The Delhi government on Monday issued a draft policy to regulate charges levied by private hospitals in the city, including a controversial provision for a partial bill waiver if a patient dies within a day of being taken to a hospital emergency.
Under the draft policy, if a patient dies within six hours of being taken to a hospital emergency, 50% of the cost of treatment will be waived. If the death occurs within 24 hours, 20% of the total bill amount will be waived.
“There have been a lot of complaints of overcharging and malpractices in private hospitals. This policy will help increase transparency,” Delhi health minister Satyender Jain said.
“The maximum number of feuds happens when the patients die within the first few hours and the relatives are handed a huge bill. We have suggested that the hospitals waive off 50% of the cost on humanitarian grounds as 50% covers the cost of consumables and medicines,” added Dr KK Aggarwal, former president of the Indian Medical Association.
The new draft policy urges doctors to prescribe drugs from the 376 medicines on the National List of Essential Medicines (NLEM), the prices for which are fixed by the Union government. For drugs not on the essential list, hospitals can charge either the Maximum Retail Price (MRP) or a mark-up of 50% on the purchase price, whichever is less, it says.
The same applies to all disposables and consumables such as gloves, syringes and cotton swabs. The policy also says that hospitals must list the cost of various treatment packages and counsel the patients on the expected complications and the added cost, if they happen. An additional surgery or procedure performed on the patient should cost only 50% of original cost. In case of complicated cases, the hospitals may prepare high-risk packages, which can cost 20% more than normal packages.
Several hospitals and health care experts described the measures as “harsh” and said they may adversely impact patient care.
“The advisory is quite harsh from the perspective of private health care services providers based in NCT Delhi. We are in the process of studying the document in detail and will be engaging with the government in a constructive manner. We completely understand the need for transparency and fair and reasonable profits. The reality, however, is quite different. Most private players are making losses or single digit returns which don’t even cover the cost of capital. Some of the recommendations may also adversely impact patient care and quality,” said Max Healthcare authorities in a statement.
“Regulating prices in this way may push health care providers against the wall and lead to deteriorating quality of services. For example, in the case of a hernia, the chances for complications are little, 96% would not need any care, but what of the 4% who might need ICU care for prolonged periods?” said Dr MC Misra, former director of the All India Institute of Medical Sciences (AIIMS).
“How can you formulate these packages when the government has not set any standard treatment guidelines? When it comes to procedures, it is not that simple. Would capping prices lead to patients being turned away or restrict their choices? And is the public sector prepared to deal with the increased patient load? The issue is very complex,” said Samit Chowdhury associate professor of Health Policy Research Unit, Institute of Economic Growth (IEG), but pointed out that consumers will benefit from the cap on drug prices.
"What if a patient die immediately after 24hours?"
This policy is not something to be implemented in haste, instead a deep analysis must be done to know it’s negative consequences. Only after involving all the stakeholders the final decision should be taken.
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