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JOE96924 t1_jdqrfyd wrote

Well, if there's no payment from the government, I understand why they'd protest. Are they expected to pay for the medicine and care for what I'm assuming is millions of patients who can't afford insurance?


pinkcheems OP t1_jdqtdf0 wrote

The bill says that in emergency cases doctors can't refuse medical treatments if patient is unable to pay. State govt. Will later cover that. but doctors think that govt will pay only official rates. So pvt hospitals might lose their profits. Btw state govt. Of Rajasthan provides free health insurance to all families in Rajasthan worth 25lakh rupees (30k$) per family.


supernova_68 t1_jdtbava wrote

Problem is govt. Itself decides the package rate for all ailments ( which is quite low) and won't pay a dime extra (they even cut TDS form the decided package rate). So if an emergency patient requires a costly medication or much longer duration of stay, its upto hospital to decide whether to take the lose and provide the service or face the inevitable fine.

Also package rate is same for all hospitals, even if one is running in a village or a capital city. Running cost of both is vastly different. For eg : a super speciality doctor might agree to visit in jaipur hospital for fraction of price than to a village 100km away from jaipur.

>Btw state govt. Of Rajasthan provides free health insurance to all families in Rajasthan worth 25lakh rupees (30k$) per family.

No it doesn't, it uses ayushman bharat as base for covering low income group, then citizen have to pay Rs 850/ family / year to include in the scheme. Also package rates are way lower in chiranjeevi yojna than national Ayushman Bharat yojna.

Also govt doesn't provide payment for almost 4-6 months for every approved case, and the appointed insurance company regularly reject cases on basis of clerical mistake, or demand investigation which are not even in minimum document list. These cases get overturned if you pay to fight it at highest level , even after that govt. Can take more than 1 year for the payment. Many hospitals have not received payment for case overturned in 2018.


Train-Robbery t1_jdto9il wrote

1 year? I'm a lawyer. If a civil case gets decided in less than 5 Years i will go to Vaishno Devi Bare Foot


supernova_68 t1_jdtpg3v wrote

Ohh... i was not talking about court case but scheme related case redressal system , which do work, IAS officer incharge at top has the final say in all cases, if hospitals still feel that court case is required they can file a case in high court.


Ftpini t1_jdswgtt wrote

Sounds like a step in the right direction then.


readerOP t1_jdqu74t wrote

If government agrees to pay, whats stopping them from overcharging for every damn thing like they do in america?


pinkcheems OP t1_jdqv2el wrote

India have this system called MRP (Maximum retail price). MRP is a manufacturer calculated price that is the highest price that can be charged for a product sold in India. No one can charge more than MRP.


readerOP t1_jdqwn52 wrote

in medical field the hospitals make deal with pharma reps to get specific brands for their hospitable with higher pricing. this already happens in private clinics where the doc has some deal with a company and prescribes only their meds which are often way more expensive than their otc/generic counterparts


pinkcheems OP t1_jdqzrbb wrote

India is a price sensitive market so it's a loss-loss situation for both hospital and drug manufacturers. In India you can't write two different MRP on same product.

  1. If manufacturer writes higher price exclusively for hospitals then they will lose general customers. So no manufacturer will raise their prices just for the hospitals.

  2. If hospital charges higher then others he will also lose customers. It's not a monopoly.

You can use this trick to only exploit insurance companies or govt but you will lose general customers. So it's loss making deal.


henryptung t1_jdshspd wrote

This sounds so much like "competition working as expected to prevent rent extraction" that it's morbidly abusing to see protest over it, as if large profits are some kind of God-given right.


readerOP t1_jdr2bar wrote

who said they will sell under the same name? generic med companies rarely have contracts with private health care providers. Ever seen a private doctor prescribe crocine/dolo for paracetamol?


pinkcheems OP t1_jdr635x wrote

India is not a free market like USA. Especially drug prices in india are highly controlled by govt. You should read drug price control order (DPCO) act, 2013 of India. There is a formula provided by govt to calculate MRP of drugs. Here is the example how it is calculated- .

Calculation of ceiling price of a scheduled formulation.– (1) The ceiling price of a scheduled formulation of specified strengths and dosages as specified under the first schedule shall be calculated as under: Step1. First the Average Price to Retailer of the scheduled formulation i.e. P(s) shall be calculated as below: Average Price to Retailer, P(s) = (Sum of prices to retailer of all the brands and generic versions of the medicine having market share more than or equal to one percent of the total market turnover on the basis of moving annual turnover of that medicine) / (Total number of such brands and generic versions of the medicine having market share more than or equal to one percent of total market turnover on the basis of moving annual turnover for that medicine.) Step2. Thereafter, the ceiling price of the scheduled formulation i.e. P(c) shall be calculated as below: P(c) = P(s).(1+M/100), where P(s) = Average Price to Retailer for the same strength and dosage of the medicine as calculated in step1 above. M = % Margin to retailer and its value =16 (2) The ceiling price calculated as per sub-paragraph (1) and notified by the Government shall be applicable to scheduled imported formulations also.


readerOP t1_jdrb1wt wrote

i think we both are arguing the same point but from different pov, yes there is dpco and subsidiaries exist for this exact reason, the trick is doctors don't directly stock, instead are mediated by the 'nearest' pharmacy, where they carry all brands so they aren't breaking laws, but companies use their expensive subsidiaries, the real profit is not in the drugs that directly treat, but in schedule H analgesics and antipyretics that doctors pad the prescriptions with. Schedule H formulation are quite flexible and companies use this loop hole to push expensive schedule H generic alternatives which if you read carefully are almost similar and could be easily replaceable by dolo or brufein (has a doctor in our family hence i know this) most of the profit is from these than the main drugs that treat whatever condition. Even some doctors don't like this but it's not that big of a deal and helps pay the bills, so they go along.


likeureallycare t1_jdrx67g wrote

As someone who has to buy medical supplies on a monthly basis for just household usage ( glucose level check stripes, guaze rolls, swabs, Saline, dressing Pads) they are sold at fair(11%) to extremely(70%) discounted prices on MRP to me depending on items in most surgical stores

This is just for private use in smaller tier 2 city , imagine hospitals in tier 1, large tier 2 cities. MRP is very high than sold price and can be used to rake large profits (this is not including inpatient medicines which is also big profit pusher)


Explorer335 t1_jdsbu9c wrote

It's cool to see the MRP printed on the box for medication from India. In most cases, it's less than the equivalent of $5 USD.


marvinhal21 t1_jdua0i8 wrote

>No one can charge more than MRP

Is that why upscale places charge upwards of Rs 500 for a bottle of water?


Train-Robbery t1_jdtou8u wrote

Already Happens to a certain extent. My father has a government job and because of that our family gets cashless treatment is hospitals, the government pays for any and all treatment even in private hospitals. Plus any medicine we buy is later reimbursed by attaching the bill.

So yeah Doctors often write unnecessary tests, they tell us to our face You have a cashless panel so just go along with it. Also Pharmacy Shops that usually offer 20% discount on the price will agree to make a Bill of full price but give us a discount either way. So suppose we buy Medicine worth 10,000, we'll pay the Pharmacy guy 8,000 he'll give us a bill of 10,000 and we'll claim that from the government. Profiting by 2,000


JOE96924 t1_jdquguo wrote

...or from going broke before the government finally pays the little that they probably will pay. I'm just guessing here, but this is what I'm assuming their gripe is.


readerOP t1_jdquwz1 wrote

this is for emergency treatment and if they can assume the worst from citizens, why can't the govt assume the worst from them? double standards.

we already pay for healthcare, these people use services built by citizens too.


jenksy t1_jdqwu3d wrote

Welcome to private health care. This is why public care for all is required.


stormelemental13 t1_jdscnsb wrote

> we already pay for healthcare, these people use services built by citizens too.

Everyone uses services payed for by public taxes, that doesn't entitle you their labor.


readerOP t1_jdtigno wrote

Yes it does in lieu of the license authorized to them by us the people of India. Stop talking out of your ass.


stormelemental13 t1_jdtjmct wrote

Lots of people are licensed, you aren't entitled to their services either.


readerOP t1_jdtk6gq wrote

yes we are, most licensed professionals are obligated under emergency and even without compensation in case of national emergency or enactment of one of the emergency clauses, stop thinking labor laws are the same everywhere. also replying to your ignorant ass queries that can easily be learned with a simple google search is really irritating.


Vordeo t1_jdtalq2 wrote

>this is for emergency treatment

Part of the problem stated in the article is that that term isn't really well defined.


mateojones1428 t1_jdui6b4 wrote

Hospitals don't necessarily overcharge for everything, those prices are negotiated with insurance companies.

If you pay out of pocket a lot of times things are reasonably priced but obviously if you need significant hospital stay in the ICU or something you are going to be charged an insane amount of money, but even for just the nurse it cost the hospital 1000-1400 for 24 hours.

Whenever I've paid out of pocket for CT scan, MRI or my knee surgery-300, 500, 1700 respectively, those were all reasonable prices to me.


readerOP t1_jdqttwe wrote

it's weird that these doctors assume poor people might abuse the system and get the good stuff for free

but then go on to show pikachu face when government distrusts THEM and assume that these greedy doctors might overcharge for everything like they do in usa and charge 10000 for paracetamol in case government offered to pay for stuff obtained under right to health (which is the best way to make health a right imo).

they can assume the worst of poor people but they don't want to be treated the same way lol.


stormelemental13 t1_jdsd42w wrote

No one has a right to another person's labor. If you think everyone should have access to emergency care, fine, put together a public health option via government run facilities, ala NHS, or through government insurance, ala Canada.

You don't just declare that people have right to demand care from private citizens and that you'll figure out a way to pay for it, maybe, someday.


henryptung t1_jdsi2di wrote

>No one has a right to another person's labor

On the contrary, everyone has a right to purchase at prevailing market rates - that's what a market is. It's also what the government will pay (MRP) for care, but it's apparently not enough.


pkb369 t1_jdsrqeg wrote

> On the contrary, everyone has a right to purchase at prevailing market rates

Except that is a deal agreed by both parties. In this case the deal is only agreed by one side (the government). The labourer has the right to refuse if they deem their value is not worth the labour.

Consider you currently do a job that pays 100k pa, but now its government run and since the minimum wage is 50k pa, they pay you that. Would you still keep working there?

This is just a broad example, I have no idea what the rates that the doctors are demanding vs what the government is willing to provide (and it makes sense as per the other commenters that the doctors will try to take advantage and jack up the price than what they usually charge because the government would pay if it was a 2 way agreed deal)


readerOP t1_jdtibi9 wrote

Except it is and part of it comes from all the subsidies and concessions private health care received from the government on agreement that they would aid the government in implementing policies as such, The protest is from useless mba's not actual doctors. if these assholes go out of business there are more than ample opportunities for doctors to be immediately reemployed. Please don't try to feed us the american health care bullshit.


henryptung t1_jdth0u5 wrote

>Except that is a deal agreed by both parties.

Yeah, labor requires an employment contract between parties to operate. Buying medical services or goods doesn't.


Guy_with_Numbers t1_jdsuzc7 wrote

No one has a right to market their labor as they wish either. Even US hospitals are legally forced to provide emergency healthcare without payment. Healthcare anywhere has tons of regulations, govts have a lot of leeway for restricting private entities in that industry.


Train-Robbery t1_jdtp1l4 wrote

Government can mandate that they prescribe only Generic Medicine, made by the government and is low cost.


chockedup t1_jdr0fga wrote

Is this related to India's caste system?


RazorBlade9x t1_jdswczj wrote

Yes. The caste system is also responsible for climate change.


Big_Simple_1782 t1_jdrm6xt wrote

No, but it's lurking in the background somewhere... Like almost everything in our country.. Sadly.


Jorycle t1_jdsb2o4 wrote

It's weird to see that stuff follow over to other countries. At my old job, 90% of the software team was from India, and at times there was a palpable animosity - eventually it was explained that there were two different castes represented in the team, and the more vocal engineers still took caste very seriously.

(Unclear why this sub's weird downvote train arrived 6 hours later for an innocuous comment, I suspect a brigade is upset about its caste situation.)


autotldr t1_jdqqr47 wrote

This is the best tl;dr I could make, original reduced by 68%. (I'm a bot)

> The Indian Medical Association on Saturday announced that it will observe a nationwide black day on March 27 to protest against Rajasthan's Right to Health Bill, which was recently passed in the state assembly amid medical professionals' demand to roll it back.

> Doctors across the state, including IMA's Rajasthan chapter, have been protesting against the Act, that gives rights to every resident to avail free of cost treatment along with 'emergency treatment' without prepayment at any health institution in the state.

> Patients can also avail 'emergency treatment' at public health institution, health care establishment and designated health care centres without a prepayment.

Extended Summary | FAQ | Feedback | Top keywords: Health^#1 Rajasthan^#2 treatment^#3 Bill^#4 state^#5


postart777 t1_jdsop4o wrote

Sounds like capitalist Indian doctors will be much happier in the United States.


echodeath t1_jdsweld wrote

Every doctor will do better in a capitalist society. Because capitalism actually fairly values your labor unlike socialism were you think everyone’s labor should be equal.


ipel4 t1_jdt6hmp wrote

Weird I remember capitalism trying to pay you as little as possible and valuing your work the least while the top in the company sweep all the money.


Train-Robbery t1_jdtoxoo wrote

Certainly a society with Inequality benefits highly educated and skilled people


circ_le_jerk_69 t1_jdtvg6c wrote

> and valuing your work the least

It's interesting then that all the countries in the world with the highest median income are all capitalist countries. It's almost as if you don't have the faintest idea of what you're talking about.


ipel4 t1_jduualk wrote

> It's interesting then that all the countries in the world with the highest median income are all capitalist countries.

That's a very valid argument until you realise there are only 4 socialist countries in the world. One of which is sanctioned to oblivion for making nukes.

A better example of why pure socialism sucks is eastern european countries who were worse off when they were under ussr occupation due to all the looting and stealing and are now faring much better.


[deleted] t1_jdt6z01 wrote



ipel4 t1_jdtc7zw wrote

> And your job under capitalism is to value your work properly by negotiating or by having someone negotiate for you.

And when everyone wants to skim you by paying you almost nothing then there is no negotiating. You work or you starve. Why do you think there's a minimal wage and other socialist laws which ensure worker rights? Also hiw would someone negotiate for me when right wing parties constantly try to dismantle unions and people still vote for them.

> With shitalism you can’t do that. Oh let me remind you, your precious unions don’t exist in shitalism.

So doesn't that mean that if a socialist country then voted to have unions it would simply be better than capitalism? :)

I'm not even for socialism, I think that a system that has free market but also worker rights (which apperantly you do not realise is anti-capitalist by nature) is simply better than both but somehow you claim the doctors would be magically better simply from it being a capitalist system. Bruh they ARE in a capitalist system. Which means there are two options, first being the doctors ask patients massive bills cause that's what they think their work is worth and the patient choosing between paying it or dying (like in the US), second there being restrictions where the patient can actually you know - afford his live saving treatments? Jeez I wonder which is better.

It's not like the doctors will be paid minimal wage (which by itself is meant to be livable off of) so you can't claim their work won't be appreciated.


blah_bleh-bleh t1_jdtkk85 wrote

India is a socialist country, we have unions. Heck we have a corporate society (employees own the company rather than management) running a cafe chain in India. Which is sort of the holy land of socialism here. Also didn’t America banned a lot of unions from being formed?


ipel4 t1_jdtn685 wrote

"Socialism shaped the principal economic and social policies of the Indian government but mostly followed Dirigisme after independence until the early 1990s, when India moved towards a more market-based economy." - Socialism in India Wiki page

> corporate society (employees own the company rather than management)

So then you're not socialist...? I guess a more accurate statement is a mixed economy since you have elements from both socialism and capitalism

> Also didn’t America banned a lot of unions from being formed?

Yep, they lie that the union would make their dalaries go down and people somehow fall for it even tho their primary purpose is literally to make them go up. They also double the work on those who threaten to start unions and then fire them for not being able to do their job.


blah_bleh-bleh t1_jdtny43 wrote

Well. It’s called Indian Socialism. Which states that every person should have equal opportunity to grow. I misspelled, not corporate but co-operative society. Like Amul, Mother Dairy. Which keeps companies like Nestle at bay and prevent them from commercialising essential sectors. Modern Policies like UPI, and ONDC exist to prevent monopolisation of internet in modern society. Like preventing Amazon and apple pay from fully overtaking their sector. So yes it’s a mix, but we still like to call ourselves socialist.


readerOP t1_jdtiy1o wrote

>having someone negotiate for you

that someone is called a union you silly fucker.


paradoxbound t1_jdt7i74 wrote

Just like the birth of the NHS. Private doctors refused to treat the poor. The NHS hired a bunch of Indian doctors.


supernova_68 t1_jdtdbqz wrote

Then do that, currently rajasthan govt. Required more than 8000 doctors in govt. Facilities, they released the post for only 1800 for which almost 8000 doctors applied. So many doctors are willing to work for govt. They just don't want to work for free.


[deleted] t1_jdtom5u wrote



supernova_68 t1_jdtq0jl wrote

Wired that a britisher is talking about castism and assuming my caste and financial status. Also i am not garing any sympathy I don't need it. I was just making you aware that doctors are willing to work for govt. Its the govt. Who is not giving the jobs.


bottlegreenblue t1_jduhumy wrote

Where does the person even state his/her caste to your reply? So you say you're British so should we assume you're a white slave owning guy who had a direct hand in the killing of millions of people? What a stupid take.


Contagious_Cure t1_jdtifss wrote

ITT Americans assuming healthcare works the same as their country everywhere else.


TheDraco4011 t1_jdtxnmv wrote

Wait so if you show up to a doctor with your leg cut off and you don't have money, they can refuse you at the door? That sounds like a good way to make desperate people violent.


ApocalypseYay t1_jdqxrbv wrote

>Private doctors in India are protesting against 'Right to health' bill.

So, .......profits before people.


DanTrachrt t1_jdr61re wrote

When those profits are how those private doctors make their living, I can’t really blame them.

It’s shitty, but it more them looking out for themselves over others.


demigodsgotdraft t1_jdrgo3e wrote

See how you like it if you're mandated to accept dogwalking jobs for $1 for 6hrs.


readerOP t1_jdtj7p2 wrote

false equivalence, slippery slope logical fallacy.


stormelemental13 t1_jdscdd9 wrote

No one has a right to your labor or your business, especially not for free.

Imagine if someone came up to you said you had to work for them because it was an emergency, with nothing but a vague promise that the government would pay you back, maybe, somehow.


kaioone t1_jdsd1pf wrote

It’s not for free, the government is refunding them.


supernova_68 t1_jdtc62r wrote

At rates lower than cost of doing business for many hospitals thats why many small hospitals in villages had already refused to participate in an already working state sponsored health insurance scheme, because the cost of doing business in their area was higher than what the govt. Was offering.

Its like mandating you to work at rate lower than minimum wage.


Train-Robbery t1_jdtp8y6 wrote

If the government says they'll do something , they definitely will not do that


Vulture2k t1_jds8p5d wrote

Isn't if kinda mandatory for a doctor to do anything in their power when there is a true emergency? I mean. For any human really? How emergent are we talking?

Well you sure know these doctors don't do their jobs for charitable causes.


RogerSterlingsFling t1_jdsd0ku wrote

Its more about carrying the costs of treatment

If you are just asking a doctor to administer first aid on the street, sure

If you are expecting a patient to rock up to your surgery and need an anaesthetist, medical imaging and pathology tests the costs add up unless the government is willing to pay the doctors for their expertise


BritianSucks t1_jdzo0hz wrote

Wtf is problem with this article and recent articles headlines?

If something positive happen in an opposition ruling state then headlines specify state name and ruling government.

But if something negative happen then they only mention ''India" like this one and others others like "India cut-off internet for 27M people" but refrain from mentioning State name and their ruling government name.


eremite00 t1_jdtrugf wrote

What was the public and/or medical establishment access to the text of the bill before it was passed? Were there opportunities to raise objections prior to its passing?


JordanJP t1_jdug53q wrote

I would be curious what in this constitutes emergency care and whether all doctors will be expected to have the same supplies or capability.


Expert-Narwhal t1_jdudmz8 wrote

Fucking end private practice. We already have socialist healthcare.


kevin_o7 t1_je9c6nh wrote

Such an ignorant statement. Step out of your room darling. You are living in some different world.


Ok-Run5317 t1_jdtjcco wrote

the intent of the doctors is questionable. they seem to be doing it just to oppose the government.


Ok-Run5317 t1_jdrihzq wrote

it's being implemented by party that is in opposition in centre. hence the protest. had it been other way round, it would have been hailed a revolutionary Bill.


kevin_o7 t1_jdruyg7 wrote

And in that case you would have written in support of protestors.


Big_Simple_1782 t1_jdrmb4e wrote

This.. This is the whole truth and nothing but the truth.

The rest is just noise.


A_random_zy t1_jdrq95y wrote

100% the truth... Why would docs protest when they are being paid thr amount they would generally get.


Train-Robbery t1_jdtpf95 wrote

They'll get Govt hospital subsidised rates, If RJ govt really cares they'll make new Government Hospitals and themselves bear the cost of treatment.

Fucking 7-8 years of education, they deserve atleast 60-70K a month.

Lawyers succeeded in Getting the Advocates Protection act in Rajasthan, If doctors show enough determination they too will be heard.


supernova_68 t1_jdtcc6r wrote

Except they aren't paid the amount they would generally get, not even close and not even on time.