Medical association claims standardisation of hospital rates is unconstitutional
Representational image. Pic/iStock
The Indian Medical Association (IMA) has decided to decline any consultative meetings called by state governments to decide upon hospital rate standardisation. Earlier this year in February, the Supreme Court of India, while hearing a Public Interest Litigation (PIL), directed the central government to find ways to regulate the rates of hospital procedures in the private sector. It sought a response from the Centre, which in April, had said the issue needed discussion with the states, IMA, as well as private players.
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“The states have now started inviting members of the medical association to decide on the rates. We have decided that we will not be attending any such meetings,” said Dr R V Asokan, national president, IMA. He added that one such invitation was extended to IMA doctors in Andhra Pradesh, which was rejected.
IMA’s city-based head, Dr Shivkumar Utture, said IMA is trying to convey to the government that while charges can be fixed for beds, OT and admission, “there cannot be fixed professional charges.”
He added, “Treatment for every patient differs depending on the severity. For one ailment, there can be differing treatments. We cannot make a menu card.”
‘No logic’
However, public health activists have refuted this. Dr Abhay Shukla, national co-convenor of Jan Swasthya Abhiyan, one of the petitioners in the case, said, “There is no logic to IMA’s stand. There are occasions when patients have a rare condition or complications for which rates cannot be standardised. There can be a separate category for it and a medical panel can be set up to scrutinise such cases.”
He added that in most cases, rates can be standardised. The medical association has gone as far as terming any attempt at standardisation as unconstitutional. “Standardisation of hospital prices is unconstitutional and invalid because it violates Article 19(1)(g) of the Constitution. If the professional fees of doctors are determined by the government or judiciary, the right to profession under Article 19(1)(g) will be violated,” reads a statement by IMA.
‘Not ideal’
Dr Shukla added that private hospitals are already accepting standardised rates. “But these are market-based standards which are not ideal. For instance, if something is overpriced in the market, then even the standard rate will be on the higher side. We saw a similar thing happen when COVID-19 began.”
IMA, however, believes any capping of charges will curtail the right of the patient to avail of technological advancements, sophisticated treatment modalities, and the use of professional expertise. Dr Dinesh Thakre, president of Maharashtra IMA, said, “They want us to do a costing study and provide us with the rates. The Centre has asked the states to hold consultations with IMA, and one after the other, our counterparts were invited in other states. As of now, Maharashtra has not invited us. We might attend the meeting here but stand firm on our demands.”
Meanwhile, Dr Shukla added that there is still an opacity where hospitals need to disclose their costs. “This is a law in the state under the Maharashtra Nursing Homes Registration Act where hospitals need to disclose their rates, but it is frequently violated and there is no action.” He added that the hospitals can continue making profits even if the rates are standardised. “It won’t be the excessive amounts that they make but they will still make sizable money,” Dr Shukla said.
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