When he first proposed his model for micro-health insurance, people laughed in his face. Today, it’s being studied by the world’s top business schools. Dr Devi Shetty, chairperson of Narayana Hrudayalaya, Bangalore, talks to Neelesh Misra about his dream of inclusive healthcare...
As a doctor, what are your feelings about the existing system?
When you work in a government hospital as a young doctor, you have a perfect knowledge of what Indian healthcare is all about.
When was it that you worked at a government hospital?
Say, 28 years ago. But nothing has changed. Today, there are cures and medicines... but a solution is not a solution if it is not affordable.
You also worked in the UK as a young man. What was that like?
When you work with the UK’s National Health Services, you see a totally different side of healthcare. In the UK, whether you’re a millionaire or a millionaire’s driver, you share the same floor, same ward, same OT.
Is that where you got the idea for the Narayana Hrudayalaya model?
I left England in 1989 [and] started in Calcutta. [There], if I saw 100 patients a day, 99 of them couldn’t afford heart surgery. I realised that to really solve the problem, we had to look at how to reduce the cost and make it affordable.
So how does your model work?
Traditionally, when a hospital is built, they plan three or four operating rooms. Here, we have 24 operating rooms. Every floor has an operating room. Every floor has an ICU. 100-bed or 200-bed hospitals are not available to the common man because the scale is small. They are like Rolex watches. Instead, if you buy 30 acres of land and build a 5,000-bed hospital, then your cost is borne by that many more beds.
How many beds do you have?
Right now, there are 3,000 beds. We aim to soon have 15,000 outpatients everyday. With that many people coming in, you can have a difference in charges. Say at 2 am, you can charge 500 rupees for a CT scan or MRI, instead of Rs 5,000. So, for patients who don’t have the money, we tell them: “Ok, come at 2 am”.
So is the aim universal healthcare?
Essentially... what we are really trying to do is make India the first country in the world to dissociate healthcare from bank balance. My aim is to have, in my lifetime, a situation where millions of people may still be living in slums with no running water and no toilets, but when they are unwell, they can access state-of-the-art healthcare with dignity.
And such a scheme is working in Karnataka?
It is. We started Yeshaswini (meaning Victor) five years ago. We now cover 30 lakh farmers in the state.
And they have access to…?
They have access to 300 hospitals across the state. Taking from this model, the Andhra government launched an insurance scheme called Arogyasri and today the chief minister proudly says he won by a thumping majority because of it. Eighty per cent of the state’s population is covered.
Is it hard getting support for such a scheme?
When I first began talking about Yeshaswini, people laughed at me. ‘You can’t get a packet of bidis for five rupees,’ they said, ‘and you want to do heart surgery?’
What is the role of the government?
Essentially, the government will not continue as a healthcare provider. It will become a health-insurance provider. And that is the best thing that could happen.
You really see this happening, government as insurance provider?
It has happened in Karnataka, Andhra, Tamil Nadu. It’s all set to happen in West Bengal. Today, the best gift a politician can give his votebank is a school. In a few years, that ultimate dream gift will be a micro-insurance policy.
The feedback column ‘Your Voice’ has not been published today due to space constraints. It will be back on Wednesday.