NEW DELHI: Public relations executive in Delhi, Swati Vashishtha (name changed), was diagnosed with a benign brain tumour this February. After consultations with doctors at hospitals, the 32-year-old settled for a microsurgery at Paras Hospital in Gurgaon.
“I had a health insurance of Rs 5 lakh and I was initially given an estimate of Rs 4 lakh with an assurance that the surgical outcome will be excellent,” Vashishtha told The Sunday Standard. “During the eight-day stay at the hospital, many complications developed following the operation and I was not satisfied with the service. To top it all, I was handed over a bill of Rs 8.5 lakh, which my family struggled hard to arrange before my discharge.”
Neena Siddiqui (name changed) of Noida, had a similar experience. Following the hospitalisation of her one-year-old girl at Fortis Noida for acute chest congestion and viral fever, she had to pay Rs 1.2 lakh this August for a four-day hospital stay. “The breakup of the bills included Rs 6,000 for diaper changing sheets. Even patient’s food was exorbitantly charged; we were shocked beyond words,” she said.
In a country where over 65 per cent people have to pay out of their pockets to meet healthcare expenses, this anger is understandable and as many experts say, justified.
A World Health Organisation-World Bank report released earlier this week highlighted that more than half of the people worldwide who get pushed into extreme poverty due to treatment and hospitalisation costs are from India.
It’s not only the cost factor but also quality of healthcare that bothers patients and their families.
Sections of physicians and public health experts are now stressing on the need to tighten regulations for healthcare providers.
In a shocking case of medical negligence earlier this month, a newborn baby was declared dead and handed over to his family in a plastic bag by doctors at Max Hospital in Shalimar Bagh in New Delhi, only to be found alive later. This had led to widespread public anger and had forced the Arvind Kejriwal government to cancel the hospital’s license.
In another incident, a seven-year-old dengue patient was charged a staggering Rs 16 lakh for a 15-day stay by Fortis Hospital in Gurgaon.
Following the outrage, the Haryana government de-empanelled the hospital and an FIR was lodged against the institution after an investigation by senior health authorities suggested that there were many instances of negligence in the treatment of the girl.
“There is a very strong popular discontent against large private medical establishments. Politicians and the government are only trying to tap it in their favour by symbolic actions. Even the Prime Minister (Narendra Modi) tried to play on it sometime back when he criticised high cost of medicine and devices,” said Amar Jesani, a Mumbai-based researcher and teacher in bioethics and public health and editor of the Indian Journal of Medical Ethics.
He added, “India has embraced the US-type private corporate hospital system, and those hospitals and doctors are refusing to accept any regulations, even the types the US has. I suspect that the government will do that on its own unless there is a big push by people.”
Priya Balasubramaniam, a specialist in universal healthcare who works with the Public Health Foundation of India, a health research institution in New Delhi, said state governments should adopt the Clinical Establishment (Registration and Regulation)Act 2010 that requires hospitals to provide a set of standard treatment guidelines.
“It was hearty to see the Karnataka government bring a stringent medical bill to regulate private hospitals, but it was diluted following stiff resistance from doctors,” she said. Representatives of corporate hospitals, however, seem to be pitching for self-regulation.
Naresh Trehan, top cardio-surgeon and Medanta chairman said many hospitals are engaged in a process with the Indian Medical Association to introduce self-regulation. “We are working with the government to increase transparency, documentation, including documenting the quantum of all materials used during treatment,” he said in a press conference on the sidelines of a health conclave on Thursday. “But there are realities on both sides, capital requirements for establishing hospitals are so huge. The absence of (health) insurance is also a challenge.”
Devi Shetty, founder-president of Narayana Healthcare, emphasised that “extra regulatory structures are not required”. “Patients with grievances have multiple options to exercise. We cannot impose first-world regulatory standards on third world infrastructure,” he said.
