How high Covid-19 bills are pushing families to the brink of scarcity

For D Nath, 50 (name changed), the battle against Covid-19 may be over, but the stress is not. Last month, the Guwahati-based businessman tested positive for the virus, was admitted to a private facility in the city. “It wasn’t a bad case of infection, but my brother, who had also tested positive, saw his oxygen level drop,” Nath recalls. “So we thought it was better to be under surveillance.” After spotting several hospitals in the city, which were all out of their budget, the duo finally found a small private hospital, which offered a lump sum of Rs 1.7 lakh for treatment, until they were tested negative.

While he thought it was expensive, Nath felt it was a sum he “could handle” so they checked in, sharing a room. Ten days later, on the morning of the release, they were presented with a bill, almost double what they had been quoted earlier. “There was this extra charge – for drugs, and so on. We argued with them all day, making several calls to the owner, general manager of the hospital – nothing worked. Until we paid, they wouldn’t let us go, ”Nath said.

Finally, after arranging money with friends and family, they paid the full amount and returned home late, only late at night.

A month later, Nath made a full recovery but it was an experience that left a bitter taste in his mouth. “Of course the virus is gone, but now I have to figure out how to pay back the money,” he said. “Fortunately, I have understanding friends.”

A doctor performs endoscopic sinus surgery on a patient with mucormycosis in an Indian hospital. (Photo: REUTERS)

He is not the only one. Across the country, many may have been successful in beating the virus, but their lives have been turned upside down by the loans they have to repay thanks to huge Covid-19 medical bills. They drew on years of savings, sold jewelry, mortgaged property, and borrowed from friends to pay medical bills.

Fear of medical bills

In Telangana, N Vignesh Yadav lost his father to Covid-19 two weeks ago. Previously, Vignesh had run into Hyderabad in search of a private hospital to accommodate his father. But dissuaded by the exorbitant prices, the 18-year-old resorted to an overcrowded public hospital. “Soon I got a call from my dad telling me there was no one around to take care of him. I begged the hospital reception staff but they fired me and three hours later he died, ”Vignesh said.

His cousin Shiva Krishna said that it would not have happened if the father had received better care, perhaps in a private facility. “We had tried, but the hospital demanded Rs 2 lakh upon admission and said the treatment would cost around Rs 75,000 per day,” Krishna said, “We also inquired at a few other private hospitals, to find out that the processing fees are the same everywhere, ”he said.

While Telangana – and several other Indian states – has capped the prices of Covid treatment in private hospitals, the reality unfolding on the ground is quite different.

In Manipur, Rita Thounaojam, whose husband Irom Maipak, a nationally awarded cinematographer, succumbed to the virus last week, had to borrow from friends and relatives and sell her gold necklace for a lakh, to pay the hospital bill.

According to Thounaojam, hospital authorities have shown that the cost of intensive care per day amounted to around Rs 9,800 (excluding charges for oxygen cylinders). However, as her husband’s condition worsened, the hospital had to administer oxygen through a ventilator. “As the oxygen cylinders were used hourly, there was no specific charge, but the total charge was between Rs 20,000 and Rs 35,000 per day,” she said. In the end, the final bill she paid was around Rs 9 lakh.

Following this, several NGOs demanded that private hospital fees be capped – and on Wednesday, the government in Manipur finally passed an ordinance to that effect.

Sadam Hanjabam, CEO of Ya_All, one of the NGOs behind the price cap memorandum, said many people continue to remain in isolation at home because they “fear huge medical bills in hospitals. “. “They only rush to health centers when it gets serious and by then it is too late,” Hanjabam said. “So if we don’t cap the price, many risk dying just because they’re too scared to seek treatment.”

Bad implementation

While price caps are in place in many states across the country, poor enforcement of orders and lack of redress for grievances make them virtually unnecessary.

After a month in hospital battling Covid-19, Annadevara Srinivasa Chary, an electrician based in Hyderabad, has finally returned home. But not before her family suffered what they described, “trauma that was beyond words.”

On the day of their release, they received a bill of over Rs 23 lakh. They had already paid one lakh as a deposit upon admission, and another Rs 3.5 lakh during treatment. “We were asked to pay Rs 19.15 lakh. The bill stated that Rs 2.45 lakh was a “consultation” for two doctors and a pulmonologist. Rs 35,000 were billed per day for isolation in the intensive care unit and Rs 25,000 per day for days in the general ward, ”explained Chary’s brother, A Devender.

While price caps are in place in many states across the country, poor order enforcement and lack of complaint remedies make them virtually unnecessary. (Drop)

Devender recalled that even organizing the deposit of Rs 1 lakh was difficult, and several relatives had to intervene. “But that was not all, we knew that the hospital bill was increasing with each passing day. In one week, we had to mortgage our house for Rs 5 lakh, ”he said.

As the story of their plight went viral on social media, the hospital finally offered them a discount. “We also had time to organize the money. But after our release we now have several loans to repay with interest, ”Devender said.

Telangana had introduced private ceiling treatment in June 2020 itself. However, dozens of complaints of overcharging by private hospitals abound. Following numerous such complaints, three hospitals received show cause notices and the license to treat Covid patients at one of the hospitals in Madhapur was canceled earlier this month.

Delhi-based activist and public health researcher Inayat Singh Kakar, who is associated with the All India Drug Action Network (AIDAN), said that while many states have put in place price cap orders, the implementation was poor.

“Different states have done things differently. For example, in the order of the Delhi government, most things, including the management of co-morbidities during Covid treatment, are covered by the cap. But in some states, the cost of all treatments is not covered, which allows the hospital to overcharge these aspects, ”she said. “In the bills we analyzed last year, we saw that many hospitals overcharge for PPE, drugs and with different ways of overcharging and profiting.

Kakar said it was therefore important for states to build on the experiences of private hospitals overcharging during the first wave and realigning orders. “There are no checks and balances to ensure that the implementation goes according to the spirit and the letter of the notification, so that hospitals get away with it,” she said.

States must be more proactive

In Chennai, a 27-year-old man working in the computer industry pays Rs 60,000 a day for his father’s treatment. For this, he borrowed from his brother-in-law and other relatives and even pledged his family’s jewelry.

On May 22, the government of Tamil Nadu issued an ordinance regulating treatment fees in private hospitals.

But according to the 27-year-old, many are unaware of the caps imposed by the government. “It’s a desperate time and many just want to walk into a hospital without questioning the price,” he said.

Such cases of overload are rampant – and only some make it to social media and ultimately get help. “A lot of stories don’t come out because people are silent about it and don’t want to fight the hospital,” Kakar said. She said many hospitals are generally unwilling to enforce the caps and, therefore, do not notify patients. “That’s why we need states to be more proactive,” she said.

While several states have recently issued caps, and some like Mumbai, Pune have performed bill audits at private hospitals, many lives have already been turned upside down by loans and debts. Some, like Guwahati-based Nath, have said they will fight him in court when things get “more normal”. Yet others are too helpless to do so.

In Hyderabad, Devender, whose brother is still on oxygen therapy at home, said the whole time was traumatic. “The idea of ​​increasing bills as your family member battles an illness like Covid is in itself torture. The mind becomes empty. We hope that no one will have to go through this, ”he said.