Why Supreme Court's Anger Against Private Healthcare Costs Is Justified

Hefty private healthcare bills have prompted Supreme Court to intervene, asking the government to fix rates. The court's concern is not without reason.

NDTV Profit's analysis of some common medical procedures showed massive disparity between the charges under the Central Government Health Scheme and what is charged by private hospitals. In some cases, private hospitals charge up to 10 times more.

The rates vary depending upon the type of implant—Indian or imported—used for surgery, the experience of the doctor performing the procedure and the type and brand of medical establishment.

The Supreme Court expressed strong reservations last week against the Union government's failure to implement a decade-old law under which it was expected to determine the rate of fee chargeable to patients in clinical establishments.

The top court observed that it would consider accepting the petitioner's request to the adoption of Central Government Health Scheme or CHGS rates as an interim measure if the government does not come out with a concrete proposal by the next date of hearing.

The court said the Clinical Establishment Act was enacted with the objective of "providing medical facilities to citizens at affordable prices".

The order came in response to a public interest litigation filed by the non-government organisation Veterans Forum in 2020. According to the PIL, the act has been adopted by only 12 state governments and seven Union territories.

The apex court said the Union government cannot shirk responsibility and claim that state governments or UTs are not responding—since health is a subject of the state—and it is, therefore, unable to notify standard rates.

This order possibly indicates relief for patients as the Union government is required to recommend price ranges for hospitals and clinical establishments across the country.

On Jan. 25, the General Insurance Council also announced some relief for patients covered by a health insurance policy by way of cashless-everywhere initiative.

The initiative allows policyholders to obtain cashless redressal of claims at all hospitals, irrespective of whether the hospital is covered under the network of the insurance provider. The idea was to ease the financial burden faced by patients for surgeries, both planned and emergency.

The council, too, recognised the varied rates charged by hospitals and clinical establishments across the country and spoke about the proposal to have a common rate chart for the empanelment of hospitals for a cashless disbursement of claims for all insurers.

While this common empanelment was to do with procedure costs charged and decided between hospitals and insurance companies while onboarding them on their tie-up list, the move is also planned to rationalise the high rates charged by private hospitals.