From Indian IT Tycoon, Health Care for the Poor

By combining tech knowhow with government funds, Andhra Pradesh state is creating the most far-reaching program in the world to deliver medical services to the masses

by Steve Hamm

Dr. Abhijeet Dashetwar, head of the cardiac department at government-run Gandhi Hospital in Secunderabad, India, stands in the middle of a cardiac care center under construction and points to where cutting-edge monitoring systems will be installed. A new government health-care insurance program for the poor administered by private carrier Star Health and Allied Insurance made it possible for the hospital to pay for the $600,000 upgrade. The old cardiac center, with just eight beds, shared operating rooms with other departments; the new one will have 15 beds and three operating rooms. "Finally we can afford the equipment we need," Dashetwar says.

The insurance is part of a multi-faceted initiative in the state of Andhra Pradesh called Aarogyasri (which means wellness or health in several Indian languages) that government leaders claim is the most far-reaching program in the world providing health care for the poor. In partnership with private industry and foundations, the government of this state of 80 million people is offering a new emergency communication system, ambulance services, a call center for advising people on their health care, and more than 100 vans that will go into remote villages to educate people and provide testing and inoculations.

The initiative is ambitious. About 10 million people qualify for the program that provides health insurance, and the mobile health program will reach about 40 million. The entire Andhra Pradesh population of 80 million is eligible to be served by the emergency response system. "We're in the lead not only in India, but in the whole world in delivering health care for the poor," declares P.K. Agarwal, the health secretary for Andhra Pradesh.

Executives Pitch In

The newest piece of the initiative, the mobile health vans, was officially launched on Aug. 22 in Hyderabad, the state capital, by Chief Minister Y.S.R. Reddy, and B. Ramalinga Raju, chairman of Satyam Computer Services, one of India's largest technology outsourcing firms. Two foundations that Raju set up are providing the management, staff, and facilities for all of the services except insurance.

For Raju, the announcement is an endorsement of his strategy (BusinessWeek.com, 12/7/06) of bringing the skills of India's vaunted tech industry to bear on the country's deep social problems. He has recruited executives from Indian corporations and multinationals to set up and oversee operations that in developed nations are normally handled by the government. Raju believes that by combining business knowhow with government funds—and making the funds go much further—it's possible to deliver quality health care for the masses. "I have no doubt that this will be a model for the rest of the world," he says.

Not everybody is a fan. Jayaprakash Narayan, president of the Lok Satta Party, a new reform political party in India, approves of the emergency medical and health information services but finds fault with the insurance program. Similar to Medicaid in the U.S., it provides free hospital treatment for people under the poverty line for major diseases such as cancer and heart disease. Narayan believes that the insurance program is wrongly conceived because, he says, it provides expensive surgery for a relatively small number of patients and fails to address the more routine and preventive health-care needs of the masses.

"What India needs is a robust public-private partnership with a focus on preventive, primary, and secondary care," he says. "The accent should be on low-cost, high-impact interventions." Narayan says the two services backed by Raju, the emergency response service and the health-care advice service, add a lot of value and are cost effective but are not a substitute for a broader-based health-care delivery system.