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Paying for free health treatment

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Seheda Khatan, whose daughter-in-law is admitted at the hospital for delivery, shows bills that she paid.

Siraha, April 7, 2016: Asthma patient Ramprit Yadav of Siraha – 2 is admitted at the District hospital for treatment. As per provision, he was supposed to get free treatment and free medicines while undergoing treatment at government hospitals. Ramprit did not. He was asked to buy medicines from pharmacies and was also asked to get x-ray from a private health facility.

“It was told that patients of asthma are given totally free treatment and medicines at government hospitals. However, I had to buy medicines from outside and also had to pay for x-ray, as I was asked to do it from outside,” he said while laying on bed no 14 of the general treatment ward of the hospital.

The only thing that Ramprit has not paid for are bed and doctor’s fee. Rest, including several tests and medicines, the hospital said sorry and he had to pay.

Another patient on bed no 11 of the same ward, Basudev Mukhiya, was listening to Ramprit’s story. When Ramprit finished sharing his saga, Basudev narrated his. “We need to bring lot of money for treatment even though we are in government hospital,” he said. “We have to buy medicines, pay for medical tests. These are very costly and its tough for poor people like us to afford them,” he said adding, “I had thought we get everything for free in government run hospital.”

Along with the cost, patients feel that they are not getting the best treatment. Ramprit added that he is very disappointed with the quality of treatment at the hospital considering the costs that he had been bearing. “I had come here in hope of receiving free treatment. But when I am bound to spend so much, why not to go somewhere else where good treatment is provided? I’m thinking of going to Darbhanga hospital of India for further treatment,” he said.

Rajbir Yadav, spokesperson at the hospital admitted that patients have been hit due to the lack of medicine in hospital. He informed that 35 percent of medicine for asthma patients comes from the drug department while the hospital manages for the rest through tender. “However, this time, neither the department has sent medicine, nor have we been able to buy it,” he explained.

Hospital chief Dayashankar Lal Karna also pointed to lack of medicines as the reason for the hospital’s inability to provide medicines to patients. “We don’t have medicines in our stock. The hospital has not received medicines for a long period now,” he said expressing hopes that the situation would improve very soon.

Child Delivery is also not free

Women who can afford to get it done in private hospital hardly come to government hospitals for delivery. Due to comparatively cleaner wards and better attention, mother-to-be wish to give birth to their children in private clinics and hospitals. However, poor women in the district come to government hospital for delivering babies thinking that it a cheaper option. However, they have to pay the same amount as private hospitals charge.

“The doctors ask for doing video x-rays. Not once, but many times. They are very costly,” said Saheda Khatoon, mother-in-law of mother-to-be Basira. Though video x-rays are crucial in assessing health status of a pregnant woman, the equipment is not available at the hospital. The lack forces mothers-to-be to get it done from private health facilities. These facilities charge around Rs 2500 for the service.

Besides, they have to pay for various medical tests – including blood and urine tests – and medicines. “I had to buy medicines from private pharmacies. Within few hours of brining my daughter-in-law here, I had to spend Rs 4000,” she narrated suggesting that the district hospital should inform the public that it does not provide free services.

“The government publicizes that its hospitals provide free delivery services but in reality you pay a lot when you access this service at government hospitals. Its claims are misleading,” she said. “Without thick pocket you cannot receive treatment here. Instead of fooling poor people, it’s very important that the government tells the whole truth to the people. So, why not tell them beforehand?”

She asserted that only providing free bed and doctor’s check up is not sufficient for the government to claim that delivery services at its health facilities are free of cost “Medicines, x-rays, video x-rays and medical tests are very expensive. Without providing these services free of cost, the government should not claim it provides free delivery services,” Khatoon added.

As per government provisions, women who come for delivery service at a government hospital are entitled to Rs 500 as transportation allowance along with cash amount of Rs 1500 for normal and Rs 7050 for caesarian delivery. Through these provisions the government aimed at promoting the culture of delivering babies in hospital. But now even though the mothers-to-be are coming to hospital, government hospitals seem to be failing to keep up their promise of providing quality health services for free.

Paying for free health treatment 1
A woman with her newly born baby at the hospital. Though delivery is free, they have to pay for medical tests, video x-rays and medicines.

Paying for free health treatment 3
Ramprit Yadav, an asthma patient, at the hospital complained that he had to pay for tests and medicines that were supposed to be free.