Covid-19 crisis: SC asks pvt hospitals if they can charge at Ayushman rates

Senior advocate Harish Salve, appearing for a health care federation that has filed intervention application in the matter, said that Ayushman is a heavily discounted scheme
As the debate around the cost of treatment for Covid-19 patients continues, the Supreme Court on Friday asked private hospitals if they were ready to provide treatment according to charges prescribed under the government’s Ayushman Bharat scheme.

The Bench, headed by Chief Justice S A Bobde, observed that the SC was not asking all private hospitals to treat certain number of Covid-19 patients for free but was asking only those private hospitals, which have been given land at concessional rates by the government, to do so.

“I just want to know if hospitals are ready to charge at Ayushman rates,” the CJI said.

Senior advocate Harish Salve, appearing for a health care federation that has filed intervention application in the matter, said that Ayushman is a heavily discounted scheme and revenue of private hospitals has already gone down by around 60 per cent as footfall has decreased. But advocate Sachin Jain, who has filed the petition, told the Bench that rates prescribed under the scheme should be made applicable to the hospitals. Jain told the Bench he can show how the scheme has been decided keeping in view the profitability of hospitals.

The Bench said: “Please ensure they do some service”. The next hearing will be held two weeks from now.

The Ayushman Bharat scheme is aimed at providing health cover to the poor. Private hospitals feel rates under the scheme are too low and, hence, unviable. According to Alok Roy, chair of Ficci Health Services Committee, and chairman of Medica Group of Hospitals, rates under the scheme were below Rs 2,000 per patient per day (all-inclusive) and, thus, it would not be financially viable to offer treatment at those rates. Private hospitals have said that, typically, one patient needs three personal protective equipment (PPE) kits every day and that adds to the cost of treatment even for a relatively mild patient.

Gautam Khanna, CEO of PD Hinduja Hospital in Mumbai, said separate negative pressure ICUs are needed for Covid-19 patients. He said since the hospital has been divided into wards — Covid patient, suspect Covid patient, and non-Covid patient — the infra as well as the manpower are under a strain. “Staff is quarantined… they have to be rested, etc. Operational beds, thus, come down. We all want to do our bit, but at very low rates it becomes unviable,” Khanna said. Hospitals with good reserves can last longer. But those that have working capital issues will be the first ones to fall, said the head of a private hospital in Mumbai.

Shuchin Bajaj, founder and director of New Delhi-based Ujala Cygnus Healthcare, felt there was a need to differentiate between profits and profiteering.

“While profiteering should be strictly clamped down, no one should be allowed to take advantage of any one’s misery. We should realise that profits of a certain small amount are necessary for any business to survive. Price capping is fine if done scientifically, but free treatment may be taking things a bit too far,” he said.

Bajaj said the government was abdicating its responsibility of providing free treatment and imposing on the private sector to fulfill its tasks.

Meanwhile, amidst allegations of hospitals charging exorbitant amounts amid the pandemic, states like Maharashtra have issued a notification taking over 80 per cent beds in private hospitals and has also capped the treatment charges for both Covid-19 and other illnesses in these beds.

In Maharashtra, the charge of a Covid-19 patient in isolation ward can’t be more than Rs 4,000 per day, while that for an intensive care unit (ICU) can’t be more than Rs 7,500 per day. Patients in ventilators will pay not more than Rs 9,000 per day. These charges include doctors and drugs, nursing and food charges. It excludes cost for PPE, equipment or diagnostic costs and even expensive drugs. But the state has said that for those the hospital can’t charge more than 10 per cent mark up over the procurement cost.

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