Private hospitals and Covid-19 patients have continued to engage in a tug of war despite efforts by the state government and the Brihanmumbai Municipal Corporation to find a middle ground by capping fees and reserving beds for patients.
While private hospitals say they have been “forced to increase charges” due to mounting expenses and losses, patients undergoing long-term hospitalisation say they are unable to foot such hefty bills.
Recently, some private hospitals have also started levying bio-medical waste handling charges leaving patients in the lurch. The move follows the Brihanmumbai Municipal Corporation (BMC) directive to hospitals to cough up
Rs 100 per kilo for disposal of biomedical waste — personal protective equipment (PPE), goggles, masks, gloves and face shields. Envoclean Private Limited has been awarded the BMC’s contract to dispose of biomedical waste.
In a recent case, a Covid-19 patient, Vastimal Rathod (68), who is admitted at Bhatia hospital’s ICU for the last 33 days, said he has already run up a Rs 13.8 lakh bill. While medicines form 21 per cent of the bill and room charges another 17 per cent, about 35 per cent of the entire bill, which is Rs 4.82 lakh, accounts for “material” charges — a component, also referred to as ‘Covid charges’ , that includes the cost of PPEs, disinfection, biomedical waste disposal and the increased salary for nurses on Covid-19 duty.
“We have paid Rs 7 lakh already. But we cannot afford so much. money I don’t know how we will manage to pay such an amount,” the patient’s relative Sanjay Rathod said Sunday, adding they have already started to look for a bed in a government hospital. Rathod said material charges have been factored in at Rs 15,000 per day and he has been negotiating with the hospital seeking a reduction in the charges.
Private hospitals, meanwhile, said they were “helpless”. Losses in March and April were maximum due to the total lockdown and nearly zero admissions. Bhatia hospital director, Dr RB Dastur, said the Covid-19 pandemic had also increased the cost of administration.
“We are not overcharging. Since the pandemic began, nurses work in six-hour shift. From three, we now have four shifts a day. Each nurse works for seven days and takes the next seven days off. Instead of 15, we need 30 nurses in the ICU. All this has increased the cost,” he said.
The hospital purchases one PPE for Rs 950, until a week ago it cost them Rs 1,400. In a day it requires 75-80 PPEs in ICU. Last month, it also paid Rs 7 lakh to the BMC for biomedical waste disposal. The hospital states it incurred losses in the last quarter.
Mumbai has 3,180 beds in 33 private hospitals that are reserved by the government for Covid-19 and non-Covid patients. Of these 580 are ICUs. Despite a price cap introduced by the state government in May, the common man struggles to afford private healthcare.
Kalpesh Porwal, who has been helping patients access healthcare, said patients carry the double burden of procuring expensive medicines used for the novel coronavirus disease and paying hospital bills.
While patients are shocked by the hospital bills, the hospitals say there have been increasing instances where patients have refused to pay the full bill and rope in politicians to ensure they are not charged.
In Bombay hospital, the management said over seven patients have left without paying the full amount in the last four months. “Hospitals are not earning since non-Covid patient admission stopped in March. For Covid-19, we have to buy good quality PPE for staff, disinfect regularly. Even we are suffering losses. Each hospital is working to its best capacity. If patients have a problem, they should approach the hospital auditor,” said consultant Gautam Bhansali.
While BMC is auditing bills of 33 major hospitals in Mumbai, it is unable to keep an eye on smaller nursing homes. Joy Chakraborty, COO of PD Hinduja hospital, said patients have become suspicious. “If we counsel their family, remain transparent, and keep them in the loop about daily cost the misunderstanding can be resolved,” he said.
Chakraborty said Covid-19 treatment is high due to newer and expensive therapies and drugs and safety equipment. “The more the patient is immuno-compromised the greater the care required,” he said.
Wockhardt hospital was recently forced to release the body of a patient, who succumbed to Covid-19, after the intervention of a politician. The family paid Rs 75,000 of the total bill of Rs 15.17 lakh for 22 days of hospitalisation. The remaining amount remains due. “A lot of times when a patient dies, the family refuses to pay the bill. In each case we provide the best of care, the outcome is not in our hands,” an official said.
At Dr L H Hiranandani hospital, where a family of an autorickshaw driver said the hospital refused to release his body until they settled Rs 8.5 lakh bill — the family paid Rs 2 lakh and could not arrange the balance — hospital CEO, Dr Sujit Chatterjee, said the hospital had assured family members the body would be released and “every assistance” provided “including waiver of the bill, if required”.
The hospital said “in the face of extreme provocation” due to the intervention of a politician, who created “a huge ruckus”, the hospital “responded and settled the matter within minutes” in a “professional manner”.