This report published in Times of India needs no further elaboration.
Corporate medical care was touted as the solution for all the ills of our healthcare system. But, the five star style, air-conditioned hospital premises hide a deep rot within. Profit motive of the hospitals, drug companies, equipment suppliers and medical consumable makers drives the system, not the welfare of the patients, professional development of doctors or healthy working life of other medical staff.
We should get rid of this profit driven healthcare system and move on to universal, high quality, socialized medical care to all citizens.
In the big bills that you run up in hospitals, medicines, diagnostics and consumables typically constitute 30-50% of the sum, while doctors get only about 10-20% for patient care. That’s what TOI found after analysing dozens of bills from various private hospitals for different procedures and lengths of stay.
Since profits on medicines, diagnostic tests, and medical consumables such as syringes, dressing and catheters are high, slashing the margins on these could potentially cut your bill by at least a third in most cases.
But Dr Giridhar Gyani of the Association of Healthcare Providers (India) points out that margins on individual items should not be viewed in isolation. “The actual price of medical procedures is much higher than what is billed to the patient. So the money for the procedures is being made from the high margins on things like drugs and consumables. Hospitals have not done anything illegal as they have never charged more than the MRP,” he said.
The analysis showed that the other significant expense heads in bills are room rent, constituting 15-25%, and equipment charges, which are usually about 10-15% of the bill.
The doctors’ share typically shrinks as the bill gets larger as the increase is mostly due to greater consumption of medicines, consumables, tests done and room rent. As for the rest of the medical staff, including nurses, technicians and paramedics, they get a fixed salary irrespective of the number of patients treated or length of patient stay.
Their salaries are also invariably lower in private hospitals than in government hospitals. Even from the doctors’ charges, the hospital management usually keeps 15-20% or more depending on the different models followed by hospitals.
“Doctors’ share in the bill is divided among several doctors in a team or over a whole department, with the senior doctors or surgeons getting a larger share. In the push to maximise profits, when hospital managements charge 200%-1,700% margin on medicines, consumables and diagnostics, the frustration of the patient with rising cost is taken out on the doctors even though they get just a fraction of the bill,” said a doctor on the condition of anonymity.
Doctors TOI spoke to revealed other profit-maximising practices, such as reusing medical devices like catheters and reducing the number of nurses in an ICU from an average 1:2 ratio (nurses to patients) to 1:3 or even 1:5 in some cases while charging patients about Rs 50,000 per day in the ICU.
“Capping margins alone will not work. The government ought to have a regulator for hospitals that will do random sampling of hospital bills, regularly review hospital accounts and carry out medical audits to ascertain if the treatment given was appropriate or not,” argued the son of a patient who died after three weeks in the ICU of a corporate hospital, having spent Rs 25 lakh.
Rema Nagarajan| TNN
Courtesy : Times of India