NEW DELHI: Responding to growing anger over the high cost of Covid treatment, most states have capped Covid treatment charges. Yet, more than 80% of families would be financially crippled by a single member undergoing Covid treatment. That’s because even at the capped charges, bills for even ten days of treatment work out to several times their monthly expenditure, an analysis of the charges and official data on monthly expenditures shows.
For instance, according to the latest household expenditure report of 2017-18 put out by the National Statistical Office, in Delhi, which has among the highest monthly per capita expenditures in the country, for 80% of the population monthly spend per person is below Rs 5,000 or Rs 25,000 for a family of five. The lowest priced isolation bed in a non-accredited hospital in the Capital would cost Rs 80,000 for ten days of treatment, more than three times the monthly spending of 80% of the population. For a patient with severe Covid in ICU care with ventilator support, the bill could be several lakh as the treatment could stretch for two to three weeks or more.
TOI put together the capped prices for isolation beds, ICU beds without ventilator and those with ventilator in 20 states and compared the cost of ten days’ treatment with the latest report on monthly per capita expenditure in each state. It shows that even with price caps, the treatment is unaffordable for 80% of the population. In all states, the treatment is free of cost in government hospitals. However, even in non-Covid times, the government share of inpatients in the country is at best about 42%. With reports of poor conditions in governments hospitals running to full capacity and wide publicity regarding bureaucrats and politicians choosing private hospitals for Covid treatment, there was a greater clamour for beds in private hospitals.
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In many states like Gujarat, West Bengal and Kerala, the fixed rates are for patients referred by the government or for those covered by government health schemes, where the government picks up the tab. Typically, only people with connections get referred through the government to private hospitals, while others do not have a choice. In states like Karnataka, Odisha and Telangana, the price caps are applicable to all patients going to private hospitals. Despite the price caps, there are exclusions which differ from state to state, such as PPE cost, high-end investigations like CT and MRI, drugs, or specialist charges. Private hospitals have also come up with ways to evade price cap such as charging rack rates for the days before a person is confirmed as Covid positive and doing the same for the days after the person tests negative but remains admitted for post-Covid complications. In many states like Delhi, there is no mechanism to ensure implementation of the caps despite a large number of complaints of overcharging.
One of the UN’s sustainable development goals is to prevent “catastrophic spending” on health, which can impoverish families. If the share of health expenditure in the total annual household expenditure is more than 10% to 25%, it is considered catastrophic. In all states, just treatment for moderate Covid in isolation beds for 10 days with the capped rates is well above the 25% threshold for 80% of households. While in states like Delhi, Kerala and Punjab with high household monthly expenditure, ICU treatment for severe Covid could be 50%-80% of annual household spend, in most other states it could be equivalent to an entire year’s household expenditure, or even double what a family would spend in two years.