Listen To Your Hearts…

For once I am borrowing, without the affiliated guilt.
The opening lines, below is the first cache, which I have borrowed from Roxette, a rock group popular in the late ’80s.

“Listen to your heart
When he’s calling for you
Listen to your heart
There’s nothing else you can do…“

Then comes the 2nd, a lift from today’s Mint, Delhi edition, page #6. An article by Srivatsa Krishna, titled NARAYANA HRUDAYALAY’S SILENT REVOULUTION.

Since the first heart surgery was done about 100 years ago, we can assume that modern healthcare started 100 years earlier. Any product or service, which started 100 years earlier, always reached the common man 100 years thereafter. But healthcare has defied this logic.
As people become wealthier, the cost of healthcare also started becoming more expensive and it is a mirage they could never touch. Well before the recession in the US, it had more people outside the ambit of health insurance compared with say just 10 years ago. The US now has at least 40 million people who have no health insurance or health coverage at all and perhaps at least 100 million people who are poorly covered by health insurance, which will give them healthcare only for catastrophic illnesses.

Ironically, this is also the best period for healthcare delivery on the globe compared with just 20 years ago. Today, we have treatment for every disease, and even if you can’t treat them, you can give them a meaningful life. Unfortunately, it is pointless celebrating our success in coming up with magic pills, fastest scanners and keyhole surgeries if the common man cannot afford all these life-saving measures. “If a solution is not affordable, it is not a solution.”

Less than 8% of the world’s population can afford a heart operation, and 92% people living on this planet, if they ever require heart operation, are going to die. Globally, around 650,000 heart surgeries are done annually. Out of this, 450,000 heart surgeries are done only in the US, the rest of the world does approximately 200,000 heart surgeries. India requires 2.5 million heart surgeries a year and conducts less than 80,000. Indians are genetically three times more vulnerable to heart attacks than Europeans and Americans. We produce 28 million babies a year in India and one out of 140 children born anywhere in the world has heart disease, which requires operations. We produce about 500 to 800 children a day with heart disease and a small percentage of them from privileged backgrounds get the operation done and the rest of them perish gradually over a period of time. Against this backdrop, Narayana Hrudayalaya (NH), headed by the charismatic Devi Shetty, has recently set a record for becoming the single largest cardiac surgery facility in the world, bypassing competitors in Brazil and the US, by performing 32 surgeries in one day.

At the flagship, 1,000-bed NH, surgeons operate at a capacity virtually unheard of in the US, where the average hospital has 160 beds, according to the American Hospital Association.
NH’s 42 cardiac surgeons performed 3,174 cardiac bypass surgeries in 2008, more than double the 1,367 the Cleveland Clinic, a US leader, did in the same year. NH charges $2,000 (Rs93,600), on average, for an open-heart surgery, compared with hospitals in the US that charge between $20,000 and $100,000, depending on the complexity of the surgery. Devi Shetty is not just giving a new life to his patients, but is actually reinventing healthcare as a business itself. NH is attracting patients from 56 countries, and apart from cardiac care, there is a 1,500-bed cancer hospital, which has just been commissioned, a stand-alone eye hospital, which has the infrastructure to perform 500 cataract surgeries every day and an orthopaedic and trauma centre, which can deal with any type of accident.

His dynamic, entrepreneur son Viren Shetty is the force responsible for the group’s expansion across India, and is on the verge of opening four new health cities with Ahmedabad, Jaipur and Chennai immediately on the anvil. NH is playing the volumes game in the cardiac care industry to reduce costs and today accounts for 12% of India’s heart surgeries. Viren Shetty plans to increase the total number of beds to about 30,000-40,000 from the current 3,000 under management. His unusual business sense has led to two compelling factors happening that make this story astonishing: NH’s mortality rate of 1.4% and profitability of about 8% post tax, prove that affordable, quality healthcare can be profitable, too. He has also conceptualized “Yeshaswini“, an innovative low-cost health insurance scheme where the poor pay just Rs150 per year and get total free care including for cardiac surgery. (The government subsidizes this by driving volumes through cooperative societies having to take mandatory membership for all their members and NH gets reimbursed about Rs60,000 per cardiac surgery.) Recession has hit the whole planet and we desperately need an industry, which can create millions of jobs so that there will be equitable inclusive growth. The global healthcare and wellness industry is worth $4.5 trillion, second only to the agro industry. To give you some idea about the potential of the healthcare industry, the UK’s National Health Service (NHS) is the third largest employer on this planet after the Chinese Army and Indian Railways. Just looking after the population of the UK, NHS created the third largest workforce. Imagine a situation in India, where healthcare is affordable to everyone and imagine the number of jobs it can create. In our country, the information technology (IT) industry gets a lot of privileges, but for a quarter of a million dollar turnover in the IT industry we need to create just five to seven jobs, whereas the same quantum of revenue in the healthcare industry requires 250 people.

Devi Shetty is a national treasure and, along with his son Viren Shetty, needs to be celebrated for creating NH, which will sooner rather than later emerge as India’s answer to Mayo Clinic and will hopefully be a global chain in quality, affordable healthcare.

Srivatsa Krishna is a Harvard MBA and an Indian Administrative Service officer. He writes weekly on business, government, infrastructure and entrepreneurship. The views expressed here are his own. Respond to this column at offtherecord@livemint.com To read all of Srivatsa Krishna’s earlier columns, go to www.livemint.com/offtherecord

My gratefulness to Dr. Shetty & his worthy son is…. heartfelt.

To build on your “Yeshaswini” doc…Yes, it Has all the makings of a Winner indeed!

I would like to end with another stanza, again borrowed, from Roxette:

“Sometimes you wonder if this fight is worthwhile
The precious moments are all lost in the tide, yeah,
They’re swept away and nothing is what it seems
The feeling of belonging, to your dreams….

Listen to your heart…“