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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?

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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.

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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.

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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

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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.

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Ftpini t1_jdswgtt wrote

Sounds like a step in the right direction then.

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readerOP t1_jdqu74t wrote

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

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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.

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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

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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.

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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.

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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?

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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.

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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.

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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)

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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.

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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?

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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

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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.

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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.

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jenksy t1_jdqwu3d wrote

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

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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.

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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.

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stormelemental13 t1_jdtjmct wrote

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

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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.

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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.

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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.

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