The state government has increased the rates of 105 treatment packages under the Swasthya Sathi scheme by 15 to 20 per cent after private hospitals said the costs were unviable.
At a meeting with representatives of private hospitals on Tuesday, the state government said the rates of 60 per cent of the packages had been increased. The private hospitals said the rate revision was below their expectations but they accepted it.
The hospitals, however, requested the government to reconsider the rates of medical management of patients in general as well as critical care units.
“The private hospitals have agreed to most of the rates and these will be implemented immediately. We’ll hold another meeting with the hospitals to decide about the rates of medical management of general wards and critical care units,” a state government official said on Tuesday.
The treatment packages for which rates have been revised include cardiac bypass surgery, cholecystectomy (a surgical procedure to remove the gallbladder), hernia repair, appendectomy (a surgical procedure to remove the vermiform appendix) and Cesarean section surgery for child delivery.
The Swastha Sathi scheme provides basic treatment cost coverage for primary and tertiary care up to Rs 5 lakh per family per year.
According to sources, in the presentation by the state government, it was shown that the rates for an open-heart surgery without the support of a heart-and-lung machine was increased from Rs 80,000 to Rs 1 lakh.
The rate for the same surgery but with the support of a heart-and-lung machine has been increased from Rs 1.3 lakh to Rs 1.5 lakh. The rate for coronary angiography, an investigative procedure to detect blocks in coronary arteries, has been revised from Rs 10,000 to Rs 11,500, said the sources.
“We had requested the government on a number of occasions and had a series of meetings with them, where we presented our case regarding the unviability of the existing rates of treatment under the Swasthya Sathi universal health care scheme,” said Rupak Barua, group CEO, AMRI Hospitals, and president, Association of Hospitals of Eastern India.
“During the course of today’s meeting, the senior officials agreed to revise the rates of 105 packages by 15 to 20 per cent. Although the percentage of increase is less than our expectations, we appreciate the state government’s positive approach towards providing quality health care to the residents of Bengal.”
Barua said the private hospitals felt the 20 per cent revision in rates for medical management may not be enough and they pointed out that providing critical care treatment even at the increased rate of Rs 3,300 a day would be unviable.
“Critical care treatment is dynamic, with the average minimum cost coming to Rs 30,000 to Rs 35,000 a day,” he said.
Officials of several private hospitals said they had requested the government to fix the bed charges for medical management of a patient in general and critical care wards, but keep other costs like doctors' fees, investigations, consumables and medicines separate. They pointed out that a patient who did not need surgery might undergo investigations like CT scan, MRI and USG. Each test can cost a few thousands of rupees on an average at a corporate hospital.
“We have expressed our concerns on the rates for medical management, which still remain extremely unviable. However, the assuran-ces given by state govern-ment officials on adoption of a consensual approach towards revision of rates on this front is comforting and we are hopeful and we eagerly look forward to the same,” said R. Venkatesh, regional director, east, Narayana Health.
Some private hospitals had earlier requested the state government to fix the num-ber of beds for treating patients with Swasthya Sathi cards. However, the government has not agreed to the proposal.
“More than two crore families have already been covered by the scheme and the number is growing every day. If the number of beds is fixed, the hospitals will be refusing many patients,” said a state government official.
