Corporate Health Plans

The Editor
The Economist
25 St. James' Street
London SW1A 1HG

Sir,

The report on Corporate Health Plans (Treatment of Choice) carried in the edition datelined Jan 19-25, 2002 is distressing.

I am a regular Indian visitor to the USA and can surmise what appears to be wrong with the funding of the existing US health plans. The US Health Scheme - as many other sectors of its economy are – is 'insurance driven'. The word "Insurance" conjures up to my mind visions of vested interests in the health care scene, doctors, surgeons, specialists, hospitals, care-centers, test labs, pharmaceutical and health-care products manufacturers, distributors and why, even patients! Each supports the other and derives excessive and mostly undeserved benefits. I have a few doctor friends here ,and back home in India, and am able to see how disproportionately high are the rewards here. And for all this to happen, the insurance companies lend their shoulders and in the process benefit themselves too.

I cannot also see that the medically-so-well-cared American is in any better state of health than the middle class in my own country, where corresponding costs are a tenth of these, or less. And the average Indian middle class man lives as well and as long as the "health-cared" American. Spending $440 billion a year on approximately 150 million people is unsustainable, to say the least. The distortion gets compounded when seen in the background of the bulk of this expenditure enriching the vested interests, identified above.

'Managed care' is a very good concept, but inherent in it is a destructive virus, in the form of continuing and unaffordable cost increases. Indian health-care systems have something to teach the USA. We have contained costs to reasonable limits, the consumers have adequate choices and insurance back-up is marginal. At the same time, for the very affluent, who want to be left alone, there are international level, state-of-the art medical care centers. The bottom line appears to be that a surfeit of structured social-security measures may become counter-productive!

The USA would be well advised to have a very close second look at the whole system, if only for the reason that the 'managed care' has become corrupt over its 15 years of existence, while far reaching developments have taken place in other parts of the world, from where lessons can be learnt.

K.V.Narayanmurti
Corporate lawyer from India now in the USA