Skip to main content

where& when& how & why the cost of treatment is controlled?? chapter 1

 where& when& how & why the cost of treatment is controlled??

In this 1st. chapter we will explore -why it's not practical to standardize the prices of treatment?

What LAW  tells?-  "Health is a state subject; the Centre can only to some extent direct the states. However, as suggested by the supreme  court(march 2024), the central govt  will hold consultations to seek the suggestions of all states' and file a reply before the Supreme Court, on or before 10th.april2024" 

Highlighting the stark difference in treatment costs between government and private healthcare centres, the apex court asserted that citizens have a fundamental right to healthcare, and the government cannot evade its responsibility in ensuring this right.

The Association of Healthcare Providers (AHPI), which represents medium and small hospitals, will also file an intervention in the Supreme Court on behalf of the hospitals, Girdhar Gyani, director general of the association, told . Gyani has also written to the health ministry recommending working out costing of various procedures based on established scientific principles and fixing rates in the 'Range' to address the categorisation of establishments.

Why fixing the prices in a Range?

treatment in private hospitals has their  own costs which are divided as direct and indirect costs depending on so many variables.

if the court or govt enforce standard prices, that  move will be "catastrophic" for the Private hospitals  as there are too many variables involved.

what are the variables in the costing of care?

"The cost depends on so many other factors, even geographies. The input cost is higher in Delhi than in UP. Since the minimum wages are lower in UP, the hospital may choose to pass it on to the patients. But the same cannot be applied in a place like Delhi. If it is standardised, the quality will suffer.

The cost structure is different in each hospital "as it depends on various factors like the experience of the doctors, facilities in the OT, the kind of infection control policy which is adopted by the hospital, patient safety measures, IT services etc."

 "Price cannot be standardised for a big hospital and a small clinic,!

Does SC has authority to  GIVE AN ORDER of price standardization in private hospitals ?

The Supreme Court has broad constitutional authority to ensure justice and protect the fundamental rights of citizens under Articles 32 and 142 of the Constitution of India. When it comes to healthcare, the right to health is part of the right to life under Article 21. Therefore, it may intervene.

(if they have then it must be same for all professionals including Lawyers, CA etc... #SupremeCourtofIndia can't do cherry picking. In fact this should start from home & first regulate Lawyers fees.)

The Supreme Court of India's recent directive to regulate prices for medical treatments and procedures has sparked a crucial discussion about the state of healthcare in the country.

Role of health insurance companies?

Currently, we observe two distinct pricing tiers: one for those with insurance and another for those without. The growing influence of the insurance sector has inadvertently contributed to the escalation of medical costs, by nudging a large population of buyers to spend incrementally more on health insurance policies - an effect large in magnitude, but goes unnoticed.

However, this trend has also yielded positive outcomes. The medical sector has witnessed increased investments, propelling India to become a preferred destination for medical procedures globally. 

The Indian medical tourism sector, valued at $7.4 billion in 2022, is projected to soar past $42 billion by 2032. India's competitive edge lies in its cost-effective treatments, with procedures like heart bypass surgery costing around $5,200, compared to a staggering $144,000 in the US. While India's medical tourism sector continues to thrive, domestic insurance penetration remains a significant challenge. 

Does fixing of prices pave the way for lower premiums of health insurance?

As of 2021, only 37% of India's population had some form of health insurance coverage. Fixing prices could help address this issue by reducing insurance costs, making healthcare more accessible and affordable for a larger portion of the population.

 The objective is a harmonious balance where quality healthcare is not only a reality for the insured minority but an accessible service for the vast majority, without compromising the investments necessary for the healthcare sector's growth and development.

  By fostering a conducive environment for investments, promoting specialized treatments, and leveraging initiatives like "Heal in India", we can solidify India's position as a global leader in medical tourism.

I had a mediclaim policy (star health)5 yrs ago that cost me about Rs 14000 then.This year its cost has become Rs 42000(including 18%GST even on insurance of this kind). Is it manageable for the public of low income groups like me ?

In the 2nd. chapter we will focus on- How to Control Operating Expenses in hospitals?


Comments