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HindustanTimes Thu,02 Oct 2014

39 million forced into poverty each year due to hospitalisation expenses: World Bank

Rhythma Kaul , Hindustan Times   October 19, 2013
First Published: 23:26 IST(19/10/2013) | Last Updated: 02:00 IST(20/10/2013)

Last year, dentist Pradeep Yadav lost his 22 years old brother, Prakash, to Acute lymphoblastic leukemia (ALL), a cancer of the white blood cells that is usually diagnosed in children. By the time the Delhi University student was diagnosed with ALL in November, 2011, the cancer had spread to his central nervous system. The doctors treating him told the Yadavs very little could be done. Prakash died in May last year.

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“We first took him to the All India Institute of Medical Sciences (AIIMS) and later to Rajiv Gandhi Cancer Institute, where doctors did their best while preparing us mentally that his condition was not curable,” said Yadav, who runs a private clinic in Sadiq Nagar in South Delhi.

In the six months that Prakash fought his losing battle to cancer, his family spent close to Rs. 30 lakh. The medicines alone cost Rs. 6,000 in a day. “Add to that high-end chemotherapy drugs, a battery of diagnostic tests, including PET Scans and blood and bone marrow scans, and hospitalisation for about 100 days and the expense kept adding up,” says Prakash.

“He underwent four cycles of chemotherapy and the doses got stronger with each cycle. His blood count would drop drastically after every chemotherapy session, and he had to be transfused whole blood and sometimes blood components,” recalls Yadav.

Though Prakash’s mediclaim policy took care of roughly half the treatment cost, his illness dealt a big financial blow to the family already struggling to come to turns with losing him to cancer.

“Our savings were wiped out in just six months. After a point, there were still newer drugs to treat him but we couldn’t afford them. I had read a lot about generic drugs but none of the doctors prescribed any generic drugs during his treatment,” he said.

“I had to literally start saving from scratch after his death. He was my brother; I loved him and wanted the best treatment for him. But what is the point of having effective medicines if we can’t afford them?” said Yadav, who since then makes it a point to prescribe generic drugs to his patients as far as possible.

At government hospitals, which do many high-end surgeries at less than half the cost — and free for the economically weaker sections — get so many patients that the waiting period for even a simple surgery for gallstones at AIIMS taking up to six months to a year. AIIMS registers 10,000 new patients a day, of which roughly 30% over one year.

The Delhi government-run Institute of Liver and Biliary Sciences (ILBS) charges Rs. 11.5 lakh for a liver transplant (that costs Rs. 22 to Rs. 30 lakh in the private sector, depending on the complications) and Rs. 2 lakh for kidney transplants, which costs upwards of Rs. 8 lakh in private hospitals.

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“Apart from AIIMS, which has just started doing transplants, we are the only government hospital doing liver transplants, which cost $250,000 in the US and $140,000 in Singapore. We do it free for EWS patients, but people often have to wait for a date because the ICU beds at the hospital are limited and are almost always full,” says Dr SK Sarin, director, ILBS.

In the absence of options, people are ready to wait.

When media professional Shamit Das, 28, was diagnosed with a cyst in the brain that needed to be removed, his first choice was AIIMS. However, the over-burdened neurosurgery department at AIIMS gave him a date that fell five months later. So he decided to go to a private hospital.

But after comparing costs across three corporate hospitals, Das decided to wait his turn at AIIMS.  “The cheapest estimate that I got was for Rs. 2 lakh for surgery. Add to this medicines and other overhead expenses and I knew I couldn’t afford it,” said Das.

He eventually got operated at AIIMS for Rs. 20,000. “It may not be a fancy facility but it is equipped to save lives and doesn’t hurt the pocket either. There ought to be more hospitals like AIIMS,” said Das.

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