India’s healthcare sector continues to grow in double digits but universal health coverage remains a distant dream. In the recent years private healthcare sector is under intense scrutiny. Long list of malpractices, violation of the protocol for diagnosis and medical duties, overcharging and exploitation by big hospitals, negligence, and ethical violations were reported at private hospitals across India.
Lack of regulation has continued over the years even as more private health establishments have been set up, which is particularly troubling in a country where there is low penetration of medical insurance and more than 60% of healthcare expenditure comes out of the patients pockets.
Arguments for regulation:
- Projections by global market research analyst Frost & Sullivan show that the worth of private healthcare industry is expected to reach US $280 billion in 2020 from the current $45 billion. So proper regulation is necessary.
- The report published by the National Pharmaceutical Price Authority (NPPA), which analysed patient bills from four prominent private hospitals of the National Capital Region, highlights that the government measure to protect common man from the big corporate hospitals is simply not working.
- Patients and health groups asserted that the unethical practices of private hospitals are a direct outcome of the regulatory vacuum which allows them to cash in on vulnerability of patients.
- Most recently, the Maharashtra FDA (Food and Drug Administration) has sent to the National Pharmaceutical Pricing Authority a report on startling overpricing of medical devices by leading hospitals.
- A regulatory authority can ensure that doctors and hospitals do not prefer prescribing and dispensing non-scheduled branded medicines instead of scheduled medicine.
Issues with regulation itself:
- Having a central regulator alone will not improve public healthcare system which is still abysmal in India and is one of the reasons for people to depend on private hospitals.
- Pricing regulation can lead to substandard delivery.
- Weakened public sector would further reduce the government’s ability to regulate the private sector.
- Enforcement is a problem because health is a state subject.
- Several politicians have invested in private healthcare industry so they don’t want these hospitals to be regulated.
- The regulatory body has to be high-powered, politically independent and represent all sections of stakeholders, particularly patients and NGOs active in the field.
- The regulator should insist on transparency i.e., hospitals need to clearly publicise their rates for standard treatments and procedures.
- The foremost job of regulators is to ensure that doctors are not paid commissions for referring patients to diagnostic centres or bringing them to hospitals.
- Need medical tribunals starting with an ombudsman at the sub-district level, a district forum, a state forum and a national forum.
- Implement CEA provisions strictly – If CEA implemented in letter and spirit, can go a long way in checking corruption in the healthcare industry.
Achieving high standards in healthcare and empowerment of patients is not possible without standard-setting and strong regulation.