Putting A Price On Human Life-Dr. Devi Shetty

How much is a human life worth? It’s a question very few of us have had to answer.

Dr. Devi Shetty, an India-based cardiac surgeon and humanitarian, offers world-leading heart surgeries at a fraction of what it costs in America. Can the U.S. health care system learn a thing or two from Dr. Shetty? 

But for Dr. Devi Shetty, a cardiovascular surgeon and founder of 14 heart hospitals in India, this question is part of his daily job.

I recently had the privilege of spending three days with Dr. Shetty and accompanying him to the Stanford Graduate School of Business where he gave an inspiring talk called “Putting a Price on Human Life.”

Attendees listened to one of the world’s most brilliant strategic thinkers describe his approach to making the world a better place.

It all starts inside his 14 hospitals, where physicians are so skilled and efficient, they can perform complex life-saving heart surgeries at $1,800 a case. And they can do so with results equal to the best hospitals in the United States. But he isn’t satisfied. He is driven to lower the cost of heart surgery to $800 a case by 2020. Why? For him, it’s never about earning more money. It’s about raising the value of human life.

Perhaps we in the U.S. could learn something from Dr. Shetty’s vision and experience.

Dr. Shetty’s vision for raising the value of human life

Dr. Shetty explains that every day there is a long line of people seeking services at his hospitals. Many of these individuals have traveled days by train in the hope that their child can obtain a life-saving heart surgery. Because few in India have insurance, families typically pay for the care by borrowing money or selling assets.

When parents in India can’t afford to pay for these life-saving treatments, they take their children home to die.

That’s why Dr. Shetty and his colleagues provide surgery at no cost to as many patients as possible. But the magnitude of the demand makes it impossible to meet the needs of all. He candidly laments that “charity is not scalable.” To pay his staff and run his hospitals, he has no choice but to charge a fee.

Given the size of the challenge he faces, one might expect to hear him talk about the necessity for “rationing.” Rationing occurs when health care providers intentionally choose not to provide care to everyone who needs it. It’s one solution to limited health care funding.

But in the three days I spent with him, Dr. Shetty never uttered the word. Rather than figuring out who should be denied, he focuses on how he can help more patients. Rationing doesn’t align with his vision. Instead, he focuses on how his team can cut the cost of surgery in half so they double the number of lives saved. When surgery costs $1800, people will die unnecessarily. But at $800, many more will live.

Dr. Shetty reminds his doctors and nurses that when someone dies who could have been saved, society is telling them their life has insignificant value. Therefore, the math is straightforward: When Dr. Shetty cuts costs in half, he doubles the value of a human life.

From vision to reality

In addition to being a visionary and a humanitarian, Dr. Shetty is also a skilled operational leader.

He continually looks for ways to reduce the cost of purchasing supplies and devices for his hospitals. For example, he contracted with young entrepreneurs to begin a company that uses the sewing skills of local people to create disposable surgical gowns and drapes at half the price of traditional suppliers. Lowering his cost structure enables him to charge less for surgeries.

He has implemented one of the world’s most sophisticated information technology systems. By noon each day, all managers in his hospitals know the profit/loss from the day before. This allows them to immediately correct waste and inefficiency. It also helps them figure out how many free surgeries they can offer the following day.

He has established practices that better promote patient recovery. For example, every patient undergoing heart surgery must bring either a family member or friend to provide some of the nursing duties during the post-operative period. His motivation is not to avoid nursing costs but to ensure the caregiver is able to provide assistance after discharge. Dr. Shetty knows that his patients often live long distances from his hospitals. This added expertise of a caregiver helps patients avoid post-hospital complications or readmission.

And in light of all this progress in his hospitals, Dr. Shetty’s vision doesn’t end within his hospital walls.

He developed an insurance program for more than 1 million poor farmers. With it, they pay less than a dollar a month to obtain coverage for whatever surgical procedure they may need. The program affords access to a variety of procedures for patients who would otherwise be denied surgery. Among them: the placement of complex heart devices.

His team has even performed pediatric liver transplants by combining the expertise of his talented local surgeons with pediatric experts in the U.S. via video-supported anesthesiology consultation.

Dr. Shetty also invests in India’s next generation by hiring impoverished women for most of the jobs in his hospitals. He explains that men will spend half of their salary on themselves while women will use more than 90 percent of their income to support and educate their children – a step towards improving the nation’s future.

According to Dr. Shetty, a society can overcome many of its economic challenges through health care, since the industry offers opportunities for all. For example, jobs cleaning the hospital helps uneducated people support themselves while they learn to read and write. At the same time, educated professionals gain additional skills and training so they too can advance themselves.

Through his work, Dr. Shetty is shaping the future of health care in India and creating a model for the developing world.

In his “spare time,” he is opening a heart hospital in the Cayman Islands – a short trip from the Florida coast.

Bringing Dr. Shetty’s vision home

It would be easy to dismiss Dr. Shetty’s work as reflecting only lower-wage scales. It would be easy to assume his vision and experiences aren’t applicable here in the United States.

But his approach to the provision of health care is, in fact, more efficient and more effective. As we learn from him, we too can raise the value of human life. By making health care more affordable, our nation can use the dollars saved to improve our country in other ways – from updating our schools to repairing our infrastructure. But it won’t happen until doctors and hospitals make the changes necessary to provide medical care in ways which are not only high quality, but also more affordable.

We have many opportunities to do so.

For instance, how effectively and efficiently we treat patients often varies greatly by U.S. geography. And according to the Dartmouth Atlas researchers, higher costs are not necessarily associated with better outcomes. One example is hip replacement surgery in the U.S., as described in a recent Forbes article. Others include spine surgery and the treatment of cancer.

In the United States, we pay more for most medical supplies and drugs than other countries. And the cost of regulation, combined with our legal system, produces high administrative expenses and a tendency for doctors to practice defensive medicine.

As long as we in the United States believe someone else will pay the cost of our health care, we are likely to ignore the opportunities to lower expenses and eliminate inefficiencies. But ultimately, if the cost of health care continues to rise at the same rate it has for the past 30 years, we too could find ourselves having to calculate the price of a human life.

We can learn much from Dr. Shetty’s vision and operational approaches. His strategic mind recognizes that what we do today shapes the future. Whether he is investing in educational systems, information technology, process improvement or people, Dr. Shetty understands the positive result his actions can have – not only on the health of his current patients but also on the lives of India’s next generation.

Dr. Shetty’s success confirms that outstanding quality outcomes can be achieved in conjunction with lower costs. He has shown that improved performance does not happen by chance or without a little discomfort. Today, everyone in U.S. health care points the finger at someone else: doctors, hospitals, insurance companies, government, the legal system, pharmaceutical companies and patients. But all are part of the problem. And all need to contribute to the solution.

Hopefully, in the near future, we will collaborate and cooperate for the greater good. If not, we may find patients deciding to go to the Cayman Islands for more than a vacation. Collected  from Forbes.com