COVID treatment at pvt hospitals in Hyderabad can burn a hole in people's wallet

“It is easier to recover from COVID-19 than from the blow that the hospital bill inflicts on you,” laments the caregiver of a 50-year-old man, undergoing treatment for COVID-19 at a corporate hospital in Hyderabad, summing up the plight of those opting for treatment at private hospitals.

“It works out to ₹1 lakh per day for critical care, irrespective of which corporate hospital one goes to,” said a source close to a senior opposition Congress leader who has been admitted to a corporate hospital in the city following coronavirus symptoms.

Earlier this week, the Telangana government issued an order allowing private hospitals to admit and treat the coronavirus-infected patients. However, the move was followed by reports of patients being charged exorbitantly, despite the government fixing an upper limit for the treatment charges.

“When we admitted our uncle at this leading corporate hospital in Banjara Hills, we were offered a 20-day package costing ₹21 lakh based on the assumption that he might need a ventilator support,” said Prashant Roopi, a senior executive at a private bank.

“The insurance cover is only up to ₹7 lakh and the rest we have to mobilise on our own,” he said.

Cap on cost

According to an order issued by special chief secretary (medical and health) A Santhi Kumari, the cost of the package to be charged by the private hospitals cannot exceed ₹4,000 per day in normal wards (including isolation), ₹7,500 in Intensive Care Units (ICU) without ventilator and ₹9,000 with ventilator support.

The package includes monitoring of patient and investigations like Complete Blood Culture (CBC), urine routine, anti-HIV, ultrasound, ECG, 2D Echo and X-ray, apart from drugs, consultations, bed charges, meals, and procedures like urinary tract catheterisation.

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However, the hospitals can charge additionally for Personal Protection Equipment (PPE), interventional procedures like bronchoscopy, biopsy, and pleural tapping, administration of high-end drugs, and high-end investigations like CT-Scan, MRI, and PET scan.

Similarly, the price of coronavirus testing has been capped at ₹2,200, and ₹2,800 if the sample is to be collected from home.

Collision Course?

Unhappy with the directive capping the treatment costs, the managements of private hospitals appear set on a collision course with the state government.

A meeting of the representatives of private hospitals with the Medical and Health Minister E Rajender on Wednesday did not go as they had expected. The government did not budge from its position and asked the corporate hospitals to adhere to the order and provide treatment to the COVID-19 patients as a “social responsibility.”

“We are all passing through a crisis. The private health sector needs to cooperate and join hands with the government in the fight against the pandemic. You must do this as a social responsibility and not as a commercial activity,” the minister told the members of the Telangana Super-speciality Private Hospitals’ Association.

He was responding to their argument that the upper limit fixed by the government would not be feasible.  “We have requested the government to reconsider its decision but the minister has asked us to treat it as a social responsibility,” the sources in the Association said.

“The cost of manpower in terms of doctors, nurses and paramedical staff has increased by 25 per cent. They work for five days and are given break of four days.  Those wearing personal protection equipment (PPE) kits can only work for four hours. These factors have increased costs tremendously,” said a senior doctor at a private hospital.

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The hospital managements might be asked to set aside a specific number of beds for providing treatment to the patients at rates fixed by the government.

“We do not know how the government has arrived at this figure of upper limit of treatment cost for COVID-19 in private hospitals. The officials have neither consulted us nor discussed with us the cost of treatment,” said Dr B Bhaskar Rao, the president of the Association.

The private hospitals, he pointed out, have to make a lot of special arrangements for treating the COVID-19 patients.

“We have to create separate isolation facilities, wards and ICUs without causing any inconvenience for other patients. We have to have dedicated manpower, including doctors and para-medical staff, exclusively to deal with COVID-19 patients, as they are not supposed to attend to other patients. We have to provide them PPEs and other facilities. The cost of treatment has to be worked out taking into consideration all these factors,” Dr Rao, who is the managing director of Krishna Institute of Medical Sciences (KIMS), said.

“For instance, we cannot use the equipment like a ventilator used for COVID-19 patients for other patients immediately. We have to fumigate the equipment thoroughly before using it again,” he said.

The association president wondered why the government should worry about charging the COVID-19 patients by private hospitals.

“Only those who can afford treatment will come to us. There are enough government hospitals to provide free and affordable treatment to other COVID-19 patients,” he argued.

Home treatment

Private hospitals are now offering home treatment packages to patients who have mild symptoms, as it is easy to treat less immune-compromised patients. With isolation wards being occupied and the waiting list increasing, patients who have been frequenting hospitals and have been referred by consultants are being given the home treatment option.

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“We have 15 patients on home treatment regime who have mild symptoms or have come in contact with COVID-19 patients. They have been given pulse oximeters for checking oxygen levels, monitor blood pressure and heart pulse rate and inform us. We have video conferencing by doctors from hospitals,” said Dr Rahul Medakkar, chief executive officer of Continental Hospitals.

Those who have room for isolation and a separate bathroom at home are opting for this facility as it is found to be convenient. The total package rate for home care is ₹8,000 and additional charges for devices and oxygen cylinder as may be needed.