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00:00Dr. BS Ajay Kumar, Executive Chairman of Healthcare Global Enterprise, joins us.
00:05Dr. Ajay Kumar, thank you for taking the time out to talk to us.
00:10Doc, what is going on?
00:12I mean, there are reports indicating that higher pricing by hospitals is coming
00:16at the cost of healthcare and patient care and well-being of patients.
00:20Firstly, you've got to tell me, is this what's happening?
00:25You know, I do not believe it is happening all over.
00:30There may be a few hospitals which are doing it.
00:33But what I would like to state here is that normally when the patient comes in,
00:39they are well aware of what the charges are going to be.
00:42Most of the hospital practice this ethics.
00:45Patients are told what is the charge, let's say private ward versus general ward.
00:51All the things are explained and the signature is obtained.
00:55The patients fully understand what is happening.
00:58Plus or minus 5 percent, it may be because of some unexpected procedure
01:03or unexpected intervention.
01:05So normally, in my best of my opinion, most of the hospitals are practicing like that.
01:10In HCG itself, we have a very system where the patient is told.
01:15We actually, majority of the time, we even videograph.
01:19And then we believe we should do the right thing for the patient at that time.
01:24And we measure the outcome.
01:25So I think most of the hospitals are now into quality outcome.
01:30So we know for a fact that this is not happening generally.
01:34But there may be instances where patients feel some of the time,
01:39some people may feel that there is an extra charge.
01:42And as you know, in the past also, there was discussion about people charging
01:46for gloves, people charging for other things.
01:48But we believe it should be a package.
01:51What I feel is the right thing to do is a package.
01:54But one of the things we need to understand is there is inflation in medicine.
01:59There is cost of operation, particularly post-COVID.
02:02The costs have gone up.
02:04For example, if you want to buy a technology, the cost has gone up over 50 percent.
02:10Like I can tell you about a CT scan, MRI.
02:13That used to be four and a half lakhs is almost seven.
02:16Four and a half crores is almost seven crores.
02:19Similarly to CT scan.
02:21For whatever reason, and the customs duty, for whatever reason,
02:24the costs have gone up.
02:26So if you do believe in doing the right thing for the patient,
02:29obviously that cost has to be absorbed.
02:32So that is why the measure I do is what is the margin.
02:36The margin should always be kept somewhere around 20, between 20 and 25 percent.
02:42I think this will control the medical expenses and do the right thing.
02:47But, of course, the talent acquisition is also expensive, getting the right doctors.
02:51So it is true that the cost may be going up, but one has to carefully study why.
02:57But still, having compared to the advanced countries, our cost is much less.
03:02I could say this categorically.
03:04For example, a PET scan in positron emission tomography in U.S. costs $3,000.
03:11We do it for actually $250.
03:14So there is a vast difference.
03:16I completely take your point, but I don't know how fair it is to compare
03:20the health care in India versus the health care internationally.
03:23Let's understand that there is a public...
03:25What is wrong in it?
03:27Because a large part of the health care in India, unfortunately, has to be private.
03:31So if the costs are that elevated, it's only going to make it harder
03:34for individuals to go out and do those services.
03:38We don't have the sort of cover or the government support that countries
03:41like the U.S. and the U.K. have.
03:43So I don't know whether that's a fair comparison at any stage.
03:46But let's move on.
03:48I will ask you one thing.
03:51If somebody comes to India and has the same outcome,
03:54our cancer patients have the same outcome as being treated in Houston,
03:58MD Anderson or somewhere, and the cost is one-tenth.
04:02In fact, books have been written about India reverse innovation.
04:05It's a Harvard case study.
04:07So we have mastered the art of cost versus outcome.
04:11But doctor, you'd agree with me that the very wealthy are still seeking
04:15global health covers and still going to countries like the U.S.
04:18And we've read about this, right, where you've had celebrities
04:21who've gone to the U.S. to deal with their problems.
04:24And the number of global health insurance covers are also on the uptick.
04:28And there is a reverse outflow.
04:30So doctors who are talented are leaving and fleeing the country.
04:34So that is another reality.
04:36It's actually not true.
04:38A lot of doctors who have gone to the U.K. have come back to India.
04:41So how much part of your patients would you say is coming from outside?
04:47So how good is health tourism doing?
04:49I mean, break that number for me, right, in terms of top line.
04:52In our Bangalore center, which is center of excellence,
04:56nearly 18 to 20 percent of revenue is from international patients
05:01coming from Africa, Middle East.
05:04One thing we have to keep in mind that some people in the past
05:09used to go to Europe or U.S.
05:11They are coming to India because of the cost differential
05:14and equally good outcome.
05:16But my point is not that.
05:18My point is, yes, the costs are going up.
05:21In fact, as you know, U.S., the percentage of GDP is 19 percent healthcare.
05:26In India, it is 2 percent.
05:28So this has been written worldwide.
05:31We have to be very clear.
05:33We have written about Indian cost versus other costs and outcome.
05:37We should not just measure cost.
05:39We should measure cost and outcome.
05:41Of course, people will say our purchasing power is low.
05:45I told that recently the parliamentary committee,
05:48yes, purchasing power is low.
05:50My job is to provide the right care to the patient at the right cost.
05:54But the job of the government is to improve the purchasing power.
05:58That is why we also recommend universal healthcare.
06:01In Brazil, for example, which is an advancing country like us.
06:05So we should have universal healthcare.
06:07So poor and rich are treated equally.
06:10But that is the only answer to this.
06:12You're right, you're right, doctor.
06:14Of course, a lot of it is also maybe out of control.
06:17There are external factors that are probably impacting the cost.
06:20So be it supply chain disruption, inflation, increased cost of medical supplies.
06:24But as long as we're doing the right thing, and that's what maintains.
06:29And you are also a listed company.
06:31So you're still answerable to shareholders as much as you are to patients.
06:35Doc, we'd have loved to chat with you longer.
06:38It's unfortunate we're completely out of time.
06:40But hopefully we'll connect again and do a more detailed chat.
06:43Because this is such an important topic and aspect,
06:46which impacts every household and every person watching us on TV as well.
06:50If not as an investor, but of course as a citizen of this country.