Getting covid care at what cost

Distressing tales of Covid-19 patients or suspected patients being charged exorbitantly by private healthcare facilities have started surfacing.

Mozammel Haque, having tested positive for Covid-19, was brought from Chattogram to the capital. After being turned away by several public hospitals when admission was sought for him, he managed to get admitted to Anwer Khan Modern Medical College Hospital.

The patient was charged Tk3.83 lakh for 14 days of treatment, while government hospitals treat virus patients for free.

Additionally, Mozammel had to buy everything he required – ranging from food to tissue paper – from outside during his stay in the hospital. He had to pay the hospital separately for the two tests to confirm that he had recovered from the infection.

The patient's son, Wahedul Haque Faisal, said his father did not have any symptoms. The elderly man was admitted to the medical facility so that doctors could attend to him promptly if any situation arose.

"My father was put on oxygen support only for 30 minutes and the hospital charged Tk86,000 for that," said Faisal.

He said his father used to clean the room on his own as no cleaner turned up during the entire period of his stay. And yet the hospital charged him Tk45,400 for "hospital service".

"Obviously private hospitals will charge for their services, but the billing should be logical. If they make patients pay through the nose amid the pandemic, middle-income people will have to prefer dying at home without treatment instead of availing medical care at private clinics," noted a visibly angry Faisal.

In another case, Saiful Islam, a businessman in Dhaka's Tejgaon, got admitted to the same hospital on June 17.

His younger brother Sourav Islam said the hospital took Tk2 lakh in advance when Saiful was admitted.

"They [the hospital authorities] told me with a straight face that treatment at normal isolation would cost Tk4 lakh per week. Besides, we would have to pay for the intensive care unit, high-dependency unit and other charges separately," said the patient's sibling.

Sourav said his brother was placed in a high-dependency unit after admission, which alone costs more than Tk70,000 per day.

"They did lots of tests which I think were not necessary," he added.

It is not only overcharging the patients that is the issue. There are more serious allegations against private clinics, like keeping dead bodies as families fail to clear hospital bills immediately.

Mohiuddin Pervez, a fisheries and livestock official at a private organisation, died at Prashanth Hospital in Dhaka's Malibagh on June 18. The hospital billed his family Tk2.56 lakh for his three-day treatment.

The hospital kept the body for a day as the family failed to clear the payment immediately.

The family members of the deceased alleged that the hospital threatened to donate the body to Anjuman Mufidul Islam, a charity organisation which carries out the last rites for unidentified persons, if they failed to pay the charges.

Rubel, brother of Parvez, said the hospital billed the family Tk35,000 for accommodation while three patients, including Parvez, were kept in a single room.

"How could the bill be that much when my brother did not even require any ICU support?" Rubel questioned.

'Patients who can afford will only come'

Anwer Khan Modern Hospital's director Dr Ehteshamul Haque could not be reached over phone for comments regarding the exorbitant bills the hospital is charging patients. He did not reply to our several text messages either.

When contacted, Private Hospital Owners Association President Dr Mubin Khan said coronavirus treatment was expensive.

"It now requires three doctors, while one doctor could handle a ward before the virus outbreak. Besides, doctors treating coronavirus patients go on a 15-day quarantine after a 10-day duty period. The hospitals manage their accommodation at hotels," he said by way of explaining the costs.

"Patients who can afford to pay private hospital bills will come to us. Those who do not have the financial capacity to do so will go to government hospitals for free treatment," he added.

'They cannot act like profit mongering East India Company'

At the beginning of the coronavirus spread in Bangladesh, private hospitals used to provide Covid-19 patients with free-treatment under a deal with the government.

The health ministry on May 24 ordered all private and public hospitals to have more than 50 beds to treat Covid-19 patients as the country started witnessing a spike in virus cases. 

The private hospitals drew back from the free-treatment contract on June 1. As the government is yet to fix virus treatment rates at private healthcare facilities, allegations of overcharging are rife.

Health experts have termed the treatment cost a mismatch between public and private hospitals and have called it "discriminatory".

"Coronavirus treatment at private hospitals is difficult for the middle class. If there is any criminalisation, availing the facility for limited income people is merely impossible," said Professor Dr Rashid-E-Mahbub, former vice-chancellor of Bangabandhu Sheikh Mujib Medical University (BSMMU).

He believes the government should intervene immediately, and all private facilities should be brought under government requisition.

"It is the responsibility of the government to provide relief to people in the lower income bracket," added Dr Rashid-E-Mahbub

Spain nationalised nearly all private clinics in the country to combat the pandemic. Even in neighbouring India, the government brought 80 percent of private hospital beds under requisition in Maharashtra. Besides, the Indian government fixed rates for private hospitals to treat Covid-19 patients in Delhi. 

"The government must step in to cap treatment charges. The hospitals cannot act like the profit-mongering East India Company while there is a pandemic out there claiming more and more lives every day," said Professor Nazrul Islam, member of the technical advisory committee of the government.

Dr Aminul Islam, director for hospitals and clinics at the DGHS, told The Business Standard that they were aware of the allegations of private hospitals over-charging Covid-19 patients.

"The DGHS is looking into the matter and legal action will be taken against such hospitals and clinics," he said.