00:00Simon, quite simply, has TPG lived up to its promise to expand health care in developing countries?
00:09Well, as you said, a number of years ago, TPG started a fund, the Rise Fund.
00:15It poured several billion dollars into that.
00:17It attracted other investors into the fund from the likes of Bono, the Gates Foundation, the World Bank.
00:25And, yeah, the idea was really to sort of expand health care, high-quality health care for countries that needed it the most.
00:32And what we've found out is that in many cases, despite investing money in the hospital, they did prioritize profits over patient care.
00:41For example, doctors were given very stringent revenue targets in some hospitals.
00:47And, you know, that's according to documents we've gathered, to staffers, both current and former.
00:56And not only that, in many cases, doctors were encouraged to, you know, refer patients, in some cases unnecessarily, to various departments for tests in order to hike bills.
01:08So there's a lot of allegations around overpricing that have been carried out inside some of these hospitals.
01:16And, you know, this sometimes falls on the weakest.
01:19You know, we had one case of a lady who came in from a very poor neighborhood who, according to her bill and family and carers, was overpriced and ended up with an astronomical bill that ended up in quite a terrible sort of back and forth with hospital management to try and get that price down again.
01:37And so I think these promises have been questioned.
01:43Yeah.
01:44I mean, I guess this raises a question, a broader question, about whether for-profit hospitals find it easy to help those that are most in need.
01:54Is there somewhat of a conflict between the need to make money, to, you know, serve your fiduciary stakeholders, but at the same time serve the original purpose of why you're launching the business in the first place?
02:10Yeah, indeed.
02:10I mean, I think if you come in with expectations of making wild profits, especially in countries, you know, where people's earnings are a bit lower, it's a very tough thing to do because your market clearly is very restricted.
02:26You know, in a country like Kenya, you do have some very wealthy members of society, but they are restricted to the top 1%, sometimes even less, you know, that people can actually afford these hospitals.
02:40And insurance coverage is very weak in places like Kenya, that really, you're talking 2%, 3% of the population.
02:49So your ability to access people in rural areas, in poorer neighborhoods, is very, very low, really, at a private hospital.
02:58And I think, you know, investors, obviously, when they come in, they have to think about their models.
03:03And, you know, this hospital in Kenya, the Avenue Hospital Network, before TPG came in, we do know that they had implemented some measures to expand healthcare to the poor through free medical camps, for example.
03:18And when TPG came in, this specific methodology of bringing free healthcare with treatment seems to have stopped.
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