City docs fretting

Many doctors say the inefficiency of government hospitals makes people turn to private hospitals. (Above) A file photo of KC General Hospital, run by the government in Bengaluru. DH Photo by B K Janardhan

The Indian Medical Association is opposing the Central government’s proposals under the National Health Protection Mission.

Dr H N Ravindra, president of the Karnataka chapter of IMA, says the rates prescribed for private hospitals under the government’s Ayushman Bharat scheme, under the national mission, are unacceptable.

The project aims to covers about 50 crore people by offering cashless treatment of up to Rs 5 lakh a family.

“The rates are much below what is prescribed in the Central Government Health Scheme (CGHS). I’m not sure what the government thinks about private healthcare,” Dr Ravindra told Metrolife.

The government does not support private healthcare with land, construction and equipment and yet creates such a hullabaloo over its functioning, he says.

“It’s surprising how the government wants to make things difficult for the private sector, which serves 70 to 80 per cent of the population,” Ravindra says.

Health and education are important for anyone and should be made accessible through government schemes, he avers.

Most doctors in the city agree with the IMA’s stand, even if they like the objective behind Ayushman Bharat. Dr Chandil Gunashekar of Desai Clinic, Basavangudi, supports the model but says the prices suggested are not feasible.

“There is an economics behind the pricing of healthcare services. In a general ward, a bypass may cost Rs 1 lakh while at a semi-private ward it might be Rs 1.2 lakh. A private ward might cost up to Rs 1.5 lakh. This model creates price-capped services,” he adds.

He blames the inefficiency of government hospitals for people going to private hospitals. “Private hospitals need to gain a margin in the business,” he says.

Dr Prashant Raysad, director of operations and strategy at Sparsh Hospital, says the scheme is good but the pricing is derived without a proper rationale.

“Certain treatments suggested by the government are so low that the money will not be sufficient even for the consumables also. The prices are around 10 to 15 lower than CGHS,” he says.

Private hospitals import equipment by paying sizeable custom duty. They aim to give healthcare on a par to with what is available in Europe, he reasons.

If prices for services are dropped, the quality of treatment will suffer, he says.

“This tariff might work for (government-supported) hospitals like Jayadeva Institute of Cardiovascular Sciences and Research, but not for private hospitals,” he says.

Dr Basawantrao Malipatil, consultant medical oncologist with Columbia Asia, says the government recommended tariff isn’t viable.

“Under the Vajpayee Arogyashree Scheme, chemotherapy for breast cancer patients should be provided at Rs 5,000, but the drug itself costs that much,” he says.

In a government hospital, salaries are generated by the government but in the private sector, salaries come from the money paid by patients, he argues.

‘Affordability is relative’

Dr Prashant Raysad, director of operations and strategy of Sparsh Hospital, says, “Healthcare, education, food and defence are the responsibilities of the state. Affordability is a relative factor. Pricing of services is controlled by competition.”

‘Present govt cheating public’

Dr H N Ravindra, president, Karnataka State Branch of the Indian Medical Association, says doctors are not being allowed to earn what they deserve.

“What right does the government have to control the rates of my services? When it’s my land and my property, how are you trying to control my tariff? Is it bad to earn the money we rightfully deserve?” he says.

In some cases, government hospital rates are higher than those at private hospitals, he says.

“Government hospital units provide dialysis for Rs 1,150 per cycle. The government takes care of the equipment, manpower, land and electricity at the units, yet the rates are high. On the other hand, in the private sector in Karnataka, patients can avail a dialysis cycle for anywhere between Rs 500 and Rs 900, he says.

If the government were interested in taking care of the poor, basic treatments would be well managed.

“The present government is cheating the public in a larger sense,” he says.

About Ayushman Bharat

*Cashless coverage of up to Rs 5 lakh a family

*Implemented through state governments

*Launched by PM Modi on April 14, 2018

Rates govt recommends

*Knee and hip replacements: Rs 9,000 each

*Stenting: Rs 40,000

*Coronary artery bypass grafting (CABG): Rs 1.10 lakh

*Hysterectomy for cancer: Rs 50,000

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