The Union health ministry has initiated a process to fix the cost of some treatment procedures, with a view to make them affordable and also to minimise allegations about inflating of the costs by private hospitals especially in case of insurance schemes.
The ministry is planning to fix the cost of 2179 medical treatment procedures which form a draft master list to be used for private and public insurance schemes. The Ministry in consultation with the Institute of Cost Accountants of India and other stakeholders has prepared a draft template for costing of procedures.
The ministry has now invited comments, suggestions and objections from the stakeholders concerned on the template and the costs of listed treatment procedures. It is expected to standardize the procedures and thus minimize the controversies. The draft master list, which already has been published, was prepared in consultation with a large number of stakeholders like CGHS, RSBY, Rajiv Arogyasree, Indian Medical Association, Health Institutions, FICCI, private insurance schemes etc.
There were mounting allegations, especially on the part of the insurance firms, that the hospitals were exploiting the insurance schemes with unnecessary procedures and inflating the costs in many cases. The cost of treatment for the same procedure also varies widely from one hospital to another.
The government had also some time back set up a committee, involving the representatives of the industry, to find out the `actual cost’ of the treatment including the prices of drugs so that the government can work out modalities of affordability, that is key to the universal health coverage.
The Ministry is also working on a proposal to introduce standard treatment guidelines (STG) in 20 disciplines under the Clinical Establishment Act in a phased manner, as part of streamlining the sector. The STGs will be binding only on hospitals and establishments registered under the Clinical Establishment Act 2010 in the States which have adopted this Act. The first of the discipline to get STG will be for clinical surgical intervention in cardiovascular diseases.
The disciplines for which the draft STGs had been developed are cardiovascular, endocrinology, ENT, gastro-enterology, general surgery, interventional radiology, laboratory medicine, obstetrics and gynaecology, organ transplant, paediatrics, oncology, urology, nephrology, GI surgery, medicine respiratory, medicine non-respiratory, critical care, ophthalmology, neurology and orthopaedics.