A black hole of hospital bills

SHIRIN SYED | Updated on January 17, 2018

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A patient’s family member pleads for a transparent pricing system to cover not just consumables but also hospital charges, doctor fees

My 80-year-old father recently suffered a mild cardiac stroke. We shifted him to a reputed hospital in Aurangabad, Maharashtra. The hospital authorities cooperated, but only till he was moved into the ICU (Intensive Care Unit).

From there on, things changed. The specialist concerned did not turn up even two days after my father was admitted. Then, his intern met and informed us that they would do an angioplasty, if required.

Informally, we were told that a stent costs ₹2 lakh. But there was no one to discuss the options and clarify our confusion on the procedure and price. The hospital authorities told us that the cardiologist would meet us a few minutes before the procedure.

Our repeated requests for a discussion with the chief doctor went unheeded even though we said we wanted to take an informed decision on the angioplasty, given my father’s age. Despite our apprehension, they took the patient to the operation theatre forcing us to make a decision on the stents from their available exorbitant options.

We were aware that stents are expensive and that hospitals procure them at a fraction of the cost from manufacturers and yet do not pass on this benefit to patients. Despite being fully aware of such practices, and conveying the same to hospital authorities, we were forced to go in for a “package” (whose details were not disclosed even on demand) of about ₹2.5 lakh. And this was because my father had already been wheeled into the room for preliminary procedures.

Finally, we received a bill of ₹1.9 lakh that included stents and ‘consumables’ at ₹1,17,000, besides cardiologist charges of ₹74,000. On insisting for an itemized bill on the stents, consumables, etc., the hospital said that three stents were used in the procedure and they had charged only for two stents (₹48,000 each). Contrary to the bill, the doctors report mentioned use of only one stent.

On bringing this to the notice of the hospital authorities, we were told that we had to pay for a second stent that was removed from the packet but could not be inserted. They agreed to reduce the price on the unused stent only when we demanded that they hand over to us the unused stent. Thus the package was reduced from ₹2.5 lakh to ₹1.9 lakh.

The Government is planning to bring stents under price control, but that will have little impact on a patient’s life if they do not crack down on the non-transparent procedures of some hospitals and doctors. Despite being aware of the hidden costs in medical procedures, my family ended up having exactly the kind of bitter experience I was warned about by friends.

Hospitals do not seem to be interested in a patient’s right to know what he/she is going through and in this case little opportunity was given to get a second opinion and make an informed choice. In the absence of a transparent pricing mechanism of hospitals, doctors, medical procedures and devices, patients don’t know what they are paying for. A regulatory authority is required to ensure that there is a system of fair and transparent pricing of healthcare services and that it is enforced. Patients and their families should be able to approach this authority if they have a grievance on treatment ‘packages’ and dubious itemised bills offered by hospitals.

(The writer is a researcher on Intellectual Property at the North Maharashtra University, Jalgaon, Maharashtra. The views are personal.)

Published on August 19, 2016

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