India’s private hospitals are getting away with billing malpractice. Why do govts not care?

It is fair to assume that in world’s fifth largest economy, a private hospital sneaking in an extra procedure to a patient’s bill – double-counting a surgery – would draw the wrath of anti-corruption agencies. But this is not so. As reported in TOI (https://tinyurl.com/mr2a6mwy), bill-inflating by private hospitals, which handle 80% of India’s medical services, has become normalised. Between a non-existent regulatory framework, authorities in cahoots with private hospitals, and govts failing to provide affordable healthcare, Indians are at the mercy of private hospitals, doctors, and diagnostic labs. Social status matters little, vulnerability is the same – from the richest to middle classes to those whom a single health emergency can knock back into poverty.

Inflated bills and hidden profits are not new discoveries. Hospitals use medicines and consumables to pad bills. These are less ‘visible’ as costs – masks, gloves, syringes, IV sets, catheters. Unit-wise low-cost, there’s no way to keep tabs on how many were consumed. Which family is going to question tests stacked up in ICUs? In 2018, TOI reported (https://tinyurl.com/2y8cxbrb) that nodal pharma pricing authority NPPA’s analysis of hospital bills had revealed private hospitals made profits of as much as 1,737% on consumables. Which govt followed up? 

Another 2024 TOI investigation (https://tinyurl.com/ce4cc7bf), brought to public attention, private hospitals’ dual pricing ‘system’ – patients paying out-of-pocket are charged up to almost a third more than insurance rates. Clearly, patients are the least empowered in the Indian health system. Hospitals even refuse to release patients or bodies of deceased until bills are settled. A for-profit medical model is simply squeezing money out of patients. Delhi has not even adopted the Clinical Establishments Act (CEA) 2010. Why? Even when BIS last year introduced billing standards for hospitals, it kept these “voluntary”. Why? Multi-aspect regulatory collapse and an unregulated private sector are not what we pay taxes for.

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