General Insurance Council Proposes Cashless for All and Rate Regulation in Hospitals

 

Following the Supreme Court's criticism of high treatment costs in private hospitals, the General Insurance Council (GIC) has proposed a two-pronged approach:

1. Cashless for All:

• GIC is willing to share its existing rate card used for the 'Cashless for All' facility with the government.
• This would allow patients to avail cashless treatment at more hospitals, potentially reducing out-of-pocket expenses.

2. Standardized Rate Card:

• GIC proposes collaboration between the central and state governments to establish a standard rate card for private hospitals.
• This card would categorize hospitals based on grade and set fixed rates for high-frequency procedures like cataract surgery and appendectomy.
• Hospitals would be required to display the rate card publicly for patient transparency.

Benefits of GIC's proposal:

• Reduced patient burden: Cashless for All and standardized rates could lower out-of-pocket expenses for patients.
• Lower insurance premiums: Insurance companies believe fixed rates could stabilize healthcare inflation, potentially leading to slower premium hikes.
• Increased patient volume for hospitals: GIC argues that hospitals might benefit from a larger patient pool due to increased affordability.

Hospitals' perspective:

• While they oppose the Supreme Court's threat to impose government-regulated rates (CGHS rates), many hospitals are open to a formal "Cashless for All" program with hospital grading.
• Some larger hospitals might resist the proposal, fearing it could affect their profit margins.

Overall, the GIC's proposal aims to address concerns about rising healthcare costs and improve affordability for patients. However, the plan faces potential resistance from hospitals and requires further discussion and collaboration between stakeholders.