NATHEALTH calls for higher level of transparency amid allegations on hospitals overcharging patients

In a joint representation to the Delhi Government, private hospitals have put forth the challenges faced by the sector and recommended higher pricing transparency by making the publishing of charges mandatory by hospitals

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New Delhi: NATHEALTH has submitted a representation on ‘COVID Package Pricing’ to Mr Satyendar Kumar Jain, Health Minister, Government of NCT on 15th June. In this joint representation, NATHEALTH has urged the government to continue to push for a higher level of transparency by mandating hospitals to publish their treatment charges. They have also recommended the appointment of Ombudsman at zonal level to inspect the complaints of overcharging.
The representation highlights the current unprecedented challenges being faced by the private healthcare providers in COVID treatment. “Pricing is a factor of quality of infrastructure, level of services, medical protocol followed, brands of medicines used, skill and salaries of doctors and staff and more importantly the medical outcomes. In the view of COVID-19, the focus of treatment protocols has undergone a significant shift and the hospitals need to equally (if not more) ensure that health care workers (HCWs) are not infected, while treating patients and the hospitals themselves don’t become hotspots or super-spreaders. The new approach has thus led to an increase in the cost of care (both for COVID and Non-COVID) and added to expenses,” the press note by NATHEALTH stated.
Presenting the hospitals’ side of the story, NATHEALTH statement mentioned that the focus of treatment protocols in COVID times has undergone a significant shift and the hospitals need to equally (if not more) ensure that Healthcare workers are not infected while treating patients and the hospitals themselves don’t become hotspots/super-spreaders. It attributed the increase in cost of care (both for COVID and Non-COVID) to:
  • Additional staff due to shorter shifts, quarantine policy post roster duty, staff getting infected during treatment and impact of PPE’s etc. on the safety and health of HCW’s and their families. It thus takes 1.75 to 2.5 times of usual staff to treat COVID patients.
  • Costs towards boarding, lodging and transportation of staff on duty and off duty, but under quarantine. This is necessary to protect families of HCW’s. In addition, free testing and treatment of HCW’s when infected, adds to the cost of operations.
  • Cost towards Personal Protective Equipment (PPE). As per FICCI study, 3-5 PPE is required per patient. Further, the price of common items like surgical mask has gone up by 80% due to surge in demand.
  • Free treatment being provided to patients from economic weaker sections
  • Unviable Schedule of Charges: Hospitals are treating patients sponsored by the Central and State Government on CGHS 2014 tariff, which was valid till 2016. Similarly, the rates of public sector insurance companies (GIPSA) have not been revised since 2016, forcing hospitals to work on unviable prices for a large segment of patients. The hospitals end up cross-funding the losses from other patient segments.
  • Non-payment of PPE cost by CGHS and GIPSA
  • Shallow penetration and coverage of insurance among general population exposing individual households to catastrophic expenditure for tertiary care.
Private hospitals within NATHEALTH – Healthcare Federation of India have jointly stated that, “We fully support the need for transparency of pricing to ensure that patients are not overcharged. Equally, there is a necessity of being viable, ensuring no compromise in the quality of care and more importantly no risk to health care professionals. The need of the hour is to embrace a collaborative approach, wherein, stakeholders work together to enhance the capacity and capability of the health system, to cater to the growing demand. Whilst the private health sector in Delhi continues to serve the community extensively and selflessly, it is, however, necessary that it survives to serve.”

*This news is based on a press release.