Predatory Private Providers

The two recent incidents wherein two hospitals belonging to well-known chains charged∝16 lakh for a 22-day dengue treatment and∝15.6 lakh for a 15-day dengue treatment respectively simply reaffirm India’s dismal health service situation. Between a public health service on the brink of collapse and a private sector that is growing aggressively, a majority of Indians face financial disaster in the case of hospitalisation. The recently released National Health Profile (NHP) 2017 reaffirms what myriad sources of international and national data on India’s health sector have been finding for decades. It shows that the government’s spending on public health is not increasing in real terms, the private health sector is growing aggressively, and the out-of-pocket (OOP) expenditure on medical services is continuing to impoverish the poor, especially in rural India. OOP refers to the amount that is paid to the service provider without any subsidy from the government or third party insurance. Incidentally, both patients in the two incidents mentioned above, died.

The resource crunch in public health services leads even the very poor to prefer private hospitals. According to the NHP 2017, despite the costs being higher by two to nine times in private hospitals as compared to the public ones, 61% rural and 69% city patients preferred the private ones. Also, one in five urban families and a quarter of all rural households are forced to borrow or sell assets for a hospital stay. Of the country’s total health expenditure, OOP constitutes 63%. This has been calculated according to the National Health Account that show per capita expenditure of the total health expenditure works out to∝3,826 per person of which∝2,394 is spent by patients from their own pockets.