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Wednesday, April 17 2024
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Bengaluru

COVID19 treatment: Private Hospitals make offer to state Govt.; Govt. yet to respond

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Bengaluru: Treatment of Covid19 patients in private hospitals has become a headache worse than a migraine for both the healthcare industry, the goverment and the patient. Some refuse to treat the patients, others are willing to treat if they are reimbursed the costs of the additional infrastructure they say they have put in place including isolation and testing facilities and additional facilities for oxygenation and ventilation. They have also factored in other social distancing and protective measures including the use and and disposal of PPE.

Private hospitals in Karnataka have offered to treat asymptomatic Covid-19 patients from below poverty line (BPL) families for Rs 5,200 per day under the Ayushman Bharat Arogya Karnataka health insurance scheme according to a report in the Times of India. The Karnataka government is yet to respond to the offer. This despite the price quoted by Private Hospitals and Nursing Homes Association (PHANA) being nearly one-third of the indicative pricing issued by Association of Healthcare Providers of India for treatment in private hospitals.

Karnataka’s treatment policy suggests a sevenday hospital stay for asymptomatic patients who are on routine check-up and do not require any medicine would be Rs 36,400. The PHANA proposal factors in PPE cost but excludes testing. The test required prior to discharge costs Rs 2,250 on an average. The treatment cost increases if the patient needs oxygen support, has to be admitted to ICU or put on ventilator.

The Government estimates of expenditure for a 14 day stay is 3.5 lakh or approx 1.75 lakh – so the PHANA rates are extremely competitive even with additional requirements of testing, special proceedures and investigations which they say would be billed at CGHS Rates or 50% of the cost. Of course drugs and plasma thereapy if required would be required to be charged at actuals they said.

The Federation of Indian Chambers of Commerce and Industry (FICCI) said it is working with the government to resolve the treatment expenditure issues in private sector and has submitted the costing framework to the Union and State Health Ministries. “Covid-19 treatment cost is difficult to rationalise essentially due to the unknown nature of treatment required and various comorbidities associated with it,” Dr Alok Roy, Chair- FICCI Health Services Committee said.

“Additionally, segregating the covid and non-covid patients is essential which needs huge investments in infrastructure. We have recommended these costs which may not be viable for the private sector, as we are in a national crisis and believe that it is our ethical responsibility to serve our patients with the best treatment possible at reasonable costs,” he said.

According to the FICCI recommendation, a patient who is paying from out of pocket should pay ?17,000 per day for treatment in an isolation ward and ?45,000 per day for ICU (with ventilator). These rates include medicines, consumables and basic diagnostics, but exclude PPE costs, high end drugs and any co-morbidities. Also, they are indicative rates and there may be individual variations to the extent of 5-10%, FICCI said in a statement.

The FICCI covid-19 Response Taskforce, categorised the covid-19 treatment according to government referred patients, patients paying from out of pocket and for patients who are covered by TPAs. The federation further sub-categorised them to three levels depending on the severity of the case. The reccommendation is based on the analysis of actual data of 150 cases of covid treatment in major private hospitals, FICCI said.

Similarly, Association of Healthcare Providers (India) (AHPI), representing majority of private hospitals in the country, also came out with a suggestive cost for treatment of covid-19 patients in private hospitals, which are not covered under agreement with Governmental run scheme; central or state. “As more and more patients are opting for treatment at private hospitals, standardization of cost becomes necessary,” said Dr Girdhar Gyani, director general AHPI. The AHPI has submitted its recommendation to the government suggesting per day charges of ?15000 for General Ward, ?20000 for Ward with oxygen, ?25000 for Isolation ICU, and ?35000 for Isolation ICU with Ventilator. “There are reports that there was no transparency in treatment cost at private hospitals and therefore need for voluntarily fixing the price for treatment of covid-19 patients was felt,” Dr Alexander Thomas, President, AHPI said. The AHPI costing suggested is based on the assessment carried out in hospitals, which are treating covid-19 patients and have the experience of actual costing relating to use of PPEs, Infection Control measures, Human Resource aspect of Healthcare workers, who are deployed in shifts and need to be quarantined etc.

There are many instances of Private Hospitals refusing to treat COVID19 patients in Tamil Nadu, Maharastra and Delhi.. and the state goverments have resorted to issuing directives for compliance. At least three states – Chhattisgarh, Rajasthan and Madhya Pradesh – have gone further, issuing orders announcing that entire private hospitals would be temporarily taken over by the government for the treatment of Covid-19 patients. Healthcare for Covid-19 patients treated at these hospitals would be free, government officials in all three states said. But governments and private healthcare providers are still ironing out the details of the partnership. The states issued orders under rules flowing from the Epidemic Diseases Act of 1897 or state-specific variations of the Act. The colonial-era law empowers the state to enforce temporary regulations to fight the “outbreak of any dangerous epidemic disease”.

Meanwhile, the Union government on Thursday filed an affidavit in the Supreme Court saying it had no statutory power to direct private and charitable Hospitals to provide free treatment to COVID19 patients – it said that it is upto the state goverments to do the needful. Acting on petition filed by Advocate Sachin Jain which submitted that COVID19 patients were being exploited by the Healthcare industry in the private sector, especially as treatment facilities were limited, a bench consisting of Chief Justice SA Bobde, and Justices Bopanna and Roy had asked the Centres Solicitor General Tushar Mehta why private hospitals which were given land free or at nominal cost by the Government should not be directed to provide such treatment for free.

A final decision is awaited. Meanwhile, patients and health authorities are struggling to provide the required health care facilities to the needy members of the public.

 

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