Dengue Death at Fortis Hospital : Medical Insurance not Enquiry is the Answer

A little girl was admitted to a super specialty hospital in Gurgao for treatment of severe form of Dengue fever. The girl was transferred from Rockland Hospital in Dwarka to Fortis Hospital in Gurgaon. Girl passed away after 15 days in intensive care unit. Her medical bill was close to 16 lakh rupees. Girl’s father said he objected to the insensitive manner the hospital dealt with him. For example, dead body was not released till all formalities were completed including full bill payment. Parents had to wait 8 hours to get access to the body of their daughter.

The story as it emerged, set the media on fire. Of the two issues such as (a) insensitive treatment and (b) high hospital bill,  media probably could not make a great story out of administrative indifference. As a result, media houses latched onto issue of high medical bill. Media highlighted how many gloves were used, how many syringes were billed, what was the cost of medicine, how much fee was paid to physician and how much to dietician etc.

Under relentless media pressure, central government and state government of Haryana has promised to look into the issue of high medical bill. Haryana government has formed a high level committee to investigate and will in most liklihood share its report with central government. There is also suggestion to create a mechanism to regulate private hospitals. West Bengal government has initiated such a mechanism by ensuring passage of a bill in state assembly.

It cannot be denied that many corporate hospitals operate for profit. More than patients, these hospitals probably own their allegiance to share holders. That is why doctors are given target to suggest expensive procedures. Doctors who meet targets are given a percentage of business accrued. This could be the reason why father of the patient was suggested plasmapheresis, even after doctors gave up hope.  Still, I think media is barking on the wrong tree when it accuses hospital of inflated bill, for the following reasons:

  •  First, though generally self curing, in some cases in children under 10 year of age Dengue fever can take serious turn. As in the present case, the child was suffering from septic shock syndrome. To treat such a serious condition she had to be admitted in intensive care medicine, and kept there for fifteen days. Charge of a day’s stay in intensive care unit  may be close to one lac rupee, depending upon seriousness of condition.
  •  Fortis hospital is a corporate hospital. It usually follows standard operating procedure for every action and maintains a record for the same. Because in case of a lapse, hospital may get sued and definitely it will get bad publicity.
  • Even in the present case, hospital has supplied a 16 page bill with break up of professional fees and consumables. As it has emerged through discussion on TV, hospital had informed parent / guardian of patient every evening of days medical bill incurred. According to Dr. Narottam Puri, an advisor to Fortis Hospital, in all likelihood signature of patients parent / guardian was taken on medical bill of the day.
  • Media houses that are complaining about use of so many gloves and syringes, will probably turn around and claim negligence if the same patient had developed an infection for not using fresh pair of gloves.
  • Compared to many government run hospitals, likes of Fortis, Apollo, Medanta etc., are comparatively high end hospitals. These hospitals cater to upper middle class and rich Indians and to overseas clients. High hospital charge may be to maintain exclusivity as well as to maintain a standard of efficiency in medical, surgical and diagnostic procedures and to execute in an orderly fashion administrative processes like cleanliness, hygiene, security, cafeteria and housekeeping  etc.
  • Instead of asking why hospital is charging high fee for specialist physicians, which they deserve based on their expertise, one may question could the hospital have supplied generic medicine compared to branded products?

Instead of blaming Fortis Hospital, opinion makers must direct their attention towards (i) creation of better government hospital and that charge less and / or (ii) creation of a system of universal insurance card for every citizens. Such that any individual can be treated in any hospital without worrying about buying a hole in his pocket.  In many developed nations, citizens are issued a health insurance card, free of cost or for a nominal charge. Such basic Medical insurance, Medicare, takes care of hospital admission cost for certain illnesses. Over and above Medicare, people are free to purchase private insurance, that cover more extensive coverage.

There are several commercial insurance policies available in the market. Most of them are beyond the reach of poor people of India. Dr. Devi Shetty of Narayana Hridyala had created a health insurance for 3.4 million farmers of Karnataka by paying Rs. 20 per month. The insurance will cover procedures for more than 800 common surgeries.

Links

After Lakhs Allegedly Billed By Gurgaon Hospital, Father Of Dead …

Fortis Hospital Dengue Death Case | Corruption in Private 

Dengue patient dies, parents billed Rs 16 lakh for 2 weeks in ICU

Health Ministry Demands Probe Into Fortis ‘Overcharging’ Family of Seven-Year-Old Who Died of Dengue  The Wire

Fortis Hospital dengue death case: Haryana govt orders probe

West Bengal assembly passes bill to regulate private hospitals in state …

Dr. Devi Prasad Shetty – health insurance scheme for Karnataka farmers

 

 

22 thoughts on “Dengue Death at Fortis Hospital : Medical Insurance not Enquiry is the Answer

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    1. True. Yes doctors have become more professional. Personal touch is missing. In this case though issue is more to do with following processes. These processes must be made more user friendly.

      Liked by 4 people

    1. Paying bill is not related to survival. Kid was suffering from serious dengue. Mortality is very high in such conditions. Because it was a serious case, child was in intensive care unit. Issue is not Bill. Parents had cleared the bill. Parents complained of insensitivity.

      Liked by 1 person

      1. How is this comment related to what I am writing in the post? Yes there are many who cannot access Healthcare because of money. But money is not equal to life. Please understand issue before you comment.

        Liked by 1 person

  1. It is very sad that the parents lost their child and had to pay such heavy bills. It is pertinent to ask if the hospital could have given generic medicine compared to branded products. Also, affordable quality healthcare and health insurance are definitely things that the govt should think about.

    Liked by 1 person

      1. I read on the net that Dr Shetty is in talk with several governments to create affordable insurance. He had approached Delhi government, a few years before, it did not move very far. There are a lot of vested interest.

        Liked by 2 people

  2. Super speciality hospitals coax money in every possible way from the patients. Even after that, proper treatment is not always available. Medical system in most of the parts of the country is corrupted 😦
    Incidents of death due to dengue happened in WB as well. Unofficially, about 80 persons had died due to dengue. However, state government denied the fact and eventually, public created a havoc on the issue.

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    1. I agree. Time has come to cover all people under insurance. While cost of treatment has gone up, doctors have lost personal touch, patients have become demanding,money spent is equated with complete recovery.

      Like

    2. True. Cost of hospital treatment has spiralled out of control. Government hospitals are unusable. Private hospitals are money minded. Patients in general equateoney spent with recovery. Human body is not a car and hospitals are not a service station. I think time has come to cover every citizen with insurance.

      Liked by 1 person

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