Healthcare Needs Regulation, Reform





The present state of disarray must not sustain

It is an outrage that private hospitals send patients off to die in the midst of an outbreak of dengue fever in Delhi.It turns the spotlight on the absence of effective regulation of hospitals and, more generally , of a functional system of healthcare. India cannot progress without improving the quality and quantity of healthcare. A regulator for hospitals is urgently needed. No hospital should refuse to treat a patient in an emergency , defined as a condition in which delayed medical care endangers life. Any hospital breaching the rule must face penal fines and the staff responsible must have their licence scrapped. Hospitals can recover the cost of emergency care that cannot be charged to the care recipient from its non-emergency services. This is superior to any corruption-prone attempt to recover the cost from the state.Many private hospitals ask for needless tests and procedures and, in fact, link doctors' remuneration to the investigations and procedures they initiate. Such link age must be made a criminal offence, since it amounts to extortion from patients and fraud on insurance companies. The Centre should write a model law for states on regulating hospitals.The regulator must monitor the working of hospitals and clamp down on medical corruption. Prosecution and penalties can be effective only when the economic incentives at work are aligned with the goals of policy . That is not the case in India. To begin with, the sheer scarcity of Master's and doctoral-level educational opportunities in medicine has made for the bane of huge so-called capitation fees. Doctors are under pressure, as soon as they graduate, to generate a reasonable return on that investment. Ethics is the first casualty . Solution: expand the number of Master's and doctoral seats in medicine.
Then there is the larger issue of resolving the conflict of interest between the hospital's desire to maximise its take and the patientinsurer's desire to minimise the outgo. The hospital undertaking to treatkeep a person healthy in return for an actuarially determined fee -managed care, in the jargon -is a workable model.
Source: Economic Times, 17-09-2015