Experts root for solution to level off rates in pvt hospitals

Pune: If hospital associations, doctors’ groups, social organisations and citizens groups sit together and find a workable solution to standardize rates in private hospitals, it would solve the current deadlock between hospitals and insurance companies, and to bring relief to patients. This was the consensus among experts at the consultation on ‘need and methods to standardize rates in private hospitals’ organised by Jan Arogya Abhiyan (JAA) on Saturday.JAA is statewide coalition of civil society organizations working on health issues. Over 30 active citizens, representatives of social organisations, doctors and journalists participated in the discussion. The broad opinion that emerged was that although the issues of regulation of rates of private hospitals is complex, it is not impossible. Senior health activist Anant Phadke from Jan Arogya Abhiyan said, “The belief that market forces will regulate prices does not hold true for the sphere of health services. There is hierarchy and major asymmetry of medical knowledge between doctors and patients, and when the patient approaches a hospital for care, he/she is vulnerable and unable to make ‘free choices’ or bargain.” “Given this situation, and the fact that healthcare is an essential good, in countries across the world it has been recognised that rates of health services must be socially regulated,” Phadke said. As a member of the national committee for regulation of rates under the National Clinical Establishments act, Arun Gadre presented a framework for working out rational rates for various health services. Gadre pointed out that due to major differences over the issue of rates between hospitals and insurance companies, the system of cashless healthcare coverage has nearly broken down. “Many hospitals are now not providing cashless services, causing major hardship to ordinary patients. Now patients have to first shell out big sums of money at the time of seeking care, and reimbursement is made later, which is often less than what has been spent and after many months. This situation has brought the need for regulation of rates to the forefront,” he added. Gadre said costly items like stents and implants are available to hospitals at half the printed cost, but hospitals charge the full amount and often make up to 100% profits. Hospitals should definitely charge patients the due amount for the services they provide, but selling medical items at double the cost is unacceptable, he added. Gadre presented the key features of a comprehensive framework that could be adopted to calculate appropriate rates of services being given by private hospitals, enabling doctors to earn a reasonable income but eliminating excess charging and profiteering at the cost of patients. Former national president of Federation of Obstetricians and Gynaecologists Societies of India (FOGSI) and senior gynaecologist Sanjay Gupte endorsed the need for standardisation of rates in hospitals, however he also noted that various issues of concern to private doctors should be addressed. Representation may be made to the government so that such rate regulation would be included in the state level clinical establishments act which is currently being drafted. This would be welcomed by all socially sensitive and rationally thinking people in the state, said national co-convenor of Jan Swasthya Abhiyan Abhay Shukla.