#SeriousQuestion

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?

let's have a good clean discussion and please no trolling.

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 πŸ€·β€β™‚οΈ

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. πŸ€·β€β™‚οΈ

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

There are many charitable health care facilities all over the country like this run by various religions. It is sad if what you say is true regarding this situation in Hyderabad. πŸ˜”

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.

consumables you mentioned and more are definitely marked up no doubts about it. But can they legally go more than the MRP? Maybe someone with consumer court experience could answer 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. πŸ˜‰

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. πŸ˜”

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?

many of us has this fear

my father was admitted for 4 days for angioplasty and his bill came to 5.2 lakhs and this was in Trivandrum

#WishfulThinking
I mentioned earlier in this thread about how much our government spends on healthcare... πŸ˜”
but is such a regulation even practically possible?

well said sir

pretty much my biggest fear

you make some excellent points

hard hitting but the truth

not too sure about that "greediness" comment though but agree with everything else

The Code of Medical Ethics Regulations, 2002

CHAPTER 3
3. DUTIES OF PHYSICIAN IN CONSULTATION
3.1 Unnecessary consultations should be avoided

Some times you have to wonder whether the consultation is warranted or not and stories such as this doesn't assuage such doubts at all

The ONLY explanation I can offer is surgeons are terrible at non surgical issues and so needs medicine doctors to handle those things. I previously worked with a surgeon who can't read an ECG. Yup true story. πŸ€¦β€β™‚οΈ

That 3rd point though πŸ‘ πŸ˜‚

@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 @Beiz the reason he said the above is that co-operatives in India 99.99% of the time are owned by politicians, similar to hospitals which are either owned by either corporates or politicians or both. They will usually have a trust as a front but if you have chai with an old worker from the hospital you are sure to learn a lot. Sadly, everyone is in it for themselves :(
@just1doctorwala @Beiz to add to the mix most of the co-operatives have been in scams and they have been turned into businesses. Some examples are Amul or Gujarat Co-operative Milk Marketing Federation Ltd. , Mother Diary and others. As far as scams are concerned Sharda Chit fund scam or the most recent #PMCBankScam comes to mind. In essence we need to overhaul the laws and have more consumer protection. We seem to be going in reverse :(
@just1doctorwala Rightly said, sir. The process needs to get momentum. And apologies for the wrong word.