High costs in private hospitals amid COVID-19

A recent survey by LocalCircles, a community social media platform, says that nearly 32% of people surveyed for a study are nervous about visiting a government hospital for COVID-19 which is offering free treatment and prefer a private hospital. But there are 57 % of people who have expressed concerns about the sky-high treatment charges at the private hospitals.

The survey also showed that 46% of people fear contracting secondary infections or other diseases in the government hospital. Some 61% of people wanted the government to cap the charges in private hospitals. The survey was filled by nearly 40,000 people giving responses to five questions on public perception of government and private hospitals for COVID-19 treatment.

Around 32% of citizens say they will rather take treatment at home and go to the hospital for emergencies as in red zones, the private hospitals have limited beds and because of the long wait for getting admissions in private and government hospitals as well.

Last month, The Apex Court had ordered COVID-19 testing free of cost for every citizen in private labs also. Following the petitions from laboratories, the court modified its order and said that the benefit will now be given to only citizens covered under the Pradhan Mantri Jan Arogya Yojana (PMJAY) and to weaker sections as may be notified by the government.

Hearing a plea filed by Sachin Jain, an advocate, the PIL sought cost-related regulations for the treatment of COVID-19 patients at private/ corporate hospitals, the Supreme Court observed that many private hospitals have been given land either free of cost or at a very minimal cost and that these charitable hospitals should treat the patients for free. The bench consisting of Chief Justice of India S A Bobde and Justice A S Bopanna and Justice Hrishikesh Roy also asked the Center to identify the hospitals which could treat these patients free or at a very nominal cost.

The Union Government filed an affidavit stating that it had no statutory power to direct private and charitable hospitals to give free treatment to COVID-19 patients. It further stated that there is no provision under the Clinical Establishments (Registration and Regulation) Act, 2010 whereby it is mandated that private hospitals running on public land shall treat COVID-19 Patients on a free basis. It said that state governments can make any policies regarding this.

The Supreme Court on 5th June 2020 sought to know whether the Ayushman Bharat Scheme can coverCOVID-19 patients seeking treatment at private hospitals. The Solicitor General Tushar Mehta replied to this that the Ayushman Bharat Scheme covers the poor and vulnerable people like rag pickers and daily wagers and if the petitioner wants it to be made applicable to all for which a reply would be submitted on the next hearing. Senior Advocate Mukul Rohatgi then made submissions on behalf of the association of hospitals said that no business will be left and it will lead to closing down of hospitals if the prayers are complied with. CJI Shri Bobde the remarked,

“You are making a sacrifice for a good cause.”  

The matter is now posted for final hearing after two weeks and the hospital bodies will submit a reply on record for the same.

In the plea, it was also referred that there are many hospitals that are issuing sky-high bills for treating COVID-19 patients with the result that even insurance companies had started rejecting claims up to 50%.

Hearing a similar plea for fixing an upper limit of cost for COVID-19 treatment by private hospitals filed by Avishek Goenka, the Supreme Court sought a reply from the Center. A bench headed by Ashok Bhusan issued notice to the Center.

The Health Minister, C. Vijayabaskar said on May 30th, 2020 that the government will soon fix rates for COVID-19 treatment but for the time being appealed to the hospitals for not overcharging the COVID-19 patients.

The West Bengal Government April 23rd, 2020 had announced that all the costs for treating COVID-19 patients in state-run private hospitals will be borne by the state government.

The Gujarat High Court in a suo moto petition also directed the state government to keep a close watch on the private hospitals stating that these are very tough times, people are dying and this is not the time to think about heavy profits from those people who are already suffering through the virus by the private hospitals. “The Association should not think of even making a profit of one rupee” the bench comprising Justice Vikram Nath and Justice JB Pardiwala observed. They also observed that hospitals have a moral responsibility as well.

On May 14th, 2020 the High Court restrained the private hospitals from demanding exorbitant fees and observed that strict action will be taken against those found to be in violation of the order, including cancellation of license and further legal proceedings. In reply to this, the private hospitals said that they have already reduced their rated by 30%. The court further took note that the private hospital agreed to reduce their rates by 30% and now they further agree to reduce by 10% for private beds for Ward and 5% for isolation + ICU and ventilation + isolation + ICU.

The high rates for treatment of COVID-19 patients in private hospitals have become a serious concern now, seeing this an association of private hospitals and FICCI member hospitals have come up with two independent sets of rates for treatment of infected patients admitted in private hospitals.

The Association of Health care Providers has suggested that patients in general wards the fee per day should be fixed at Rs. 15,000 per day, inwards with oxygen it should be Rs. 20,000 per day and isolation ICUs can cost up to Rs. 25,000 every day. It has proposed that the rate per day for isolation ICUs with ventilator support can be fixed at Rs. 35,000. Some patient groups lambasted the proposals saying it’s simply an attempt to overthrow efforts of the various governments to expand affordable access to COVID-19 treatment.

Some of the suggestions include that there should be a time-bound settlement of mediclaim by insurance companies and cashless treatment facilities be extended to all insured patients. The other things include directing the insurance companies to immediately settle full claims and frame and advertise the mechanism to avail private hospital facility as per the choice and affordability of the patient.

These are exceptional times and many citizens are left without any income. Their savings are also at the end. People are suffering because of less number of beds available in government hospitals and the high costs in private hospitals has left the people with poor medical facilities and also violates the rights of the citizens under Article 14 and Article 19 (1)(g) of the Constitution of India. Article 14 provides for Equality for law and Article 19 (1)(g) provides for the Right to practice any profession or to carry on any occupation.   

Given the limitation of resources under the public health sector, it becomes apparent that the government/public health sector alone may not be able to manage the fallout, and hence extensive participation of the private healthcare sector would be required. So it is better the Centre and States shall start forming policies and laws regarding the high costs charged by the private hospitals for treating COVID-19 patients.

Be aware.

Stay safe.