The choice for COVID-19 patients opting for treatment in Delhi’s many private hospitals is between a possible recovery and a sure way to penury.
It is so since the rates charged from patients are exorbitantly high.
The Delhi government tried to fix them over a month ago so as to bring these within the reach for at least the higher strata, or those who are a wee bit above the average middle-class bracket. Yet, the privately-run hospitals are reported to be overcharging.
Five patients studied by a group of civil society activists after their treatment in six different private hospitals of the capital city were found to have paid far more than the rates prescribed by the government.
The group led by All India Drug Action Network (AIDAN) has written to seek the intervention of Delhi Chief Minister Arvind Kejriwal and other higher-ups in the state and central governments; and, thus, raised the issue of flagrant flouting of hospitalisation rates laid down by the government as far back as June 20.
Mayanka Sanghotra from Radhey Shyam Park Extension in East Delhi got her 52-year-old mother Narender Kaur admitted to a nearby private hospital on June 24 with symptoms of COVID-19 fever. Soon she found that the hospital was charging over ₹60,000 a day when the rates prescribed by the government were in the range of ₹15,000 to ₹18,000 for a day for ICU treatment. She was given a provisional bill of ₹11,26,085 on July 11 by the hospital.
This made Sanghotra write to the hospital where among other things she says, “In spite of repeated requests, the billing has still not been revised and brought in line with the government rates. Today I have received the provisional bill summary covering 18 days of admission which comes to more than ₹11 lakhs, which is unaffordable for my family.”
Other cases that AIDAN and 19 other voluntary organisations have taken up with the chief minister and other authorities are no less startling. The hospitals at the time of admission mostly take consent of one or the other family member accompanying the patient to pay according to the rates set by the facility. The harried relatives who take their patient seldom pay attention at the time of admission to the charges that are going to come their way eventually. They are made to sign on dotted lines along with making an initial deposit. This hospitals accept even if it is in tens of thousands of rupees against a final bill that may go up to a million rupees or even more.
This is in sharp contrast to the Delhi government order which fixed the maximum rates, in an NABH (National Accreditation Board of Hospitals)-approved hospital, for an admission in the ICU without need for ventilator care at ₹15,000 per day and for an admission in the ICU with ventilator care at ₹18,000 per day. Within these rates, the maximum per day charges for PPE were also capped at ₹2,000.
The order further says, “The rates for private hospitals beds would be all inclusive as a package. This will include, but not limited to: bed, food and other amenities, monitoring, nursing care, doctors’ visits/consults, investigations including imaging, treatment as per the national protocol for COVID care and standard care for co-morbidities, oxygen, blood transfusion etc.”
It also makes clear that the package rates would “include costs of medical care of underlying co-morbid conditions including supportive care and cost of medications thereof, for the duration of care for COVID. Since many of the COVID patients have conditions such as hypertension, diabetes, cardiovascular problems etc. The charges for medical care of such co-morbidities will be a part of the package. This would include short term haemodialysis as a part of acute care during the current admissions.”
The government order goes on to say, “The rates would apply to standard care of COVID-19 patients as per the National Guidelines. But these would not cover experimental therapies (e.g., remdesivir etc.). Standard management of co-morbidities would be covered. The charges will not include the cost of COVID-19 diagnostic test(s) as well as IL-6 Levels.”
It finally warns, “There will be no compromise on the quality of clinical care services provided to the patients receiving services on the proposed package rates.”
The Delhi government has also directed private hospitals to set aside 60 per cent of their beds for COVID patients where these rates are supposed to be applicable. For non-ICU isolation bed, the charge was fixed between ₹8,000 and ₹10,000. However, the hospitals are skirting the government order by often claiming that the patient had to be put in a twin-bed ward.
Moreover, most private hospitals have been built on subsidised land allotted by the government. This brings them under the mandate of providing free treatment up to 10 per cent of their capacity or intake to patients from economically weaker sections. It means that a 200-bed hospital has to keep 20 beds for patients belonging to the EWS category and provide them free of cost treatment.
None of these guidelines laid down by the government are being followed. And instead the private hospitals in Delhi are using the current pandemic as an opportunity to make a quick buck. This is not only costing patients heavily but, according to the AIDAN and its civil society peers, are also driving COVID victims into myriad other inconveniences.
These are like their being used for experimentation by turning them into virtual guinea pigs without their consent and driving them into disputes with insurance companies since there is often a mismatch between the hospital invoices and the rates fixed by the government.
Thus, the organisations raising the issue say, the sooner the government orders an audit of private hospitals and starts a redressal mechanism for patients’ grievances, the better.
(The writer is an independent journalist based in Delhi. He tweets @abidshahjourno)