Health is wealth, for the hospitals

When a friend carried his 40-day-old baby to a reputed children’s hospital in the western suburbs last week, the first question he was asked at the time of admission was whether he had medical insurance for the child. A negative reply was met with dejection, and over the course of the next two days it emerged why. An insured patient is good news for the hospital — administer all the tests, prescribe all the medicines, slap all the extras on the bill and everyone’s happy. The patient gets the full treatment, the hospital bloats the bill and the faceless insurance company pays up for the cashless claim.

Of course, what goes around comes around and someone has to finally foot the bill — and that someone is the consumer. Medical insurance premiums have been rising sharply; the premium for group medical insurance schemes has nearly doubled in the last couple of years. Paying a fat premium to get income tax rebates is one thing, and actually landing in a hospital to qualify for the insurance claim is another. Even if you do manage to dodge the disqualifying riders and evade the pre-existing illnesses clause, the fine print governing the claim process will unravel to you that ‘cashless claim’ is just a marketing term to sell you the policy. To top it all, some of our five-star hospitals can be so exorbitant that they can max out the Rs5-lakh ceiling of your medical policy in a matter of days.

God bless you if you don’t have insurance, and you land in hospital. You not only have to pay for the bed and breakfast, but also give your contribution for all the expenses that go into the making of a healthy facility — right from the Rs1 crore that goes into the creation of a doctor to the multi-crore land for the hospital, from the cut to the local politician for protection (yes, even hospitals need protection) to the local general practitioner’s cut for recommending patients. Last heard, wily GPs demand as much as 40% of the patient’s bill as kickbacks.

With this kind of pressure on costs — and their very survival — nobility is the last thing on the minds of the practitioners of the noble profession. Every department is a revenue vertical and every patient is a business opportunity (and why do you think hospital managements are teeming with MBAs these days). The price of every dose of medicine administered, every flying visit by a consultant and every test for every part of your body is proportionate to the category of the room (no MRPs for consumer protection here) and the only choice you have is to pay by cash or by card. If you are lucky, one of the tests will be relevant to your diagnosis and you could well get well. Don’t crib about the money; thank God you walked out alive. And now that you are alright, keep some cash aside to pay next year’s premium on the cashless policy.