Urgent need for a universal public health care system
The corona virus pandemic has revealed the failure of the health care system in our country and the inhuman utterly parasitic attitude of private hospitals.
The public health care system in India has shown itself to be completely incapable of dealing with the problem. The government hospitals have been facing critical shortage of hospital beds, isolation spaces and other essential life-saving equipment and services. They have failed to deal with the health care crisis, due to shortage of doctors, nurses and other staff and lack of essential protective gear for the doctors and health workers. They have had to drastically cut down emergency services and regular OPD and other non-Covid medical services, which has caused enormous problems for people requiring treatment for regular non-Covid ailments.
In this situation, the government has designated some private hospitals for Covid-19 care and asked for 60%-80% beds in these hospitals to be reserved for this purpose, with a suggested “cap” on the charges levied to the patients.
The Delhi government has capped Covid-19 treatment rates at Rs. 8,000 (non-NABH-accredited hospitals) and Rs.10,000 (NABH-accredited hospitals, including entry-level facilities) per day for an isolation bed, and Rs13,000-15,000 per day for a bed at an intensive care unit (ICU), and Rs15,000-18,000 per day for an ICU bed with a ventilator. (NABH – National Accreditation Board for Hospitals & Healthcare Providers). The Brihanmumbai Municipal Corporation (BMC) notified that charges for a COVID-19 patient in the general isolation ward cannot exceed Rs 4,000 a day, the maximum charge for an Intensive Care Unit (ICU) is capped at Rs 7,500 a day and for ventilators at Rs 9,000 a day. These “capped” charges do not include charges for PPE kits and other necessary accessories and services.
These charges are already unaffordable for a large majority of workers and working people in the cities. However, despite the announcement of the “capped “ charges, the reality is that the state governments and the central government have failed to check the rampant looting of people and profiteering by the private hospital managements in the name of Covid-19 care.
In Delhi, Mumbai and other major cities reports indicate that many of the private hospitals are actually reserving much fewer beds for Covid-19 patients than what the government’s instructions say. They are also openly violating the government-mandated charges using the excuse that “it is not financially profitable”. Amidst the severe restrictions of the repeated lockdowns and the prevailing disinformation and fear-psychosis created by the state authorities, private hospitals across the country are reported to be looting people in the name of Covid-19 care and taking advantage of the helplessness of people to multiply their profits.
Reports from across the country show that a 12-day stay at a private hospital to cure coronavirus can cost more than ₹8 lakh. On an average, it can cost anywhere between ₹40,000-50,000 a day. The costs are much higher if the patient is shifted to the intensive care unit or is put on ventilator support. Moreover, the authorities of the private hospitals are reported to be dealing with the patients and their families in an extremely rude and insensitive manner, when they cannot afford to pay the costs immediately, including refusing to admit even critically ill patients.
Reports of investigations carried out at 4 private hospitals in Mumbai indicated that the charges were: Rs 21,000 per day to Rs 27,000 per day for general ward, Rs 33,000 to Rs 40,000 for deluxe room, Rs 35,000 per day for a bed in the ICU and all these exclude additional charges which are not revealed upfront. These include PPE kits of the staff charged at Rs. 8000 per kit per day. An initial deposit at the time of admission ranges from Rs 2 lakh to Rs 5 lakh, depending on the patient’s condition. These private hospitals claimed that they did not have any instructions from BMC about reservation of certain number of beds for Covid-19 patients.
In Delhi and the NCR region, several private hospitals are reported to be charging Rs. 10,000 per PPE kit and up to Rs. 1 lakh for a single day’s hospitalization. If ICU and ventilator services are required, the costs may go up to 2-2.5 lakh per day. Many smaller private hospitals in Chennai are reported to be charging Rs. 40,000-50,000 per day, even for normal hospitalisation. People who are unable to pay the money are being denied admission in the private hospitals, even if they have tested positive and are in urgent need of hospital care.
Many private hospitals in Calcutta are insisting on steep cash deposits before admitting Covid-19 patients and turning them away if they are unable to pay. A resident of Calcutta who had tested positive was refused a bed in a private hospital in the city, because he was not able to pay a security deposit of Rs. 1 lakh in cash for admission. Other private hospitals in Calcutta are known to have demanded security deposits of up to Rs. 7 lakh.
Many cases have been reported in which the private hospital has charged Rs. 1 Lakh or more for admitting the patient. When the hospital has been unable to provide the patient the necessary treatment and services, they have asked the family to shift him to another hospital but have refused to refund the money.
Private hospitals have not accepted the health insurance packages for Covid-19 treatment being offered by the government or private medical insurance companies. As a result of this, many patients covered by insurance schemes have had to spend almost half of the cost of the treatment from their own pockets. Many patients are also facing problems receiving their claims from the insurance companies which have added Covid-19 treatment to their package for the first time and say they are still in the process of negotiating the insurance coverage amounts with the hospitals.
In many private hospitals, it has been found that patients who were fit to be discharged were continuing to be kept in the hospital, so that more money can be made by the hospital management by charging the patient for additional days.
The central and state governments could have used their enormous powers to ensure that the private hospitals actually provided health services to all in the conditions of the present health emergency. However, they have not done so. They have allowed private hospitals to loot the people in the name of the pandemic.
The Covid-19 pandemic once again reinforces the urgent need for a universal public health care system, which will provide complete medical and health care, including specialized treatment, for all members of the society. Only such a system can treat the working people with the compassion and care they deserve, as the producers of the wealth of the society, and not as a source of loot for the profit-greedy capitalists.