Last week, it was unfortunate to learn that Irrfan Khan, the Indian actor with a global appeal, was diagnosed with a neuroendocrine tumour. He informed his fans via a tweet before he went to the US for treatment.

The chief minister of Goa, Manohar Parrikkar, also left for medical treatment to the US, though it’s not very clear what afflicts him. UPA chairperson Sonia Gandhi has been to the US ample times for treatment, but it remains a matter of speculation as to what exactly is her ailment.

Yuvraj Singh, the cricketer who’s back playing for Team India after a heroic battle with a rare form of cancer – mediastinal seminoma – is a role model for many, but the fact remains that he was treated abroad.

The Indian elite, whether a politician, actor or sportsperson, feel almost obligated to get treatment in the west. The cost of treatment there is astronomical, sometimes three to four times of what it costs in India. There’s little transparency as to who pays for the treatment of politicians; in some cases it is the government that foots the bill.

It was understandable 20 years ago that those who can afford it go abroad but now it stands testimony to their lack of faith in the Indian medical system. After all, it’s a question of life and death.

A senior doctor at AIIMS who has treated prime ministers and presidents in the past doesn’t want to sit on moral judgment about these issues.

“I would never advise someone to travel abroad, for world class treatment is available in India at a much cheaper price,” he says. That’s true, for India is the second most sought after destination for medical tourism in the world, next only to Malaysia, which many American patients go to.

But rich Indians travel to America.

The government introduced the “Medical Visa” in June 2005, with initial validity of the visa being for a year or the period of treatment, whichever is less. It can be extended for a further period of one year by state governments/foreigners regional registration offices (FRROs)/foreigners registration offices (FROs) on production of medical certificate from reputable/recognised/specialised hospitals in India.

Medical tourism is one of the fast-growing segments of the economy and is already worth $6 billion. The number of arrivals in the country on medical visa was 66,254 in 2014, which grew to 1,22,121 in 2015 and 1,77,972 in 2016.

According to Patients Beyond Borders (PBB), the world’s most trusted medical tourism portal, “patients willing to undergo some of India’s cultural challenges will realise savings of up to 85 per cent on high-acuity procedures such as heart and joint work. Serving more than 300,000 international patients annually, the vast subcontinent welcomes international medical travellers in several large metro areas: Bangalore, Chennai, Hyderabad, Mumbai and New Delhi.”

India is particularly popular with Bangladesh, the Turkic states, the Middle East and East Africa. In a written reply in the Lok Sabha, Minister of State for external affairs VK Singh said restrictions on medical visa existed only for those people from Pakistan where a recommendation letter from the Adviser to the Prime Minister on foreign affairs is required for obtaining a visa.

India is the destination for cheap yet quality treatment. Alas! The Indian elite and celebrities are not so convinced. But they shouldn’t be surprised if, in the US, they get treated by an Indian doctor trained in India.

There are as many as 41,000 Indian specialists practising in the US alone – and more than one in five US surgeons is of Indian descent. As per FBB, “Unlike its Asian counterparts, which have traditionally encouraged medical travel by aggressively recruiting top-of-the-line physicians from other countries, India produces some of the world’s finest physicians and surgeons internally, with excellent in-country teaching hospitals and research centres.”

While India is among the cheapest destinations for medical treatment, our celebrities prefer the US and Europe. If medical procedures to pharmaceutical products and prescriptions as well as administration and staff are taken into consideration, the US is the most expensive country in the world followed by Switzerland, Norway, Netherlands, Sweden and Germany.

A retired bureaucrat who has helped many politicians go abroad for a cure – his daughter is an India-trained doctor and works in a super specialty hospital in the US – says: “America is a prime attraction for those who can afford it because the treatment is better. Period. But, yes, value for money for a treatment in the US is less. But who cares? Not if you have the money.”

He explains that for high-profile cases, confidentiality as to what afflicts the patient is crucial. Politicians in particular are more than willing to pay extra just to evade the media. Nothing gets leaked to tabloids or the paparazzi there. As for actors, it’s possible for them to have a facelift or an organ transplant without anyone knowing. For others, who can deny it, a treatment in the US, even if it’s a nose job, is a status symbol.

So all the best for your treatment!

This story was first published in the Patriot.