Towards ‘fair’ pricing of Covid treatment

PT Jyothi Datta | Updated on July 03, 2020

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Covid costs stack up against patients but healthcare institutions are hurting too

Over the last several months, authorities in different parts of the country have capped testing and treatment charges for Covid-19, following patient complaints of being “fleeced”.

Hospital bills, in some cases, have run into several lakhs as patient-families say they are made to pay for personal protective equipment (PPE), for example, at prices that are more than the market price. The prices of laboratory tests too have been capped, hovering at about ₹2,000 per RT-PCR test. But it does not end there as patients may need two tests or more. This could extend to family members, if a person tests positive for Covid. The costs add up, as laboratory tests are just the beginning, with treatment costs, including hospitalisation, medicines, etc, set to follow. And, there’s the fact that lab costs are not covered by health insurance, though treatment is.

Acknowledging how the costs stack up for patients, hospital and laboratory industry players, however, urge authorities to not take a “one size fits all” view. A more scientific approach to pricing, they say, will protect consumers and not force healthcare institutions into an unviable corner.

Hospitals in Maharashtra, Rajasthan, Tamil Nadu, and Delhi, for instance, have capped treatment costs. “In Mumbai, hospitals have not increased prices since December last year,” says Gautam Khanna, Co-chair, FICCI Health Services Committee and Chief Executive, Hinduja Hospital. Different hospitals have cost structures linked to the quality and services provided, he says, adding “fixing Covid treatment prices from a patient perspective is fine, but capping non-Covid services too is not appropriate.”

Caught between rising input costs (equipment, PPE costs, masks, etc) and capped overall treatment costs, he says, “there’s angst in hospitals”.

Industry hands point out that someone always foots the bill, be it patients through out-of-pocket payments or citizens through taxes paid towards running public utilities and hospitals. “Private hospitals are borrowing money to pay salaries to their staff, and that was in April/May,” he says, indicating that some could be facing closure. “If access is the focus, then it’s necessary to ensure that hospitals are open,” he says, and urges authorities to think through prices keeping industry costs also in the picture.

“Hospitals need to pay salaries to doctors, nurses and support staff,” he points out. Healthcare workers are getting demotivated as they are criticised for their actions, despite being at work everyday at much risk to themselves and their families, he rues, adding, “Have a heart for people coming to work at the hospitals, because for every one incident that goes wrong, another 99 are okay.” On PPE billings, he says, “When PPEs are billed to a patient, it’s not that of just the doctor attending to the patient, but five other support staff also on the job, who the patient may not have noticed.”

Khanna urges Governments and organisations to make health insurance mandatory for people. Aspiring for free healthcare will require greater Government healthcare spends and more, to ensure top-quality services across healthcare institutions.

Testing times

When it comes to diagnostic tests and out-patient treatments, health insurance does not cover them, points out Arindam Haldar, Chief Executive of SRL Diagnostics. Against the Covid backdrop, patient-centric price-caps are understandable, he says. The concern is when price-caps vary; for example, Chandigarh caps testing prices at ₹2,000, Delhi at ₹2,400, Maharashtra at ₹2,200 and ₹2,800 (with sample collection) and Tamil Nadu at ₹3,000 and ₹3,500 (with samples). Input costs are not capped and there’s GST payment, etc, leaving little room for them, when the end-price is capped as well. The industry is talking to multiple vendors to contain costs, he says, adding, “But there should be one scientific authority to approach to sort things out”.

While the Government does well on keeping prices in check, a collaborative approach works better even in patient interest, than an adversarial one, says an industry hand — something Governments may do well to keep in mind as rising Covid cases indicate there’s still much ground to cover.

Published on July 03, 2020

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