Introduction
The healthcare industry figures among the fast-growing industries in India. It consists of healthcare providers, medical equipment producers, health insurers, and academic institutions. Public hospitals, corporate hospitals with super specialised capabilities, charity hospitals, private hospitals, rehabilitation centres, small and medium nursing homes, private clinics, and diagnostic centres are just a few of the establishments in India that offer healthcare services.
However, the cost of health care has been rising at an unprecedented rate in recent years. The health inflation rates have seen a year-on-year increase of 7.4% in 2022, growing practically in lockstep with retail inflation. A close examination of the subgroups reveals an increase in the price of medications by 10.7% year over year, as well as increases in the cost of medical tests by 6.5%, consultation fees by 4.5% and hospitalization expenses by 5.9%. Due to the high hospitalization costs in India, these figures are concerning not only for economists but also for the end consumers of the healthcare ecosystem. While the effects of health inflation are felt throughout the entire healthcare system, the private hospital admittance rate in India is more obvious to end consumers. In India, the distinction between public and private healthcare is stark. A treatment which would lie in thousands in the former would increase to lakhs in the latter.
This article aims to look into the reasons for the rise in private hospital costs, as well as possible recourse.
Why Is Healthcare So Expensive In India In Private Hospitals?
India's public hospitals are infamous for having a lack of staff, outdated equipment, and excessive wait times. While the pandemic brought the poor state of the public hospitalisation system to light, people in both rural and metropolitan cities relied on public health providers even in non-pandemic times due to the severely restricted reach of the public sector. Despite the fact that the average cost of hospitalization in India is higher in private hospitals than in public ones, the situation still looks bleak.
They charge more because private hospitals are occasionally more commodious than sizable public hospitals, and patients are aware that they are paying more for the added service. In terms of whether your insurance is accepted and/or the overall amount of out-of-pocket costs, these hospitals frequently charge more for identical treatments and medical services. Private hospitals frequently have fewer patients under the care of each hospitalist and nurse, which gives the care a more individualised feel. Because private facilities exist for profit, they often deny extra care to people who cannot pay or have no insurance. In contrast to private hospitals, public hospitals do not budget money for slick advertising. They use a portion of their higher fees to cover expenses like marketing and advertising.
Cost Transparency
The health sector in India is in a complex state, with market conditions ranging from highly competitive to oligopolistic. Indian healthcare is in a complex state, from oligopolistic to fiercely competitive market circumstances. Service fees and reimbursements from a variety of insurers, including private commercial, employment state insurance schemes, central government health schemes, state government-sponsored insurance schemes, and others, may all be sources of income for one and the same hospital. In this circumstance, prices for the same service could vary. Pricing is consequently often arbitrary and unfair, and it is also not clear. Additionally, the hospital's financing options, which include cash, bank loans, donations, venture capital, and stock markets, might have an impact.
Patients have the fundamental right to receive comprehensive information from hospitals regarding their medical bills and treatment. Every patient and their caregivers are entitled to information about the hospital's rates for each type of service it offers and the facilities it offers, which should be displayed prominently and in a brochure. At the time of payment, they have the right to obtain an itemized, comprehensive bill. It would be the organization's responsibility to post important tariffs prominently in both the local language and English and to provide all patients and caregivers with a booklet including the whole schedule of fees.
Furthermore, Consumer rights are rigorously protected under the new Consumer Protection Act of 2019. The consumer has a basic and natural right to invoices and treatment information. A hospital cannot ever be allowed to withhold from its patient the costs and details of their medical care.
Steps An Individual Can Take To File A Complaint If Overcharged By The Hospital
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You can make a complaint with the hospital in the following ways if you think you were overcharged by a hospital:
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Keep all supporting documents, including medications and bills, close to hand at all times.
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Lodge a formal complaint to the hospital's management so they can act immediately to rectify the situation.
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You have the option of filing a complaint with the local medical officer of the government.
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You can also contact your insurance company to ask about the matter; they are a party affected and would be ready to address any instances of hospital overcharging.
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Write a letter or send an email to your State’s Office of the Controller of Legal Metrology.
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Contact the state or Central health ministry; they can assist you with your problem.
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You can write to the Indian Drug Council and Indian Medical Council.
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Submit a complaint to your local consumer court.
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If you choose to file a case against the hospital, you can get in touch with a lawyer to do so.
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A person may also file a writ petition under Article 226 and Article 32 of the Indian Constitution because the right to health is recognised as a fundamental right under Article 21.
Legal Remedies Against Overcharging Under Several Indian Statutes
Remedies under Consumer Protection Act, 2019-
You can hold the hospital accountable for unfair trade practices and overcharging if they have charged you more than the initial estimate and are unable to explain the reasons. You can file the case before the consumer court constituted under the Consumer Protection Act. If a service provider (in this case, a hospital) charges a price that is higher than what is (a) fixed by any law, (b) displayed, or (c) agreed upon between the parties, you may complain about them under the Consumer Protection Act. You can ask for a refund of the excess amount collected as well as any other compensation you want. Similarly to this, deceiving a customer about the price of a certain service is an unfair trade practice, and you have the right to complain about it.
Criminal Action-
One can always file a criminal complaint against a particular doctor or the hospital's management, alleging medical errors including overcharging.
Disciplinary Action Under Indian Medical Council (Professional Conduct, Etiquette And Ethics) Regulations, 2002-
The punishments and disciplinary actions for misconduct are outlined in Chapter 8 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics and Regulations, 2002) enacted under the Indian Medical Council Act, 1956. A medical professional who is judged to have engaged in misconduct by the relevant Medical Council may be subject to the following punitive measures:
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For a set amount of time or permanently, the name of such a medical professional may be removed from the list of medical practitioners.
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The council has the power to stop a doctor from performing a procedure or engaging in another practice while it is being investigated if a complaint has been made.
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To make the public aware, it should be extensively reported if the doctor is fired in the local news and in publications from other medical associations or organizations.
Conclusion
The overcharging of private hospitals is a serious issue that requires a government response. If price-fixing protocols and methods are not put in place before reforms, the mere announcement of insurance coverage will not assist reduce poverty or out-of-pocket spending. The same goes for providers (hospitals and doctors), who need to be governed and have channels for complaints from customers. It’s high time to prioritize people’s health over political expediency and false rhetoric.