[MuraliR]

er.., I said Rs 1.5Lakhs for treatment of terminal disease and not delivery.

Or, were you referring to Spitfire's post?

[sgiitk]

The bsis of all the woes is that the State has totally abdicated its responsibility towards the healthcare of the citizens. Whatever crumbs are left are monopolized by you know who.

Also, we are barking up the wrong tree. have we got decent medical colleges after 60 years of government misrule? Have we got decent healthcare for the public? have we been successful in separating Primary, Secondary 7 tertiary Healthcare? The answer is a big NO. So teh mechanisms have failed.

Costs apart we must accept that the private sector is capable of providing healthcare of a global standard.

What is needed is not control of everything but something like the following.

1. Define the standards and not how healthcare is delivered.?
2. In cases where the patient cannot pay arrange to reimburse the patient/facility promptly.
3. Have proper separation of Primary, Secondary & Tertiary functions, so that everybody need not rush to the expensive tertiary facility unnecessarily.

[wildon]

Well in my opinion best is not to say you have health insurance policy/card to the hospital. Get the treatment from wherever you are comfortable and get the discharge cards, bill etc and later claim it. My six days of hospitalization for viral fever resulted the following.

[H3LIOS]

Originally Posted by PRADEEP KUMAR

In today's scenario a Doctor spends close to 30 Lacs for his UG course(if not thru merit alone) and close to 1.2 crores for a PG seat(non merit category). They look at getting back their investment. They finish PG after 7.5 years study.

Yes, that is true. In fact, I strongly believe that the commercialization of education has a direct impact on the commercialization of health-care industry. Add the nonsense of "insurance cover" and the general deterioration in morals & ethics in our society and we can see that we are drifting to a place that is highly undesirable. The situation is so bad that effectively a person can just buy a doctor degree if he/she (or parents) has enough money.

India, as a country, is drifting from a completely socialist culture to a completely capitalist economy. IMO, neither is good. We should strive for a balance. We declare that Education and Health are the fundamental rights of every citizen, but there is no mechanism in place to ensure that these rights can be exercised.

I really really hope we do not end up like the US health system. But personal greed always seems to win over the greater good, and the IMA is a puppet in the hands of the insurance companies, pharma giants and the doctors themselves. So any hope to redeem the situation lies in the hands of our politicians - and that is what is known as "Sealing our Doom!!"

Cheers.

[Guite]

Apparently money can't buy everything: love, happiness, blah blah blah, but it can buy... oh man, I can't even bring myself to say it out loud! The irony!

[sierrakamat]

agree with pradeep kumar about the disgust that he feels and i am a practising family doctor since 15 years.agree to all the reasons given by all you guys .
BUT the trend has started ever since mediclaim and cashless facilities were introduced .in the earlier stages the insurance companies sanctioned obnoxious amounts for minor procedures may be just to attract their customers and to make mediclaim attractive this in turn gave hospitals a chance to make full use of sanctioned amounts (they got addicted to higher billings).the doctors attatched to these hospitals were given targets for indoor admissions and generation of revenue or face eviction from their consulting rooms (for poor performance)leading to unnecessary hospitalization and prolonged stay addind to the patients misery is the kick back system including the pharma companies licencing depts police litigations referrrals et al
solutions dont seem to be in the offing just get your insurance and your prayers right the next time you go to a hospital its going to get WORSE.

[Matt]

Hi Folks,
Its is a little OT.
My wife has this group medical insurance policy from her Employer. It covers her parents.
Recently my MIL was admitted in a hospital in Kottayam, Kerala. She had Osteo Artritis and her condition was really bad as she could not walk because of severe pain in her knees. Even though they had medical insurance coverage they went for a normal(no super speciality) hospital. She was bedridden for about 4 days or so. Doctor insisted it because her blood sugar level, Cholestrol and BP were high. She was discharged in 6 days and the total billed amount came around a very nominal 4k INR.
But when my wife submitted the bills and other docs for the Insurance claim, the insurance company denied it saying that the Osteo Arthritis needs no hospitalization and blah blah...
Even though the amount is not very high I don't feel like letting this go.
BTW, the insurance company in question is TTK healthcare.
What shall I do next?

Thanks

[benbsb29]

Originally Posted by Matt

But when my wife submitted the bills and other docs for the Insurance claim, the insurance company denied it saying that the Osteo Arthritis needs no hospitalization and blah blah...
Even though the amount is not very high I don't feel like letting this go.
BTW, the insurance company in question is TTK healthcare.
What shall I do next?

Matt, my insurance provider is also TTK, and they have started acting rather immature these days for such claims.

A colleague whose parent had to undergo such a treatment also met with similar resistance when he presented his claim. However, raising his voice, and after making him run around for 2 months, his claim was finally sanctioned. He threatened to approach the company's HR if his claim was not processed.

You could try with a firm voice to make them understand, but that failing, do send a stonker of a mail to the TTK higher-ups. If this still doesnt work, escalate, copying your company's HR contact as well. Something should work out.

[BaCkSeAtDrIVeR]

Originally Posted by cruiser_1982

Insurance authorized 40000 and I paid the rest.Looks like the current medical system in India is already working like that in the USA. They always try to claim the maximum of our claim limit. This is one of the biggest and one of the most famous hospital in Hyderabad with three branches in the city.

Originally Posted by Spitfire

Simple Example:

My friend's wife delivers in Manipal Hospital, Bangalore: Total 1.5 lakhs. No C-Section, natural delivery. Stay of 6 days. 2 before and 4 after. Non-AC room, with monkeys (yes the real ones) walking outside the window.

My wife delivered 6 months before in Panaji, Goa: Total 17k. No C-Section, Natural Delivery, AC room, 8 days - 3 before delivery, 5 after delivery..

Hospital expenses fo KV2 (kid version 2) cost before 6 K. 11 months back.

Expenses for KV1 was little below 5 K, 3.5 years back.

Both at a missionary hospital, in Ernakulam. (Lourdes). Stay was for around 7 days, and included couple of days in the ICU for the kids. (both had slight jaundice).

Yes, we were asked if we had health insurance. We don't. Wife has medical reimbursement, which is NOT available in case of natural delivery.

Originally Posted by srishiva

It was a government hospital and it cost them 25K. He said it could have taken close to 40 or 50K and they saved about 25K. There is a fixed amount that people have to pay to the doctor, the nurse etc., The medicines, OT supplies etc., have to be bought by the patient. Don't know what happens to the medicine that the govt incurs the cost for.

You know what? There are vested interests in keeping govt. hospitals free. If the treatment is free, they can "charge". If money is to be paid, treatment becomes obligatory, and no "charge" can be levied. And doctor does not keep the entire "charge" to himself. He needs to "share" the loot with local politicos and ministers failing which, he will be transferred to a hospital where "charging" is impossible because the patients are poor.

Originally Posted by rkg

Moral of the story

Go to manipal -- they will do all tests required for MD thesis work, if you have any symptoms similar to the area they are doing MD

they give medicines which will aggravate your condition so that you will get admitted.

IIRC, cost of MBBS (NOTMD) is around 15Lakh per year.

For 5 years, the total cost is 75Lakh.

And another 25L for 2 year's MD.

Total investment on a doctor is a cool crore.

At a mere 5% interest rate, it requires a ROI of 41.6K per month.

Originally Posted by sgiitk

Costs apart we must accept that the private sector is capable of providing healthcare of a global standard..

Err... the emphasis is on ethics and affordability. Both are lacking..

What is needed is not control of everything but something like the following.

And strange that this thread comes up on the same day the govt. doctors in Kerala are going on a strike. For the nth time this year.

And here is some more food for thought. The govt. of Kerala has introduced a health package scheme for teh poor. They pay a nominal amount - to get a "smart card", which will assure them free treatment at all govt hospitals (!!!!), and select private hospitals. This is the beginning of privatisation of health care in Kerala.

Sadly, the govt. is now run by the political party which opposed a Rs. 2/- levy on inpatients in paywards of govt hospitals (who pay around 50 per day) for the room, who had a monthly income of about a fixed threshold.

[tsk1979]

If you take an above average doctor 40 years old, and an above average IT professional 40 years old, the IT guy will be earning probably 2-5X what the doctor earns.

A dentist fresh out of UG course is offered 3000/pm salary by most hospitals(5000 if unrecognized medical college).

So who makes the money? Well the businesses running hospitals!

[Spitfire]

Originally Posted by tsk1979

If you take an above average doctor 40 years old, and an above average IT professional 40 years old, the IT guy will be earning probably 2-5X what the doctor earns.

The IT guy does not get the tax concessions like the doctor does.

IT guy here whose sister is a doctor.

[shankar.balan]

The doctors fees are about average in first class hospitals like Manipal and Apollo - Surgeons fees can vary depending on the complexity of the job.
the infrastructure fees, ICU charges, Operating Theatre Charges, Room Charges etc are the ones that silently add themselves onto the bills and make the total go up.

Yes - it is the hospitals or the "trust" or company that makes the money - in a way, they also need to make enough to support the infrastructure, quality, cleanliness, maintenance, house-keeping et al. And frankly, lets just ask ourselves how many of us would actually check in to a Government Hospital if we were ill and how many of us would prefer private medical care?

Even abroad Private Medical Care is very expensive when compared say, with the NHS - the only thing is that if one wants to use the NHS, one has to wait one's turn because there is a huge waiting list.

But in India, we dont even have this option - which is a criminal negligence on the part of our government. If they want to take their cut, let them do so, but at least let them provide the required essential services.

Or else it is about time we Indians took a few leaves out of Fidel Castro's book - Cuba has had first class medical facilities available for its Citizens for a very long time - the true value of this is that without exception, first class facilities are available to the regular man on the street/ common man.

Originally Posted by tsk1979

If you take an above average doctor 40 years old, and an above average IT professional 40 years old, the IT guy will be earning probably 2-5X what the doctor earns.

A dentist fresh out of UG course is offered 3000/pm salary by most hospitals(5000 if unrecognized medical college).

So who makes the money? Well the businesses running hospitals!

[ikoneer]

The TN government very recently launched an insurance scheme for the poor people as well. Yes, it is a good scheme but again it indicates that having an insurance is inevitable and it is in this direction things are going to move in future.

God save people without insurance.

Coming back to insurance claim, when my wife was admitted in hospital for delivery, had these cashless facility with 50K limit. They said they will send the bill to insurance department and even on the discharge date, bill preparation is always 'in process'. Even today i don't what's the amount charged.

[Matt]

Originally Posted by benbsb29

You could try with a firm voice to make them understand, but that failing, do send a stonker of a mail to the TTK higher-ups. If this still doesnt work, escalate, copying your company's HR contact as well. Something should work out.

Thanks benbsb . My wife did take this issue with the HR folks in her company(Satyam). The HR personnel did ensure that something will be done by her, but not so surprisingly nothing is done so far. Now she may need to mail to the higher-ups in the TTK. Another thing to note here is that Satyam does not pay the Insurance premium for the Employees dependent parents. My wife paid for it, since it was a group policy she got it at a lower rate.

Does it help to go with the IRDA-Ombudsmen way?

I know that 4k is not a huge amount. But still I can't sit down and take these things.

[DCEite]

Originally Posted by tsk1979

If you take an above average doctor 40 years old, and an above average IT professional 40 years old, the IT guy will be earning probably 2-5X what the doctor earns.

Slightly OT, but at 40 the doctor is reaching his career's prime (skills, and employebility wise), whereas at 40 the average IT guy not much desirable for the company compared to say when he was 27.

So the doctor is actually better off even with lower salary.