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What India can teach Sweden about healthcare

As debate rages in Sweden about the role of private firms in the country's publicly-financed healthcare system, liberal commentator Nima Sanandaji suggests Swedes may find a solution inspired by an innovative heart surgeon from India.

What India can teach Sweden about healthcare

One of the hottest topics in Swedish politics these days is what role private firms can play in the delivery of publicly funded healthcare services. Are healthcare companies profiting at the expense of taxpayers and patients or improving services through innovation and choice? It is clear that the Swedish welfare debate has come to focus more on problems than solutions. Positive visions are hard to come by.

Perhaps we could take a cue from Devi Prasad Shetty, the Indian heart surgeon who is described as the Henry Ford of healthcare by the Wall Street Journal?

Devi, who performed India’s first operation hearth surgery on a baby and treated Mother Theresa after she had a heart attack, soon realized that many Indians couldn’t afford cardiac surgery. Rather than trying to haggle down the price, they would simply turn their backs and go home once they heard what an operation would cost.

Shetty’s solution was simple yet radical: make heart surgery affordable for the poor through higher efficiency.

In 2001, Devi Shetty founded Narayana Hrudayalaya, a specialist hospital outside of Bangalore where thousands of cardiac operations are performed annually. Next to it he founded a cancer hospital and a highly specialized eye hospital. Last year the magazine Fast Company listed Narayana Hrudayalaya as one of the most innovative companies in the world.

Thanks to a high level of specialization, the price tag for open heart surgery in the hospital has been pressed down to under $2,000. This is only a third or less of the cost in other parts of India. Although the cost is low, the quality is so high that patients from countries in the west also travel there to seek care. India’s National Innovation Council has noted that Shetty has successfully created a “health city”, where large specialist hospitals draw benefit of proximity to each other.

In Sweden, we seldom, if ever, turn our eyes to a country such as India to look for inspiration. After all, aren’t they supposed to learn from us? But precisely since resources are so scared in India, sometimes smart ideas can arise which escape us in the rich world. The innovation for which Devi Shetty is so highly praised is, interestingly, not really new. He has simply managed to implement the ideas of smart organization, economies of scale, and a high level of specialization to healthcare. These ideas have existed, and thrived, in modern economies for more than a century now. But they have been slow to spread to the field of healthcare.

That might soon change, however.

Currently Shetty is, with the help of western capital, working on expanding his healthcare concept to other parts of India, as well as to various countries in Asia and Africa. The goal is to create more health cities, increasing the number of sick beads from 5,000 to 30,000. Not only will more patients be able to take advantage of efficient and affordable healthcare, but economies of scale might be improved further.

Perhaps Sweden wouldn’t be bad off if Dr. Shetty decided to build one of his health cities here? After all, we desperately need positive visions on how health services can be improved. And it is only appropriate for India, which has historically played such an important part in the development of medicine, to continue to inspire us to change.

Nima Sanandaji is a Swedish writer of Kurdish origin. He has a PhD in polymer technology and has written numerous books and reports about subjects such as integration, entrepreneurship, and women’s career opportunities.

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Emergency room visits to cost 50 francs in Switzerland

People who visit the emergency room for non-urgent treatment will now need to pay 50 francs after the Swiss government issued final approval for a rule change.

An ambulance approaches Geneva University Hospital. Emergency room visits will now cost 50 francs in Switzerland. Photo: Fabrice COFFRINI / AFP
An ambulance approaches Geneva University Hospital. Emergency room visits will now cost 50 francs in Switzerland. Photo: Fabrice COFFRINI / AFP

The proposal was originally developed by Zurich National Council member Thomas Weibel and received approval by the National Council in 2019. 

The Council of States on Wednesday accepted the parliamentary initiative, meaning that people who seek treatment in the emergency room for non-urgent health issues a fee of 50 francs. 

This will be introduced as a co-pay, meaning that the patients would have to pay out of their own pockets (i.e. it will not be covered by insurance). 

READ MORE: Switzerland to introduce 50 franc fee for emergency room visits

MPs argued that this measure may dissuade those who are not seriously ill from going to the emergency room and overloading the system, while also taking medical staff away from patients who need urgent help.

Opponents countered that this may discourage people from visiting hospital who actually need treatment, however the measure passed with a narrow majority. 

EXPLAINED: Everything you need to know about health insurance in Switzerland

No concrete indications were given as to what amounts to ’non-urgent’ treatment in the eyes of the law.

This is expected to be laid out by the National Council who are now charged with the responsibility of drafting the rules. 

Exemptions could apply to children and adolescents under the age of 16, patients referred to the emergency room by a doctor, and those whose treatment subsequently requires hospitalisation.

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