Thread by @just1doctorwala

Extremely irresponsible reporting.
If I can even call this reporting.
Seems more like a hit job.
Especially now in time of pandemic
All this kind of reporting does is fester panic and mistrust to the modern medical profession.
The cost figures mentioned make absolutely no sense.

https://twitter.com/RemaNagarajan/status/1291752082689597442

Of you would bear with me I would like to go point by point and ask a few questions about her "figures"

These are some of the TOP most expensive more luxurious private hospitals.
Notice the second hospital? That's right! that's where Amitabh Bachchan and family were admitted.
Private hospitals are profit making no denying but just like hotels you get regular hospitals to 5* level.

So easy to cherry pick the most expensive hospitals in India and outrage over their price. But is this the whole story? Are these the ONLY hospitals in India? What about government hospitals? Have we given up questioning our government to increase healthcare spending?

Private hospitals exist ONLY because government hospitals cannot handle the load. In fact it is so bad that in states like Maharashtra government decreed a law that private hospitals have to provide a certain % of beds at government hospital prices. No one else in world does that

While we are at it let us outrage over Hilton Taj and Oberoi for charging 200 rupees for a tea when the roadside chaiwala sells it for 5 rupees. Because you are literally doing the same thing here. Have some sense of logic and context please.🤦🏽‍♂️

ABG
Cost of machine is correct
BUT
Very few read VERY FEW hospitals rent. In fact the hospitals that rent actually charge less. Big hospitals like those mentioned generally buy the equipment outright and this allows them the freedom to charge more. So basically fake news.

They have spliced two different facts and joined them together. You can easily see how they manufactured this fake news.
1. Some hospitals rent machine and allows them to charge less. Most charity hospitals do this.
2. Some hospitals buy out right to allow them to charge more.

Further the 50 rupees mentioned is probably the lowest charge. A hospital with a very high patient count might get that rate. Else the rate is much much higher. My previous hospital paid 200 per test. And even then the maintenance schedule were sporadic.

Manufacturers much prefer hospital buying outright & do every trick in the book to encourage that. They delay maintenance. Finally the management got fed up with doctors complaining about breakdown & ended up buying another machine. Hence why I said very very few hospitals rent

Also how conviniently we forget a few things
Rent or bought
The following costs are not explained in the article
1. Lab tech salary
2. Electricity to run the lab & machine
3. IT hardware & software to link machine to hospital EMR
4. EMR itself is expensive
5. Reagent cost

6. Maintenance cost
7. Oh and don't forget taxes from our lovely caring government

Any answers for any of these questions in the article? Please let me know if you find them. 🙏

Ventilators
The average price mentioned is correct
The current best practice is to have 1 ventilator for 2 ICU beds so numbers match

Now let's talk about the 4000 rupee "ventilator charge"

BULLSHIT!

Like someone in their office threw a dart and picked the number it fell on.

What exactly are the costs involved in running a ventilator?

Let's start from the top.

1. Intubation. The act of inserting the ET or breathing tube into patient safely and securely.
a. Done only by well trained anaesthesia, critical care or emergency physicians. Their salaries?
c. Supported by nurses trained in this. Their salaries?

d. Further supported by biomedical staff 24/7. Their salaries?
e. Cost of the tube, connectors, tubings? Oh have a look at image below for the HME filter we connect to tubing before connecting to ventilator. We use two of these per patient btw. Protects machine from infection.

f. Drugs used to intubate. Intubation is an extremely traumatic to mouth and thraot process. We have to give certain drugs before during and after to make the patient comfortable to tube. What about the cost of these drugs?

AND

ALL of the above is before we even think about
2. ICU running costs
3. Electricity costs
4. Oxygen costs
5. ICU doctors nurses & cleaning staff AND their PPE kits.
6. Cost of service & maintenance of ventilators

Please let me know how to do ALL of above in 4000 rupees 🙏

Bi-pap

3000 average daily charge they claim

Remember that HME filter? Yeah we use that here too.

The costs they mentioned can vary greatly. Putting an "average cost" is a massive cop out. Hospitals tend to say for example 4000 rupees ventilator charge but will charge all the items used separately. Some will just charge the whole amount together as ventilator charge.

The point of this entire thread is very simple
There are costs. There are visible costs there are hidden costs. That is fact of life. Asking for more transparencies is easy in theory but very difficult in practice. If I may make a very silly comparison...

This article is in Times of India.
Times of India makes how much through the countless sponsors and adverts? Do they really need to charge 10 rupees to buy one copy?. Also why massive discrepancy between Delhi and Mumbai Vs Madhya Pradesh and Kerala?
Isn't it the same paper? 😉

In conclusion I just want to say
Shoddy hit job piece
Zero value
Anyone with a sense of decency and common sense and business acumen with real world experience would know the truth. Unfortunately today we trust the media blindly. We need to stop & find out for ourselves. 🙏