Know An Insurance Product January 2019

Know An Insurance Product January 2019

Know An Insurance Product January 2019

The Clinical Establishments Act :

The Clinical Establishments Act has drawn up standards that hospitals must meet and needs healthcare providers to declare the services provided. If there are transgressions of these standards, the authorities can cancel registration. 

The Medical Council of India is supposed to set standards but it only registers doctors on the medical register of India.

Now, medical councils are elected bodies and members have to fight elections. Their purpose is to look after the interests of doctors and not to annoy them with enquiries and punishments – very rarely does the council resort to suspending a licence of a doctor, leave along cancelling it. Once admitted into a high-end private hospital, patient has no estimate of what the ultimate bill might be as the hospital charges whatever it wishes to.

Private hospitals are in it for profits and there will be anything from a 00 to 500 cases against each in consumer courts, most often about billing. Public hospitals have enormous problems, government doctors siphon off patients telling them to come to their private practices where they charge them five time the cost. They also need to be put under check. There are many ways whereby the medical sector can be regulated and, indeed, there is a crying need today.

Lack of Regulation : 

Super specialty corporate hospitals hire highly qualified people, have state of the art equipment and are highly organize. So a man, who has money but no insurance, has at least this outlet where he might be paying four times what he should but he gets the service. Regulations was only confined to asking hospitals to earmark and admit patients from the weaker sections as per the undertaking given while availing of he concessions, generally providing 10% of in-patient department and 25% outpatient department care free of cost. Even this was completely unsuccessful.

India needs medical tribunals starting with an ombudsman at the sub-district level, a district forum, a state forum and a national forum. Each of these should have a judge, a doctor and a medical administrator who know about hospital administration. Country needs such medical tribunals that can look into these specific cases of malpractice, negligence, apathy and overbilling.

The private health sector is the outcome of a policy change that encouraged the establishment of specialty hospitals as the time of liberalization.

Between 1992 to about 1998, a slew of concessions were given and Foreign Direct Investment was permitted for the health sector, With that, foreign money and Indian money could come into the health sector, treating is as an industry. Land was given at concessional rates to hospitals as well as income ta exemptions and huge customs duty exemptions. This ensured that it was worthwhile and profitable for investors to invest in the health sector.

Medical negligence and malpractice cases need lawyers that can interpret medical findings and are conversant with best practices and treatment regimen.

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