low-cost public system.
The increased preference of Maternity Tourists for the city’s exceptional private medical facilities has highlighted an alarming issue with the Hong Kong medical community. Currently the Hong Kong Public Healthcare system is experiencing an alarming shortfall of qualified medical professionals, with many moving from public facilities to private institutions. This has left the city’s public medical community severely short staffed, to such an extent that there have been calls to allow overseas medical practitioners, who have not passed the Hong Kong medical exam, to practice within Hong Kong public hospitals.
Additionally, the flood of doctors away from the public system has emphasized a serious supply concern; as private medical facilities receive more bookings, and expand ever further, the costs associated with treatment are likely to increase. This does not bode well for a city whose private medical costs are tied with Israel for being the second highest, on average, in the world; the USA is, of course, the most expensive place to receive healthcare treatment on earth.
Outside of medical pricing, there are additional problems posed by the Hong Kong public medical sector’s “brain drain;” namely that, public hospitals within the city are vastly more prepared to handle any complications arising from a pregnancy. For example, Prince of Wales hospital, one of the city’s most well regarded public healthcare facilities, in the last two years lost more than 10 senior doctors (including obstetricians) to the private sector. Prince of Wales hospital is also one of the few hospitals in the city which is able to offer comprehensive intensive care to newborns in the event of a complication of pregnancy, which will occur in roughly 2 out of every 100 births in Hong Kong.
The move of qualified medical practitioners away from the hospital means that, given enough time, such facilities may simply not be able to handle the treatment associated with complications of pregnancy, and will not be able to offer local mothers the treatment which has long been promised to them.
Hong Kong’s close proximity to China has seen the city bear the brunt of the Birth, or Maternity Tourism trend for most of the phenomenon’s existence. However, as recent events, such as the closure of the San Gabriel “Maternity House,” show, mere proximity is not the underlying cause, and distance will not ensure protection. While local policy makers are stating that a flat ban on maternity tourists would be unacceptable, they are asking how the situation can be resolved.
Dr York Chow, Hong Kong’s Secretary for Food and Health, has said that he is keen to liaise with both the public and private sectors to improve the outlook for healthcare in Hong Kong. However, the Private Hospitals Association president, Dr Alan Lau, has said of any potential legislation or reforms, “we are willing to discuss the matter and strive for good quality of care … but any drastic measures contradicting the free market would be regrettable. The government would need good justification to limit our maternity beds.”
As such, it is highly likely that yet another mandatory rate increase on non-resident mothers giving birth in Hong Kong public hospitals is on the cards. Local mothers can expect the government to act in their interests and protect public healthcare services, and the accessibility of those services to pregnant residents. While any legislation would potentially avoid instituting stringent requirements on Hong Kong private hospitals, due to the city’s commitment to free-market principals and standing as the world’s freest economy, simple supply vs. demand suggests that medical inflation within HKSAR is not set to decrease any time soon. With the growing demand for private hospitals and private medical services, the sector could see a record pay day and increased costs at the expense of HK residents, in favor of mainland mothers who are prepared to pay for the best services available.
Mar
30
US Maternity Medical Tourist Situation Mirrors Hong Kong
Filed Under China, China insurance, Expat Insurance, Health Insurance, Healthcare, Hong Kong, Medical Insurance, USA Health Insurance | 1 Comment
American authorities have announced the closure of a “Maternity House” in the Californian city of San Gabriel, according to a New York Times report published March 29th, 2011. Neighborhood residents had complained repeatedly about the excessive noise coming from a local building, and the large number of pregnant women seen entering and exiting the area. Police officers and building inspectors discovered that the building was a center for Chinese medical tourists, who were using the home as a means to deliver their babies in the USA, thereby granting the child American citizenship. This situation is by no means unique to the USA as Hong Kong, for many years, has experienced a massive influx of mainland mothers looking to give birth within the city.
There are a number of reasons which can be used to explain the increase in Chinese mothers traveling abroad to give birth. One of these is with regards to the People’s Republic’s notorious “One Child Policy,” stating that Chinese nationals, within China, are only allowed to conceive, and give birth to, one Child. By going overseas to deliver, the mother is able to escape the bounds of Chinese legislation, and potentially have an additional baby upon return to her home nation.
The second reason for going overseas to give birth is more to do with having a form of “insurance” against untoward changes within the People’s Republic of China. In the case of the USA, any child born within the bounds of America’s borders automatically becomes a Citizen of the USA under the 14th amendment. Once the child is 21 years of age, they are then a full citizen of the country, and are able to petition the government to allow their parents to join them as residents of the US.
In Hong Kong this situation is paralleled, mainland mothers giving birth within the HKSAR gain their child “Right of Abode,” and consequently Permanent Residency; in addition to being granted the privilege of living in one of China’s most prosperous cities as their child’s guardian. While technically a part of China, Hong Kong operates under the “One Country, Two Systems” principal, and immigration of PRC nationals to the city is tightly controlled. By having a child in Hong Kong, the families of these children are able to ensure that they will not be deported for illegal immigration or visa over-stay infringements.
However, Hong Kong, unlike the USA, has healthcare system which is predominately public in nature. While private healthcare services and hospitals do exist in the city, the majority of residents receive their medical treatment through low cost, government run healthcare facilities. With a large number of pregnant mainland mothers using the maternity facilities at public hospitals within Hong Kong there was a serious strain placed on the city’s healthcare services. In some cases Chinese mothers accounted for more than 30 per cent of all deliveries at certain hospitals within Hong Kong.
In fact, this situation progressed to such an extent in Hong Kong that in 2008 the city’s government passed legislation introducing mandatory pricing for non-resident mothers wishing to give birth in Hong Kong public hospitals. Non-resident mothers who have booked their delivery in a Hong Kong public hospital are now required to pay a minimum booking fee of HK$ 39,000 (US$ 5,005.82) for a three day, two night maternity package. Non-resident mothers who have not booked a hospital bed, in other words, walk-ins, are charged HK$ 48,000 (US$ 6,161.06). The costs here do not include any complications of pregnancy, but are only for a routine delivery, and even then represent the minimum amount that a non-resident mother can be expected to pay; for Chinese nationals this no mean sum, as the nation’s average annual income is a paltry US$4,520.
Further to this, the Hong Kong government has not made any specific legislation with regards to the city’s private maternity hospitals, where the average maternity costs for a routine delivery are in the US$ 8,500 range; a cesarean section, or c-section, at the same hospitals will typically be priced at US$ 12,838. In comparison, the USA federal average for a routine child delivery comes in at roughly US$ 7,600.
As can be seen from the costs involved, the women undertaking this Medical Maternity Tourism phenomenon are clearly not from the lowest strata of Chinese society. With Chinese companies offering one-stop maternity tourism services from between CNY 50,000 – 90,000 (US$ 7,623 – 13,721), it is evident that these women, and their families must be, at least, slightly well off.
This then poses the question of why, exactly, the rate at which Chinese mothers are traveling overseas to give birth is increasing.
In recent years the PRC’s Central Government has made extraordinary strides towards improving the standards of the nation’s healthcare system and services; going so far as to introduce a comprehensive private China health insurance system, and stepping up much needed overhauls of the country’s top hospitals. In many cases China is able to offer private medical services which are on-par with, if not exceeding, those of their western counterparts. Hospitals like Parkway Shanghai are able to deliver some of the highest standards of medical treatment within the People’s Republic of China, and while they mainly serve foreign national expatriates, do cater services to Chinese residents.
The reason for this development then cannot be the quality of care, or even the cost of treatment, as these are both adequately covered within the People’s Republic. Additionally, unlike the furor over “Anchor Babies” within the USA, the Chinese mothers in question often return home after giving birth, and are usually in possession of above average financial means.
The issue of Chinese mothers giving birth in the USA is baffling American immigration experts, who say that the women are not acting in violation of current American laws. However, as in Hong Kong, there is apparent anger towards the trend. From the New York Times story:
“These people aren’t doing anything in violation of our laws,” said Mark Krikorian, the executive director of the Center for Immigration Studies, which advocates tougher immigration controls. “But if anything, it is worse than illegal immigrants delivering a baby here. Those kids are socialized as Americans. This phenomenon of coming to the U.S. and then leaving with people who have unlimited access to come back is just ridiculous.”
While there are many women from Asian nations participating in similar activities, such as South Korea, the Philippines, and India, it is Chinese mothers who are driving the trend. Not only are these mothers driving the trend, but their actions imply long term forethought towards the question of; where is it best to deliver my child overseas?
When looking at the American medical system the first thing which is immediately apparent is the need for some form of health insurance. Medical services within the USA can be prohibitively expensive, a much publicized and debated issue, necessitating some form of comprehensive health insurance coverage. However, it is important to realize that many insurers will impose a significant waiting periods on policy benefits such as maternity coverage. In some cases, the waiting period associated with maternity can be as long as 24 months from the start of a plan, although the norm would be closer to 12.
As such, it is obvious that these “Maternity Tourists” will have been planning their delivery trip for quite some time prior to departure. However, looking at the overall situation, it becomes much more complex than it can first seem.
Of those Chinese nationals and residents who do possess a health insurance policy, the type of policy prevalent within the population is “local health insurance.” These are medical insurance plans which are designed to work solely within a specific country, in this case China. These plans will not cover the policyholder overseas; while Hong Kong is considered to be a part of China, it is technically a separate national entity, so local China health insurance will not provide cover in the city, never mind the USA. However, in the case of Hong Kong, these maternity tourists tend to cover the costs related with the birth out-of-pocket.
American health insurance would then seem like an option; however, obtaining domestic USA health insurance to cover the costs associated with the birth is also a difficult proposition for foreign nationals, as an American residential address is typically required to access a plan. Looking at the waiting periods which will be involved, the logistics here would mean that the Chinese mother would have to be “resident” in the USA for a period which far exceeds the length of stay granted by her visa. As American immigration experts have cited the legality of this type of action, this is most likely not the case.
The last proposition for insurance coverage of the birth is with regards to international health insurance plans, which provide medical protection on a global basis. However, Chinese regulations, and the restrictions put in place by many of the major insurance providers operating on the mainland, mean that unless the Chinese citizen is an expatriate residing outside of their home country, they will be unable to obtain this type of policy. Due to the fact that American immigration experts cite the fact that many, if not all, of these mothers return to China after giving birth, having been abroad on temporary tourist visas, this is most likely not the case.
At the end of the day, it is extremely difficult for these mothers to fund their maternity tourism via insurance, which lends strong weight to the fact that they are paying for their maternity services out-of-pocket. If the USA is seeking options to resolve this potentially concerning issue, a price increase, or mandatory down payment such as that in place in Hong Kong may be a solution. In 2008, the year that “maternity tourism” began making headlines in Hong Kong, there were 7,462 babies born in the USA to foreign parents. Since then, the number of maternity tourists has only increased, and as China continues to generate more wealth, is likely to continue doing so.
Mar
28
India Waives 5% Service Tax on Private Healthcare
Filed Under Healthcare, International Healthcare | 3 Comments
Patients seeking private medical treatment in India will no longer be faced with an upcoming 5 percent service charge. India’s federal government last week announced the rollback of the planned tax on health-care services after encountering substantial pressure from opposition political parties, the healthcare industry as well as the general public.
Giving his general budget speech before Parliament, Finance Minister Pranab Mukherjee stated: “The proposed levy on healthcare has raised considerable anxiety in the House and outside. We have decided to exempt the new levy in its entirety; both in respect of services provided by hospitals as well as by way of diagnostic tests until the Goods and Services Tax comes into force.” The bill was later passed by the House.
The original proposal, prepared by Mukherjee on February 28th for the 2011 budget, introduced a tax on all medical services, including diagnoses, provided by air-conditioned hospitals with a capacity exceeding 25 beds. The move instantly evoked a strong reaction from the medical community with several distinguished doctors dubbing the scheme a ‘misery tax’. The proposal was in fact projected to increase the real cost of medical treatment for Indians by around 7 to 12 percent.
The move to withdraw the service tax has been welcomed by the healthcare industry in India. Shivinder Singh, Managing Director for Fortis Healthcare (India) said: “We welcome the finance minister’s decision to roll back the service tax proposed for the healthcare delivery sector. This positive step will benefit the common man, while providing a boost to the industry.”
Apollo Hospitals’ Executive Chairman Dr. Prathap C. Reddy explained the present situation: “Inflation in healthcare sector has been over 300 per cent in past decade. The industry has still tried to contain prices. Now, with the government relenting by taking back the proposed burden on the sector, it is good news not just for the industry but also for the people,” he added “I appreciate the rollback by the government. This new levy was like stretching pockets of over 85 per cent Indian patients.”
Ameera Patel, CEO and Executive Director of Metropolis Health Services, concurred that this was a positive development: “The new tax was a big drain on the pockets of patients, especially old people. It would have been a complete disaster,” she said.
The private healthcare sector is determined to support this initiative. Efforts to reduce their own costs will be given renewed impetus to boost the number of patients seeking preventative care and early diagnosis, helping to curb the rising prevalence of chronic diseases in India. During the past weeks budget discussions, almost all political parties had pressed the finance minister to remove the healthcare service duty. The announcement that the 5% service tax had been withdrawn was met with applause by members of Parliament.
The medical tourism industry in India is also relieved that the healthcare service tax has been waived by the Finance Minister. Concerns arose that making private treatment in India more expensive would put their healthcare facilities at a competitive disadvantage against other Asian markets that also cater to international clients.
A growing number of people from Western Europe, North America and Africa are visiting India every year for the sole purpose of receiving medical treatment. Patients are attracted by the lower costs and a high standard of private healthcare that remains comparable with the best in their home countries. The Indian medical tourism industry has been growing substantially and is projected to generate over $US2 billion a year in revenue by 2012. However, other Asian countries are also committed to taking advantage of this lucrative global market and are invested in building their own internationally-renowned healthcare facilities.
Companies Mentioned
Fortis Healthcare
Fortis Healthcare Limited, founded in 1999, is a leading healthcare provider with a network of 46 hospitals, satellite centers and heart command centers in India. The company also offers diagnostic, travel, IT and financial services through it’s’ wholly owned operation Religare Enterprises Limited.
Apollo Hospitals Group
Apollo Hospitals is the largest healthcare provider in Asia, third largest in the world. The company operates 53 hospitals, a total capacity of 8500 beds, across Asia. The company also offers medical consultancy and pharmacy services. Apollo Hospitals was founded in 1983 and is based in Chennai, India
Metropolis Health Services
Metropolis Health Services operate a chain of medical diagnostic and research facilities. The company has a worldwide network of operations. Metropolis was founded in 1981 and is based in Mumbai, India.
Mar
25
Mergers Expected in Thailand Healthcare Sector
Filed Under Healthcare, Hong Kong, International Healthcare | 1 Comment
Industry analysts are expecting the increase in merger and acquisition activity in Thailand’s healthcare sector to continue. Thai healthcare providers are determined to integrate more with one another to give them a national competitive advantage over the large foreign multinationals now entering the market.
Under the ASEAN Economic Community (AEC) agreements, by 2015 many industries will be increasingly liberalized across the continent, including the private healthcare sector. Regional market integration will theoretically expand the local healthcare market to over 580 million people.
Khazanah Nasional, Malaysia’s state investment branch, has identified Thailand in particular as a healthcare market with great growth potential and would be aggressively pursuing opportunities in the region.
Pongsak Viddayakorn, board member at Bangkok Dusit Medical Services (BGH), Thailand’s leading hospital operator, explained: “The cash-rich Malaysian state investment firm is in the process of pitching acquisition proposals to almost all Thai healthcare providers, leading local players to look for accelerated consolidation to curb what is feared will be a foreign invasion.”
In July 2010, Khazanah Nasional won a fierce bidding war with India’s Fortis Healthcare to acquire Asia’s largest hospital operator: Parkway Holdings Limited of Singapore.
Mr. Pongsak predicts similar activity in Thailand: “The remaining smaller-scale players failing to bond with the local giants may be forced to team up with one another or else eventually sell out to foreign investors.”
BGH, aware of impending foreign competition, is committed to protecting its market share. In December 2010, the group acquired both the Phyathai Hospital and Paolo Memorial Hospital chains, 8 medical facilities in total, from the Health Network Group for a total of 12.6 billion baht (US$ 315 million). The acquisition is expected to be completed by the second quarter of 2011 and will expand the BGH hospital network to 27 facilities, with an estimated 20,000 a-day outpatient capacity once the merger is completed. This achievement has turned Bangkok Dusit into the second largest hospital group in the Asia-Pacific region outside of Japan.
The most recent acquisition in Thailand was made last week by Bumrungrad Hospital Plc (BH), the country’s second largest listed hospital conglomerate. On March 19th, BH purchased a 24.99% stake in Bangkok Chain Hospital Plc (KH), chief operator of Kasemrad Hospital Group, from developer Land & Houses Plc for 3.53 billion baht (US$ 116.7 million) at a share price of 8.50 baht (US$ 0.28) per share. BH has been subject to its own shareholding change recently. Last month BGH purchased an 11% stake in BH.
KH operates a health network of six hospitals under the Kasemrad brand, with approximately 1,240 beds and an operational capacity of 9,400 outpatients a day. Bumrungrad’s acquisition will expand their coverage and give it greater penetration into the growing Thai middle class market through the new locations in KH’s multi-facility network.
BH is now committed to extensive investments both in and outside of Thailand as part of their revised expansion strategy. Bumrungrad International was established in 2005 as a subsidiary to focus on advancing acquisition, development and management of medical delivery services throughout Asia and the Middle East. The firm has partnered with strategic international investors including Bangkok Bank plc, Hong Kong listed Asia Financial Holdings Ltd., Singapore’s Temasek Holdings and Istithmar World of Dubai. BH is currently working in conjunction with Asia Financial to develop a 500 bed private hospital in Hong Kong at a cost of US$ 300 million. The Hong Kong government is auctioning off four land plots for potential private hospital development. If their bid is approved, the project is expected to commence next year.
In Thailand, BH has outlined increased spending to increase the capacity of their medical facilities. 1.4 billion baht (US$ 46.3 million) has been earmarked for domestic infrastructure spending on top of the roughly 600 million baht (US$ 19.8 million) in annual costs attributed to equipment and facility upgrades. Through its international investment branch, the firm now operates 104 clinics and hospitals in 8 different markets.
The industry outlook for the Asia-Pacific region is good. The lucrative private healthcare market in Asia has become an increasingly important engine for growth. India, Singapore, Malaysia and Thailand have emerged as key medical tourism destinations for international clients. In addition to this, the rising level of disposable income among the native Asian populace has increased awareness of better quality of healthcare available through privately run medical sources as well as supplementary health insurance options. The low interest rate environment and improved knowledge of investment products are concurrently driving up demand for investment-linked insurance products, which are providing insurers in emerging markets in Asia with a significant scope for new written premiums.
Companies Mentioned:
Bangkok Dusit Medical Services
Bangkok Dusit Medical Services, together with its subsidiaries, operates a private hospital network in Bangkok, other Thai provinces and in Cambodia. The company was founded in 1969 and the first Bangkok hospital commenced operations in 1972. Private healthcare facilities include Samitivej hospital and BNH hospital.
Bumrungrad International
Bumrungrad Hospital Public Company Limited was founded in 1980 and is based in Bangkok, Thailand. The company’s primary activities are owning and managing hospitals. Its flagship facility, Bumrungrad International hospital, is a prominent medical centre attracting over a million patients annually and has been nominated as one of the world’s top ten international hospitals by Newsweek International.
Parkway Holdings
Parkway Holdings Limited is one of Asia-Pacific’s leading providers of healthcare services. Parkway operates a provider network of 16 hospitals with more than 3,400 beds throughout Asia, including Singapore, Malaysia, Brunei, India, China and the UAE. Parkway was first listed on the Singapore stock exchange in 1975.
Fortis Healthcare
Fortis Healthcare Limited, founded in 1999, is a leading healthcare provider with a network of 46 hospitals, satellite centers and heart command centers in India. The company also offers diagnostic, travel, IT and financial services through it’s’ wholly owned operation Religare Enterprises Limited.
Khazanah Nasional
Khazanah Nasional is the investment holding arm of the Government of Malaysia. The company acts as strategic investor in new industries and markets and manages these investments on behalf of the Malaysian government. The company became incorporated as a public limited company in September 1993 and began operations the following year. Khazanah holds investments in more than 50 companies, who are involved in many diverse industries including: banking, electronics, healthcare, manufacturing, and telecommunications.
Join us on Google +
