What does Obamacare Mean for the Rest of the World?

The passing of the health-care reform bill in the US last week seems to be heralding significant changes not just for the US but also for the rest of the world. Coming on the back of heated debate and partisanship, the bill legalized sweeping changes in the US insurance markets, expanding coverage while enforcing strict consumer protection regulations.

Most post-fact analysis have focused on the political impact of health care reform. And aside from debates on public spending, I have not seen much discussion on the impact of these reforms on the global healthcare market. In this context, I feel that this news item that I came across this morning could be interesting:

With the US Healthcare Bill being the latest and most high profile effort to revamp healthcare – Indian hospital chains expect to see more patients being sent here as part of efforts to expand coverage and provide quality services at economical costs.

The US Bill has made US customers cost-conscious; the economy is sluggish and earnings are down. As a result, insurance providers were forced to look at options outside the US in locations such as India, Singapore, Thailand and Malaysia, he added.

Making a similar observation, the Apollo Hospitals Managing Director, Ms Preetha Reddy, said that US insurers were scouting around the world for good, economical private institutions. And while Indian hospitals would see volumes of overseas patients increase as a result of cost-control efforts by Governments, there would be competition from places situated closer to the US, such as Mexico and Barbados, she added

The Fortis Hospitals Chief Executive, Mr Vishal Bali, told Business Line that US insurance companies had visited Fortis’ JCI (Joint Commission International, US) accredited hospitals in Bangalore and Mumbai. Fortis was already empanelled by Companion Healthcare, a subsidiary of BlueCross BlueShield of South Carolina, he said.

Frost & Sullivan’s Ms Dipta Chaudhury pointed out that insurers could soon include surgeries done abroad in cheaper locations such as Thailand and India under their insurance umbrella as rising number of insured population added to costs. “This will reduce the cost burden on the insurance companies as well as help the overall Indian healthcare market,” she added.

From this article it seems, contrary to what I had assumed, that health care reform in the US would give a fillip to the booming medical tourism industry. Referring to a Deloitte Consulting report, Wikipedia says:

An estimated 750,000 Americans went abroad for health care in 2007, and the report estimated that a million and a half would seek health care outside the US in 2008. The growth in medical tourism has the potential to cost US health care providers billions of dollars in lost revenue

Further, what could reforms mean for the existing healthcare infrastructure in the US.  Already with the expanded coverage the US maybe facing a shortage of primary-care doctors. Would this mean increase in demand for expat doctors? And as this NYT article points out, it may even mean significant changes in medical school admissions and finance structure.

And what would all this mean for the US as public spending on health care seems to be set to increase substantially? Is there someone out there who could provide some perspective on this? Especially in terms of the impact of these reforms on the US hospitals and medical practitioners?

A Video, And My Two Bits, on Afghanistan

Check out this video of Gurkha soldiers in Afghanistan bonding with the locals over Hindi/Urdu and Bollywood.

The situation in Aghanistan and Pakistan is often perceived in terms of the US involvement there- the “Just War’, “Obama’s War” or, more ominously, as another Vietnam. Such tired terminology ignores the fact that the Afghanistan war is more of a regional problem, in which the South Asian nation states of India and Pakistan have great stakes.  The Obama administration certainly recognizes this, but has so far failed to get India and Pakistan, the two states with most to lose from a deteriorating Afghan situation, to join the effort in stabilizing the country.

Obama Love-Fest Continues


While I count myself amongst fans of Barack Obama, the Nobel Committee’s decision to award him with the Peace Prize did come as a WTF moment this morning (to lots of people judging by FB news-feed). The Nobel Committee honoured him this morning for “his extraordinary efforts to strengthen international diplomacy and cooperation between peoples”.

Obama excels at  public diplomacy, and has a cult-like following around the world. No other world leader shares his commitment towards nuclear disarmament and a multilateral world.  However, awarding the Nobel to him with the war in Afghanistan bringing new dead everyday, Guantanamo still open and troops still in Iraq strikes as  pre-mature. Further, he has been active as president for only 10 months. Granted that he has made significant departures in that period, would it not have been more seemly to honour a longer commitment to human-rights and world-peace.

Not that the Nobel Prize is a sign of anything. Gandhi, being amongst the famous non-recipients.

But for now the Obama love-fest continues.

The Economist published yesterday the favourites to win, foremost amongst whom were