Sunday, April 18, 2010

Obamacare - good for some!

I note that one country at least is looking forward to a bonanza from Obamacare.

U.S. healthcare reform gave 32 million new Americans insurance, the new U.S. president a feather for his cap and a good seven years' boon to the workload of India's $61 billion outsourcing industry.

India's Economic Times declared it the industry's "biggest bonanza yet" and "far bigger than the Y2K." While it's too early to know the extent of the boon, India's outsourcers — the call centers, the medical record transcribers, the software developers — are quietly gearing up for the increase in administrative work and technology development the health care legislation promises.

. . .

It's the classic outsourcing debate but with a newer, larger scale: Does the $940-billion bill, coming as unemployment persists at just under 10 percent, mean sending another round of jobs abroad?

Anything that is electronic in health care can be offshored — sent outside U.S. borders — and no state or federal regulations prohibit personal medical data from leaving the U.S. (Some insurers, however, choose to keep personal health data within U.S. borders.)

India's outsourcers get new health care work in two ways, by the initiative to computerize personal medical records included in last year's stimulus bill and by run-of-the-mill maintenance of health records both for the newly insured by the reform and the millions of others who already are but whose insurers will need to cut administrative costs.

That's where Firstsource Solutions, a Mumbai-based IT firm, sees an opening. Managing the new enrollments and claims, expanding member databases and revenue cycles that come with these 32 million "is very significant" for their business, its CEO Ananda Mukerji wrote in an email, adding that Firstsource has been watching the U.S. health care space since 2006.

Up to 41 percent of the money spent on a health plan in the U.S. goes toward administrative costs, according to a recent Deloitte Center for Health Solutions study. Insurance companies will face mandates to spend as much as 90 cents of every dollar on the actual well-being of a client, Mukerji adds, which will "drive increased need for administrative efficiencies, and thus increased demand for outsourcing."

Similarly, the initiative to digitize medical records could be a multibillion-dollar boost to India's high-skilled software developers. "You don't have enough people in the U.S. to put together these solutions and even if you did, it would be too expensive," said Sudhakar Ram, CEO of Mumbai-based IT solutions firm Mastek. He estimates that digitizing medical records will cost between $10 million to $20 million per U.S. hospital, based on his firm's similar work in the U.K. "That's a huge amount of investment. ... I would say it's a significant opportunity for Indian [firms] over a five- to seven-year time frame."

. . .

In the U.K., TV reporters highlighted the risk of sending health data abroad when they went undercover and were able to buy personal health records from a London hospital that had its health records processed in India.

There's more at the link.

I wonder how long it'll take before the first US patient records are illegally copied and offered for sale over the Internet? I imagine there'll be plenty of unscrupulous takers for such information. You want insurance? Your insurance company may not be able to access your private information here, but I'll bet diamonds to dirt they'll be able to buy any information they need from a third party outside the country . . . and end up either denying you cover, or charging you a lot more than you might have expected. There may be fertile new opportunities for blackmailing individuals with their sensitive health care information, too.

Unintended consequences strike again, it seems.



Dev-il said...

I wonder how long it'll take before the first US patient records are illegally copied and offered for sale over the Internet?....

Ever wondered how come data within US borders cannot be stolen or illegally copied. Data on the wire has no boundaries. I do not agree that this is related to outsourcing.

Jenny said...

Forget the administrative services, if it sticks around long enough I see the "medical tourism" market in India and SE Asia just BOOMING as we cycle down.

... Which really, passing the torch from one Brit colony made good to another wouldn't be that bad for the globe. Not my first choice, but it could be hella worse.