National Nurses United

18 J A N U A R Y / F E B R U A R Y 2 0 0 6 C A L I F O R N I A N U R S E It would be a stretch to put the growing crisis of healthcare coverage on the back of outsourcing, but given the projection that some 3.3 million relatively well-paying jobs will go foreign in the next 15 years—and that estimate may be conservative— it is certainly part of the problem. One of the central selling points of outsourcing is that it will lower health costs. "Saving money on administrative costs seems to me to be a bit around the corner," says Todd. "You could save all those costs by simply switching to a single-payer system, which is really the only way to go." CNA's Burger is deeply skeptical that "telemedicine" will re- duce costs or improve medicine. "Sometimes we go along with these new technologies and gizmos because they are supposed to save money," she says, "but nothing in medicine has gotten any cheaper. In fact, costs and profits are way up." Burger argues that offshoring and cybermedicine are about cut- ting human providers out of the process, and increasing profits, not lowering the cost of healthcare. "When you actually work with human beings," she warns, "you understand that you can't cut corners." Conn Hallinan is a foreign policy analyst for Foreign Policy in Focus and a lecturer in journalism at UC Santa Cruz. This article was reprinted from Revolution magazine. Feature Story W ipro and Apollo are worth a second look. Headquartered in Bangalore, India, Wipro began life as Western India Products Ltd., producing sunflower oil and laundry soap, then moved into computers in the early 1980s. Partnering with giant GE in the 1990s as a health information systems provider, Wipro is now itself a giant corporation, a diversified global IT provider traded on the New York Stock Exchange. Wipro Technologies spans IT work in telecom, retail, energy and utilities, manufacturing and avionics, offering services from broadband and wireless local area networks to multi- media and industrial automation. Apollo Hospital Group, India's largest for-profit hospital corporation and Asia's largest "integrated healthcare compa- ny," according to its website, moved into telemedicine with the government of Andhra Pradesh, marketing the service as a way to bring healthcare to the 80 percent of India's popula- tion who live in rural areas. A 2003 press release recalls how former President Bill Clinton marveled at the company's dedication to bring health care to people outside the big cities. But an Internet search, which turns up a full site for the Apollo Group, also offers a cyberview of Apollo Telemedicine, based in Falls Church, Va., and founded by a western man in 1993, rather than the Indian men associated with Apollo's telemedicine program begun in 1999. The Virginia-based Apollo Telemedicine's site also offers a look into its "solutions" for healthcare, including telepsychiatry, where a psychiatrist can interact live with a patient "remotely in real-time" using a robotic camera. pharmaceutical industry source told The Guardian that clinical trials can cost one-tenth of those in the west, and that Glaxo- SmithKline was also moving its research to India. It has opened a research facility in Singapore as well. Public Citizen's Wolfe says that there's "a quality issue as well as a jobs issue" involved. "The FDA has shown its inability to rigorously inspect the Chiron plant in Britain," says Wolfe. "The plant was inspected in 1999, and they found lots of problems. They went back in June 2003, still there were problems there and the FDA didn't get it together. Now we're at this place with flu vaccines [not being available] when the FDA knew there were problems in the plant. "That just goes to show that insuring quality in healthcare providers, with outsourcing in particular, is difficult. And as serv- ices, like diagnostic services, get outside this country, it's difficult to check, to maintain standards of quality care … not that quali- ty inside this country is up to par. "But you have to ask the question—why is Chiron, a U.S.-based company that will make up to 90 percent of the vaccine for our use located in another country? Can it be made cheaper there?" Over the past three years, 68 percent of the industries that have been losing jobs tend to provide health coverage to employees. By contrast, 55 percent of the job growth is in industries that do not provide healthcare, according to a recent Economic Policy Insti- tute study. All but five small states are experiencing this trend. OUT OF INDIA

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