Universal Health Care – A Lesson From Bangalore

As US lawmakers struggle to compromise on what is likely to be a highly compromised health care bill, it would behoove them to visit Narayana Hrudayalaya in Bangalore.  Narayana Hrudayalaya, which means “God’s compassionate hospital” in Sanskrit is today the world’s largest heart hospital, performing up to 50 major cardiac surgeries per day—more than the Cleveland Clinic and Mayo Clinic combined.  Set up in 2001, its founder Dr. Devi Shetty believed that through scale, he could offer world class health care and drive costs down, much the way it would work in any other business.  Today, with over 1000 beds, 24 operating rooms, state-of-the-art equipment and doctors from all parts of the world, a heart surgery can cost as little as Rs 65,000 (about $1500).  Moreover, no one is turned away from the hospital.  Those who cannot afford treatment are provided care at no cost.  While every patient receives the same quality of care, wealthier patients have the option of higher priced private rooms.  These higher prices subsidize those who cannot afford treatment.

With its specialization and scale, Narayana Hrudayalaya’s model has many benefits.  It is able to attract the best doctors at a fraction of the cost of the west, it has buying power with equipment vendors, and it has created operating efficiencies with its practice of thousands of heart surgeries.  In addition, the center has become a globally recognized center of excellence.  It has treated patients from 73 countries, does the largest number of heart surgeries on children in the world, and is the only center in Asia to have implanted a 3^rd generation artificial heart.  In collaboration with the Indian Space and Research Organization (ISRO), Narayana Hrudayalaya has set up 17 coronary care units in remote hospitals.  They are linked to the main hospital in Bangalore via satellite, such that ECG images can be transmitted and heart specialists can diagnose conditions, recommend treatment or initiate a transfer to Bangalore.  The hospital also has a visa office to help foreign patients (including patients from Pakistan) process documentation.  Outside the main entrance is a chapel broken into four quadrants, one each for Hindus, Muslims, Christians and Sikhs.

The need for innovative models like that of Narayana Hrudayalaya cannot be overstated.  India spends more on health care as a percentage of GDP than only 4 other countries in the world.  It needs to perform 2.5 million heart surgeries a year, of which 300,000 are needed for children.  However, only a total of 80,000 heart surgeries take place.  Narayana Hrudayalaya’s 2 hospitals (one in Bangalore and one in Calcutta) alone account for 12% of all heart surgeries in the country.  With its success in heart surgeries, Narayana Hrudayalaya is now taking its models to other specialties and other cities.  In Bangalore, it has already set up a “Health City” around its heart hospital, with the world’s largest cancer hospital, an orthopedic hospital, eye hospital and kidney hospital.  It has also announced Health Cities in other locations including Hyderabad, Mysore and Ahmedabad.  Dr. Shetty has taken health care back to its basics and its power lies in its simplicity.  Anyone looking for solutions to the world’s health care debacle needs to take notice.