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.
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?
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