A tale of two fathers: Dengue deaths, inflated bills and govt apathy

They lost their children, but were given bills of around Rs 16 lakh by hospitals

Government hospital entrance | Reuters Representative image | Reuters

“Our stories are the same,” the two fathers of children who died of dengue last year said at a press meet on Thursday. Both Jayant Singh and Gopendra Singh Tomar, lost their children to dengue, and were handed over inflated bills of around Rs 16 lakh by two corporate hospitals in Gurugram. And both said that despite having approached several authorities, including the PMO, they had got no justice yet. 

"It has been exactly 90 days today (Thursday) since my son died, and the hospital charged me this amount. There's no government agency that I have not approached with my complaint in all these days, including the state [Haryana] health minister, the Union health minister, the National Pharmaceutical Authority, and the PMO. But nothing has happened... Even the police have not registered my FIR, and told me that unless the doctors' report comes, they will not do so... If this inaction continues I might just end my life," said Tomar, as he broke down during the press meet. 

Tomar told THE WEEK that he had brought his son Shaurya from a hospital in Gwalior to Medanta hoping for better treatment. "But in the 22 days since he was admitted at the hospital's ICU, we had little information on his treatment. Doctors said that they would need to give him seven injections worth Rs 15,000 each. Despite our limited means, we arranged for the money," he said.  

However, when the child's condition deteriorated—he caught an infection in the hospital—the hospital tricked his family into signing a LAMA document (leaving against medical advice), Tomar said. "After 22 days, the hospital staff told me, 'you are poor, you wouldn’t be able to afford the treatment here anymore. Your child is fine, and you should go to a government hospital'," he said.  

On November 20, Shaurya was taken to the Ram Manohar Lohia hospital, where he died two days later because of the infection. Over 45 per cent of their bill was for medicines and consumables—on which the hospital made huge margins—while lab charges made up for another 9.5 per cent. 

Tomar and Jayant's case only confirm what a recent study by National Pharmaceutical Price Authority (NPPA) revealed after an analysis of patient bills from four prominent private hospitals—those which make profits to the tune of 1,737% on drugs, consumables, medical devices and diagnostics. The study, released earlier this week, shows that non-scheduled drugs comprised 25 per cent of patient bills, consummables made up 9. 56 per cent, and diagnostic services accounted for 15. 56 per cent. While the study did not name the four hospitals that had been analysed, activists from the All India Drug Action Network said that those under scanner were Fortis Gurugram, BLK super speciality hospital, Medanta Medicity, and Max Hospital in Shalimar Bagh. 

"The NPPA findings that non-scheduled medicines make up around 25 per cent of the combined bill costs are hardly surprising given that almost 90 per cent of the pharmaceutical market remains outside price control. Hospitals are easily able to use this to their advantage by choosing to prescribe more expensive medicines," said Dr Mira Shiva, co-convenor of the All India Drug Action Network (AIDAN). Shiva added that in its report, the NPPA has acknowledged that the market-based formula for fixing ceiling prices leaves room for huge trade margins. 

"The central flaw of the Drug Price Control Order, 2013 is the deeply flawed market-based pricing mechanism that legitimises profiteering and high prices. AIDAN has consistently advocated for expansion of the scope of the DPCO to cover all essential and life-saving medicines and to reinstate a method of cost-based pricing that provides reasonable profits to companies,” she said. 

Dr Sumit Ray, senior consultant, critical care, Sir Gangaram Hospital said that hospitals made huge profits because they procure medical devices in bulk at cheap rates, but the manufacturers put a higher MRP on it. "It is time for the government to regulate these practices. Self -regulation by private hospitals doesn't work," he said.

The Centre has been pushing for the Clinical Establishments Registration and Regulation Act, 2010, to be implemented across states. While the Act does not provide for fixing costs, it does provide for good quality treatment that could reduce costs for patients, said Ray.