Hospitals in Telangana are up in arms against the government price cap on treatment costs for COVID-19, arguing that the price cap does not take into consideration the cost increase in operating hospitals. The Telangana Hospitals and Nursing Homes Association (THANA) warned that with a third wave being predicted, private hospitals will be forced to either withhold or quit COVID-19 care services.
Dr Rakesh, President-elect of THANA, says both the state and the Union government must step up to address the rise in the cost of essentials to operate hospitals. “Hospital managements are forced to pass on the added cost to patients, but the picture being painted is that hospitals are fleecing patients,” he says. Hospital managements in Telangana point to the revised Government Order issued earlier this month that capped treatment and investigation charges for COVID-19 treatment at private hospitals.
The prices were first capped in June last year and a revised GO was issued on June 23, 2021 based on directions from the Telangana High Court. The updated GO fixed routine ward and isolation charges at Rs 4,000 per day, ICU without ventilator at Rs 7,500 and ICU with ventilator at Rs 9,000. The price for blood tests, X-ray, ECG, consultations, beds and meals were also capped. The price for PPE kits was fixed at Rs 273 per kit. Rates were also fixed for investigations and ambulances.
“The average price of one oxygen cylinder was merely Rs 450 pre-pandemic; the price shot up to Rs 4,000 per cylinder during the COVID-19 second wave for hospitals,” says Dr Rakesh. “There are instances when a patient would require 28 to 30 oxygen cylinders. Based on our procurement rates, the treatment cost for the patient will be over a few lakhs for oxygen cylinders alone. The transport cost also shot up to Rs 5 to 6 lakh during the peak,” he adds.
THANA says simple consumables like rubber masks and gloves were also black-marketed during the second wave, which pushed up the cost of procuring these essentials. “A flow meter (used to regulate oxygen) used to cost Rs 600 pre-COVID-19, but now each costs us Rs 4,700 including Goods and Service Tax (GST). Severe COVID-19 cases require ICU care, which has several types of machinery, and operating them costs electricity. I pay a commercial rate of Rs 17 per unit of electricity, this used to cost me just Rs 1 lakh per month pre-COVID-19, but with the inflow of patients and ICUs working non-stop it personally costs me Rs 5 lakh a month,” says the doctor, adding that these factors contribute to the increase in bills for patients.
“There may be a couple of hospitals that may have tried fleecing patients but most hospitals were forced to hike treatment costs as operational costs increased,” says Dr Rakesh.
Apart from rising treatment costs, THANA says the salaries of their hospital staff were hiked. “We raised salaries four times for doctors and hospital staff who are involved in COVID-19 treatment. We even had to convince families of these staff to allow their loved ones to work. We arranged separate accommodation, treatment facilities and security for them,” says Dr Rakesh.
Hospitals say they are also going to face a rise in costs in the long term as many of the equipments used for investigations and tests during COVID-19 treatment developed wear and tear. “An equipment that used to carry out perhaps 5 tests a day was being used to carry out 300 tests. It will naturally develop wear and tear, which pushes up maintenance costs. Our annual maintenance contracts in the coming years will be high,” Dr Rakesh says.
THANA said they explained their concerns to the Telangana government but received no support. “If similar measures are fixed in Ayushmann Bharat and Aarogyasri, it will be difficult for private hospitals to give Covid care under these schemes. Without any discussion with hospitals it’s better that no such impractical and insensitive charges are to be fixed by governments,”,” he adds.
“It is true that there was rampant black marketing of essential hospital items during the second wave. But private hospitals need to prove that they have procured these items for a higher cost,” says Venjapathi S, President, Telangana Chemists and Druggists Association. “Often the bills given to patients show the items at MRP itself without explanation of cost break-up,” he says.
The task of controlling the price of medical equipment rests with the Drug Control Administration. Officials with the state and the Union government were both unavailable for comment.
