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MARCH 11, 2007
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The centre is looking at removing the distinction between FDI and FII investments. This will impact sectors like asset reconstruction, real estate and aviation, where separate ceilings apply to FDI and FII investment. However, allowing FDI through the FII route in the realty sector could result in prices shooting through the roof. The Asian financial crisis of the '90s is still fresh in mind, and a method should be devised to moderate possible volatility in key sectors.

S&P And After
For the first time in 14 years, international credit rating agency, Standard and Poor's (S&P), has raised India's credit rating to investment grade. S&P is the last of the three major international rating agencies to do so. Moody's Investors Service did it in January 2004 and Fitch Ratings in August 2006. The upgrade is likely to spur the flow of foreign investment into power, steel and other industries, which receive less than a tenth of the funds going China's way.
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Business Today,  February 25, 2007

Come, Heal Thyself
Medical tourism could be a Rs 7,000-crore business by 2012, if private hospitals continue to invest in high-end beds.
Finger on the pulse: An Uzbek patient with Escorts' Dr Trehan
Convalescing after his open-heart surgery at Delhi's Escorts Heart Institute and Research Centre (EHIRC), B. S. Sayitkulov (62) from Tashkent (Uzbekistan) is as happy as happy can be. He tells his son, who can speak English, to tell this writer that he has been to Russia, North America and many countries of western Europe on business trips and knows a lot about heartcare facilities there. "But doctors, surgeons and nurses in India are the most professional in the world. I could not have received the treatment and care I got at Escorts in Moscow or London," says Sayitkulov, as he is wheeled from his second-floor room to the first-floor room of Dr Naresh Trehan, the founder and Executive Director of EHIRC, and India's poster-boy for cardiology. At the doctor's room, Sayitkulov adds to his gratitude by suggesting that Escorts should consider setting up an hospital in Uzbekistan. "Life-saving heartcare is just one of the many comparative advantages India has," says Dr Trehan. "Today, the entire SAARC region, Afghanistan and CIS countries look at India as a destination for cardiology, orthopaedics, cosmetic treatments, eyecare, dentistry and other specialties."

Various studies, starting with CII-McKinsey's in 2001, have put India's medical tourism (nowadays called medical value travel) potential between $1.48 billion (FICCI-E&Y projection) and $2 billion (CII-McKinsey) by 2012, accounting for 3-5 per cent of the total healthcare delivery market. "India received close to 2 lakh foreign patients in 2006 and IHCF (Indian Healthcare Federation, an industry association) members earned revenues of about $335 million," says Vishal Bali, CEO, Wockhardt Hospitals. "There is 30-35 per cent year-on-year growth in number of foreign patient arrivals. So, I think we can reach the $2 billion target in 2010," he says.

Dr Devi Prasad Shetty's Narayana Hrudayalaya has become a global destination for paediatric heart surgeries

Wockhardt, which has eight hospitals across India and many more in the pipeline, treated 2,000 foreign patients, 80 per cent of whom were from the us and the UK. Most of these patients were here for high-end procedures such as coronary angiography, angioplasty and stenting, brain surgery for abnormal blood vessels, corrective skull surgeries, and neuro-muscular disorders, among others.

Fortis Healthcare, which now controls EHIRC and other Escorts hospitals, logs an average of 400 foreign patients a month in its dozen facilities, a majority of them from the developing countries, but a growing number from the developed world, says Daljit Singh, President (Strategy and Organisational Development). Fortis plans to have 35-40 hospitals by 2010, with primary focus on the domestic market, but with the medical tourist in mind as well.

In Bangalore, Dr. Devi Prasad Shetty's Narayana Hriduyalaya has become a global destination for paediatric heart surgeries. "There are more than 30 IHCF members, including Apollo, Wockhardt, Fortis and Max, which we are vigorously promoting in international markets, particularly the us, the UK, and West Asia," notes Amitabh Kant, Joint Secretary, Ministry of Tourism. "We have made these entities adhere to uniform price banding and standards of medical healthcare so that we can promote Indian healthcare as a quality-benchmarked industry," says Kant, who is better known as the prime mover behind the Incredible India campaign.

Value Healthcare

In safe hands: Tanzanian patients at a Care hospital
So what's India's trump card versus the developed countries and rival healthcare destinations like Thailand and Singapore? "A cardiac procedure costs anywhere between $40,000 and $60,000 in the us, $30,000 in Singapore, $12,000-15,000 in Thailand and only $3,000-6,000 in India. The associated costs of surgery are also low," says the FICCI-E&Y study. The overall success rate of cardiac bypasses in India is said to be 98.7 per cent, compared to 97.5 per cent in the US, says the same study. "Indian healthcare is no longer about only the cost differential; it's about the value differential," says Bali. "Today we offer life-saving therapies to the world, from heart surgeries to minimally invasive neuro-surgeries.

In eyecare, for example, India has state-of-the-art facilities such as Sankara Nethralaya in Chennai, Aravind Eye Hospital in Madurai and LV Prasad Eye Institute in Hyderabad. "In ophthalmology, I can say with confidence that our facilities and therapies are as good as those of the developed world. Moreover, our pricing doesn't discriminate between Indian and foreign patients," says Dr Lingam Gopal, Chairman-elect of non-profit Sankara Nethralaya, whose 265-bed facilities in Chennai and Kolkata attracted about 5,000 foreign patients in the first half of 2006.

Bali says the presence of 61 million people with no health insurance in the us, overstretched National Health Service (NHS) in the UK and, more generally, a greying population in the West are "natural" opportunities for India, given the huge cost advantage that it has and the prestige that Indian clinicians enjoy in the Western countries. The government-IHCF team has a strategic focus on the developed world. The logic: if you can attract the Americans and the Britons, you can attract anyone in the world.

Dr Gopal's Sankara Nethralaya treated 5,000 foreign patients in the first half of 2006 at its Kolkata and Chennai centres

Trehan points out that Indian healthcare providers are already seeking tie-ups with health insurance companies in the developed world. "Very soon you will see insurers in