What is the illogical reason behind hospital room tariff and other charges?

[mclachlan]

If all the treatment is same, how can hospital changes ICU, surgery and doctor charges depends on the room considered.

In case some of you not aware, for example if one gets admitted in the hospital and availed sharing room and final bill comes around 3lacs, where for private room this bill can be more than 4 lacs.

Edit: just a bit more context why this is a rant for me; we have 20% co-pay, so it will be around 60k in case of sharing room and 80k in case of private room here goes from our pocket. So although we have private room eligibility and sufficient coverage, we sticked to sharing room to minimise bill. And with consumables which are not typically covered, eatup nother 10% of bill

 

[joshuaawarm]

@mclachlan Here is my experience on similar matter.

I had to take a relative to a hospital emergency directly from a party. Told them we dont have insurance, they start treatment and according to doctor no hospitalization will be required.

His son came and without talking to us went directly to billing with his tpa card (limit was 20lakh) and suddenly hospitalization was required. Not in ward but an icu hospitalization. According to same doctor CT scans and mri was Urgent and must be done within next 30 mins. They have dedicated counters named a "financial planning" guy there told us it would cost us a minimum of 50k per day and minimum 4 day stay will be required according to diagnosis.

I literally had a fight. Took the relative to another hospital 10mins away. I knew 2 doctors there, both of them said he had too much to drink and thats why he was in drowsy state. Spent a day in hospital and got discharged. They only administered some minerals etc which were low due to excessive urination and low hydration in body. Total bill was 15k something including all the medicines, blood tests and doctor visits.

I have no idea why we dont have rules and regulations laid out for this kind of behaviours.only God knows if we would have admitted him in the first hospital what misdiagnosis the doctors must have done to milk the insurance company.

 

[erin333]

@joshuaawarm ha ha ! Sadly not the first time I have heard of something like this ! Imagine trusting such idiots with your life .

 

[randy3]

@joshuaawarm Doctors have targets from the management. That's how corporate hospitals work.

 

[trumpeter2]

@randy3 Doctors have targets from politicnas who own the land of the hospital.

 

[kerrshay]

@joshuaawarm Argue with the insurance company. Argue with the hospital. What's next?

 

[nol]

@joshuaawarm

both of them said he had too much to drink and thats why he was in drowsy state.

this can be pretty serious and probably better to admit with saline and check for stroke...

 

[joshuaawarm]

@nol It was 6 months back. Since then he has quit drinking. Not because drinking is bad but he came to a realisation health care is expensive and most probably he'll not be able to afford it.

 

[aspeck]

@mclachlan Been reading abt health insurance space recently since a relative was hospitalized & they are facing reimbursement issues from ins. co., charges for hospitalization & associated treatments are opaque as f**k..

Although you can demand & get an itemized list of products used during & after procedure,
there isn't a rate card or equivalent displayed publicly at most places; most ppl wouldn't get to know the difference...

Considering your example - say you've opted for a shared room & I've opted for a single occupancy private room. You get charged ₹50 for a syringe & I get charged ₹100 for the same syringe.

1) How will I know that I'm being charged extra?

2) If you have insurance, rates are broadly decided for specific ailments/procedures with the ins. company depending on policy coverage eg. type of room covered (single with AC) etc. Here, the over-charging for general use products should largely get curbed.

3) If you don't have insurance, besides being royally screwed, there's no way to know the prices beforehand. At best, the hospital can give you an estimate & the final cost may increase considerably. There can always be a justification given saying each procedure is subjective - your case required extra resources

Now, having a tariff list preferably on each hospitals website or physical copy available at location, will go a long way to curb this issue somewhat. I realise it's easier said than done due to the sheer no. of products used & the fact that prices itself fluctuate.

Haven't given this much thought so happy to get opinions/perspectives - it's akin to necessary evil at this point unfortunately

 

[comicbookguy]

@mclachlan This is something that always bothers me. I get charging extra for the room. But the procedure in the OT is also charged extra, and all else. It's something that needs to be declared illegal

 

[pollyton]

@comicbookguy Fun fact this happens in govt hospitals too where general wards and private rooms exist. It’s not illegal it’s simply to cater for different stratas of society

 

[naka]

@pollyton I dont think you understood the case.

Surgery cost is different for a ward, shared room or a private room. It is correct for room tarrif to be different. But how is it possible to charge a differential rate for surgery or OT charges? OT is the same OT, right?

 

[fejesusor]

@naka It's pretty simple, if you eat same quantity and quality of a dish at a 3 star hotel and 5 star hotel even though they are owned by same chain prices would be totally different.
Or the same logic which attracts higher tax rates on premium items, it's higher because you have money to pay for premium services so you better be subsidizing others who don't have much.
Pretty much the way Indian economy and system is designed to work.
Hospitals are asked to keep general ward prices under some check by authorities however private wards are considered luxury thus they are allowed to profit from them.

 

[maurie]

@fejesusor

if you eat same quantity and quality of a dish at a 3 star hotel and 5 star hotel even though they are owned by same chain prices would be totally different

The analogy is not good - rates of the 3-Star and 5-Star rooms may differ, but if you go to the same restaurant to eat the same food made in the same kitchen and served by the same staff, pricing the experience differently doesn't make sense.

 

[vintagebloom]

@naka Unfortunately, It's also a business and that's how patients are viewed by this hospital more you pay more will be charged from you.

 

[pollyton]

@naka Its possible because its legal. If it was illegal they wouldnt do it. They have to make money and thats how hospitals work.

 

[naka]

@pollyton Absolutely. No argument on that.

 

[pollyton]

@naka Exactly. For every gareeb treated free of charge there’s a rich guy getting the same treatment for tens of thousands/lakhs.

 

[naka]

@pollyton May be true for charitable hospitals. Is this also true for corporate hospitals?

 

[pollyton]

@naka Its true for government hospitals as well. Also i highly doubt corpos are treating anyone free of charge.