New Delhi: The Supreme Court Tuesday asked the central government to frame guidelines regulating costs of Covid-19-related treatments, while observing that no individual should be turned away from a hospital due to its higher rates.
A bench led by Chief Justice S.A. Bobde was hearing a PIL filed by advocate Sachin Jain for free or subsidised medical treatment to Covid-19 patients, particularly in hospitals which had received government land at concessional prices.
The bench gave the government two weeks’ time to frame the guidelines under the Disaster Management Act, after the judges expressed their inability to fix uniform treatment rates for all private hospitals across the country.
The court observed that conditions and availability of medical facilities vastly determines the cost of treatment and these two factors vary from state to state.
“We are not equipped with what could be the best model of treatment for Covid patients,” the bench noted in its order.
The central government had already responded to Jain’s petition, saying it has no statutory power under the Clinical Establishments Act, 2010 to direct private and charitable hospitals on how they should treat Covid-19 patients.
Such a direction can be issued only by the state governments, it said, in an affidavit filed before the top court on 5 June.
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On Tuesday, the bench told Jain, “We have to tell you that the union government says it cannot say but ask the states to take a decision. We cannot go into each issue. There are different terms under which land has been given to each hospital.”
‘Every state has different constraints and needs’
In its last hearing on 5 June, the apex court had sought to know from private hospitals if they were ready to charge from Covid-19 patients the rates fixed under the central government’s Ayushman Bharat scheme.
Ayushman Bharat provides health insurance cover to the country’s poor and downtrodden.
On Tuesday, senior advocate Harish Salve, appearing for a group of hospitals, said it was not feasible for private medical establishments to follow a uniform model for Covid-19-related treatments. The costs for treatment, therefore, cannot be the same for all private hospitals.
“Each state has its own model. For example, in Maharashtra 80 per cent beds in private hospitals are reserved for Covid-19 patients. Charitable hospitals are already providing treatment. However, Covid-19 has deterred people from visiting a hospital for any other treatment,” he said.
Salve submitted that procedures followed for Covid-19-related treatments also varied from hospital to hospital. “It is not that hospitals are here to make money in this situation,” he told the bench.
The senior advocate also blamed insurance companies for putting financial burden on patients. “The real mischief is the insurance companies. All the treatment (for Covid-19) is covered but they do not pay. Why can’t they pay?” he asked.
‘Treatment costs shouldn’t be higher in these times’
Petitioner Jain argued that he was not asking the court to direct hospitals to give free treatment but lay down a regulatory mechanism so that patients are not overcharged.
CJI Bobde then told Jain that the court did not doubt his motives.
“We share the same concern. But we also understand the constraints. Circumstances in each state are different. These are things that are economic reality. Treatment is much like lawyers’ fee,” the bench said.
Solicitor General Tushar Mehta later informed the bench about the constitution of a high-level committee that has been formed to look into the issue.
“Many of the concerns have been taken care of. If there is something left, that too will be taken care off,” the senior law officer informed the bench.
It was then that the bench directed the government to frame guidelines for regulating costs of Covid-19-related treatments.
“We don’t think the union should regulate the price of treatment. But this is not to say that the union government should do nothing. There is no reason for the union not to exercise powers under the National Disaster Management Act, 2005,” the bench noted.
It also said, “We have to completely agree that the cost of the patient’s treatment should not be higher in the present times. There are several models of treatment presented before us. The Gujarat model is most suitable. However, there is a difference of opinion that the Gujarat model may not work in the state of Maharashtra.”
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