Union Disrupts Plan to Send Ailing US Workers to Bharat

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Union Disrupts Plan to Send Ailing Workers to India

 

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[ Union Disrupts Plan to Send Ailing Workers

to India

[ Mon, 16 Oct 2006

 

Union Disrupts Plan to Send Ailing

Workers to India for Cheaper Medical Care

 

By Saritha Rai

The New York Times

October 11, 2006

 

BANGALORE, India, Oct. 10 -- A few weeks ago, Carl

Garrett, a 60-year-old North Carolina resident, was

packing his bags to fly to New Delhi and check into

the plush Indraprastha Apollo Hospital to have his

gall bladder removed and the painful muscles in his

left shoulder repaired. Mr. Garrett was to be a test

case, the first company-sponsored worker in the United

States to receive medical treatment in low-cost India.

 

But instead of making the 20-hour flight, Mr. Garrett

was grounded by a stormy debate between his employer,

which saw the benefits of using the less expensive

hospitals in India, and his union, which raised

questions about the quality of overseas health care

and the issue of medical liability should anything go

wrong.

 

" I was looking forward to the adventure of being

treated in India, " Mr. Garrett said the other day.

" But my company dropped the ball. "

 

The union, the United Steelworkers, stepped in after

it heard about Mr. Garrett's plans, saying it deplored

a " shocking new approach " of sending workers to

low-cost countries as a way to cut health care costs.

Its officials insisted that Mr. Garrett be offered a

health care option within the United States.

 

" No U.S. citizen should be exposed to the risks

involved in traveling internationally for health care

services, " Leo W. Gerard, the president of the union,

said in a recent letter to the Senate and House

committees that oversee health care. He expressed his

concern about the willingness of employers to offer

incentives to employees to go overseas.

 

Mr. Garrett, who works for Blue Ridge Paper Products

in Canton, N.C., had volunteered to get his treatments

in India in return for a share in the company's

savings. Blue Ridge now says it will find Mr. Garrett

a treatment alternative in the United States and will

offer the overseas option only to its salaried

employees.

 

IndUShealth, a company based in North Carolina that

arranges health care in India for Americans, would

have made Mr. Garrett's medical arrangements. The

company acknowledged that its plan to send Blue Ridge

workers to India was " on hold " but said it was

exploring deals with other employers.

 

The union's resistance has brought to the fore a

critical question in the path of the globalization of

the health care industry -- who is liable if something

goes wrong in an overseas hospital? And underlying all

this is the even more explosive issue of potential job

losses in the American health care industry, in an

economy already sensitive to the large-scale shift of

jobs to cheaper overseas locations.

 

Even as the debate continues about insurers' role in

health care outsourcing, hundreds of uninsured and

under-insured Americans have already gone on their own

to India for treatments.

 

With medical costs in India routinely 80 percent lower

than in the United States, experts predict that

globally standardized health care delivered in

countries like India and Thailand will eventually

change the face of the health care business.

 

Providing health care to foreigners could generate $20

billion for India by 2012, according to a study by

McKinsey & Company, the consulting firm, although

McKinsey did not say how many patients that figure

represents. With 150,000 overseas patients last year

--though only a small fraction of them Americans --

India is already the global leader in importing

foreign patients for low-cost treatment. Its best

hospitals have Western-trained doctors and are

equipped with modern equipment.

 

Still, cross-border medical liability in countries

like India could prove to be a major hurdle, the

experts say. In the case of Mr. Garrett, Blue Ridge

Paper asked him to sign a release saying that he was

" on his own as far as medical liability, " said Bonnie

Blackley, the benefits director at Blue Ridge.

 

Tom Keesling, president of IndUShealth, said " the

Indian physician and hospital would be directly

responsible for any malpractice. "

 

Zubin Daruwalla, health care analyst at the consulting

firm Frost & Sullivan, said there was no uniform code

in India on what could be considered medical

negligence and what compensation ought to be paid.

" Compared with the huge payouts in the United States,

Indian courts award small amounts, " Mr. Daruwalla

said.

 

So, as Mr. Daruwalla noted, in addition to traveling

back and forth to India to fight a legal battle, an

American patient might have to be content with a few

thousand dollars of compensation in case of a problem.

 

Employers have been trying to get their workers'

health care costs under control, and the pressure to

outsource health care is inevitable, said Aaditya

Mattoo, an economist with the World Bank in Washington

who specializes in global services trade.

 

But United Steelworkers, the largest industrial union

in North America with over 850,000 members, said it

would fight any effort by American companies to send

employees abroad for treatments. " We are confident

that we are in a position to block any employees being

exported to India, Thailand or Mexico, " said Stan

Johnson, a spokesman. " The ailing American health care

system cannot be cured by sending patients abroad. "

 

But Harpal Singh, chairman of Fortis Healthcare, a

large New Delhi-based chain of hospitals, said

American corporations would not be able to resist for

long the lure of overseas hospitals offering

first-world health care delivered at third-world

costs.

 

McKinsey has forecast that by 2008, top companies in

the United States firms would spend as much on health

care on average as they made in profits. As insurance

costs become unaffordable, companies are scaling back

or dropping health benefits.

 

" The health care opportunity has the potential to

outshine outsourcing and deliver big advantages for

both Indian and U.S. businesses, " said Mr. Singh, who

is also co-chairman of the Working Group on

Healthcare, which was set up by two influential trade

groups, the United States-India Business Council and

Confederation of Indian Industry.

 

Fortis, Mr. Singh's company, runs a dozen hospitals in

and around New Delhi, including a modern 250-bed

cardiac hospital in neighboring Mohali where uninsured

American patients represent a fifth of all patients.

The chain plans to add 35 hospitals in the next five

years. Many of these, and those run by rival hospital

chains like Wockhardt and Apollo, will be built to the

specifications of international hospital certification

agencies.

 

To be sure, swarms of employer-sponsored patients are

unlikely to descend on Delhi or Mumbai any time soon.

Crowded airports, traffic-clogged streets, distressing

poverty and a reputation for grime can put off even

the average Western tourist, let alone a patient

arriving for treatment.

 

Mr. Johnson of United Steelworkers said Mr. Garrett

had been saved from the hazards of international

travel and being treated in an alien culture, in

addition to the malpractice risk. " Cost may be a

downside but there are many upsides to his not going

to India, " he said.

 

If there was an upside to staying home, Mr. Garrett

said he could not see it. He was all set to go to

India with his fiancee and then return in good health

to marry her later this year. Instead, his treatment

has been delayed and he is now left to pay high

incidental expenses and a higher co-pay for his

treatment in the United States. " I've been left out in

the cold, " Mr. Garrett said.

 

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