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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
Globalization of Healthcare

Outline

  • Global Marketplace for Healthcare
  • Major Trends that Affect the Market
  • Way Forward

2

global marketplace for healthcare
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

how big is the global marketplace for healthcare imf
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

the devil is in the detail imf
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

binding constraints
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

economic zones
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

expanding beyond borders
Expanding Beyond Borders

Multi-nationals

  • Old World
    • Major US and European Companies
  • Brave New World
    • South Africa (Netcare)
    • India (Apollo)

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cross border demand
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

major trends that affect the market
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

so four years ago things looked rosy
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

slide29

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

this is not the first financial crisis
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

in healthcare what goes down always comes back up
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
the way forward
The Way Forward

Discussion

  • Strength in Numbers
    • Role of the World Bank Group
    • Role of the IHF
    • Role of Others

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