New Delhi: Placing the onus of fixing the price range for medical treatment services in private hospitals on state governments, the Centre has informed the Supreme Court that it has shared a pricing template for procedures with them, and can only determine the costs when they respond to it, ThePrint has learnt.
In a 37-page affidavit filed in the apex court Monday, the Union health ministry underlined that each state should determine standardised medical costs based on regional factors, recognising that rates vary due to local conditions and types of healthcare services.
The affidavit said that how much a patient has to pay for treatment is determined by the location of the facility where the procedure is carried out, the type of the hospital, and the qualifications or experience of the doctors.
ThePrint has viewed a copy of the affidavit, which also says that cost cards can only be prepared based on inputs from all stakeholders, including private players in the states, as a one-size-fits-all approach may not be feasible.
“This would require additional time to initiate the exercise and proceed further as it shall be both manpower and time intensive,” said the central government in the affidavit.
Meanwhile, the Supreme Court Monday accepted the impleadment made by the Indian Medical Association (IMA) — the largest association of doctors in India — the Association of Healthcare Providers of India (AHPI), a group of private hospitals, and others arguing against the standardisation of rates.
Their case was made stronger by the Centre, which said that fixing any price range may lead to serious compromise of quality of healthcare or patient treatment.
Fixing rates may lead to serious issues, like rendering healthcare setups financially unviable, and many other players may jack up the price, the affidavit said, adding that it may also make the healthcare sector uncompetitive, considering the economic dynamics and interaction of market forces.
In February this year, the Supreme Court had issued a notice to the Centre asking why the range of prices for treatment services in private hospitals, under the Clinical Establishments (Registration and Regulation) Act, 2010, had not been fixed.
The notice had come during the hearing of a public interest litigation (PIL) petition filed in 2020 by an NGO, Veterans Forum for Transparency in Public Life, which had wanted to know whether the fees charged from patients in private hospitals were in line with the act.
Girdhar J Gyani, director general, AHPI had told ThePrint last week that the association does not support the idea of fixing standardised rates for private hospitals across India.
“But if such a move is to be taken, we will demand a comprehensive and scientific exercise to establish what should be the standard rate for a particular procedure or treatment in a hospital. So far, such an exercise has never been carried out in the country and rates fixed for schemes, such as the Central Government Health Scheme (CGHS) are too low, and make the hospitals bleed,” he had said.
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What do the states think?
The Central government informed the SC that last month that it had held a meeting with the states to discuss the matter in which Gujarat and Madhya Pradesh had said that fixing any rate range may lead to serious compromise of quality healthcare and treatment services and may diminish the level of standards in private facilities.
Uttar Pradesh and Uttarakhand also emphasised that fixing rates could interfere with the market forces.
The states where the Clinical Establishments Act, 2010 has been adopted — UP, Bihar, Himachal Pradesh, Telangana among others — however, showed willingness for rounds of discussions with stakeholders, and invited the ministry’s guidance.
The states, which have their own legislation, said that there was no provision for determining the range of rates for medical services or procedures under the state laws.
The affidavit said that many of these states have a provision to display the rates for various treatments. West Bengal, it said, informed the Centre that as 90-95 percent of the population is covered for quality and affordable access to healthcare by state schemes, it does not intend to fix rates of services in private settings.
“Many states, such as Uttar Pradesh, Chhattisgarh, Telangana, Himachal Pradesh etc, requested the ministry to share the costing template outlining the costs of procedures with states to discuss in the consultation/stakeholders meeting. It was suggested that the same may be utilised as the baseline framework to work out the range of rates through costing exercise for various medical procedures as applicable for the particular state,” the ministry informed the court.
(Edited by Mannat Chugh)
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