I'm curious to see your thoughts on this.
Do you feel that getting treatment from a private hospital in India today is very expensive?
If no, then that's it, but if yes, why do you think it is so expensive and what are your suggestions to make it not so?
getting a lot of good responses
keep it coming
i plan to use some of them and give my opinions on them
since Mastodon doesn't allow quote tooting I'll post screen shots of some of the replies and my reply to them
first up
100% true
private health care facilities are for profit enterprises and are thus businesses
no arguments from me here
the common complaint from pretty much everyone is that private healthcare is expensive
compared to what is a question I throw out to the rest of you to ponder and help answer
1. I don't personally know of different rates between insured and non insured patients but I have seen different rates for Indian citizens and foreign nationals for the same procedure. So what you say might very well be true.
2. Private labs have been known to offer doctors "commissions/cuts" to entice them to send their patients there for tests and imaging. Open secret. Shocking further is some hospitals do this too. Offer very low salary but "cuts" for each blood test x ray etc etc.
3. True about targets. Hospitals try to avoid paying high salaries by working out such schemes with doctors.
One hospital I had interviewed for offered me a low base salary but I could make upto "3 times that amount" per month if I ordered a bunch of tests & diagnostic imaging. I turned down that hospital & instead moved to the hospital I work in now.
At the end of the day, I can now say, whether I see 1 patient or 1000 patients my salary is fixed.
But whoever took the other hospital job 🤷♂️
yes our government needs to do so much more
A comparison between two "biggest" democracies is telling: the U.S.’s health expenditure is 18% of GDP, while India’s is still under 1.5%.
In Budget terms, of the U.S. Federal Budget of $4.4 trillion, spending on Medicare and Medicaid amount to $1.04 trillion, which is 23.5% of the Budget.
In India, allocation for healthcare is merely 2.2% of the Budget.
All 2017 data.
noticed many say "unwarranted investigations" as a reason for high cost
I think this can be looked at in two ways.
1 as I mentioned earlier those doctors who work on cuts
2 and honestly more common though, is that we live in a very litigious society. And in India we hear every day about a doctor getting beaten up. All this amounts to something known as "defensive medicine". Safer to do the test and get a negative result than not doing it and risk getting sued or worse for missing a diagnosis.
Doctors tend to favour certain brands of drugs most of the time for reasons not always nefarious.
I'm not denying there are a few here too who gets "cuts" again but majority of us don't. Some times we just prefer one brand over another for different valid reasons eg: quality control.
As per the notification of MCI Dated 21/04/2017 the doctor should prescribe drugs with generic names with the brand name in brackets.
Unfortunately as of now this is not mandatory. Only a guideline. 🤷♂️
I assume you mean "imported" but yes you are 100% correct.
Many of the imported equipment and drugs are highly taxed so adding to costs.
Indigenous production is present but not as widespread or as good quality yet to match the International standards.
Think of the automobile industry in the 1990s and today. Today cars are manufactured in India and are exported to various countries. Who could have even dreamed of this back then. We need the same for healthcare devices and drugs
well you got me here! 😜
dietician is an interesting question and i used to wonder this myself till I looked it up
All hospitals have to have a dietician planning the meals menus etc and this is required as per the National Accreditation Board for Hospitals & Healthcare Providers (NABH) guidelines.
I have attached a screen shot of their "Checklist of Hospital’s Food services (Kitchen) for NABH accreditation preparation" showing the relevant points regarding this.
the system indeed has a lot of flaws and only good communication hard work and honesty and transparency can solve this
i hope this little thread of mine helps with this even a tiny bit
health insurance premiums seem to be going higher and higher and no one seems to be doing anything about it
as for the "benami" bit, well this is India after all 😜
got some responses from the bird site too
will post my replies here
maybe when i get some free time i will repost all this there
I've turned off cross posting for this thread to avoid confusions
I've already talked about the tests earlier. As for the fees most hospitals don't even give that "consultation fee" to the doctor. Yup I know you find that hard to believe but it is true. Very few hospitals actually give that fee to docs and even still it will be a portion of that not the full amount
I feel sorry for the duty doctors
most hospitals hire fresh out of MBBS doctors as "duty doctors" in the wards ICUs because it is cheaper to hire them rather a specialist in Hospital Medicine or Hospitalist. Yes that is a real speciality. 😉
Most of these young doctors have no clue honestly what is the rational for the respective consultant prescribing drugs or procedures and I think it's not fair to hold that against them.
As for the bill discrepancies that is unfortunately quite common. 😔
someone once compared difference in different private hospitals to difference in different star hotels
you get what you pay for
crude comparison but apt in most cases really
morally questionable?
ICU rates are very high in private hospitals
in fact I have seen hospitals in my area RAISE their ICU rates multiple times over the last 5 years
there seems to be a lot of people complaining about wrong billing issues
any suggestions on how to rectify this?
I honestly believe that most doctors only order for tests/investigations to back up/prove their clinical diagnosis.
Ultimately modern medicine is now practiced as evidence based medicine. Evidence is these tests. The courts also insist we have evidence and these tests are accepted in courts too.
Eg: I might be good enough a doctor to touch your abdomen and say that you have an inflamed appendix, but would you let a surgeon operate on you before we confirm my diagnosis with an ultrasound scan?
@just1doctorwala here in sweden i literally just got refunded for almost the entire year worth of payments to my insurance company because it's a cooperative "owned" by the clients themselves, and apparently we did well this year with not too many big claims so everyone's getting most of their share of the payments back.
maybe something you guys could try for?
@Beiz wow! that is so cool
not sure how that would work here in India though
@just1doctorwala i don't see why not. isn't it rather a question of if there is someone out there willing to run an insurance company that doesn't have the main goal of being predatory and getting filthy rich.
unsurprisingly, when people work together, good things happen.
@just1doctorwala
That.
Make upto.
This nexus is what destroys trust and makes patients doubt.
Also, it is one of the major reasons of stress between hosp/doc and patient.
Also, pharma.
Precisely, why in patient/doc conflicts, which keep cropping up, I never take sides.
Both sides have reasons.
System is to be blamed, to a large extend, then the individuals involved.
@just1doctorwala Compared to average income. On an average I expect to pay not more than 5% of my income towards regular healthcare and up to 10-12% for illnesses.
However, this month when I had a headache I ended up paying almost 20% of my income towards doctors, medicines, tests etc. I am not taking into account the loss of pay in my calculations.
Now if it was something major the cost would've been prohibitive.
@just1doctorwala You have to also consider thaat clinic visits, tests and most medicines are not covered under any health insurance. This is an added expense to a middle class family.
This year I took the decision of not going for Medical Insurance because the premium is higher than my expected average expenses for regular healthcare.
@just1doctorwala
Of course, comparison with govt wud be ridiculous.
But, even among pvt, there is variations.
And I suppose, the comparison would be there...
Facilities provided versus charges.
@just1doctorwala These days there's only one thing on which a person is going invest money which is health and life
Since people are only interested in going to private health care...they are cashing it!!
It's just business for them
@just1doctorwala There are separate rates for those with health insurance and those without it for the same procedure....
I once met the owner of a Diagnostic lab on a flight, and he said up to 40% of the billed amount is paid in commissions to the doctor prescribing the tests...
Doctors and surgeons working for a hospital have "sales targets". Their fixed remuneration is write paltry and they get a cut of the revenues they contribute directly.
Oligarchy of profiteers...
Back in 2007, a colleague in the US, a director in a market leading software product company, so obviously he had what he thought was ample health insurance cover for his family... however, when his son was diagnosed with an ailment, he discovered it won't.
India going down the same path.
Insurance only seems to increase the cost of healthcare. it doesn't make healthcare more accessible.
and the government in India has often jawboned about health tourism.. another factor.
@just1doctorwala We have free dawa khana near Charminar Hyderabad.
Free of cost inexpensive medicine's & free treatment from piles to prostate cancer.
It's run financed by Sunni Muslim Waqf board & under Minority Muslim ministry of Govt of Telangana.
But Owaisi's & private hospital Mafia are out to destroy them.
Owaisi themselves have 4-5 big private hospitals.
Hyderabad has largest number of hospitals but not doctor's
Now everyone in Hyderabad is dying regular due to dengue, malaria etc
@just1doctorwala to come to conclusion, should having better consumer laws and protection go a bit way. I know that the 2013 supreme court verdict made doctors liable but how much has it resulted in the hospital management board and doctors liable is yet to be known.
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