When the state abdicates its primary responsibility, it invariably throws its citizens at the mercy of brute non-state operators. This is true for both the political security sector as well as the private health sector.
When the Frontier Constabulary and the Levies fail to provide security and justice, the Lashkar-e-Islam and the TTP step in. Similarly, the failure of the public health sector creates the space for private hospitals, which come across as money-minting machines. Often, patients with modest financial means — once admitted, end up indebted because of the huge bills accruing from consultants’ fees, multiple tests and lodging.
And once a patient walks in, the staff at these commercial health facilities pounces on them like starving vultures, making sure to fleece as much as possible. Every new patient means another money-minting object for doctors, paramedics and the administration.
Two personal experiences within last three years have exposed the brutality of the commercial nature of two prime private hospitals in Islamabad. In the first instance, a surgeon implanted three stents into my father’s artery to save his life. Ironically, the surgeon came several hours later than the time he had indicated for the procedure. He performed the procedure twice on my 87-year-old father, first for two stents and then next day for the third. Three months later, my father died of cardiac arrest. His treatment had cost more than a million rupees.
Some doctors I consulted later wondered as to why a seriously sick 87-year-old patient was made to go through an angioplasty at all. This prompted me to ask the owner of the hospital during a dinner as to whether he would recommend angioplasty for a person older than 80 years.
“No I won’t advise because such a person is already on borrowed time,” he said. Why? Because he had himself signed the documents for my father’s surgery by another known surgeon. “Oh really, did I?” was his response. He promised to get back to me, which he never did.
For over a week, the intensive care unit (ICU) of that hospital looked like a parking lot for the patients of respective surgeons and consultant physicians. Doctors were not supposed to touch other doctors’ patients. And the doctor in charge would have the moral integrity to seek a second opinion for the ailment of my mother. On a critical day, the consultant doctor didn’t show up at all and I drove him myself from his clinic to the hospital where my mother was struggling with epileptic fits.
The following few days were not different either except for a better response after we complained to the executive director of the apathy of doctors and the casual attitude of the staff at the ICU.
During our stay we witnessed another patient being ripped off for what was a simple case of hypertension; within 24 hours, this patient had to cough up almost 40,000 rupees — all this because of a false alarm that a consulting doctor had raised when the patient walked in.
What is the remedy for the common man, particularly those with limited financial resources?
There is no check on doctors who draw salaries from the government, but perform tests and surgeries at private hospitals. Tax evasion in this sector, particularly by prominent surgeons and physicians, is brazenly common. The situation is worse in smaller towns.
No accountability. Nor any sense of responsibility, and hence the rip-off, with countless patients falling victim to the insatiable greed of private hospitals.
Published in The Express Tribune, May 21st, 2014.
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