Arbitrary charges by tony 5-star hospitals

Sumedha Sharma in Gurugram

SIXTEEN lakh for dengue treatment’ — the one-liner on social media made us talk about the virtual non-existent healthcare infrastructure in the country. The father of 7-year-old girl Adya who died of dengue shock syndrome, took on one of the premier health institutes. He has demanded to know why costly antibiotics were given instead of generic drugs in the entire treatment process. The hospital in question was booked for culpable homicide but came ‘clean’ in terms of charges about medicines and consumables. 

The inquiry committee set up by the Haryana government has not only probed the alleged negligence, but also raised questions about healthcare or ‘medical tourism’ stylized by five-star hospitals. The government panel was headed by Dr Rajiv Wadhera, state’s additional director general (health). 

Premier medical institutes of Gurugram credit themselves with providing world-class healthcare. Patients ‘understand’ the cost of hospital stays, but are baffled by the drug prices. As pointed out in Adya case, the doctors had allegedly used a cheaper version of an antibiotic up to midway into her treatment. For the rest of the course of treatment, the child was put on a variant of the same salt.

The drug prices in the country are controlled by the National Pharmaceutical Pricing Authority of India through Drugs (Prices Control) Order (DPCO). The DPCO is basically a list issued by the government under Section 3 of the Essential Commodities Act, 1955, spelling out the MSP of life-saving drugs. Ironically, most medicines and consumables used in critical care are not included in the list, giving a free hand to pharmacists and hospitals to charge arbitrarily. 

“Such issues are pending for a long time. The lacunae ensure huge profits, but a patient suffers as there is no forum where he can appeal. An autonomous regulatory authority can help. It should be free from influence and political control. It should have legal and judicial powers to not just regulate but also penalize violators,” says Dr Ashok Goel , a leading pharmacologist associated with Baba Farid University of Health Sciences, Faridkot (Punjab). 

The Adya inquiry committee has also raised questions about charges on ICU admission. Though not directly related to the case, the panel has challenged the bed cost which is as high as Rs 12,000. That is in addition to what a patient pays separately for everything — equipment and even cables. “In that case, what do they mean by bed charges? Does a patient pay around Rs 15,000 just for a mattress?” asks a committee member. 

The hospitals are unmoved. “Yes, it’s a business for us because we bought lands at commercial rates and pay our bills at that rate. We spend huge amounts to target medical tourists from abroad. Surely, charity is not our forte. We are bound to ensure right diagnosis and treatment, but we must be free to decide the cost. The government should upgrade its own hospitals. For instance, the government hospital in Gurugram does not have a cardiac unit leave aside facilities such as the CCU. The people who come to us know they can’t afford, but they have no choice,” says owner of a Gurugram-based posh hospital.