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Globalization of Healthcare From Crisis to Opportunity

Globalization of Healthcare From Crisis to Opportunity. Chicago June 1, 2010. Globalization of Healthcare. Outline. Global Marketplace for Healthcare Major Trends that Affect the Market Way Forward. 2. Global Marketplace for Healthcare. Outline. From Local to Global

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Globalization of Healthcare From Crisis to Opportunity

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  1. Globalization of HealthcareFrom Crisis to Opportunity Chicago June 1, 2010

  2. Globalization of Healthcare Outline • Global Marketplace for Healthcare • Major Trends that Affect the Market • Way Forward 2

  3. Global Marketplace for Healthcare Outline • From Local to Global • Size of Global Market • Sub-markets • Economic Zones • Aggressive Posturing by Emerging Markets • Cross-border Demand • Firms Strike Back (Porter’s Five Forces) 3

  4. How Big is the Global Marketplace for Healthcare (IMF) Rounding Up • Global GDP US$55 trillion • Global Health Spending US$5.5 trillion • Spending on Health in all Low Income US$550 billion • Spending on Health in Africa US$25 - 30 billion 4

  5. The Devil is in the Detail (IMF) Rounding Up US GDP US$16 trillion Global Health Spending US$5.5 trillion Financial Bailout US$3.0 trillion US Health Spending US$2.7 trillion New Health plan US$800 billion US derivatives markets US$666 trillion 5

  6. Binding Constraints • Overall level of GDP • Share of GDP channeled through the public sector • Share of public sector resources allocated to health care • Share of health expenditure in public sector used to pay for health workers and health education • Share of GDP channeled directly through households • Household spending of health care • Share of private expenditure on health care devoted to health workers and health education Fiscal Space 6

  7. Sub Markets

  8. The Case for Investing Across Subsectors

  9. The Case for Investing Health Services Subsector

  10. Economic Zones HiA Facility US$1 Billion Total • 500 million loans • 300 million equity • 200 million for TA Other Zones • EU • Eastern Europe • North America • South America • Middle East • South Asia • East Asia 10

  11. Expanding Beyond Borders Multi-nationals • Old World • Major US and European Companies • Brave New World • South Africa (Netcare) • India (Apollo) 11

  12. Cross Border Demand What/Where • Medical Tourism • US (Mao Clinic, Leahy Clinic, Cleveland Cl) • Thailand (Bumrungrad) • Jordan (King Hussein) • Beyond Tourism • Hong Kong • Singapore 12

  13. How Firms React to Competitive Threats Michael Porter’s Five Forces

  14. Major Trends that Affect The Market Outline • Opportunities • Expansion in Health Insurance • Global Financing Mechanisms • Epidemiological shits • Threats • Financial Crisis • Technological Arms Race • Human Resources Crisis 14

  15. Scaling up From 40 Million to 4 Billion: Who is Doing it?

  16. 100 Years of Reform in the US – New York Times

  17. It is Popular Everywhere

  18. The New and the Old Players in Health Financing

  19. So Four Years Ago Things Looked Rosy 7 years of 5% ave. growth … … with reducing inflation … Annual GDP Growth (%), Sub-Saharan Africa, 2000-06 Annual CPI (%), Sub-Saharan Africa, 2000-06

  20. The Sky Was the Limit

  21. Then Suddenly Everything Changed 22

  22. The World Economy went into a Tail Spin 23

  23. Normal Market Response

  24. But This Time that Didn’t Work

  25. Consumer Confidence Rapidly Collapsed 26

  26. New and Realistic Approaches were Needed in Health Care 27

  27. As in the Past Donor Funding is Already Affected 28

  28. Need for Renewed Political Commitment to Public Spending • Ghana • Chad • Cote d'Ivoire • Kenya • Namibia • Swaziland • Senegal • Comoros • Mauritania • Mozambique • Sudan • Cameroon • Congo, Rep. • Equatorial Guinea • Nigeria • Gambia, The • Togo • Gabon • Sierra Leone • Burundi • Eritrea • Guinea • Central Afr. Rep. • Zambia 25. Lesotho 26. Zimbabwe 27. Seychelles 28. Ethiopia 29. Madagascar 30. Benin 31. Angola 32. Guinea-Bissau 33. Tanzania 34. South Africa 35. Mauritius 36. Mali 37. Uganda 38. Cape Verde 39. Sao Tome & Pri 40. Congo, DR 41. Burkina Faso 42. Botswana 43. Malawi 44. Liberia 45. Rwanda

  29. Instead Ministers of Finance Recently Rescinded

  30. Need to Capture the Very Valuable Private sector Resources

  31. This is Not the First Financial Crisis • Great Depression 1930s • Oil Crisis of the 1970s • Inflation 1980s • East European Crisis (1990-1997) • East Asian Crisis (1997-1998) • Argentinean Crisis (2001) • Russian Crisis (1997-1998) • Peruvian Crisis (1988-92) • Mexican Crises (1980s and 1990s) 32

  32. In Healthcare What Goes Down always Comes Back Up World Bank Lending • From US$ 20 billion • To US$100 billion US Health Spending • Up 100 Billion /year

  33. Medical Technology Arms Race Hi Tech 34

  34. Human Resources Crisis Outline 35

  35. The Way Forward Discussion • Strength in Numbers • Role of the World Bank Group • Role of the IHF • Role of Others 36

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