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 Practices such as "defensive medicine" and aggressive marketing by
hospitals, which cost the United States an estimated $250 billion to
$300 billion annually, are emerging as a serious problem in India,
the Washington-based institution warned.
The comments come as India's new government has vowed to crack down
on unethical practices that plague India's $74 billion healthcare
industry, where doctors say getting kickbacks for referring patients
or passing inflated hospital bills to insurers is widespread.
The World Bank warned that as more people are able to afford
healthcare and the government ramps up insurance coverage, the risk
of excessive care may increase, in notes released from an April
meeting with policymakers and insurers.
Awareness of how get a medical claim remains low in India and
out-of-pocket expenses remain high. While more than 630 million
people are forecast to have some form of health insurance by next
year, more than half the country will remain uninsured.
Prime Minister Narendra Modi's government is also working on what
may be the world's largest health insurance program, partially
inspired by the "Obamacare" law in the United States.
As more and more patients become insured, the size of their bills
may grow, the World Bank said. "Individuals in India with private
voluntary health insurance are two to three times more likely to be
hospitalized than the national average."
Some doctors in India have already joined the movement. Last month,
the All India Institute of Medical Sciences convened a "Society for
Less Investigative Medicine", which puts the onus on both doctors
and patients to tackle the problem.
The society's founder, Balram Bhargava, said it was not ideal that
Indian doctors adopted the so-called American medicine practice of
taking a defensive strategy of doing checkups to avoid patient
litigation.
UNHEALTHY PRACTICES
Last week, Health Minister Harsh Vardhan called for tougher laws in
the health sector after a television news channel reported that some
laboratories allegedly offered kickbacks to doctors who referred
patients to their diagnostic centers.
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Some doctors complain unethical behavior is more rampant in the vast
sector of private health care providers that capitalize on low
spending in the public health system. Private health providers have
created 80 percent of the new hospital bed capacity in the last
decade, according to PwC-NatHealth report.
Malpractice, such as falsifying patients' diagnoses to pass
unnecessarily high bills on to insurers, led one worker in private
health to quit his job in favor of a low-paying government health
service job.
"I quit because there was dirt there," said Sunil, who declined to
give his last name or the name of the hospital he left. "Such
practices did not suit my conscience."
Arun Gadre, an associate coordinator at the non-profit organization
SATHI, is publishing a book featuring interviews with dozens of
doctors in the private sector.
"The medical private sector has stooped to such low levels just to
earn money," Gadre, himself a doctor, said.
"One nephrologist working in a corporate hospital was asked by his
CEO for an explanation why a person was discharged without kidney
biopsy, even though no operation was actually required."
(Editing by Krista Mahr and Robert Birsel)
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