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Compare and contrast the financial and interventional factors found within both a developed country and also a developing country.

HCA 4303, Comparative Health Systems 1

Course Learning Outcomes for Unit IV Upon completion of this unit, students should be able to:

1. Compare and contrast the financial and interventional factors found within both a developed country and also a developing country.

Reading Assignment Chapter 5: The Healthcare System in Canada Chapter 12: The Healthcare System in India

Unit Lesson In this unit, we will examine the Canadian and Indian healthcare systems. More specifically, we will compare and contrast the two countries in relationship to their status financially and functionally. Although these two cultures are very different and describing those differences would be relatively easy, they are actually very similar in comparison. For example, both Canada and India have a government-managed and funded care system. The Canadians passed a healthcare act in 1984 that provides universal access to, and payment for emergency care, as well as many routine and preventive care procedures. India’s system is also administered by the government with the bulk of the hospital and clinical care provided by private corporations. Unlike Canada, the Indian healthcare system is grossly underfunded and inadequate (Lovett-Scott & Prather, 2014). Other similarities between India and Canada include the fact that both countries have difficulties with access to health care in rural areas, both face long waits for diagnostic tests and non-emergency procedures even in urban settings, and neither health system provides any significant funding for dental care. Additionally, the people of both countries have the security of knowing that they will not be burdened with exorbitant hospital bills and other medical costs incurred from a catastrophic medical condition. But both report paying for much of their routine care out of their own discretionary funds. In this unit, you are asked to do something very similar to the paragraphs above by developing a “memory matrix” to practice gathering information about two countries and comparing and contrasting their primary characteristics. This is as simple as drawing a table and using a y axis (vertical) to list the characteristics you are examining and the x axis (horizontal) to list the two groups you wish to compare and contrast; in this case, it would be India and Canada. Sorting and cataloging these characteristics helps to show patterns as well as to highlight certain aspects that might be missed if not examined side-by-side. A comparative analysis requires us to look for similarities and dissimilarities between two or more groups. It is also important to look for connections that are not immediately apparent. There is one very interesting connection related to the Canadian and Indian healthcare delivery systems; Canadians are large consumers of medical tourism in India (Turner, 2011). The term medical tourist is typically used to describe someone that travels outside of their own country to receive medical care that they would not be able to receive or afford in their home country. According to research conducted by the Deloitte consulting firm, healthcare costs are increasing each year in most developed countries, yet the cost is being managed better in certain developing nations (Deloitte Center for Health Solutions, 2008). The former legitimate concerns about the safety and quality of care available in

UNIT IV STUDY GUIDE

India Compared to Canada in Regards to Finance and Interventional Strategies

HCA 4303, Comparative Health Systems 2

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many countries is no longer an issue since organizations such as the Joint Commission International (JCI) and others are accrediting these facilities. Knowing that Canadians face lengthy waits for numerous medical procedures, it stands to reason that those with the financial means to do so would entertain the concept of seeking care in other countries. Although many of the countries provide outstanding care in state-of-the-art facilities, their decreased overhead allows them to provide the care at a fraction of the cost. Much of the medical tourism business has an element of tourism along with the medical care. Hotel chains, resorts, and spas often offer a complete package allowing patients to rest and recuperate in first-class style. Companies in Canada specialize making all the arrangements to include air travel to India, ground transportation, passports, visas, meals, sight-seeing, and luxurious living accommodations. As a point of reference, Table 1 compares the cost of six common surgical procedures in the United States and Canada. No wonder why affluent Americans and Canadians would choose to maximize their resources by shopping around for the best deal. Other specialty services include reproductive health, dental care, and plastic surgery. People from around the world also visit developing countries to purchase organ transplants— an illegal practice in most countries. Table 1. Comparative Analysis of Cost of Care in United States versus India

PROCEDURE NORTH

AMERICA INDIA PERCENT

Hysterectomy $20,000 $3,000 15

Knee Replacement $40,000 $8,500 21

Hip Replacement $43,000 $9,000 21

Angioplasty $57,000 $11,000 19

Heart Bypass $130,000 $10,000 7

Heart Valve Replacement

$160,000 $9,000 6

(Woodman, 2008)

One interesting and rapidly growing component of medical tourism surrounds the elderly. Canadians face long waiting lists to enter a long-term care facility and then often experience poor quality of care once admitted. Conversely, the Indian culture reveres the elderly and puts forth great effort to make their final years pleasurable and to maintain their health as long as possible. This concept was driven home in the movie The Best Exotic Marigold Hotel, a 2012 British comedy-drama film directed by John Madden in which a cast of elderly men and women find life in India to be tranquil, restorative, and affordable. It is worth reiterating here that India is not the only country that is developing a niche market within health care by providing services at a reduced price to those from wealthier countries. However, it is important to understand this phenomena is not likely to end in the near future since the supply under managed care will continue to exist as will the desire for countries such as India to capitalize on the opportunity. Hopefully, this discussion comparing and contrasting the financial and interventional aspects of India and Canada as well as elaborating on their connection within the business of medical tourism has been helpful. You will now have an opportunity to review this material by building your memory matrix. By being able to do this, you are one step closer to being able to comparatively analyze any two countries on the eight key factors of determining true access to care!

References

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Deloitte Center for Health Solutions. (2008). Medical tourism: Consumers in search of value. http://www.globalwellnesssummit.com/wp-content/uploads/Industry-Research/Americas/2008- deloitte-medical-tourism-consumers.pdf

Lovett-Scott, M., & Prather, F. (2014). Global health systems: Comparing strategies for delivering health

services. Jones and Bartlett Learning. Turner, L. (2011). Canadian medical tourism companies that have exited the market: Content analysis of

websites used to market transnational medical travel. Globalization and Health, 7(40), 1–16. Woodman, J. (2008). Patients beyond borders: Everybody’s guide to affordable, world-class medical travel

(2nd ed.). Healthy Travel Media.

Key Terms

1. Activities of daily living 2. Long-term care 3. Medical tourism 4. Single payer 5. Universal health coverage