As the number of those infected with the novel coronavirus in Maharashtra nears 90,000 and crosses 50,000 in the city of Mumbai alone, patients and their families are facing the crisis of mounting hospital bills.
On June 7, the state government deputed five IAS officers and two auditors to keep track of bed capacity and availability in private hospitals in times of the ongoing COVID-19 pandemic. This, following complaints that 35 prominent private hospitals had not shared enough beds with the BMC for COVID-19 patients as per the government's mandate that 80 per cent of all beds in private hospitals be reserved for COVID-19 patients and other emergency cases. Also, the charges by the private hospitals for these reserved beds were to be as per the rates fixed by the government. The state has acquired 80 per cent of beds across all private hospitals and nursing homes till August 31 this year and has also capped the price of the treatment. The hospitals are free to charge their own rates in the remaining 20 per cent beds.
However, on the ground, the situation looks entirely different.
"While the rule is to reserve 80 per cent of all beds in a hospital, what is actually happening is that the hospitals are reserving 80 per cent of a certain number of beds only. So, this leads to a very small number of beds and even for these beds, the rates charged are not as per the government mandate. A virtual loot is going on," says Brinelle D'souza, faculty at Tata Institute of Social Sciences, Mumbai. At Bethany hospital in Thane West, Dsouza's friend was asked to pay Rs 91,000 for one and a half days his father spent in the hospital's ICU and to add to it, they paid a whopping Rs 10,000 for the ambulance service for barely a distance of 3km from Bethany hospital to Sapphirre hospital in Thane.
The BMC earlier announced that it will create separate email IDs of these officials where one may send across a complaint of overcharging in a hospital with regard to reservation of beds. But it is easier said than done, says Virenraj Thakkar, who was charged Rs 3 lakh for a seven-day hospitalisation at a renowned private hospital in the city when his 31-year-old brother was tested COVID-19 positive in the last week of May. "The bill was just so vague. We were charged Rs 6,000 for the PPE alone, on everyday basis. There were charges under sub-heads we couldn't even think of. But we don't want to raise an issue, because we might still need to follow-up in case any emergency comes up. And, anyway, who will go through the process of writing emails when under such severe stress?" questions Thakkar, who, along with his father, tested negative for the novel coronavirus.
Jolly Antony, a resident of Andheri narrates the experience of one of his friends who had to spend 12 days in a well-known, posh, private hospital in Andheri. "They were charged Rs 18 lakh, which included Rs 8,000 per day only for the PPE kits worn by the staff. But the family was quite well off and didn't mind paying. But think about those who cannot afford these costs, have no medical insurance and are desperate to get treated because there are no available beds in public hospitals anyway," says Antony.
When THE WEEK reached out to four high-end corporate hospitals across the city to find out the charges, here is what the numbers looked like: Rs 21,000 per day to Rs 27,000 per day for general ward, Rs 33,000 to Rs 40,000 for deluxe room, Rs 35,000 per day for a bed in the ICU and all these exclude additional charges which will not be revealed upfront. An initial deposit at the time of admission, ranges from Rs 2 lakh to Rs 5 lakh, depending on the patient's preference. When inquired about the beds reserved under BMCs mandate, the operators said there were no instructions.
N. Santhanam, CEO of Breach Candy hospital—one of the high-end private hospitals in south Mumbai—refused to accept the 80:20 ratio proposed by the BMC, saying that if his hospital reserves 80 per cent of its beds for COVID-19 patients, then those who are non-COVID will also turn infectious. "The government has nowhere said that 80 per cent of the beds have to be reserved, because it realises that creating beds for COVID-19 patients depends on the infrastructure of the hospital. It has left it to the hospitals to decide the number of beds a hospital wants to allocate to COVID-19 patients.
"Of the 110 beds at Breach Candy hospital, 55 have been reserved for COVID-19 patients and we are charging only Rs 4,000 for these beds, in accordance with the BMC notification," he said. However, when THE WEEK checked with the operator at Breach Candy hospital this evening to know the charges, we were told that per day rate of a bed for a COVID-19 patient in the ward starts from Rs 10,000, while the charges of a bed in the COVID-19 ICU is Rs 35,000 with ventilator, and Rs 28,000 without ventilator.
At Saifee Hospital, a posh multi-specialty facility overlooking the Arabian sea in south Mumbai, insisted on a deposit of Rs 1.5 lakh for a twin-sharing room before a COVID-19 patient is admitted. "Additional charges include Rs 3,800 per day for PPE kits, Rs 750 doctor's fees, Rs 6,750 for tests, Rs 1,500 per day for the use of ventilator, among certain other charges," the operator told THE WEEK.
The Mumbai chapter of Jan Swasthya Abhiyaan took up the issue of regulating charges of COVID-19 treatment in private hospitals in the Supreme Court, demanding that state governments ensure free treatment for COVID-19 is provided to patients even in private/corporate hospitals, and that states should reimburse the costs of private hospitals at standard rates based on Standard Treatment Guidelines as well as fixed, cost-based inputs. Free treatment must be inclusive of medical interventions, investigation, medicines, consumables, PPE, special equipment, which are all essential components of COVID-19 treatment, JSA noted. Since April, petitions have been filed for regulating the cost of treatment for COVID-19 patients in private and corporate hospitals to a minimum and for free treatment for the vulnerable sections of society.
Shailee Bhutia, who admitted her septuagenarian father in a well-known corporate hospital in south Mumbai, says she was sure that her insurance company would foot the "inflated" bill in case it exceeded a certain amount. But to her horror, the latter refused. "For four days in the ICU, and three days inside the ward, my father's hospitalisation bill came up to Rs 5.5 lakh. We were charged Rs 3 lakh for the isolation bed alone. The company straightaway denied paying and we had to pay the money ourselves," she says.
In India, where only 20 per cent of the population has health insurance coverage, and most end up paying out of their pockets for accessing healthcare services, the issue is staring in the face.