What India can teach Sweden about healthcare

As debate rages in Sweden about the role of private firms in the country's publicly-financed healthcare system, liberal commentator Nima Sanandaji suggests Swedes may find a solution inspired by an innovative heart surgeon from India.

What India can teach Sweden about healthcare

One of the hottest topics in Swedish politics these days is what role private firms can play in the delivery of publicly funded healthcare services. Are healthcare companies profiting at the expense of taxpayers and patients or improving services through innovation and choice? It is clear that the Swedish welfare debate has come to focus more on problems than solutions. Positive visions are hard to come by.

Perhaps we could take a cue from Devi Prasad Shetty, the Indian heart surgeon who is described as the Henry Ford of healthcare by the Wall Street Journal?

Devi, who performed India’s first operation hearth surgery on a baby and treated Mother Theresa after she had a heart attack, soon realized that many Indians couldn’t afford cardiac surgery. Rather than trying to haggle down the price, they would simply turn their backs and go home once they heard what an operation would cost.

Shetty’s solution was simple yet radical: make heart surgery affordable for the poor through higher efficiency.

In 2001, Devi Shetty founded Narayana Hrudayalaya, a specialist hospital outside of Bangalore where thousands of cardiac operations are performed annually. Next to it he founded a cancer hospital and a highly specialized eye hospital. Last year the magazine Fast Company listed Narayana Hrudayalaya as one of the most innovative companies in the world.

Thanks to a high level of specialization, the price tag for open heart surgery in the hospital has been pressed down to under $2,000. This is only a third or less of the cost in other parts of India. Although the cost is low, the quality is so high that patients from countries in the west also travel there to seek care. India’s National Innovation Council has noted that Shetty has successfully created a “health city”, where large specialist hospitals draw benefit of proximity to each other.

In Sweden, we seldom, if ever, turn our eyes to a country such as India to look for inspiration. After all, aren’t they supposed to learn from us? But precisely since resources are so scared in India, sometimes smart ideas can arise which escape us in the rich world. The innovation for which Devi Shetty is so highly praised is, interestingly, not really new. He has simply managed to implement the ideas of smart organization, economies of scale, and a high level of specialization to healthcare. These ideas have existed, and thrived, in modern economies for more than a century now. But they have been slow to spread to the field of healthcare.

That might soon change, however.

Currently Shetty is, with the help of western capital, working on expanding his healthcare concept to other parts of India, as well as to various countries in Asia and Africa. The goal is to create more health cities, increasing the number of sick beads from 5,000 to 30,000. Not only will more patients be able to take advantage of efficient and affordable healthcare, but economies of scale might be improved further.

Perhaps Sweden wouldn’t be bad off if Dr. Shetty decided to build one of his health cities here? After all, we desperately need positive visions on how health services can be improved. And it is only appropriate for India, which has historically played such an important part in the development of medicine, to continue to inspire us to change.

Nima Sanandaji is a Swedish writer of Kurdish origin. He has a PhD in polymer technology and has written numerous books and reports about subjects such as integration, entrepreneurship, and women’s career opportunities.

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How Sweden plans to digitalize healthcare

The Swedish government is investing in digitalization of its 1177 Healthcare Guide with the aim of improving accessibility.

How Sweden plans to digitalize healthcare
Today it's possible to find advice about health problems and treatment on the 1177 website. Photo: Claudio Bresciani / TT

The government on Thursday announced the decision to grant 33.5 million kronor to the Swedish Association of Local Authorities and Regions (SKL) to develop the 1177 Healthcare Guide (Vårdguiden), a website where people can find out information about different healthcare issues. 

“We hope that this will benefit all patients in the country,” Minister for Health and Social Affairs Lena Hallengren told reporters at a press conference.

She said that Swedish healthcare needed to become more accessible and that more digital options will be introduced to the 1177 Healthcare Guide, including for example the possibility to communicate via video calls.

Another aspect of the plan is the introduction of digital booking, and the possibility for patients to keep track of their referrals online.

Healthcare in Sweden is organized at a regional level and in some areas it is already possible to carry out an online doctor's visit, either via a chat function or a video call.

But the investment would be used to “weave together different functions”, the spokesperson for SKL's healthcare department said. 

It will remain possible to contact 1177 by phone as well, something which would be particularly important for groups which are less likely to turn to digital solutions, Hallengren said.

READ ALSO: What to do if you need a sick day in Sweden


healthcare – (en) sjukvård

accessible – tillgänglig

online doctor's visit – (ett) nätläkarbesök

patient – (en) patient

doctor – (en) läkare

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