Drama festival at Tagore Theatre Sept 23 2017
April 7, 2018
More Doctors or Better Doctors
June 17, 2018

Capping the treatment cost

Media headlines reveal rather often that private hospitals slap astronomical bills on most of their patients. Overcharging is said to be common and it defies logic. The patients, already bogged down by sickness have little recourse to protest or get refund of overcharged amount. Besides over-charging medical mal-practices are also alleged to be common. Citing the case of Yash Arora a leading daily from South mentioned ’ Seven years after Yash died his father’s  life revolves around documents — dozens of files of medical records, paperwork tracking legal proceedings, newspaper clippings on medical malpractice, and treatment protocols set by the government. Despite his meticulous data-gathering, and FIRs there hasn’t been much progress on the legal front’. “Yash had caught TB only because the hospital put him in a room with a TB patient. This was a violation of medical protocol. This was much more than negligence. This was a death sentence,” says Mr. Arora. Another aggrieved father joined Arora, following the death of  his 7 years old  daughter Adya in October 2017, leaving behind a huge bill for Mr. Singh.  Singh created a Facebook page called ‘Fight Against Healthcare Corruption’. It has quickly become a platform where about 6,000 people across the country have connected with him with their own stories. “Everyone who got in touch has faced similar problems. They all want to know how his case got highlighted by the media. They are now demanding that an independent body be set up, to investigate cases of medical malpractice. Similar is the case of 7 years old Shaurya parmar, who also died of dengue like Adya. Families who have alleged overcharging by private hospitals have found common cause against the government, which has for years failed to regulate the private sector health industry.

Amid mounting pressure from the affected families and the attendant media glare, Adya’s death led to the filing of public interest litigation (PIL) in the Supreme Court. The PIL demands the regulation of India’s unregulated private health sector, from neighborhood clinics to corporate hospitals, under Article 21 of the Constitution, which guarantees the right to life and personal liberty. On March 23, in response to the PIL, the apex court sent notices to the Medical Council of India (MCI), the Union Health Ministry, Haryana’s health department, the NPPA, and doctors at Fortis hospital. The PIL sought to turn the spotlight on “a larger systematic and structured loot of desperate patients… which is engineered by and between pharmaceutical companies, diagnostic labs, doctors and ultimately corporate hospitals.”

 

With awakening of public to the extent of hype against medical profession and loss of trust in the doctor-patient relationship, which was so sacrosanct in the past, governments are mulling capping of various charges for interventions, tests and medicines. Recent proposal of a union territory Government in Delhi  to regulate charges is being hailed as a great reform by some people. Some others esp doctors call it a dehumanising decision under which doctors will not be able to give their best.  Most of the proposals — ‘capping medical costs, regulating medical packages, prescribing drugs only from the National List of Essential Medicines’ or Jan –Aushdhi stores— are well-meaning, noted an editorial in a daily newspaper from North. The argument that public health facilities need to be shored up and government spending on health deserves a boost is not at cross purpose. Need and importance of private medical treatment, esp the family physician cannot be undermined. While public should not expect philanthropy or charity from the practicing doctors, greed can’t be justified. Regimentation by the governments to control private practice can be counter-productive. Doctors and hospitals have to exercise self control and self-discipline and work for the welfare of the patients, while earning a fair and ethical compensation. In a noble gesture several medical associations have decided not to offer or accept cuts/commissions for referral of the patients for Radiological investigations, lab tests or surgeries. Unfortunately most of the hospitals are not owned or run by doctors, who have no role to play in fixing various charges or preparing inflated bills. However it does soil the fair name of noble profession! The real bosses are corporate honchos who work behind the curtains and whose only motive is profit.

In case of propriety medicine and generic medicines the cost of medicines to the manufacturer be mentioned over which 20 % profit can be allowed. No doubt a generic medicine with the same contents is often cheaper by ten times. A tablet costing one rupee to the manufacturer, being sold for 20-50 rupees to the patient speaks of a big scam.  Same is true of implants and other medical devices and consumables. Who is responsible for this? Not the doctors! Why doctors are getting blames and punishments for such scams, where they have no role to play? Correction of this one anomaly alone will be giant step in the direction of affordable medical treatment.

SPEAK India an NGO at Chandigarh is spearheading a movement to ensure ethical and affordable treatment to patients across the country. SPEAK is working on a new model of health where focus has to shift from patient care to ‘wellness and fitness’ of the entire population, thus reducing the patient load and attendant problems by 70-80%

Jan Swasthya Abhiyan, a network of civil society organizations has started working in Delhi towards securing the right to health for all. All India Drug Action Network (AIDAN), another independent network of many NGOs working for patient rights has also become a coordinator of sorts for the families that want to pool their resources together for a common cause. The brainstorming sessions between the families, lawyers and activists gives all of them hope. More importantly, it gives them a strategy.

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