| NEW DELHI, July 31
NEW DELHI, July 31 India needs to curtail
excessive medical care that leads to patient overspending as
more people get health insurance, the World Bank said on
Thursday, adding voice to a growing chorus against overtreatment
in the country.
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
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
Prime Minister Narendra Modi's government is also working on
what may be the world's largest health insurance programme,
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 hospitalised 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.
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
Some doctors complain unethical behaviour is more rampant in
the vast sector of private health care providers that capitalise
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 favour 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
organisation 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
(Editing by Krista Mahr and Robert Birsel)