Growing Cost of Healthcare in India: Who is to Blame?
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In the last two years, the ongoing COVID-19 pandemic has been perceived to cause an increase in the cost of healthcare services across the country. During the peak of both the first and second waves of the pandemic, it became a regular practice to come across numerous reports in newspapers in which COVID-19 patients and their kin alleged that their treatments were overcharged by private hospitals in the country. Presently, the common perception among citizens is that the private healthcare industry has heavily profiteered from the current crisis at the cost of hapless patients.
But is this the entire picture or is it only a piece of a more intricate puzzle?
Over-Reliance on the Private Healthcare Sector
Much before the pandemic, a 2019 report by a government agency highlighted that the number of private hospitals in India was twice the number of government hospitals. Ironically, though, 85.9% of India’s rural population and 80.9% of the urban population did not have a health insurance policy. Consequently, despite the availability of high-quality private healthcare services in their vicinity, many patients found it economically difficult to avail themselves of the same.
On the other hand, the public sector which offers free or low-cost healthcare services to patients remains underdeveloped in many regions of the country. In fact, in 2020, India was ranked low on a list that compared the amount of money allocated to the health budget by different countries across the world. Thus, many government facilities though manned by some of the most dedicated health personnel are poorly maintained in terms of equipment and health infrastructure.
This used to lead to hesitancy among patients in approaching public centres for medical services.
In this scenario, the COVID-19 pandemic further exposed the gaps in the public health infrastructure. An increasing need for ICU beds, ventilators, centres with advanced diagnostic facilities led to the flocking of patients to private hospitals.
Implications of the COVID-19 Pandemic on Private Hospitals
Image Source: https://www.careinsurance.com/blog/health-insurance-articles/buy-health-insurance-to-manage-high-cost-of-medical-treatment-in-india
The information given above would make it seem that with COVID-19 patients keen on approaching private hospitals, this was purely a period of growth for them. However, one must realize that, unlike public hospitals, private hospitals do not receive any funding or subsided resources from the government. Thus, their business model has to be self-sustaining.
During the first few months of the pandemic, all non-emergent diagnostic and interventional procedures and paramedical services came to a standstill, as hospitals and doctors grappled to understand how to deal with the situation. While these patients were willingly deferred by doctors until the necessary precautions could be instituted; on the other hand, even patients needing urgent treatment or regular follow-up of chronic systemic conditions became anxious about visiting healthcare facilities. Many deferred their treatment, despite the possibility of facing serious complications.
As a result of the same, the number of patients visiting hospitals drastically reduced and led to these facilities experiencing a fair bit of monetary losses as well as loss of patronage by patients.
Subsequent lockdowns and the travel restrictions imposed in the country meant that private hospitals lost out on patients, who used to visit them from different parts of the country. International medical tourism declined.
Fluctuating Government Regulations
Another fallout from the pandemic for private hospitals was, that the lack of public facilities meant that many private facilities were taken over by the government and had to abide by their regulation regarding admission of patients, the number of beds in the facility retained for COVID-19 patients etc.
These government regulations underwent frequent changes during the pandemic and differed across cities and states, especially inconveniencing hospital chains that were unable to follow a uniform protocol across their branches.
In this duration, private hospitals have admitted patients who could not afford their charges and have had to turn away non-COVID patients due to a lack of beds. Also, the lack of awareness and fear of contracting COVID on hospital premises caused outpatient visits in these hospitals to decline despite them following the best of social distancing, sanitization and disinfection protocols.
Does this mean that private hospitals are justified in overcharging patients?
No, of course not!
Based on the description of the legal proceedings of the cases registered against hospitals, it is fairly evident that many of them did indulge in overcharging patients.
Access to good healthcare is a birthright of every citizen of this country and any practice, which threatens this right should be dealt with promptly.
The only reason for putting forth this essay is to point out that the COVID-19 pandemic hasn’t been exactly a bed of roses for facilities either!
Also, while the private sector has its negatives, many times the good work done by it in terms of bringing in new technology and treatment protocols, foreign investments and increased professionalism in healthcare administration often goes unnoticed. Also, we do not give private institutes enough credit for helping needy patients when they can and also, conducting numerous free surgical procedures and treatment camps as part of their corporate social responsibility initiatives.
So, Where Do We Go From Here?
We need to develop regulations that are conducive to both private health care institutes and patients as well. Some steps have already been taken in this direction such as:
1. Capping on the bed and procedural charges at private institutes
2. Recruitment of auditors to oversee the billing protocols in private hospitals
3. Inclusion of a greater number of private hospitals under state insurance schemes
4. Development of public health facilities
5. A 13% increase in the health budget of India
We can only provide the best treatment to our patients when the public and private sectors work together in unison.
The future goal of healthcare administrators should be regulation of the private sector and development of services in the public sector!
Featured image source: Image by Gerd Altmann from Pixabay
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About the author
Dr.Nikhita Gune is a qualified pediatric and preventive dentist, currently working at NH SRCC Children's Hospital, Mumbai.She is also a consultant at various private dental clinics and charitable trusts across Mumbai. She maintains her own blog on oral healthcare of children on a popular parental guidance website. A bibliophile right from childhood, being a writer has always been her dream.
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