The central government is working out a scheme to provide insurance coverage of Rs 5 lakh to 50 crore Indians for hospital care, on the assumption that such secondary and tertiary care costs more. However, studies have pointed out that, in-patient care forms only 20 per cent of the patient's out-of-pocket expenses, and that medicines, diagnostics and outpatient care cost more.
Diagnostics, per se, make up for only ten per cent of the health spend. However, the latest Economic Survey points out that the cost of diagnostics vary hugely from city to city. A lipid profile test, for instance, costs anywhere from Rs 90 to Rs 7110, while an electrolyte test could range from Rs 30 to Rs 3000. A thyroid test, another common one, could cost anywhere from Rs 100 to 3100, and the price of a 2-D echo cardiography for the heart could range from Rs 500 to Rs 5200.
The huge price variation is compounded by "scanty" data on quality and accreditation of diagnostic establishments. The Clinical Establishments (Registration and Regulation) Act, 2010, has been adopted by only 10 states and 6 Union territories, says the survey. Initially, the Act came into force in Sikkim, Mizoram, Arunachal Pradesh and Himachal Pradesh, and all union territories [as on 1-3-2012], except Delhi. Subsequently, Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Rajasthan and Assam also adopted it.
The union ministry of health and family welfare has been pushing the states to implement the Act for regulating prices and quality. West Bengal and Karnataka have passed their own versions of the Act last year, and earlier this month, the Kerala Assembly passed its own version.