A friend of mine recently fell from his bike while taking a turn, and ended up getting some minor bruises on his leg. He approached a 'reputed' hospital in Bangalore to get his leg attended to. On realizing that my friend is an IT professional, the doctor casually asked him whether he had medical insurance coverage. When my friend proudly produced his TTK card, the Dr advised him to get admitted for a day so they could start their treatment. They gave him a local anesthesia and proceeded to clean the small wound on his leg and then dressed it up. He was asked to take rest under observation and was subsequently discharged after a day. The bill for a day of treatment was 22,000 Rupees. My friend was not that bothered as he could use his TTK card to foot the bill.
A win-win situation for you and the Dr, right?
WRONG!
We are actually allowing ourselves to be trapped into a black hole. We might think that medical insurance premium is anyway covered as a part of our cost-to-company and we don’t have to keep contributing anything in an active manner. The premium we pay may look poultry when compared to the bills we are able to pay using the card. But one simple thing we need to realize is there is nothing called a free meal. We will have to pay the prize, if not today, then tomorrow. And if might be a case of us paying through our noses.
We are going through the nascent phase of medical insurance industry in India. All the sops we enjoy now are part of the incentives the medical insurance industry is sowing for a grand harvest for them tomorrow. In simple words, they are promoting medical insurance policies by making them easily affordable for the majority. They will be more than happy to foot your bills for a limited period, gain your trust and then suck you in.
Some of the hospitals in Bangalore have two different rates. A lesser rate for people who pay without medical insurance and a rate which is multiple times the original rate which is for people who pay using medical insurance. Nobody complains as they are not aware of the danger yet. In future, as more and more people are lured in to taking a medical insurance, these hospitals will start making the hyped up rate their default rate. Insurance companies will start increasing the premiums to their liking. You and I will be left with no option but pay the high premiums as the medical costs will become unaffordable otherwise.
Cut to USA. One of the major issues in this year's presidential election is going to be related to medical expenses, universal medical care and affordability of health insurance. Each of the presidential candidates has come out with their own strategy to address the issue and most probably this is going to be the single largest issue which will decide the outcome of the poll. The way the medical industry functions in USA is really pathetic. Costs of hospitalization and treatment are astronomical and are not affordable for general public. You cannot survive without having a health insurance policy. And the insurance policies are not cheap as they are here in India. The policy will amount to a substantial part of your salary, if you are opting for full coverage for the entire family.
Something from my personal experience: A simple dental root canal surgery costed me around 2200$. Because I had a copayment insurance I had to pay around 400$ and the rest was taken care of by the insurance company. Just compare this with the current rates in India. Even the copayment I made is much more than the entire cost of surgery if performed in India now.
According to Wiki:
The U.S. spends more on health care, both as a proportion of gross domestic product (GDP) and on a per-capita basis, than any other nation in the world. Current estimates put U.S. health care spending at approximately 16% of GDP. The health share of GDP is expected to continue its historical upward trend, reaching 19.5 percent of GDP by 2017. In 2007, the U.S. spent a projected $2.26 trillion on health care, or $7,439 per person.
Americans without health insurance coverage at some time during 2006 totaled about 16% of the population, or 47 million people. Health insurance costs are rising faster than wages or inflation, and medical bills are overwhelmingly the most common reason for personal bankruptcy in the United States.
Cut back to India. If anyone goes to Manipal Hospital for delivery with a TTK card, they will invariably opt for cesarean and hand them a bill of 50,000 Rs. The simple reason is that is the upper limit set for a delivery by TTK. I have heard rumors that TTK has blacklisted Manipal Hospital because of their atrocious claims.
In India, we have a chain of solid, reliable and not so expensive state owned and private hospitals due to the good work of a lot of doctors, hospital administrators and government regulations. We should not allow that backbone to be broken to satisfy the greed of a bunch of private hospitals and insurance companies.
Things we can do
1. Spread awareness.
2. Even if you are paying using insurance, make sure the charges are just and reasonable.
3. Find out the regular rates at the hospital. Object to paying more and try to bring it to higher authorities' notice.
4. Pay from your pocket and get it reimbursed later. (suggested by Sand)
Tuesday, April 29, 2008
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9 comments:
Yeah, Manipal was blacklisted by Oriental insurance/TTK for frauds. Same with sagar appolo also I think.
The best you can do is "say no medical insurance, when asked".
Pay from your pocket and later get it reimbursed.
Sand,
That sounds like a good idea to pay and then reimburse. I have added that to the post. If the fraudulent hospitals are blacklisted by all the medical insurance providers, then it is in fact a good step. All we can hope for is more government regulations on the amount that can be charged and claimed.
I see the seriousness of the post. Yes, indeed its taking all of us into a dangerous situation. I can easily draw an analogy of the shopper giants like RelFresh/FWorld/FMall and the likes swallowing smaller retailers! Finally they will be the monopolised leaders of the trade..
Its not just limited to hospitals. Even hotels have a special rate which is much higher than normal rate for corporates.
Good Post..The atrocious charges are mostly levied by the so-called 'super speciality' hospitals. This should be checked.
i ve been paying thru the nose for all my hospital stints thanks to ttk..didnt really realize the long term gains for the med ins cos in the biz.
Rat,
Yea... I used to be a supporter of the capitalistic, open market ideology until I realized the issues with that approach. A notion that the true capitalist businessman will work for the society’s best interests and will not do anything that hurts the public interest is sadly a theory that holds good only in Ayn Rand books. We surely need some government regulations to put all these big players in their respective places.
Gasper,
I would say that is partly an arrangement between these corporates and hoteliers. Some corporates have their internal protocols which say a grade A manager should be accommodated in a room costing not less than X rupees and a grade B in a room worth Y rupees and so on. Now, if the hotel doesn’t have a room in that bracket, they upgrade the prize of a cheaper one.
Karthik,
Thanks. Yea... most often the so called ‘Five Star’ hospitals are the ones which employ this practice.
Poison,
Of late, have been reading about your frequent visits to the hospitals. Hope you are fine now... :)
I am hoping that my fears will remain fears and there will be some action by someone concerned so that our lives wont be determined by the greed of a med insurance provider.
If u want to see the real state of affairs in USA with regard to medical insurance watch the documentary 'SICKO' by Michel Moore
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