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The state of health-care

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Tehelka runs a long report on the state of private health-care in India:

Rohit Luthra had heard stories of private hospitals fleecing patients. “They seemed exaggerated,” Rohit, the co-owner of an IT company in Delhi, says. He had recently taken two family members to corporate hospitals for cancer treatment, and was ‘fairly satisfied’ with the handling. Then, in June 2010, Gajanand Singh, 40, an employee in his firm’s purchase department, fell ill. Gajanand came from a poor family in Munger, Bihar, and had been with the company for about seven years. He went home to a wife and three children. A dentist saw something unusual in Gajanand’s swollen jaw and recommended a biopsy. On 26 June, Gajanand found he had non-Hodgkin’s lymphoma, a kind of blood cancer, in advanced stage. Two days later, his first stop was the All India Institute of Medical Sciences (AIIMS). Panicked by the crowds there, he went to the Max Super Speciality Hospital in Saket, South Delhi. His company’s group health insurance covered him up to Rs. 8 lakh. The company also sent its employees to double up as attendants to Gajanand in hospital; he was a well-liked employee due to his quiet diligence and respectful conduct.

Doctors at Max suggested chemotherapy. Gajanand wanted to go to AIIMS but feared the delay, so the Max doctors suggested he start the first course of chemo at Max, and could later move to AIIMS. Gajanand was admitted on 13 July and chemo drugs were administered over three days. On 16 July he developed well known side-effects of chemo: vomiting, dysentery and plunging blood counts. He did not recover. On 27 July, four days after the hospital had moved him to the isolation room of the intensive care unit, Gajanand died.

The cancer he had is typically detected at a late stage, when treatment is ineffective. What did surprise Rohit and his colleagues, though, was how the hospital handled the case. “There was only one doctor taking the decisions, not a panel or a team, even after we asked for it. Senior doctors were not informed,” says Rohit. After Gajanand’s death, oncologists elsewhere told Rohit chemo is not advised to a patient at such a late stage of that cancer.

And then there was the bill for Gajanand’s treatment. Rs. 7.95 lakh, just a shade under the maximum insurance cover. Gajanand’s life had run out remarkably close to his insurance limit of Rs. 8 lakh.

“We think the doctors knew Gajanand wouldn’t survive. But they wanted to maximise the hospital’s revenues from the insurance company,” says Rohit. When Gajanand’s company complained to the hospital about the treatment offered, the response left them ‘very unhappy’. When Tehelka contacted the Max Hospital authorities, they said, “The patient and his family were briefed about the patient’s condition, the prognosis and the estimated cost.” They say another doctor examined the patient on the request of the family, and that a multi-disciplinary team of the hospital’s tumour board as well as the medical oncology team discussed the line of treatment in detail, which was communicated to the patient and his family, who signed a written consent. On the bill coming so close to the insurance amount, hospital authorities say the thirdparty assessor or the insurer “does not disclose the coverage limit of the patient.”

After all, Gajanand went to Max because AIIMS was too crowded. Most government hospitals have degraded to a point that the experience is dehumanising. In comparison, private hospitals offer immediate care. Patients are pampered even, and attendants feel reassured.

Rohit says his confidence is shaken. He is now considering the only real recourse: the consumer court. His chances are, however, slim.

“Almost all cases of medical negligence under the Consumer Protection Act fail because it is impossible to get a doctor to testify against another doctor. They fear being ostracised,” says Jehangir Gai of Mumbai’s Consumer Welfare Association.

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Written by Arhopala Bazaloides

January 29, 2011 at 3:55 am

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