While on one hand the private healthcare sector in India provides modern technologies and excellent treatment facilities, on the other hand its rising cost has become a major cause of concern for the common citizens. Every year, crores of people in the country lose their savings or get trapped in debt just because of the treatment of some serious disease. The high-level expert committee (Health Care Reform Panel) formed to deal with the problems like arbitrary hospital bills, excessive room rents and huge margins on medicines has given many revolutionary and practical suggestions in its latest report. If these recommendations are strictly implemented, treatment in private hospitals in the country will not only be affordable but will also bring transparency in the entire process. Bed Charges on 3-Star Hotel Tariff: Arbitrary room rents will be curbed. The biggest financial burden for the patients admitted in private hospitals is the room rent (Bed/Room Rent). In the current system, many big corporate hospitals charge Rs 10,000 to Rs 25,000 per day even for a simple room. The committee has taken a strong stand on this and recommended that bed charges in private hospitals should be capped on the lines of the average fare of a 3-star hotel depending on the city or category concerned. Further, the committee has suggested complete abolition of the prevalent system under which doctor's visiting fees, nursing charges, ICU charges and cost of surgical procedures change depending on the room category (e.g. general ward, twin sharing or single private room). The committee clearly states that the doctor's knowledge and surgical equipment remain the same, hence it is completely unfair to increase the total cost of treatment merely on the basis of the patient staying in an expensive room. OPD and Pathology Cover in Health Insurance: Relief from out-of-pocket expenses The bulk of health insurance in India still provides coverage only for hospitalization for 24 hours or more (IPD). However, statistics show that 60 to 70 percent of the total out-of-pocket expenditure on health of any common citizen goes towards hospital visits, doctors' fees (OPD consultation), blood tests, MRI/CT scans and regular medicines. The committee has suggested to the Insurance Regulatory and Development Authority of India (IRDAI) and the Central Government to make OPD and pathology tests mandatory in all health insurance policies. With this, the patient will not have to spend huge amount from his pocket for the treatment of minor diseases or initial tests. Also, due to timely investigation, serious diseases can be detected in the early stages, which will also save the cost of major operations later on. Margin Capping on Prices of Generic Medicines, Consumables and Implants Medicines and medical consumables (such as gloves, syringes, drip sets, cotton, bandages, etc.) contribute significantly to the final bill for hospitalized patients. It is often seen that private hospitals force patients and their families to buy medicines from the in-house pharmacy of the hospital, where huge profits of 300 to 1000 percent are charged on the MRP. The committee has made the following main recommendations to curb this profiteering: Limit on trade margin: A maximum limit of 30 to 50 percent should be fixed on the trade margin of non-scheduled drugs and consumable items. Freedom to buy medicines from outside: Patients should be given complete freedom to buy medicines and medical items from any authorized or Jan Aushadhi center outside the hospital. Use of generic salt: It should be made mandatory for doctors to prescribe only salt (generic) name in place of branded medicines. Standard treatment packages and digital rate boards: There will be complete transparency in billing. Often the biggest complaint of patients is that the estimated cost mentioned at the time of admission doubles or triples at the time of discharge. Unknown fees and 'other charges' mentioned in the bill leave family members confused. To solve this problem, the committee has suggested implementing Standard Treatment Guidelines (STG) and fixed package rates. Fixed package rates should be fixed for common and routine surgeries like cataract, angioplasty, knee-replacement, hernia and gall bladder. Along with this, it should be made mandatory for all private hospitals to display the rate list of treatment, bed charge, investigation and surgical packages through digital boards at their reception, entrance and official website. Patient Rights Charter and Grievance Redressal Mechanism To protect the rights of patients and their families during treatment, the Committee has stressed on strict implementation of the 'Patient Rights Charter'. This includes the patient's legal right to be informed about his disease, his treatment options, to get a second opinion from a second doctor, and to get a copy of his medical records immediately. The committee has also recommended that an independent 'Healthcare Ombudsman' or grievance redressal cell be constituted at each district and state level. If a hospital charges bills in excess of the prescribed standards, tries to withhold the dead body in the name of bill arrears after the death of a patient, or provides wrong treatment, the patient's family members will be able to file a quick online complaint in this cell, which will attract strict action and penalty within 7 to 15 days. The main objective of these comprehensive suggestions is to make the healthcare system in the country more humane, affordable and transparent so that no family has to face financial ruin in order to protect their health or the lives of their loved ones.
