States have done well to step in to regulate charges for COVID-19 care in private hospitals
The role of the state as a big brother is
problematic, and yet only a vigilant, just state can temper the
avaricious excesses in the society it governs. The move by certain
States to regulate hospital fees charged in the private sector for
COVID-19 care falls square in this category. Bombarded with reports
about exorbitant bills being raised in the private sector for hospital
care of persons who tested positive for COVID-19, a few States decided
to get involved, rightly so, and set a cap on the tariff that can be
charged by private hospitals. In some instances, the Indian Medical
Association also prayed for intervention by the government to regulate
this. Maharashtra was the first to fix a tariff, followed by Gujarat and Tamil Nadu,
three of the States seeing a high number of COVID-19 infections. For
the initial part of the epidemic, it was the State that was the primary
testing agent and care giver, for all COVID-19 cases. At that stage, few
private hospitals, if any, were in the front line of the battle. All
tests were initially done by the government, and anyone who tested
positive was shifted to a government hospital for isolation and
treatment. However, as the number of cases increased, naturally calling
all hands to the deck meant the significant involvement of the private
sector. Complaints of overcharging followed. Media reports revealed
differential rates across the country, but costs were upwards of ₹7 lakh
for a minimum 14-day period of hospitalisation, even for mildly
symptomatic or asymptomatic patients. If intensive care unit care is
warranted, then the rates would be much higher.
The state’s
intervention could not have been delayed any further. In fact, in
retrospect, the strategy employed by the Central government to cap the price of tests for COVID-19
at ₹4,500 in private labs could have been used to regulate private
hospitals’ charges too. Hospitals have been graded into categories,
depending on facilities provided, with reasonable rates fixed per day
for each category. ICU rates are naturally higher, and States have
specified that private hospitals should follow the tariff for beds or
they could be charged for violations. Making it a participatory process,
the private sector was also co-opted into discussions on tariff. Tamil
Nadu has also fixed a separate tariff for beneficiaries under the Chief
Minister’s Comprehensive Health Insurance Scheme (now subsumed under the
Central Insurance scheme) making it easy for patients from lower income
groups to access private care treatments for COVID-19. It has also
re-fixed the rate for testing in a private lab at ₹3,000 per test.
Further watchfulness should continue on the part of the State, but shorn
of high-handedness. Staying alive to the hardships of its people, it
must ensure ̥that the harsh times are not further exacerbated by
profiteering.
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