Private healthcare has turned into a money-making enterprise

Repeated instances of how some private hospitals, testing laboratories, doctors and referral agents have turned healthcare into a well-oiled mafia-like operation calls for changes in the law and an overhaul of healthcare administration that will provide exemplary punishment to the guilty. The fact that some of the storied names in private healthcare figure in the recent cases of medical malpractice and gross negligence makes the matter even more urgent. That is because these cases endorse the view that private healthcare is primarily a money-making enterprise and patient care takes second place to it.

While the public healthcare infrastructure is in tatters, private medical services are marred by unethical practices and lost the people’s confidence. If the daylight unregulated loot by high-end hospitals continues, there might be a day when civil unrest leading to healthcare riots may breakout against this mafia of sorts.

Leave alone the lofty principles of the Oath of Hippocrates. Basic ethics have not been practised by the hospitals that were out to just keep the billing on their patients running while operations, tests, medicines and procedures were done with criminal intent to profiteer.

The cases in point are the two high-profile incidents that brought both Max and Fortis hospitals, both among the biggest healthcare services brands, under public scrutiny last week. A Fortis hospital in Gurugram billed over Rs 15 lakh for treating a seven-year-old girl admitted on suspicion of dengue and reportedly administered several drugs and injections without requirement. After the girl succumbed, the hospital claimed to have used 660 syringes and 2,700 gloves in a fortnight, which her family, yet to recover from its bereavement, discovered on close scrutiny of the billed amount.

Worse is the case of Max Hospital and its doctors who declared a newborn baby dead and handed over the child in a parcel like a dead foetus. It was only while relatives were taking the child for cremation along with its twin who had died that the newborn was found to be alive. As outrage built over the incident, the hospital sent the doctor concerned on leave, perhaps in an effort to escape public outrage. The same hospital had demanded Rs 50 lakh to keep the twin babies, who had been born prematurely, in a nursery, if the FIR filed by the hapless father was anything to go by. Administering three injections on the pregnant lady costing Rs 35,000 each is yet another grave indication of what the hospital, its management and doctors were up to. Keeping the bill meter running is the only criterion in most cases of explicit ‘aggressive medical practice’ that’s not only unethical but inhuman to the core.

Latest reports of Income Tax sleuths uncovering a nexus between doctors and testing laboratories in Bengaluru in a multi-crore scam shows how deep scamsters have entered the healthcare system. It is well known, that doctors and medical experts are routinely paid commission by top notch laboratories for expensive medical tests. These commissions ranged between 20-30 per cent of the billed amount on the patient by testing laboratories and IVF centres.

Several doctors especially in sub-urban and rural areas have turned referral agents for large hospital chains having outlets in cities as part of the loot system put in place. The kidney transplant racket at New Delhi’s Apollo Hospital that hit the headlines last year is only symptomatic of the corrupt system and chains of nursing homes, touts and agents operating in South Asia.

Government spending on improving public healthcare infrastructure or medical services is just not enough to inspire confidence in people. The National Health Accounts data for 2014-15 points to the fact that centre and states put together spend a measly Rs 1,108 per person on healthcare. This is perhaps one of the lowest globally raising serious questions on the unworkable system. Most obnoxious was that government willing spent Rs 2,300 crore on just 36.5 lakh of its own employees, judges, bureaucrats, members of parliament that includes serving and retired personnel.

Centre and state governments will have to take full responsibility for the huge corruption, exponential rise in costs, unethical practices and crime that’s rampant. Perhaps, one option should be to make healthcare an affordable public service on demand. Act now and not later. Government agencies should be proactive and go beyond being reactive, like ordering probes once malpractices come to light. They should send out the message to all concerned that any healthcare malpractice will be met with the toughest criminal action.