Jan. 28, 2022

Rolando Ganoza, CEO at Alium

Rolando Ganoza, CEO at Alium
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Season 1

CEO and founder of the Alium group of companies in Peru. Rolando is a dentist, a service provider for the local dentistry sector, and a medical device distributor of dental products. Rolando’s academic credentials include a global executive MBA from the IESE business school, a fellowship in endodontics, and a degree in dental surgery.

WEBVTT

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Welcome to the Latin Metech leaders podcast.

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A conversation with Metech leaders who have succeeded or plan to succeed in Latin America.

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Please subscribe on your favorite podcasting platform, apple podcast, Spotify, Google podcast.

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Amazon music is teacher tune in.

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I heard radio Pandora or

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Welcome to the Latin met leaders podcast.

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A conversation with leaders who have succeeded or plan to succeed in Latin America today.

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Our guest is Orlando za from Peru is the CEO and founder of the, a group of companies.

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Orlando is a dentist, a service provider for the local dentistry sector and a medical device shooter of innovative dental products.

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Orlando's academic credentials include a global executive MBA from ESA business school in Barcelona, Spain, and a fellowship in endodontics and a degree in dental surgery.

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So Roland is a real pleasure to have you here today.

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I look forward to our conversation today.

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Welcome to the show.

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Thank you very much.

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It's my pleasure.

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I'm looking forward to talk with you.

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Excellent Rolando.

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Beautiful.

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All right.

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So let's talk about your involvement with the medical device, uh, business in, in Peru.

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I'm gonna tell you my, my short story because I have a long one.

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Yes, my, my in short, when I finish my MBA, um, I, I make a, a turn at 180 degrees turn because, uh, at the beginning I wanted to live the, the health sector.

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Then I realized, uh, that in the health sector in countries like man, Peru is gonna be an explosion of technology innovation.

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It's gonna be the, the, the, the, the, the epicenter of the quake.

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So, um, I, I, I re re remake my plans.

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So I, eh, relaunched my dental clinic, making a investment with digital dentistry, technological cat for, for my lab and scanner.

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We, we go completely to digital something different here in Peru at five years ago, I'm talking about five years ago.

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So, uh, in the process, we were discovering some problems in the market.

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For example, uh, with the lab at the beginning, we make a very good passage, but, uh, it was, uh, it was too big for our needs.

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So friends of mine start coming here asking for, Hey, what I, what I do with this machine, tell me I want to make a job.

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Okay.

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And, and then the, the dental lab start making a, a turn alone start, start working alone, done.

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Okay.

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That's good.

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But in the process, we found that, eh, there was, there were no enough, uh, eh, products to be mailed, to be, uh, worked on.

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So we start importing goods.

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We make all the certification need by the Peruvian country or the Peruvian government.

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And we start importing Sarnia, uh, PMA and different, uh, materials for our cat system.

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So, um, we start dealing with the government and, uh, with the permissions licenses and registers, uh, that was our beginning.

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Then, eh, we start making our own brand, uh, we start representing different brands from Brazil, uh, Germany, uh, China, Italy in the, um, health sector, specifically in dentistry.

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Uh, now we want to expand a bit, not only for cat camp, we jump on the orthodontics appliance and, uh, also with, um, uh, protected over implant.

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It's a very possible, we are working in niche in very specific niche.

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Part of our business is develop the market because, uh, sometimes the, the doctors, the dentists are not aware about this technology about this solution.

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So half of our time is, is spending in, um, teaching and spending

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Educating.

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Yeah, yes.

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Hmm.

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And this is, this is gonna happen for the next, uh, 10 years.

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We are living now in the, uh, industry 4.0, the fourth industrial revolution in one generation, we will need to change the mind of the people working on health, specifically health sector, because it is spread around the world.

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And it's very difficult.

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The, the, the, the, the dentist and the doctors, they love the, the comfort zone.

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Uh, it's difficult to take out them for, for the comfort zone, but, eh, eh, in more in countries like, like mine, that, uh, we are very conservative in, in, in, in our mind.

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So we are looking for people who want to take the risk to jump out the comfort zone, and they will lead because we are like this.

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They are leading another guys and another doctors to jump out the, the zone.

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So the, this is now our situation H how we, um, ended in, uh, in medical devices sector.

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Okay.

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Very good.

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Nice story.

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All right.

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So what trends do you see happening in Latin America, in Peru, in, in terms of economic, social, um, disease issues?

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I mean, what do you see that is, that is happening in the region?

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Latin America has been, uh, uh, roughly, uh, heated by, by, by the pandemic.

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We, we have a, had very big problems in the health sector.

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Any, any national health system has been enough, uh, qualified to, uh, confront to front the, the, the, the pandemic.

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So, uh, in, in countries like Peru, for example, where 90% of the population is covered by the national health system, and only 10% is by private.

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Uh, these 90% has been very, very, very damaged and, uh, the national health system as well, they basically close, uh, any other, uh, uh, any other treatment, more than COVID.

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So a lot of surgeries, a lot of, uh, um, chronic, uh, PA patients were, were put aside.

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So it is, it is very tragic now they are recovering.

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So this is an opportunity as well, to, uh, improve the system, to, to change.

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They already know that, uh, the, the lack of beds, the lack of hospitals, uh, has been put in, in, on, on the lights now.

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So they need to work hard in the national health systems.

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Uh, they unify the health system, uh, to, to improve the services, to, to get better.

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One of the things where the, the crucial, the crucial key here is digitalization to the, the digital transformation, be able to, eh, uh, uh, get more patients with the same resources, eh, because the resources are always limited, uh, more than governments like ours.

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So we need to improve the, the, the healthcare delivery quality, uh, to those people.

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All those is made by technology is the only way yes.

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Yeah.

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Telemedicine and things of that.

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Yes.

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Especially in a country like Peru, that is in the Anden region.

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People are for remote, um,

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Locations, right.

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Specialists, the doctor who are very specialized, they don't want to go to, to very remote province.

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Only Lima.

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Yes.

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That's it.

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Lima.

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Lima has the third of the population of Peru.

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It is a huge city and concentrated all the resources.

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It's not good.

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So if, if you want to, the telemedicine is, is, is a, a huge resort.

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We didn't go, go, go down.

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We didn't dig in, in, in Peric because, uh, still they don't, we don't have this, neither the connectivity.

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We have a problem with the connectivity.

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Let's start from the beginning.

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We don't have internet in the rural songs.

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So we need to make them come into the technology with internet.

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At least then we can talk about daily medicine.

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So deployment here is huge, but I, anytime I see a problem, I see an opportunity,

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An opportunity.

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Yeah.

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Yeah, yeah.

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And, and how do you see the new government?

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What trains do you see with the new government with federal

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Federal Castillo?

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Um, yes.

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New government Castillo is very, very left, very lefty, uh, is, it has been a surprise for us, but, uh, well is what we have.

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We, they have only three weeks, maybe one month.

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Yeah.

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In the government.

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Yeah.

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They start with the left foot as well.

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So we hope they, they will change these things and start making good things.

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Uh, they were not prepared for government.

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They were, they, they didn't have the, the enough people that, well, I think they need to a bit, um, understand that sometimes you want some of the requirements they have are totally agreed.

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They, we need, we need to get out, uh, people for the, for the poverty.

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Totally agree.

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But sometimes the, the mean the way they are proposing is notebook, but they need, and the, the proposal was to, uh, get stronger national health system to improve the, so this is gonna be opportunity to sell medical devices, to improve the, the, the, the health, the, the attention to the patients.

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So, sure.

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Yeah.

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I think we, we,

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And, and, and to build hospitals, I guess you're gonna start building hospitals in rural areas and all that.

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The last hospital build here one, five years ago is, is incredible.

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We, they, they, then they get stuck with the new ones for legal problems.

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So they need, they need to, to enact this, this, all this, uh, barriers and, and, and work with, with, along with companies who will supply, uh, medical device and, and get better.

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This has to be attached to, uh, training programs, because most of the doctors here are not training to use, uh, high-end technology,

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High end technology.

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Okay.

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And also the other trend that I imagine is happening in, in, in Peru, Orlando is since the middle class is growing, Peru has had a huge economic growth in the past few years, actually before the pandemic.

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So the middle class has been growing and adopting more Americanized, more westernized lifestyles, you know, eating hamburgers, fast food.

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Yes.

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Yes.

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The GFAS in the corner.

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the, the numbers, the numbers in, in, in economics.

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Uh, and I, and I realized that when I was outside abroad in, in, in taking the MBA, the numbers are very good.

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Uh, sometimes you look better at the numbers from outside that from

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Inside.

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Exactly.

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Okay.

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Yeah.

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Uh, yes, we have improved a lot.

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We need to improve much more and we need to insist in the same economical model for at least 20 or 30 years to get out of our situation.

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Um, we need to be patient.

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I hope the new government will understand this and, uh, and insist with, um, some, uh, freedom.

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Some, uh, we, we call the, this, um, uh, freedom of economics because people need to work.

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People, the people need not, not need, they want to be free to make business.

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And it's very important.

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All the pools now this week, uh, are, are heading to that people need, or they want, they ask for freedom.

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Um, and the government is thinking in another way, they, they, they want the, the, the government or the states take over some part of economy and rule of them.

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Yeah.

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Yeah.

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And I, I, I strong, I am strong.

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I am a stronger believer in, um, uh, rules of the economy of the free economy, like, uh, free

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Exactly.

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The free market dynamics.

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Yes.

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Yeah, totally agree.

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But that, the problem here is also we, the, the health factor is overregulated, this is a problem.

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Not only for, uh, um, the, the, the issues, the medicines, the equipment also for the services.

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So, um, that's the problem in part, the problem in part, we need to adapt as, as, as usual.

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So yes, the regulation is, is, is, is hard.

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Is the regulation is, is they have a lot, sometimes is contractory, but with a good lawyer, with a good equipment, we, we always find a way to proceed with the, uh, licenses with the registers.

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Okay.

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So let's, I guess you already answered my third question that I usually ask my guest, which, which is, how do you see Peru as a place to do either clinical trials or to commercialize medical technologies?

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So, uh, do you wanna expand on that?

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Do you know anything about clinical research in Peru?

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Do

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You know?

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Yes.

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Yes.

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Even if I'm a, a strongly believer of the free of the freedom in the commerce, uh, when you are in this register systems, you are protected by the barriers.

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So you to get one, uh, sanitary register for, uh, medical equipment could take like, uh, I don't know, eight months, one year, once you get it.

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Yes.

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Yes.

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It's, it's, it's, it's complicated.

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Once you get it, you are protected because the other guy who wants to jump in the market needs to pass through this one year process.

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Uh, it's not good for the client.

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It's not good for, it's not good for innovation, it's it have a lot of problems, but for the company, for the, for the brand who already has the, the sanitary register is very good because they are protected.

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Yes.

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And the name of the regulatory ISIT right.

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DEIT

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The sumos medicals.

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Yes.

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The problem is for the, is, is, uh, overloaded by the, at the beginning, they said the pandemic, we are just focusing in co issues and co goods.

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But now I don't know why they are still are delaying the losses.

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I don't know, 45 days.

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And they took eight months.

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Um, okay.

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Wow.

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Yes.

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They don't have one dentist in their staff.

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So we need to explain.

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Yes, no one.

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So if we want to, to, to import braces for ATIC appliance, we need to explain what different between different prescription or brackets.

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So it is like a, they, they are good people.

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They are, they, they, they are making their job very careful.

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They're professional.

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Yeah.

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Yes.

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But, uh, they don't have the resources or they, they will make, they, I would love to see them working in a team with different professionals in different areas to improve.

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And to be quick, they need to study from the, from scratch.

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What's a bracket.

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What, what is a bracket?

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What understand what they are signing because they are signing.

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They, they are giving the authorization because one, they director signed this.

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If there's any problem, the director will get a shoe.

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This is not, it's not, it's complicated.

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So they are Puting themselves.

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When we understand how they work, we get better things at the beginning, we were very confrontational with them, eh, but no, we need to understand what is the reality of the DEIT?

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What are they doing?

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Why are they doing the, the Perian legislation is a copy and paste of the European.

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It's the same.

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The problem is not legislation is the people who, uh, read or who interpret, who, who, who, who, who explains the, and implement, implement the, the, the legislation.

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So they sometimes have a different approach.

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They need, they, they want more information.

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Um, we were working with Germans, uh, brands with, uh, Brazilian Brazil is very complicated as well, but Peru is more, um, and, and visa.

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I think the name of the Brazilian authority, the, the guys we were working with, they already have the am visa, uh, number that this registration, but here they are, they said, it's no way they are.

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They are asking you for this.

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This is like this.

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So we talk with them.

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We, we have the, the, um, the ability to talk with the reg with the, with the guys here and ask them before sending the, the, the file.

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What do you want, how do you want?

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So we make it better for them.

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We, uh, uh, rise, more information.

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We put it like they want to, we express the families because we trying to make families with the registrations at, as, as they want.

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So at, at to, to make it easier, we don't want to, uh, spend four, three months and get an, an, um, uh, a letter from them asking for more information.

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This is terrible.

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Cause it, it send us to the square one.

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We don't want it.

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So we try to make better at the beginning to talk with them, asking what do you want?

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How do you want it?

00:18:05.618 --> 00:18:19.430
And, and, and giving them, even if we want to fight with the provider, because at the end, we, we make some tension with the provider, because we are asking for some as amount of, of information that they say, what are you asking for me?

00:18:19.630 --> 00:18:20.910
We are, you want to copy me?

00:18:21.910 --> 00:18:24.309
No, I, I don't want to can't copy you.

00:18:24.390 --> 00:18:27.660
I just want to send information to the authorities.

00:18:28.420 --> 00:18:28.950
It's a process.

00:18:29.829 --> 00:18:32.069
Uh, we need to understand, we need to live with this.

00:18:33.029 --> 00:18:35.990
Uh, and we have the resources for

00:18:35.990 --> 00:18:36.108
That.

00:18:36.950 --> 00:18:36.950
Okay.

00:18:37.190 --> 00:18:41.230
Are, are there any initiatives to improve the Heit work by the new government?

00:18:41.368 --> 00:18:41.589
Yes,

00:18:41.589 --> 00:18:42.269
They are talking.

00:18:42.299 --> 00:18:49.339
They are talking about to make a change because the pandemic also discover this, uh, we have some problems with the vaccines.

00:18:51.299 --> 00:18:51.299
Yeah.

00:18:51.880 --> 00:19:08.589
So, so yes, they have talked to change it, but, uh, nobody knows how know when sometimes the, uh, uh, the medicine is worse than the, the sickness.

00:19:09.150 --> 00:19:13.470
So I, I hope I, yes, no, I, I, I hope they will.

00:19:13.471 --> 00:19:14.309
They will make better.

00:19:15.150 --> 00:19:16.108
Uh, it's very easy.

00:19:16.829 --> 00:19:19.269
Uh, uh, but we dunno.

00:19:19.858 --> 00:19:20.150
Okay.

00:19:20.500 --> 00:19:20.789
Okay.

00:19:21.170 --> 00:19:29.380
So let, let's talk about the, the approval process, the pathway we already discussed that, uh, it will take about a year, a to 12 months.

00:19:30.000 --> 00:19:35.220
And, um, does it matter what type of, uh, device it is, a low risk, high risk device?

00:19:36.420 --> 00:19:38.460
Uh, basically we are working with, yeah.

00:19:38.618 --> 00:19:41.339
With class two and class three, uh, class one.

00:19:41.340 --> 00:19:44.569
They don't need it doesn't need any, any registration?

00:19:45.410 --> 00:19:45.730
Uh, really?

00:19:46.289 --> 00:19:46.569
Oh, that's

00:19:46.569 --> 00:19:46.650
Great.

00:19:46.930 --> 00:19:46.930
Yes.

00:19:47.130 --> 00:19:48.170
Class one, no class two and three.

00:19:48.269 --> 00:19:48.490
Yes.

00:19:49.730 --> 00:19:53.890
Uh, for example, uh, theit has, has a list.

00:19:55.190 --> 00:19:56.829
They, they sometimes work in, in the other way.

00:19:56.900 --> 00:20:02.430
They have a list of goods, uh, who doesn't need orientation.

00:20:03.690 --> 00:20:07.569
This, this list is actualize it every six months, every three months.

00:20:07.750 --> 00:20:10.009
So we are always looking, looking at that list.

00:20:11.190 --> 00:20:20.440
See if, if we have, uh, any opportunity there, but the other, the other thing, class two and class three, we, of course, class two is easier.

00:20:21.039 --> 00:20:24.279
Class two is class three is a bit difficult, but it's no problem.

00:20:25.200 --> 00:20:25.400
It's no problem.

00:20:25.680 --> 00:20:25.680
OK.

00:20:26.240 --> 00:20:26.240
Okay.

00:20:26.240 --> 00:20:29.200
Is it a reference country that they need to see?

00:20:29.201 --> 00:20:32.519
Like the United States approval, FDA, C mark from Europe.

00:20:33.190 --> 00:20:39.509
It's better when they have a FDA and C, but no, if, if not necessary, it's not mandatory.

00:20:39.700 --> 00:20:40.269
It's not needed.

00:20:40.650 --> 00:20:41.150
Oh, okay.

00:20:41.339 --> 00:20:41.630
Okay.

00:20:41.970 --> 00:20:44.150
So you can, you can have home country approval.

00:20:44.549 --> 00:20:44.549
Yes.

00:20:44.550 --> 00:20:48.319
Let's say you have a product from China and they don't have FDD market.

00:20:48.400 --> 00:20:49.960
I can get it in the market.

00:20:50.480 --> 00:20:50.480
Okay.

00:20:50.589 --> 00:20:51.079
Very good.

00:20:51.640 --> 00:20:51.640
Yeah.

00:20:52.279 --> 00:21:02.019
Actually we have also like country, we have a treatment of free agreement, uh, with Europe, with China, with United States.

00:21:02.079 --> 00:21:10.849
So there is a called valor in Peru could be from six to 11 or 12 with this

00:21:13.170 --> 00:21:13.170
Import.

00:21:15.049 --> 00:21:24.400
Don't pay that so less in, in taxes at the moment, importation at the moment we import the goods.

00:21:26.430 --> 00:21:26.930
And also,

00:21:27.410 --> 00:21:27.849
Could you repeat

00:21:27.849 --> 00:21:41.029
That when with countries with, uh, no, uh, three free agreement, uh, we have to pay 6% of the ad valorem.

00:21:41.289 --> 00:21:45.700
It means, uh, okay, got in the safe value.

00:21:45.920 --> 00:21:53.339
We have to pay 6% at the moment we get the yes, here in customs, we need to take up of customs.

00:21:53.340 --> 00:21:59.329
We need to pay the VA, the VT tax and the valor.

00:22:01.130 --> 00:22:15.920
We, if, if we can demonstrate with, uh, origins, origin certificate, that these goods come from a country, uh, is a tricky thing because it's not only a country, it's the city in the country, which we have a agreement.

00:22:16.880 --> 00:22:16.880
Yes.

00:22:17.200 --> 00:22:19.400
Because we have a problem with a Chinese provided.

00:22:19.401 --> 00:22:26.150
They send us the good from Hong Kong and they are in Ze and the certificate was in Ze.

00:22:26.490 --> 00:22:28.670
And he say, no, but this in Hong Kong, but come on.

00:22:28.671 --> 00:22:29.069
It's China.

00:22:29.450 --> 00:22:29.910
No, no.

00:22:29.911 --> 00:22:33.589
It's a different cities that they are always trying to, to hit you with

00:22:34.589 --> 00:22:34.589
It.

00:22:36.230 --> 00:22:36.430
We learn.

00:22:38.470 --> 00:22:38.470
Yeah.

00:22:38.670 --> 00:22:38.670
Yeah.

00:22:39.069 --> 00:22:39.910
You learn, you learn.

00:22:40.170 --> 00:22:45.700
So do you use a regulatory first consultant or you do this, uh, yourself, your

00:22:45.700 --> 00:22:45.940
Company.

00:22:46.079 --> 00:22:48.819
We need a, we, we, we, we use a consultant.

00:22:49.380 --> 00:22:53.779
It's it's we use a consultant for, for the, uh, regulatory issues.

00:22:53.920 --> 00:22:55.299
We need a consultant for a lawyer.

00:22:55.440 --> 00:22:55.819
For law.

00:22:55.839 --> 00:23:00.730
We need a, we have a consultant for, for import, for, uh, customs as well.

00:23:01.009 --> 00:23:07.289
No, we love, we love to work with guys who are very, very skills in sector.

00:23:08.250 --> 00:23:14.289
It's I, it was not for customs.

00:23:14.529 --> 00:23:25.160
We are maybe in the company working with, uh, we didn't match good, or we didn't have the feedback, or we didn't have the service we asked for at the beginning.

00:23:25.180 --> 00:23:25.960
So we changed.

00:23:26.200 --> 00:23:26.440
We changed.

00:23:27.059 --> 00:23:31.720
We like, um, Steve Joseph fell often fell quickly.

00:23:33.769 --> 00:23:34.900
Well said, yes,

00:23:36.599 --> 00:23:37.740
Yes, we, we try it.

00:23:37.740 --> 00:23:38.329
Doesn't work.

00:23:38.400 --> 00:23:38.690
Okay.

00:23:38.759 --> 00:23:39.049
Next.

00:23:40.049 --> 00:23:42.250
And, and, and so on, because it's a problem.

00:23:42.430 --> 00:23:44.970
And it it's the same with the regulatory issue.

00:23:45.799 --> 00:23:52.319
Uh, we get a company with a couple of, uh, guys, very John, very, very, very, very clever with contacts.

00:23:53.319 --> 00:23:54.039
They love to work.

00:23:54.108 --> 00:23:55.920
They handle these things very good.

00:23:55.980 --> 00:24:01.839
So we are now very, really, very happy with we, the team we have built with them.

00:24:03.039 --> 00:24:03.529
Very good.

00:24:03.559 --> 00:24:04.049
Very good.

00:24:04.230 --> 00:24:06.720
So let's talk about the market in, in Peru.

00:24:06.900 --> 00:24:07.839
How big is the market?

00:24:07.940 --> 00:24:09.079
How big is the population?

00:24:09.380 --> 00:24:11.640
How percentage of the population is covered by insurance?

00:24:12.059 --> 00:24:14.279
How is the reimbursement in the system?

00:24:14.420 --> 00:24:15.759
Can you talk about that please?

00:24:16.460 --> 00:24:16.680
Yes.

00:24:16.740 --> 00:24:20.880
The, we are, um, more than 30 million people, uh, okay.

00:24:20.881 --> 00:24:33.450
Most on most of them in the Peruvian coastal, uh, we have like a 2000, uh, more than maybe 3000 kilometers of coast in the Pacific ocean.

00:24:34.569 --> 00:24:38.410
Uh, the country is more than 1 million, uh, square kilometers.

00:24:38.970 --> 00:24:39.368
It's a big one.

00:24:40.450 --> 00:24:42.160
Uh, and it's very hard.

00:24:42.269 --> 00:24:43.680
Geography is very complicated.

00:24:43.779 --> 00:25:06.319
We have, uh, like, uh, uh, dorsal spine going to north from north to the, and yes, we, the people is living there and separated country to the desert coast and the Amazonian rainforest, um, with rivers in the Masonian, it's impossible to think about the highway, for example, the, they use rivers or the highway.

00:25:06.539 --> 00:25:06.759
Yes.

00:25:07.559 --> 00:25:07.559
It's.

00:25:08.220 --> 00:25:15.319
And also we have a lot of, uh, national reservation, uh, reservation for, for forest and animals and all this stuff,

00:25:15.559 --> 00:25:16.559
National parks and all this.

00:25:16.880 --> 00:25:16.880
Yeah.

00:25:17.039 --> 00:25:17.039
Yes.

00:25:17.380 --> 00:25:27.349
And, um, the, like I, I said before, 90% of the population is covered by the national, uh, health system is a problem because it's not integrated.

00:25:27.950 --> 00:25:31.829
Actually we have three or four entities in the national health system.

00:25:32.069 --> 00:25:45.019
The, the government or the state, uh, own health system is Salude is a, some type of insurance, uh, for, for workers standalone.

00:25:45.460 --> 00:25:57.269
They have their own hospital doctors, their systems paid by the workers, by the companies and the military, and, uh, Navy police.

00:25:57.299 --> 00:25:58.630
They have their own systems.

00:25:59.608 --> 00:26:07.029
And the, in, in, uh, more than 15 years ago, we start making, we call the decentralization process.

00:26:07.329 --> 00:26:16.618
So, uh, the government received for years, a lot of critics because they, they lead, they manage everything from Lima.

00:26:16.680 --> 00:26:20.940
So they start the, the political division of Peru regions.

00:26:21.140 --> 00:26:28.420
We have a lot of regions, maybe 12, and, uh, they start giving autonomy to the regions, uh, basically in the budget.

00:26:28.960 --> 00:26:32.180
And part of this budget was, uh, the health system.

00:26:32.640 --> 00:26:39.529
They start, eh, managing the budget in, in the health sector, health sector, in each region.

00:26:40.029 --> 00:26:42.730
The problem was they have the money, but they don't have the skills.

00:26:43.858 --> 00:26:46.559
So they start to ate the health system.

00:26:46.618 --> 00:26:51.519
Now they are talking about re integrate in one piece, all the national health system.

00:26:51.759 --> 00:26:54.240
So this is the status know.

00:26:54.539 --> 00:26:55.880
So they regions very good.

00:26:56.160 --> 00:27:11.059
They ares very, very bad working with this in the, in the, in the private sector, we have 10%, it's the high end, the, the, the class, uh, they are, we have four or five, uh, insurance company.

00:27:12.299 --> 00:27:27.410
Um, there was a gap here in the law because the law allows them to allow them to, uh, integrate vertically all the, yes, it's not good because the comp, the insurance company start buying medical clinics.

00:27:28.269 --> 00:27:33.089
So they not, not only, uh, they provide the service and they pay for the service.

00:27:33.720 --> 00:27:45.279
This is not good because they, uh, adjust the tariff so hard because they don't care if they lose money in the clinics, they will earn money in the top, in, in the company, in insurance company.

00:27:45.660 --> 00:27:49.480
But what happened with the clinics with no rooftop?

00:27:49.549 --> 00:27:52.720
Like, uh, then, uh, like an insurance, they

00:27:53.759 --> 00:27:53.759
Okay.

00:27:53.910 --> 00:27:57.269
Damages the market is a price down competition.

00:27:57.630 --> 00:27:57.630
Yeah.

00:27:57.769 --> 00:27:57.990
Yes.

00:27:58.529 --> 00:28:00.630
So the reimburses working here.

00:28:00.660 --> 00:28:00.950
Okay.

00:28:01.190 --> 00:28:06.349
We, they have a different tier of, of cleaning, no tier one, maybe they own clinic.

00:28:06.789 --> 00:28:18.819
You maybe you don't pay anything or you pay just a five or 10% of the, of the bill, another type of clinic you pay maybe 50% with higher tile tariff because they negotiated.

00:28:19.880 --> 00:28:25.230
And, uh, the out of pocket in Peru is very high for

00:28:26.150 --> 00:28:26.269
It's very

00:28:26.299 --> 00:28:26.589
High.

00:28:27.150 --> 00:28:31.710
Not, not only in private, only in the health, the national health system, because what

00:28:31.990 --> 00:28:31.990
Happened?

00:28:32.190 --> 00:28:32.589
Not in the public.

00:28:32.990 --> 00:28:32.990
Yes.

00:28:33.089 --> 00:28:36.059
For example, my, my mother, my father was a Navy officer.

00:28:36.060 --> 00:28:37.819
So my mother is in the Navy system.

00:28:37.839 --> 00:28:39.740
In the, in the, in the, so

00:28:41.279 --> 00:28:41.700
Regime.

00:28:42.019 --> 00:28:42.019
Yeah.

00:28:42.299 --> 00:28:42.299
Yes.

00:28:42.380 --> 00:28:49.940
I, I went to the Navy hospital to get their medical because she's 85 and she had some chronical disease.

00:28:49.941 --> 00:28:51.980
She's very fine, but she had some chronical disease.

00:28:52.559 --> 00:28:56.769
So I went for the, and sometime they don't have this, this appeal.

00:28:56.990 --> 00:28:58.450
We don't have it now.

00:28:58.710 --> 00:28:59.490
We don't have it.

00:28:59.880 --> 00:29:00.170
Okay.

00:29:01.400 --> 00:29:08.480
I don't have problem to, I'm gonna buy the medicine for my mother, but what happened with the guy who doesn't have his resources?

00:29:08.549 --> 00:29:09.039
Exactly.

00:29:09.920 --> 00:29:09.920
Yeah.

00:29:10.240 --> 00:29:10.799
But that's a problem.

00:29:12.190 --> 00:29:13.230
Theoretical theoretically.

00:29:13.450 --> 00:29:14.430
Yes, they are.

00:29:14.490 --> 00:29:18.269
She is covered, but in the practice, mm-hmm, not so much.

00:29:18.630 --> 00:29:20.869
Mm, okay.

00:29:21.150 --> 00:29:21.509
I see.

00:29:22.130 --> 00:29:25.230
But is, is healthcare constitutional right?

00:29:25.589 --> 00:29:26.150
Improved?

00:29:26.250 --> 00:29:26.470
Yes.

00:29:26.769 --> 00:29:26.990
Yes.

00:29:27.500 --> 00:29:27.789
Okay.

00:29:27.890 --> 00:29:30.420
So everybody has access to the system, regardless.

00:29:30.460 --> 00:29:31.140
I mean, in paper,

00:29:31.440 --> 00:29:32.539
Health and education.

00:29:32.920 --> 00:29:33.140
Yes.

00:29:33.680 --> 00:29:35.619
But the problem is the quality,

00:29:37.319 --> 00:29:37.519
The quality.

00:29:37.630 --> 00:29:37.920
Yeah.

00:29:38.619 --> 00:29:43.920
We are not going to talk about the quality, but we problems in the quality in the, in the private and, and the public sector.

00:29:44.180 --> 00:29:47.839
But, uh, the, the coverage is not good.

00:29:48.500 --> 00:29:49.410
Let's start from the beginning.

00:29:49.650 --> 00:29:49.650
Okay.

00:29:50.660 --> 00:29:51.650
Let's start for the coverage.

00:29:52.170 --> 00:29:52.410
It's not good.

00:29:52.480 --> 00:29:54.690
It's not, it's not, uh, 100%.

00:29:55.509 --> 00:30:00.440
And, uh, uh, the other side, the quality is, is complicated.

00:30:01.559 --> 00:30:01.559
Okay.

00:30:01.670 --> 00:30:02.759
What about reimbursement?

00:30:02.829 --> 00:30:11.119
What about, what if I bring a new medical device and I wanna get in a code for, in the system so I can get reimbursed by the system.

00:30:11.539 --> 00:30:14.160
And there are actually four different systems or something like that.

00:30:14.259 --> 00:30:17.359
So you have to get reimbursement in each one of them or what

00:30:17.589 --> 00:30:20.190
Some of them do not allow to make any reimbursement.

00:30:20.849 --> 00:30:23.869
The, the specifically the public sector.

00:30:24.990 --> 00:30:36.109
Actually, we have a huge problem now, uh, with the COVID because the national health system, uh, run out of, uh, uh, BES for, uh, intensive care, ICU

00:30:36.549 --> 00:30:36.549
Vets,

00:30:37.230 --> 00:30:37.430
ICU vet.

00:30:37.430 --> 00:30:37.430
I see you bets.

00:30:37.440 --> 00:30:37.500
I see you bet.

00:30:37.619 --> 00:30:37.619
Yes.

00:30:37.621 --> 00:30:38.140
I see you bet.

00:30:38.200 --> 00:30:46.259
So they, they, they went for the private, they will all also collapse it, but by the people have said, no, it's not possible the private sector.

00:30:46.460 --> 00:30:47.099
So they, okay.

00:30:47.339 --> 00:30:59.299
The government say, I'm gonna pay, uh, for, for the guys, I'm gonna send guys to the, to the private, well, they send some, I don't know, maybe, maybe 100, they didn't pay anything, but they still have process.

00:30:59.799 --> 00:31:00.019
Yes.

00:31:02.490 --> 00:31:02.490
Wow.

00:31:02.549 --> 00:31:05.650
One thing is when they say, and the other thing is they do.

00:31:06.890 --> 00:31:07.180
Yeah.

00:31:07.680 --> 00:31:12.099
So it is maybe it's not a problem of, of the good intentions.

00:31:12.329 --> 00:31:14.930
Sometimes they have good, good intentions.

00:31:15.109 --> 00:31:25.849
The problem is the system is so complicated that now we need to reimburse to the clinics with the 100, or maybe you have five, you have 10.

00:31:25.960 --> 00:31:26.250
Okay.

00:31:26.750 --> 00:31:28.089
The process is very complicated.

00:31:28.809 --> 00:31:34.740
You have to demonstrate to the government or to the national health system, you made this design.

00:31:35.380 --> 00:31:39.619
They, they start looking for any error in the, in the medical history.

00:31:39.940 --> 00:31:41.299
No, you didn't do that.

00:31:42.259 --> 00:31:45.809
You file is a problem.

00:31:46.599 --> 00:31:46.890
Yeah.

00:31:46.891 --> 00:31:47.170
Yeah.

00:31:47.269 --> 00:31:52.009
But in your case, you are in the private sector, you sell cash.

00:31:52.289 --> 00:31:52.289
Yes.

00:31:52.529 --> 00:31:52.880
Right.

00:31:53.099 --> 00:31:54.920
To other dentists and all that.

00:31:55.640 --> 00:31:57.480
And, and, and their patients pay cash.

00:31:57.700 --> 00:32:00.480
So it's a cash system where you are.

00:32:00.680 --> 00:32:00.680
Yes.

00:32:01.279 --> 00:32:07.000
Actually one of, one of the things we made at the, from the beginning is our products will, will be sell in cash.

00:32:07.299 --> 00:32:07.519
Why?

00:32:07.670 --> 00:32:18.269
Because we trying to lower as much as possible prices have people, uh, in charge to, uh, call you for the bill is gonna cost me.

00:32:18.950 --> 00:32:18.950
Okay.

00:32:19.430 --> 00:32:22.910
I don't want that cost you if you want that you want credit.

00:32:23.190 --> 00:32:23.190
Okay.

00:32:23.191 --> 00:32:24.029
You have to pay for that.

00:32:25.279 --> 00:32:38.069
You have to pay for the system who is gonna call you to pay the bill if, if you are making numbers and, and you see, okay, this, this gonna cost me this, uh, uh, amount of this amount of this.

00:32:38.099 --> 00:32:38.390
Okay.

00:32:38.960 --> 00:32:41.480
I, I want to be very efficient.

00:32:41.720 --> 00:33:02.619
I want to have the best price in the market with the best product I have to took out all these over coasts overheads, but because we are working in a niche, but if we need a, a huge machine, um, a million machine, for example, we're talking about maybe$500 here,$5,000 here.

00:33:03.380 --> 00:33:10.420
Uh, we are talking with the bank to make a lease, for example, because we don't want to, uh, we are not expert.

00:33:11.460 --> 00:33:13.500
We don't have expertise with, uh, credits.

00:33:13.839 --> 00:33:16.980
So we, I prefer to go to the bank and pay the bank.

00:33:17.500 --> 00:33:20.329
What, what they are going to ask me and make a list with them.

00:33:21.490 --> 00:33:22.170
They're expert at that.

00:33:22.390 --> 00:33:22.609
Yes.

00:33:22.990 --> 00:33:23.210
Yes.

00:33:24.089 --> 00:33:24.089
Yeah.

00:33:25.009 --> 00:33:27.049
All right, Rolando, we're close to the end of the show.

00:33:27.190 --> 00:33:34.390
And usually the last question I usually, um, ask my guest is your, your words of wisdom.

00:33:35.309 --> 00:33:49.859
Uh, if you had the CEO of a medical device company from the United States or Europe, that is just looking at Peru as a place to do business as a place to commercialize, uh, his or her medical technology, what would be your best advice to him or,

00:33:51.059 --> 00:33:55.809
Well, first you have to find a partner, a reliable partner here.

00:33:56.670 --> 00:34:00.369
We have been talking about the, the spaghetti.

00:34:00.440 --> 00:34:12.849
This is spaghetti, all, all this national health system and regulations, and is the, but we have also the, the, the source, the pesto all is the corruption.

00:34:13.769 --> 00:34:16.260
So this, all, this is involving corruption.

00:34:16.260 --> 00:34:23.900
So for example, we, as company, we want to be as far as possible from the corruption, we want to work fair.

00:34:24.940 --> 00:34:25.619
It's, it's important.

00:34:25.719 --> 00:34:29.460
Not only for my company, because I don't want to destroy my company.

00:34:29.820 --> 00:34:33.690
I don't want to destroy also the brand I am representing.

00:34:34.630 --> 00:34:42.690
So this is important for any, any, any, uh, company coming to Peru to be very, very, uh, acute, very clever.

00:34:42.809 --> 00:34:44.369
I said, I don't want corruption.

00:34:44.489 --> 00:34:45.969
I want to play fair.

00:34:46.329 --> 00:34:47.329
I want to, to go.

00:34:47.840 --> 00:34:53.880
Even if it's the longest way I want to, to go through, through all this process by law.

00:34:54.639 --> 00:34:56.460
So this is my best recommendation.

00:34:58.260 --> 00:35:06.349
Find a good partner, uh, get know him, uh, and go, go, go, go with them sometimes and follow the law.

00:35:06.570 --> 00:35:06.789
Yes.

00:35:06.949 --> 00:35:07.949
When yes, yes.

00:35:07.951 --> 00:35:13.619
By the book, you, if the it's it's complicated, but it's not impossible,

00:35:14.170 --> 00:35:15.019
It's not impossible.

00:35:15.179 --> 00:35:16.980
And it's worth it because it's a huge market.

00:35:17.039 --> 00:35:18.059
30 million people.

00:35:18.380 --> 00:35:18.380
Yes.

00:35:18.739 --> 00:35:18.739
Yeah.

00:35:19.179 --> 00:35:19.179
Yes.

00:35:19.739 --> 00:35:21.820
And we need to develop this a lot.

00:35:22.219 --> 00:35:29.730
So the I'm, we are working in dentistry, in data dentistry, not to, uh, fight our competitors.

00:35:29.869 --> 00:35:41.199
We are working to increase the, the pie to increase the market outside are more people that inside actually, that this is an opportunity for all devices in medical as well.

00:35:42.480 --> 00:35:43.119
Excellent, excellent.

00:35:43.559 --> 00:35:46.639
Rolando, I, I really loved our conversation.

00:35:46.780 --> 00:35:48.719
And how can people get in contact with you?

00:35:49.119 --> 00:35:50.239
Uh, email LinkedIn?

00:35:50.579 --> 00:35:50.800
Yes.

00:35:50.980 --> 00:35:51.760
I'm in Linkin.

00:35:51.880 --> 00:35:52.760
I am in Facebook.

00:35:52.880 --> 00:35:53.719
I am in Instagram.

00:35:53.780 --> 00:35:55.159
My name is Orlando GZA.

00:35:55.960 --> 00:36:06.030
Uh, I, I will share with you the, the, my contest, but whatever you need, I'm open to discuss, to talk, to give you my advice.

00:36:07.340 --> 00:36:07.579
Excellent.

00:36:07.940 --> 00:36:08.579
Fernando, thank you.

00:36:08.581 --> 00:36:08.980
Thank you.

00:36:08.981 --> 00:36:10.980
The industry needs more people like you

00:36:11.420 --> 00:36:12.139
Oh, thank you very much.

00:36:13.980 --> 00:36:18.769
The whole idea of my show is to show Latin America's land of opportunity.

00:36:19.190 --> 00:36:27.690
And one of the problems here in the region in Latin America, including Peru, is that patients have not access to innovative medical technologies.

00:36:27.989 --> 00:36:43.920
So interviews like this with people, with experts like you help or in, in contribute in one way or another to, to, to have patients better access to medical innovation and to make companies in the us or Europe aware of the opportunity that Peru represents.

00:36:45.010 --> 00:36:45.880
Thank you very much.

00:36:45.949 --> 00:36:46.679
Yeah, I really,

00:36:47.840 --> 00:36:47.920
All right.

00:36:48.170 --> 00:36:50.360
Thank you so much, Orlando, have a great day

00:36:51.840 --> 00:36:52.260
Byebye.