The following
article is based on research that was conducted by Susmita Chatterjee of Public
Health Foundation of India, Carol Levin of Department of Global Health,
University of Washington, USA and Ramanan Laxminarayan of Princeton
Environmental Institute, Princeton University, New Jersey, USA.
The researchers considered five criteria,
including cost per OPD case, cost per inpatient (IPD), cost per
emergency room visit and cost per surgery. For this, they selected five
hospitals, based on their willingness to cooperate and the accessibility of
hospital data. Two hospitals were from north India and three were from the
south. The findings are based on data collected from April 2010 to March 2011.
Now it's 2022. so
we may add medical inflation at 12% every year that mounts almost 100%. so, we
read the figures by doubling them.
FOR 140 crore people, the existing
health care infrastructure is not enough.
In India,
government health care services are organized into several tiers. Primary
health care is provided through a network of 1.5 lakh health &wellness
subcenters, 27000 primary health centers (PHCs), and 6000 community health
centers (CHCs), 1200 sub-district hospitals with 30-100 bed capacity each and
600 district hospitals with 300 beds on average each and 300 govt medical
colleges with700 beds on average each and another 1000 other hospitals includes
big institutes like AIIMS, army,industrial,ESI,Regional excellency
centers, railway and local bodies.
Private
healthcare 20 times costlier than public healthcare: study.
|
Compare
costs |
||||
|
Hospitals/cost per case |
OPD |
IPD |
Emergency |
Major
OT |
|
Charitable hospital |
200 |
4000 |
1000 |
50000 |
|
District hospital |
200 |
1000 |
2000 |
4000 |
|
Tertiary care hospital |
500 |
1500 |
1000 |
20000 |
|
Private hospital |
5000 |
15000 |
50000 |
50000 |
|
Private teaching
hospital |
||||
Despite the high cost of treatment, the private sector still
takes care of 80 per cent of all outpatient care and about 60 per cent of all
inpatient care. it shows that people want good quality care thats available in
private hospitals when compared with public hospitals.
Recent CCI's report:
India’s largest hospital chains abused dominance
through excessive pricing, finds CCI investigation.
The CCI investigation is the first such action against exorbitant prices of medicines and services fixed by hospitals, which have operated free of regulation so far.
A four-year investigation by India’s fair-trade
regulator(Competition
Commission of India (CCI)) has concluded that some of India’s largest
hospital chains abused their dominance through exorbitant pricing of medical
services and products in contravention of competition laws.
The CCI investigation is the first such action against
exorbitant prices of medicines and services fixed by hospitals, which have
operated unencumbered by regulation so far. The watchdog’s action could
potentially rein in the prices of medicines and healthcare equipment, or at the
very least, bring transparency in the way hospitals sell these items, according
to competition lawyers.
Some hospital room rents exceeded those charged by
3-star and 4-star hotels, according to the findings by the DG, who
examines anti-competitive practices.
The investigation found that these hospitals do not
allow the use of purchase of consumables, medical devices, medicines and
medical test results from outside, adding that patients use the service of
in-house pharmacy and laboratories for ease of convenience
27 crore Indians are poor. --- How to
define the poor?
In times when a daily expenditure of Rs 27 has been set as the cut off mark for deciding
whether a person is below or above the poverty line, the outpatient
treatment (OPD) services in private hospitals charge as high as Rs 2,213. The
cost of visiting an OPD in district hospital is Rs 94 which is also quite high
for a poor person if one considers the poverty line decided by the Planning
Commission.
Similarly, in-patient stay cost is Rs 394 per day in a district hospital,
Rs 614 in a tertiary care hospital, Rs 1,959 in a charitable hospital and Rs
6,997 in a private hospital.
According to the research, the emergency visit cost is the lowest in
charitable hospitals (Rs 385) and highest in private hospitals (Rs 21,873).
Surgical procedures are very expensive, both in private and charitable hospitals—Rs.
24,016 and Rs. 27,430 per procedure. The emergency visit cost at a private
hospital is also exceptionally high compared to that of other hospitals.
1.While
India’s healthcare costs look inexpensive to medical tourists, they are costly,
almost unaffordable, for the average Indian citizen. The healthcare expenditure
of Rs 1500 for a poor family may seem like a paltry amount, but it is 50 per
cent of their monthly income.
the 68th round
survey of the National Sample Survey carried out during July 2011-June 2012
reveals some alarming facts about how little money people have to spend on
food, nutrition and health.
Household Consumer
Expenditure in India" survey conducted by the National Statistical Office
(NSO), the average monthly spending by an individual is at
just Rs.1500/-in 2021.
Reveals the average
expenditure on goods (food and non-food) and services.
Distribution of
monthly consumption expenditure in urban and rural India 2019-2020. As of
December 2020, around 50 percent of households in urban India spent no
more than 2.4 thousand Indian rupees per month. Meanwhile, 37 percent of
rural Indian households had at most 1.6 thousand rupees to live on.
The socalled
economic growth has maintained huge inequality in per capita expenditure on
very essential needs such as food, health and education. The level of inequity
is very-very high in the context of per capita expenditure on education and
health.
On education, the bottom 5 per cent population in rural India is spending just
Rs 7.54 per month whereas top 5 per cent in urban India is spending a 120 times
higher amount of Rs 908.12 per month. This disparity is one of the reasons why
the largest section of the society, the poor, is denied Right to Education with
quality. The spending difference on medical expenditure in these two categories
is 40 times. Just to inform you on expenditure levels for availing conveyance
services, the top 5 per cent population in urban India spends 116 times more
than the bottom 5 per cent rural population. Even today, the average Indian is
struggling hard to get right to quality education and basic health services and
because of uneven growth they not able to spend on it. It also indicates that
withdrawal of the state from essential sectors is really causing distress in
almost every segment of society.
Emerging pointers
The Indian
insurance policies are such that their first effort is to evade the payment or
pay only a portion of the bills of the corporate hospitals.
As per modest approximation any major procedure costs between Rs 2 lakh and Rs 20 lakh. The follow-up upkeep cost is separate.
The main effect of the rising cost is, therefore, either complete non-availability or accessibility of poor-quality health care; patients are even pushed to poverty.
The Government establishments can
look after only a small section of patients, waiting period is huge, add to
this uncaring attitude of staff, prevalent unhygienic conditions, gross
inconsistency in the demand and supply of facilities, and the picture looks
depressing.
A patient, thus, has to knock at the
gates of private institutions. The corporate hospitals are beyond the touch of
even middle-class people.
One of the major worries for most
senior citizens is declining health. In the face of steep payments for health
insurance and increasing healthcare costs, managing health-related expenses can
be really difficult. Health insurance does not take care of all your
requirements like day-to-day care (OPD needs). Even if your cover is adequate
for hospitalization, various constituents do not get paid by insurance companies.
Therefore, you need to keep aside some money for your healthcare needs as you
come close to age of 50 years.
Unfortunately, many of the elderly
don’t have health cover and are possibly out of range for getting one because
of their circumstances. They can find out if they can get covered as dependents
of their children’s corporate health plans.
Improved life expectancy,
quick urbanization and lifestyle changes have led to the advent of varied
problems for the elderly in India. The elderly population undergoes high rates
of morbidity and mortality due to infectious diseases. Unattended chronic
disease, high-priced medicines and treatment and malnutrition are part of old
age life in India as there is no system of reasonable healthcare.
Insurance cover that is
elderly-sensitive is practically non- existent in India and, if provided, it’s
very costly, limited to hospitalization and with many omissions. Healthcare
system for elderly in India is awfully bad and very costly which many can’t
afford as equated to developed countries where government schemes and
healthcare system look after their senior citizens.
In present times, people normally
live longer but a long life is valuable only if it is disease-free. India faces
a hastily increasing healthcare crisis. In addition to recurrent diseases like
dengue, we have chronic lifestyle-related disorders such as diabetes. This is
compounded by one of the fastest rising elderly populations in the world: by
2050 we will have 240 million elderlies.
Health care has become a profitable
business venture. Most corporate hospitals are prosperous, growing, opening new projects
all over the globe but charity, concession, assistance do not exist in their
vocabulary.
Many of these hospitals have got
prime land on subsidized rates, in lieu of which they were supposed to deliver
free beds to poor and worthy patients. But hardly any of them do that. As in
investigations, many drugs are needlessly prescribed without sound symptoms,
antibiotics, vitamins, tranquillizers, analgesics, food supplements are the
common ones.
=====
what type of measures the govt
should implement to regulate the prices of drugs &diagnostics
which are major contributing factors for about 70% of healthcare pricing.?
Does introspection among corporate fraternity can change the scenario?
We will discuss it in the next post...
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