#69 The Globalization of Healthcare
Yes, we have all heard the stories. Stories of patients in need of treatment in the Western hemisphere traveling to countries such as Thailand or India in need for more affordable healthcare, stories of hospitals in the so-called developed world outsourcing certain diagnostic procedures to the so-called emerging markets, or stories of hospitals in the United States who meet their staffing needs by recruiting nurses and doctors from other countries. In a time when the World Health Organization ranks countries such as Singapore 6th among the world’s healthcare systems and the United States only 37th, quality concerns are no longer an issue in discussions about the globalization of healthcare. Only questions of liability are still raised as big impediments to a fully globalized healthcare industry. But even these no longer seem to be barriers for business. In Europe, Capio of Sweden, which operates in several European countries including Norway, Denmark, Finland, France, the United Kingdom, Spain, and Switzerland, is owned by global private equity form Apax. And let’s just look at other world regions. Dubai Healthcare City is the world’s first healthcare free trade zone, attracting global brands such as the Mayo Clinic from the USA, Great Ormond Street Children’s Hospital from the UK, the German Heart Centre or the American Academy of Cosmetic Surgery Hospital. The Cleveland Clinic has entered a contract to manage a hospital in Abu Dhabi and has established similar arrangements with hospitals in Austria, Canada, Egypt and Saudi Arabia. Or, let’s look at recent transnational mergers and acquisitions activity in other world regions. In mid-July US-based private equity firms Carlyle and TPG acquired Australia’s Healthscope for nearly US$ 2 billion. Among several hospitals in Australia, Healthscope also has operations in New Zealand, Malaysia and Singapore. In late July, Integrated Healthcare Holdings Ltd of Malaysia won a battle against the Indian Fortis group over Parkway hospitals of Singapore. It seems that the pace at which the world of healthcare is becoming flat is accelerating rapidly.
November 22, 2011 @ 3:33 am
I studied the U.S Healthcare system and all of its faults as part of my undergraduate degree in Healthcare Administration and I couldn’t agree more with the blog post on the globalization of healthcare. At the very core of the issue surrounding the U.S Health system and that of another country (like France) is the fact that in America, it is perfectly acceptable to make money off of someone who is ill or who is suffering from a terrible disease. No other country has quite the intricacies of the third party payer system where an individual purchases insurance in case they ever become sick, much like how a car owner purchases auto insurance in case they are in a car accident. In countries like Canada, France, and England, every worker contributes a small amount of tax off of their paychecks into a universal health system that provides care to sick individuals, regardless of their level of health. What does this say about the American culture and the American employee? Are we too stubborn and self-centered to contribute a nominal fee so that people don’t perish (physically or financially) when they become sick? I think the issue has to do with the American worker being incredibly individualistic in nature when trying to achieve goals that benefit them, not anyone else. Having to pay a little extra in the form of a healthcare tax would mean that that American worker is taking care of someone else and isn’t being considered with their own wellbeing. A culture like that of England (where I was originally born) might be focused towards the greater good, permitting employees to pay slightly more in the form of a payroll tax, ensuring that healthcare is available when they need it.
The fact that the quality of healthcare in the U.S is better than in other countries is irrelevant because a vast majority of American’s don’t have access to the excellent healthcare and would be better off partaking in medical tourism to cure their ailments. Due to the barriers associated with trying to access care in the U.S (money, lack of insurance, inability to access care) more and more individuals are willing to travel outside of the U.S, especially since the quality of care in other countries is improving. Sooner or later, costs associated with medical treatment are going to have to decline otherwise patients are going to seek more affordable treatment in different countries.
March 15, 2013 @ 2:15 pm
Reading the globalization of healthcare three basic concepts came into my mind right away: Competition, privacy and future potentials.
1.) Competition
As in all other industries, including many areas of public services, markets started to develop and competition became stronger due to globalization. Healthcare has been so far in the hand of the public in many western but also eastern countries. In countries which are not well developed yet it essential that the public sector takes care of this essential and highly state duty.
Regarding the current situation in Western Europe, including Austria, Germany, Italy and many other countries there is a real problem with the efficiency and effectiveness of the current system. Besides, poor management, high operating costs and poor process innovation in hospitals and health care institutions is often the case. If anyone has visited a public hospital for ambulant treatment lately it is obvious many times that with overcrowded waiting rooms and doctors and nurses with more than 60 hour weeks the current supply and quality standards probably do not meet the market’s demand.
Globalization and a certain private component in health care is a necessity in my point of view and for sure it will increase competition and the number of competitors on a certain defined market.
Regarding the quality level of the services provided, standardization, as also in many other industries becomes an important issue. Without proper standardization, there will be a risk that WHO high ranked countries (http://www.who.int/whr/2000/media_centre/press_release/en/) like France, Italy, Singapore and Austria will lose their standards, whereas lower developed countries on the world health organization like countries in Africa, Russia and Brazil will benefit from higher standards. Nevertheless, health care companies will mainly expand to countries with already high wealth standards or fast developing economies like the BRIC countries, unfortunately not supporting third world countries which still lack minimum health care standards.
As mentioned earlier, the private sector also play an important role in healthcare, as seen in WHO’s ranking with France on first place with a combination of public and private companies serving the population for health regards.
2.) Privacy
With many different privacy laws and regulations throughout the world, how will privacy be handled, if a patient ‘s data from a high privacy country is transferred to a low privacy country due to the laboratory there? How can insurance companies claim diagnostic reports and clinical evidence if they legally have no access to it? How will global companies, many times managed by investment funds secure this very sensitive topic? How can they guarantee security?
Those are all questions that need to be answered prior to globalization and liberalization of the health care market.
3.) Future Potentials
On a scientific level, healthcare is already an international topic with professionals exchanging information, holding congresses and seminars on special fields of health care, surgery and treatment. Many surgeries are already performed on a global basis with doctors performing surgical activities electronically with monitors and high end IT systems.
Transforming experiences from other industries, it is well known that the private sector often performs more efficiently than the public sector due to differences in organization, management, strategy, human resource planning and investment opportunities.
The public sector on the other hand is also inevitable since it makes and executes laws and legislation and defines certain industry standards and has a distinct long term orientation. To me this perfect combination of public and private, global and local healthcare will provide optimum service for a country’s population.
September 30, 2018 @ 8:22 pm
Globalization of Healthcare
I would agree that healthcare has become a global business. The World Health Organization existence assists with researching and quantifying effective care (Who we are, 2018). However, they have no means of maintaining accountability as they have no authority. Therefore, quality of care seems to be a topic of conversation, but not of action.
Some organizations however have heard the call of ethical responsibility as global citizens. They have taken best practice suggestions, perfected them, and have now made a business out of selling their expertise. The Cleveland Clinic does well in this market. They still have a one physical location outside the U.S. in Dubai, but they also have added consulting locations in Peru, Saudi Arabia, and the United Arab Emirates (Locations and Representative: Global resources, 2018).
If these organizations are great at what they do, why not enter the health market themselves? The challenge is regulations and unfamiliar political waters. Capio of Sweden had ventured into Spain before being purchased by Apax 2006. Within a few years, the holdings in Spain were sold off by Apax because the government requires 30-year commitments. The company must build the hospital and receive reimbursement based on census versus encounters with patients. At the end of 30 years, the hospital ownership is transferred to government ownership (Capio AB, 2011).
The challenge at present being felt globally is the lack of available health care providers. Some health care investors are crossing global lines to assist with funneling talent to areas that require more bodies. Estimates identify that by 2030, there will be a 30% gap in primary care physicians in urban areas. Essentially not enough doctors for the number of patients (Who we are, 2018).
This poverty of people has also called for radical reforms in existing health care systems such as the National Health System (NHS) in the UK (Macnair-Smith, 2018). Health systems are beginning to see profit losses. This challenge restricts reinvestment into technologies and modern medicine. Therefore, companies across the world have Global Intake Centers within their hospital that cater to different languages and cultures and provide another source of revenue. The House Institute in Los Angeles has apartments set up inside the hospital for international families to stay. This is now a marketable. If you can’t enter markets because of regulations, then bring the patients to you. Perhaps one day we will see universal care, but until then private interests which account for approximately 20% of healthcare holdings, will continue to globalize the industry.
References
Capio AB. (2011). Retrieved from Apax: https://www.apax.com/investments/healthcare/our-investments/capio-ab/
Locations and Representative: Global resources. (2018). Retrieved from Cleveland Clinic: https://my.clevelandclinic.org/patients/international/locations
Macnair-Smith, M. (2018, August). As the NHS turns 70, its time to get serious about transformation. Retrieved from NHE: http://www.nationalhealthexecutive.com/Comment/as-the-nhs-turns-70-its-time-to-get-serious-about-transformation
Who we are. (2018). Retrieved from World Health Organization: http://www.who.int/about/who-we-are/en/
September 30, 2018 @ 8:31 pm
Globalization of Healthcare
I would agree that healthcare has become a global business. The World Health Organization existence assists with researching and quantifying effective care (Who we are, 2018). However, they have no means of maintaining accountability as they have no authority. Therefore, quality of care seems to be a topic of conversation, but not of action.
Some organizations however have heard the call of ethical responsibility as global citizens. They have taken best practice suggestions, perfected them, and have now made a business out of selling their expertise. The Cleveland Clinic does well in this market. They still have a one physical location outside the U.S. in Dubai, but they also have added consulting locations in Peru, Saudi Arabia, and the United Arab Emirates (Locations and Representative: Global resources, 2018).
If these organizations are great at what they do, why not enter the health market themselves? The challenge is regulations and unfamiliar political waters. Capio of Sweden had ventured into Spain before being purchased by Apax 2006. Within a few years, the holdings in Spain were sold off by Apax because the government requires 30-year commitments. The company must build the hospital and receive reimbursement based on census versus encounters with patients. At the end of 30 years, the hospital ownership is transferred to government ownership (Capio AB, 2011).
The challenge at present being felt globally is the lack of available health care providers. Some health care investors are crossing global lines to assist with funneling talent to areas that require more bodies. Estimates identify that by 2030, there will be a 30% gap in primary care physicians in urban areas. Essentially not enough doctors for the number of patients (Who we are, 2018).
This poverty of people has also called for radical reforms in existing health care systems such as the National Health System (NHS) in the UK (Macnair-Smith, 2018). Health systems are beginning to see profit losses. This challenge restricts reinvestment into technologies and modern medicine. Therefore, companies across the world have Global Intake Centers within their hospital that cater to different languages and cultures and provide another source of revenue. The House Institute in Los Angeles has apartments set up inside the hospital for international families to stay. This is now a marketable. If you can’t enter markets because of regulations, then bring the patients to you. Perhaps one day we will see universal care, but until then private interests which account for approximately 20% of healthcare holdings, will continue to globalize the industry.
References
Capio AB. (2011). Retrieved from Apax: https://www.apax.com/investments/healthcare/our-investments/capio-ab/
Locations and Representative: Global resources. (2018). Retrieved from Cleveland Clinic: https://my.clevelandclinic.org/patients/international/locations
Macnair-Smith, M. (2018, August). As the NHS turns 70, its time to get serious about transformation. Retrieved from NHE: http://www.nationalhealthexecutive.com/Comment/as-the-nhs-turns-70-its-time-to-get-serious-about-transformation
Who we are. (2018). Retrieved from World Health Organization: http://www.who.int/about/who-we-are/en/
January 8, 2022 @ 5:17 am
How bad the US needs universal health care has become more and more visible with COVID and how the hospitals are filling up quickly. As the hospitals are private there has to be private parties willing to open new hospitals to help us during this pandemic. However the cost and risk of opening a hospital is higher than the award right now as everything is uncertain. However, now with the new Omicron variant that is less likely to be deadly but is more contagious, the problem we face is hospitals beds available. In countries where the government has more control over the health care they are able to open new hospitals to deal with the high demand. The US are not making more space in their hospitals for COVID patients and the lock downs and restrictions on their people is going to last longer.