A review of a few private hospitals in Lucknow, India by Republica has brought out a surprising revelation that the rate for CT (computed tomography) scan and MRI (magnetic resonance imaging) charged by them are significantly less than what patients have to pay at Bir Hospital and Tribhuvan University Teaching Hospital (TUTH).[break]
Bir charges Rs 2,000 for plain CT scan of head and TUTH Rs 2,800, but the same test can be done at as low as IRs 590 (Rs 944) at one Samra Hospital in Lucknow. Even Charak Hospital, which is considered among the high-end private hospitals in Lucknow, charges only IRs 900 (Rs 1,440) for the test.
Likeiwse, MRI tests start at over Rs 7,000 at TUTH. Apart from Army Hospital and BP Koirala Institute of Health Sciences, Dharan are the only government institutes to provide the service in Nepal. But Samra Hospital charges IRs 2,900 (Rs 4,640) while they start at just IRs 2,500 (Rs 4,000) at Krishna Medical, another hospital in Lucknow. The expensive Charak charges IRs 4,200 (Rs 6,720) for the facility.
The rate disparity is even greater if we compare the private centers in Lucknow with those here in Kathmandu. The plain CT scan of head that can be done at Rs 944 in Lucknow requires Rs 3,200 at the Metro Radiology and Imaging, Rs 3,390 at the Bluecross Nursing Home, and Rs 3,500 at Norvic International Hospital and Kathmandu Imaging.
Similarly MRI, which starts from Rs 4,000 at Krishna Medical, starts from Rs 8,670 at Bluecross, Rs 9,450 at Kathmandu Imaging and Rs 9,500 at Metro Radiology and Imaging. The private centers in Kathmandu point at the low volume in comparison to the private centers in Lucknow, India, for their compulsion to charge higher rates.
“We hardly get four CT scans requests a day while those in India get around 50 a day,” Chief of Administration at Bluecross Ajaya Mathema says justifying the price disparity. Accountant at Kathmandu Imaging Juju Kaji Maharjan concurs. “Apart from the low volume, we also have to bear other costs like running a generator due to ever-increasing power cuts,” Maharjan says.
While the private centers charge exorbitant fees to recover their huge investments that go into millions, the public don´t fare better even at the public hospitals. The government hasn´t set any guideline about rates at the public hospitals, leaving the individual hospitals to fix their own rates. “We don´t put the ceiling for cost on anything. We leave it to the individual hospitals,” Health Secretary Dr Sudha Sharma says.
“But the rates we charge is lower than what other private centers here in Nepal charge,” reminds acting director at Bir Dr Dhruwa Prasad Singh when told of the corresponding rates in Lucknow. Dr Singh and Health Secretary Dr Sharma both concede that the public hospitals set their rates looking at the corresponding rates at private hospitals, which are very high.
Private centers immediately increase their rates--a senior official at TUTH claims--once the public hospitals, especially the TUTH, decide a price hike thereby pushing the patients into the vicious circle of financial hardship.
Why does the government hospitals charge higher rate than the private hospitals in Lucknow who, obviously, must be making money even at their rate?
“The machines and chemicals are not available to us at the rate Indian hospitals get them even after we take into account various subsidies and concessions government provides,” argues acting director at Bir Dr Dhruwa Prasad Singh. The rate was fixed many years ago--much before he joined the hospital seven years ago, he reveals.
“We provide free services to many poor patients. So, we have to compensate for that,” Dr Singh gives the actual reason. Health Secretary Dr Sharma contends that we cannot compare the rates of two countries when first told of the price disparity. She also gives the same reasons proffered by the acting director of Bir while trying to explain the anomaly.
The government hospitals provide most facilities for free and Bir also has to compensate for the free services it provides to very poor patients, Dr Sharma says. “The amount given by the government is not sufficient and the hospital has to generate revenues for sustenance,” she states.
General Secretary of the Consumers´ Rights Protection Forum (CRPF) Jyoti Baniya claims the government cannot charge higher rates to some patients to compensate for the free services given to other. “It is unethical. The government should fix the price ceiling for every commodity and service to ensure that common people are not cheated in this manner,” Baniya demands.
(with inputs by Sahara Sharma from Lucknow, India)
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