Business of Loot, Proof of Illness.

(c) Dr. Rajas Deshpande

“Is the patient Dying? Operated? Bleeding severely? Dead?”
“No”
“Then we will not pay his / her medical bills”.

The insurance companies (most) have been giving a hard time to both patients and doctors: no patient’s bill is fully paid even if they have a genuine illness. OPD bills and investigations are not paid, and in many cases, unless IV fluids / injectables are used in medical conditions, insurance is not sanctioned. This causes unnecessary use of these injectables and “inflated” diagnoses. Medical bills in cases like impending stroke / TIA, Severe Vertigo, Demyelination, Parkinson’s Disease, Alzheimer’s disease etc., observation for chest pain and hypertension, head injury etc. are usually not sanctioned, unless there was a proof of investigation abnormality (What was the need to admit a patient with high BP and chest pain? Ask some imbeciles). There is no proof for many medical diagnoses, and many a times admission for observation or drug titration is critically important.

The insurance companies seem to believe that all patients and doctors are out for a fraud. In fact, patient is the consumer and the families of the sick must not be compelled to run about for their right, if they have paid for the insurance. It is sickening to see treatment, surgical and procedure equipment being ‘modified’ to accommodate budgets sanctioned/dictated by the insurance companies. Neither the govt., nor the media fights for the patient’s right to get the best here, allowing scot-free profiteering for the insurance companies while clamping only the doctor’s fees. How unjust and cruel is the “deductible” concept in health insurance? If the illness is genuine, why deduct?
©Dr. Rajas Deshpande

Extremely high levels of profit making in the corporate set-ups, hand in hand with the insurance companies, is killing down small hospitals and individual practitioners. This “profit the powerful” system is being cultivated. This increases the anger of general public towards the entire medical profession, as doctor is the only face they see, while it is the non-doctors who make most profits in this whole ‘business’.

A unified national ban by all medical professionals together (IMA) upon accepting fees-control dictated by Insurance companies will alone solve this issue. Let the patients also understand that while the doctor cares and treats, carries responsibility for their health, it is the insurance companies and others that dupe them during this process. The doctor’s fees and total income in most cases is usually less than 10 percent of the whole bill that the patient pays.

IMA should speak for the doctors for resolving these issues:

1. Unified basic fees structure for doctors across country according to qualifications, experience and difficulty level of the case.

2. De-linking doctor’s fees from Insurance company controls: we did not work hard for years to earn for insurance companies and corporates. Doctors must refuse to accept fees rates dictated by insurance companies and corporates, both of these earn over 2-300 percent profit, while the patient comes to them because of the doctor. The patient ends up thinking that it is the doctor who’s duping them.

Most doctors want to do away with corruption, and offer best to their patients. This system is failing. Our society must understand that charity healthcare is never a solution if they want advanced treatments. Media must rethink about the incessant doctor bashing: that is contributing to doctors leaving India.We can foresee a severe healthcare crisis in few years if things don’t change.

Pray Change.

©Dr. Rajas Deshpande

Please do share unedited in the interest of our profession and our patients.

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