Hospitals list rate flaws for feedback
July 9: The state government has extended the time for private hospitals to officially give feedback and suggestions on fixing rates for treatment and levying non-medical or incidental charges on patients.
The state health regulatory commission recently issued a notice stating that private hospitals would have to send their feedback latest by July 31.
Representatives of several hospitals have already said that it would not be possible for them to implement the rates proposed by the government. As for doing away with non-medical charges such as the fee for providing medical records, the proposal is under consideration, they said.
The government also wants private health care to scrap the system of differential rates for the same treatment and diagnostic tests and procedures. This is done based on the categories of beds or rooms chosen for patients.
Hospitals in Calcutta intend to request the regulatory commission for a meeting to discuss the proposals.
The commission had announced last month that the rates it had fixed for Swasthya Sathi, a health scheme for the poor, would be the “reference” points for determining what are “reasonable” charges for treatment at private hospitals. Most hospitals had sought six weeks to reply on the proposals.
“The last date for sending suggestion/feedback has been extended by the commission up to 31 July, 2017. All the clinical establishments are requested submit their suggestions/feedback within this date,” the notice issued by the West Bengal Clinical Establishments Regulatory Commission states.
This is also the timeframe within which hospitals would have to send feedback on levying non-medical charges.
Private hospitals contend that most of the rates under the Swasthya Sathi scheme are not viable and that they would like to explain to the commission why it would not be possible for them to follow it.
“We will request the health commission to hold a meeting with us. We would like to explain why the rates are not viable,” said the CEO of a group of hospitals. “Alternative viable rates can be discussed, which is why such a meeting is essential.”
Swasthya Sathi, a health insurance scheme launched by chief minister Mamata Banerjee in December 2016, prescribes rates for individual treatments. A government official said more than 2.2 crore people had so far paid for treatment based on these rates.
Under the scheme, the cost of total glossectomy, a surgery to remove all or part of the tongue, cannot be more than Rs 14,000. Doctors said the minimum cost of this surgery in a private hospital was currently around Rs 1.5 lakh since it involved reconstruction of the removed portion of the tongue. “This is a long and complicated surgery requiring highly specialised skills,” an official representing a private hospital said.
Laryngectomy, a surgery involving removal of the larynx or voice box, is supposed to cost Rs 14,400 under the Swasthya Sathi scheme. The average cost for this surgery in a top-grade private hospital is approximately Rs 2 lakh.
The CEO of a large corporate hospital in town said private health care units could stop charging a fee for non-medical services like handling of insurance claims, providing medical records and disinfecting operating theatres. He said the government’s proposal to do away with differential charges for procedures, diagnostic tests and doctors’ fees depending on category of beds or rooms was also acceptable. But rates for treatment based on the Swasthya Sathi scheme are not viable for the simple reason that different hospitals have different operational costs, he argued.
“Fixed costs like salary, annual maintenance contracts and loan repayment as well as variable costs like buying surgical equipment and drugs are different for every hospital. So there can’t be fixed rates for everyone. A logical calculation should be done,” the CEO said.
An official of another private hospital said his organisation was considering how to bring down rates for cardiac surgery and other categories of cardiac treatment, as also for radiation therapy. “There are many cancer patients who go to other states for treatment because there are not many facilities in government hospitals here. We can bring down the rates for radiation therapy. But it will not be viable to bring down all rates.”