West Bengal: Private hospitals set to meet over Swasthya Sathi concerns – Times of India

Kolkata News
KOLKATA: Amid the state-wide scamper to enrol for the Swasthya Sathi scheme, private hospitals have been left worrying about the feasibility of admitting patients under the system that will now see a phenomenal increase in the number of registrations. Unless the price structure of the new scheme — which makes all Bengal residents eligible for the health insurance — is rationalized to make the packages under the scheme sustainable for hospitals, it could turn out to be a financial burden leading to large scale patient refusal, they pointed out.
“The existing prices are almost one-third of our normal charges or even lower. While the scheme is a brilliant idea and we believe that it will help to reach quality healthcare services to everyone in the state, we would request the chief minister to reconsider and revise the rates for private hospitals under Swasthya Sathi. We are already under a strain since the pandemic has adversely affected our financial status,” said AMRI Hospitals CEO Rupak Barua, who is also the president of the Association of Hospitals of Eastern India (AHEI). The AHEI plans to meet soon to discuss the scheme once the details are conveyed to the hospitals.

A senior health official said public health schemes were meant to be priced low. “Prior to the implementation of Swasthya Sathi, we had a discussion with all stakeholders and none had objected to the pricing,” he said.
Barua added that hospitals are yet to receive any communication from the government with regard to the new scheme. “Once the details arrive, we would like to look at the price structure and then have a discussion with the government,” said Barua.
Introduced in 2016, the existing scheme offers treatment under a series of packages with ceilings on charges. Private hospitals argue that the packages are priced too low for them to be able to treat patients under the scheme. Even though package prices for the new scheme are yet to be announced, they are unlikely to be any different, they fear.
The success of the new scheme will depend on the pricing, said Medica Superspecialty Hospital chairperson Alok Roy. “Unless you can make it reasonably viable for private hospitals, there will be refusals. While a few of us have been accommodating patients under the scheme, there are several who turn away such patients. The purpose of Swasthya Sathi will be defeated if we can’t address this issue,” said Roy.
Under the present scheme, charge for a coronary angiography is capped at Rs 9,000 while that for medical treatment of heart failure is Rs 18,000. Hospitals can charge up to Rs 3,000 for thyroid cancer and diabetes treatment.
A private hospital official said while the scheme will help increase the affordability and give access to high quality healthcare, especially to those who otherwise find it beyond their reach, it should be restricted to the underprivileged sections of the population. “If the coverage extends to the affordable and affluent segment, hospitals would find it impossible to sustain operations unless there is a reasonable rate revisions done to enable long term viability,” said the official.
A private hospital chief said doctors, especially senior surgeons, were often reluctant to attend to all government scheme patients, including Swasthya Sathi.
“They refuse to operate upon these patients and have to be persuaded. It makes things difficult for us. The charges prescribed under the scheme are too low, particularly for surgeries. Even treatment charges are too meagre,” he said.
Another hospital official suggested that the government should penalize hospitals for refusing these patients just as they do for overcharging and medical negligence.

Source: https://timesofindia.indiatimes.com/city/kolkata/private-hospitals-set-to-meet-over-swasthya-sathi-concerns/articleshow/79596764.cms