India’s worst-hit city during the coronavirus pandemic, Mumbai, may be gearing up for another calamity—a purely manmade one this time. 53 private charitable hospitals have written to Chief Minister Uddhav Balasaheb Thackeray on the matter of government’s pricing on non-COVID-19 beds in private healthcare facilities.
The Association of Hospitals, ‘a forum for not-for-profit hospitals’, has flagged that Maharashtra government’s notification mandating the private healthcare facilities “to cap prices for all procedures across all classes of beds will make the sector collapse” as untenable.
The letter—signed by Dr RK Choudhary, honorary secretory of the association—also suggests measures to build a sustainable partnership between the government and private hospital.
Can Mumbai Hospitals Be Sustained?
The Quint spoke to Dr Sudhakar Shinde, the CEO of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana; Mahatma Jyotiba Phule Jan Arogya Yojana, who confirmed the receipt of the letter by the Maharashtra government. “The government has received the letter and concerned officials and ministers will take it into consideration.”
Another senior bureaucrat from Maharashtra said, “How selfish are these hospitals! They want to milk the coronavirus calamity even after taking all the benefits from the government.”
Inconclusive Meeting Between Maharashtra Government & Private Hospitals
A meeting held in ‘mantralaya’ on Friday evening attended by the chief secretary and the representatives of the hospitals ended without any ice-breaker.
The meeting was attended by Chief Secretary Mr Ajoy Mehta, Principal Secretary (Health) Dr Vyas, Municipal Commissioner Mr Iqal S Chahal, and Health Commissioner Dr Shinde. The top officials of the Maharashtra government decided, after many arguments with the hospital representatives, that 80 % of the hospital capacity (COVID-19 and non-COVID) are to be charged at government rates (GIPSA-General Insurance Public Sector Association), and balance 20 % is to be priced as per hospital rates.
Private hospitals are not happy about it.
Dr Hiren Ambegaonkar, CEO of SL Raheja Hospital, told The Quint that the hospital incurred a loss of around Rs 1.3 crore in April and more is expected in May due to the fall in revenue. “The 29th April circular from Maharashtra government mandates that all non-covid beds in all hospitals are to be charged only general ward GIPSA rates. The people in government are not willing to understand the economics of running a hospital. Single room patients subsidise the general wards otherwise the hospitals are going to collapse. For the so-called good of population today, you can’t make irrational decisions that will surely end in the collapse of healthcare infrastructure.”
Ambegaonkar further added that the association presented the government with three choices listed as below:
1. We (private healthcare) give you hospitals, you run them and pay for the fixed costs.
2. Let us keep charging the patients what we have been. If there is any surplus left after our expenses, we’ll put it in CM’s fund .
3. Allow us to ladder the charges. We’ll work out a formula to sustain our operation without causing any problems to the general ward patients.
Another CEO, requesting to remain anonymous, shared, “We have been incurring additional expenses on account of building capacity for COVID-19. This is unfair on the part of the government to subject us to further losses.” The CEO also stated that the BMC is sitting on a cash-pile of around Rs 80,000 crores, which happens to be taxpayers’ money. “Why are the BMC and the Maharashtra government passing their responsibility to the private hospitals instead of using taxpayers’ money for taxpayers’ benefit?”
Chief Secretary of Maharashtra has taken cognisance of the fact that the number of operational beds has come down because there isn’t enough manpower to deal with patients. Nurses are supposed to be in quarantine for 15 days after serving 15 days in the hospital, dealing with COVID-19 patients. The Chief Secretary has assured the hospitals that nurses and other auxiliary staff shall be provided to private hospital to raise the numbers of operational beds. The hospital administrations, however, remain sceptical about their operational capacity.
The hospitals are not on board with the government’s demand of 80% beds—ICU as well as general ward— to be charged at the GIPSA rate. Maharashtra government has on Friday relented that the hospitals can charge 20% beds their original rates. Private hospitals say that this would not meet their fixed expenditure demands. “How can we tell our doctors and nurses and other employees to risk their lives and come to work if we are unable to pay even their salaries,” asks the CEO of a prominent Mumbai hospital.
One of the attendees of the Friday meeting says that the healthcare department of Maharashtra government seems to be in a lot of pressure from Delhi and also negative press globally.
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