A WEEK after the Supreme Court called out private hospitals on the Covid-19 treatment cost, two major associations representing such facilities have suggested a cap of Rs 35,000-68,000 per day. However, this does not include the additional cost of “high-end” tests and medicines, as well as treatment for those with comorbidities.
While these rates are not binding, the Association of Healthcare Providers of India (AHPI) and Federation of Indian Chambers of Commerce and Industry (FICCI) are submitting their suggestions to the central and state governments.
Major private hospitals, including Apollo Hospitals, Fortis Healthcare, Dr LH Hiranandani, PD Hinduja and Kalinga Institute of Medical Sciences, are likely to implement the rates suggested by at least one of these associations, The Indian Express has learnt.
The AHPI, which represents around 10,000 private hospitals, has suggested various ceiling rates, depending on the type of treatment: from Rs 15,000 per day for general ward to Rs 35,000 per day if the patient is in the Intensive Care Unit (ICU) and on ventilator support.
The suggested rates include the cost of basic medicines, testing, personal protective equipment (PPE) and “all” other required elements in the treatment of a patient without comorbidities or complications unrelated to Covid-19, said AHPI Director General Dr Girdhar Gyani. However, it will not include the cost of “high-end” investigations, medicines and treatment required for patients with underlying conditions.
The FICCI has listed proposed rates according to the category of patient: whether he is government-referred, paying out of his pocket, or with insurance. Depending on these categories, and whether the patient is admitted in an isolation ward or ICU (with or without a ventilator), it has suggested a cap of Rs 13,600 to Rs 68,000 per day. The rates, based on an analysis of 150 actual COVID treatment cases in “major” private hospitals, are “indicative” and there may be individual variations to the extent of 5-10 percent.
The rates suggested by FICCI include medicines, consumables and “basic” diagnostics, but don’t include treatment for patients with comorbidities and the cost of “high end” drugs. PPEs, which it had earlier calculated to cost around Rs 10,000 per day, are also excluded.
“In these difficult times, the private healthcare sector is doing its best to serve with high standards of ethics, transparency, professional competency and compassion,” said Dr Sangita Reddy, FICCI president and Joint MD, Apollo Hospitals Group.
FICCI’s member hospitals have “pledged” to adopt these cost recommendations.
Dr Sujit Chatterjee, CEO of AHPI member Dr L H Hiranandani Hospital in Mumbai, said the proportion of patients with comorbidities, or requiring high-end treatment, was not as high as those who need basic treatment. “For instance, in a 24-bed ICU, about 10 patients would require high-end intervention,” he said.
According to him, the cost of a 10-day treatment using AHPI’s rates would not exceed Rs 3.5 lakh for patients without comorbidities and would be around Rs 9 lakh for those with comorbidities.
“It does manage to bring down the cost…it’s fair,” he said. “At the end of the day, if any business or facility is not self sustaining, you can’t borrow and live,” he added.
On May 28, The Indian Express reported that private hospital bills ranged from Rs 2.6 lakh for a six-day stay to around Rs 16.14 lakh for almost a month, and for those who had insurance, the out-of-pocket expenses ranged from Rs 60,000 to Rs 1.38 lakh.
Last week, the Supreme Court asked “why can’t private hospitals, given land free of cost, treat Covid-19 patients for free.”
“We are hoping to put pressure on hospitals that may not be inclined to follow these rates. Some of our members have said that they can provide this treatment for even less than the rates that have been suggested. We are suggesting that hospitals can charge less than, or as much as these rates, but not more,” said AHPI’s Gyani.
“Patients who feel they are being charged more than the rates we’ve suggested can reach out to us and we can connect them with other accredited hospitals that are our members who will charge within these limits,” he said.
Meanwhile, Inayat Kakar, a public health activist and lawyer, said: “Self regulation by private players defeats the purpose of public interest and accountability. As we can see, the rates being demanded by FICCI and other private bodies are still unaffordable for most people and only serve to enable private hospitals from continuing to profit. In the event of violations, patients would still be left on their own.”
According to Brinelle D’Souza of Jan Swasthya Abhiyan-Mumbai, AHPI’s ‘suggested indicative pricing’ for treating COVID-19 patients in a general ward is “arbitrary and unjustified and way above the prices set by the Government of Maharashtra.”
“During the pandemic, corporate hospitals have been indulging in profiteering with impunity,” said Malini Aisola of the All India Drug Action Network, a patient activist group. “The rates being proposed are excessive and misleading, because they exclude high-end medicines, PPEs, etc, which contribute hugely to bills. The rates also do not cover comorbidities which is the case for most severe patients. The rates are meaningless because they cannot be enforced,” she said.
Maharashtra is among the few states that has capped the rates for COVID and non-COVID treatment in the state to “redress” grievances regarding “exorbitant” amounts charged by healthcare providers to patients not covered under any health insurance.
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