With the number of coronavirus cases rapidly increasing in India, cracks have been appearing in the healthcare system of the country. There have seen several complaints of unhygienic conditions in government hospitals, there not being enough ICU beds, not enough ventilators, and exorbitant charges being levied by private hospitals, especially in cities such as Mumbai.
According to a survey by LocalCircles, the general notion amongst many in top metros is that most government hospitals are for the underprivileged and are badly maintained, while the private healthcare system in is considered better than government run hospitals in terms of quality.
When asked where they would prefer to go for treatment if they were to test positive for coronavirus, 32% citizens said they would want to go to a private hospital while 22% said they would want to go to a government hospital. 32% said they would not want to go to a hospital at all.
In red zones, especially high virus load districts, many citizens have expressed concerns about limited capacity in private hospitals and long waiting times in government hospitals to get admitted for COVID-19 treatment.
When COVID-19 started spreading in India in March 2020, only government hospitals were designated as centres for COVID-19 treatment, but this was then opened to select private hospitals as well.
Speaking of concerns with government hospitals, the LocalCircles survey revealed that 46% citizens are worried about secondary infection due to crowd and poor adherence to standards as the top risk with government hospitals. 32% said lack of adequate infrastructure and resources, while 16% said long waiting time and inefficiencies were key issues.
“The top concern amongst people with government hospitals is that even a mild COVID-19 case could worsen after going to the hospital because of additional exposure and have increased chances of a secondary infection. This is particularly important in people with co-morbidities and the senior citizens,” the survey revealed.
With respect to private hospitals, one of the top issues that has repetitively been raised on LocalCircles has been the exorbitant charges imposed by them for COVID-19 treatment. Citizens have shared screenshots of private hospital lobbies where ICU charges of as much as Rs 30,000 a day were quoted and charged to COVID-19 patients. Multiple bill copies were shared by relatives of COVID-19 patients and a charge of Rs 9 lakh for a 12-day COVID-19 treatment is not uncommon, LocalCircles claims.
57% of those surveyed said exorbitant charges was their main concern with private hospitals, while 14% said unnecessary tests, 7% said lack of knowledge of COVID-19 treatment protocols and 5% said difficulty in getting admission.
LocalCircles claims many consumers have reported that PPE kits and cost of medicines have been a major component of the bills of people that they know, who have been admitted in a private hospital for the treatment of COVID-19. The cost, they said, would almost double in case the patient was in the ICU.
To address the issue of exorbitant charges, 21% of the respondents said that government should cap per day ward/room and ICU charges for COVID-19 treatment, while 40% said the government should standardise or mandate per day COVID-19 ward/room and ICU charges based on hospital category (similar to hotel star ratings).
On Saturday, the Tamil Nadu government was the first state to announce a cap on treatment costs for COVID-19 patients in private hospitals at Rs 7,500 a day as the maximum daily charge for treatment in general ward and Rs 15,000 as charge for ICU treatment.
A PIL too, was filed in the Supreme Court seeking a cap on fees to be charged in private hospitals in treating COVID-19 patients, saying that private hospitals are impinging Articles 14 and 21 by charging exorbitant fees making it inaccessible to many. The SC has sought the Centre’s reply on the PIL.
Interestingly, 28% respondents of the LocalCircles survey said the government should take over 80-100% of the capacity of private hospitals under the Epidemic Disease Act, while 2% said government should just set up a functioning complaint redressal mechanism specifically for COVID-19 which imposes heavy penalties for overcharging. Only 6% said government should let private hospitals charge what they find appropriate to sustain their business.
According to people, the price cap or standardisation must be done in conjunction with the government making enough beds available for treatment at private hospitals.
LocalCircles says it will be submitting a copy of the report to senior stakeholders in various state governments as well as in the Central government so that action can be taken on the concerns raised.
The survey received over 40,000 responses from 237 districts of India. 63% respondents were men while 37% respondents were women. 46% respondents were from tier 1, 35% from tier 2 and 19% respondents were from tier 3, 4 and rural districts.