“I can right away,” Arun said. “Not everyone in healthcare in India is thrilled with this sudden explosion of the private sector, creating these islands of excellence, like the Queen Victoria Hospital. It’s fostering a startlingly divergent two-tiered system. Right now more than eighty percent of healthcare spending is in this relatively small sector, starving the much larger public health system, particularly in arenas like communicable diseases in rural areas. I know a number of academic types who are passionately opposed to the Indian government’s subsidy of medical tourism, even if ultimately it is for India’s good in relation to foreign exchange. To understand, all you’d have to do is travel from this hospital to a public hospital. It is the equivalent of moving from medical nirvana to a medical underworld.”

“That’s fascinating,” Laurie said. “It never entered my mind to think of it as a zero-sum situation.”

“Nor I,” said Jack. “That means there are probably radical medical students who are against it as well.”

“Without doubt. It’s a complicated issue, just like every other issue in a country with a billion people.”

“But why would the hospital administration want to block any investigation?” Laurie asked.

“I can’t help you there. If I had to guess, it’s probably some misguided bureaucrat’s decision. That’s the usual explanation for irrational behavior in India.”

“And why just Americans? You get medical tourists from other countries, right?”

“Absolutely. In fact, it’s my belief most come from the rest of Asia, the Middle East, Europe, and South America. Still, it is the USA that has been specifically targeted of late. I believe the government’s department of medical tourism is specifically looking to the U.S. as a major source of growth to push it beyond thirty percent per year. We have the capacity. The existing private hospitals are currently underutilized.”

“What is your personal feeling about medical tourism?” Laurie asked.

“Personally, I’m against it, unless the profits went for public health. But that’s not the case and will never be the case. The profits are being skimmed off by the new megabusinessmen, of which we have more than our share. Plus, in my view the two-tiered system that’s being created is ethically untenable.”

“Yet you are utilizing the private hospitals,” Laurie pointed out.

“I am. I fully admit, but I’m also doing my part for the public hospitals, too. I split my time, working pro bono at the public hospital as an ob-gyn while supporting myself and my family with my private infertility patients. Since there are not too many of us, I’ve made it a point to join the staff of most private hospitals for my patients’ convenience, although I have offices only at two.”

“Are you on the staff at the Aesculapian Medical Center?”

“I am. Why do you ask?”