00:00All right, let's take the conversation further now.
00:03Joining me is Dr. Rajiv Jaiwardhan, Honorary Senior Consultant, Gastroenterologist, Sunrise Hospital, Cochin, Chairman Scientific Committee, IMA Cochin, past President,
00:14Indian Medical Association, Cochin Branch.
00:17I also have with me Abhijit Bose, Chief Operating Officer, Consumer Voice.
00:22I'd like to cut across first to the doctor who's joining us, Dr. Jaiadevan.
00:29Dr. Jaiadevan, you know, you just heard Mr. Munde there and it's quite astounding that the markups that in his
00:37review that, you know, have come to light is anywhere from a thousand percent to two thousand eight hundred and
00:46fifty percent on hospital consumable goods,
00:50which pretty much echo where what most has been the grouse of middle class families across the country, where they
00:57are handed this one fat bill by hospitals and there is just no explanation behind them.
01:03This is a good question.
01:05And for our viewers, let me clarify something up front.
01:08MRP or maximum retail price is the maximum price a seller can charge a consumer for a package product.
01:17So, which means if it is, whether it's a syringe or an implant or an IV set, the consumer should
01:25not be charged even one rupee above the MRP, which is printed on the package.
01:32The issue here is, is the MRP being far greater than what the hospital paid to purchase this product from
01:44the manufacturer.
01:44It's not that the hospitals are selling above the MRP.
01:49I just want to get that clear.
01:51The issue here is whether there should be a limit on how much the manufacturer can mark up the MRP.
02:03For example, if a product costs 10 rupees to manufacture, can they put a price of 20 rupees or 200
02:11rupees on the packet?
02:13Right now, under Indian law, there is no cap on how much they can mark up such a product.
02:23In contrast to certain essential medicines, we know that there is something called the essential medicine list.
02:30For instance, paracetamol, basic antibiotics like ampicillin.
02:34They all have a price cap with certain caveats in the sense, certain dosages and certain routes of administration, certain
02:43preparations.
02:43They come with certain price caps.
02:45So, nobody can charge a patient more than the price cap.
02:50But this price cap does not apply to consumables, which can range from something as small as a glove set,
02:58to a gown, to an IV set, to a stent, to an implant.
03:03So, the issue here that's being raised is how much can you mark it up?
03:08So, that is the issue.
03:09But Dr. Jaidevan, one direct question, which has been raised by Mr. Munday, which is constantly raised in multiple private
03:19hospitals across the country, and there is no real answer to it.
03:24With what you say, where hospital consumables are concerned, and we'll give the list out in terms of the markups.
03:29The IV set that you speak of, the MRP is 17 rupees, but it's retailed in hospital.
03:35The price that they charge is over 60 rupees.
03:38How does this add up?
03:40Yeah, it should not add up.
03:42And there must be what is called a trade margin rationalization.
03:46That is, say, not all IV sets are manufactured with the same quality or up to the same standard.
03:53It's just like all mobile phones are not the same.
03:55But there must be a limit to which the initial price can be increased.
04:02But Dr. Jaidevan, that's what I'm saying.
04:03You know, we're giving, it's actually not 50, 11 rupees an IV set.
04:06It's in hospitals, it's charged over 300 rupees.
04:10A catheter, 29 rupees is the MRP, and it's been charged in hospitals.
04:15The markup is a 94% at 310.
04:18Why is it?
04:19And it's a question that every person who visits or is forced to visit a hospital and is admitted asks.
04:26Why is this massive markup, which goes not just beyond 100%, but sometimes, like Mr. Munde pointed out, 2,800
04:36% markup.
04:38Yes, the hospital should not, by law, be selling any product to the patients above the maximum retail price.
04:47The hospital should not do that.
04:48If they're doing that, that's against the law.
04:50But they're doing it across all hospitals.
04:53I just want to bring in Avijit Bose, Chief Operating Officer, Consumer Voice in this.
04:56You know, Mr. Bose, what Mr. Munde has practically done is voiced the frustration of lacks of Indians who face
05:05this on a daily level where any hospital admission practically means wiping out the savings of an entire family.
05:13And most of it comes in terms of hospital consumables, sometimes marked up to 2,800% with no answers
05:21or explanation given.
05:25I would say the issue is not whether a hospital should make money.
05:29The issue is whether a captive consumer should pay a price that has no transparent relationship with the procurement price.
05:36I would slightly disagree with the doctor that hospitals are not aware.
05:45It is being, you know, portrayed as hospital is not aware.
05:48Now the consumer is also aware.
05:50In fact, the consumer has lost trust in hospitals.
05:55That's a very sad story.
05:57So, and the patients, the patients who are not very literate are also exposed to AI and Internet now.
06:04So, hey guys, change.
06:06Now is the time we should not, you know, keep anyone into doubt.
06:12So the difference between trade price and MRP is huge.
06:16So I was seeing on your screen, it is still playing 600%, 700%, 900%, 2,800% as Mr. Munday
06:25said.
06:26And I must appreciate Mr. Munday's step.
06:28Except for one thing, Mundagar Coffee, which was my favorite.
06:32So anyhow, that's not the point of discussion here.
06:34So the thing is, we must, you know, inculcate trust in our consumers if we do these kind of things,
06:43which is 900% to 2,800% markup.
06:46And secondly, the markup should be regulated by the regulators, especially when the patient is absolutely captive in such situations.
06:55And markup percentage also should be managed if the cost of the consumable is very high.
07:02So if the cost is very high, the markup percentage should be less.
07:08So that is what I would say is the right way.
07:11And NPPA has already experienced in the case of stents.
07:15But Mr. Boss, this is not the first time.
07:17And the question I want to ask you is, this is not the first time that it has been flagged.
07:22This time, of course, it's come from Mr. Munday.
07:24But a lot of consumer bodies have flagged it time and time again and always hit a wall.
07:30We have been, you know, fighting a lot about this thing.
07:34I mean, constantly we are chasing this issue.
07:38All right.
07:39You know, I thank both of you for joining us because I really hope Mr. Munday has raised this issue.
07:45And he says he's asked for a review.
07:48Now, will that review happen?
07:50Because for a lot of us out there and, you know, there's I don't think any family who doesn't agree
07:55or resonate with what Mr. Munday has said,
07:59that every time you walk into a hospital, you do not know what is the bill that you will be
08:04handed over at the end of your unfortunate hospital stay.
08:08And a lot of that bill is contingent also on hospital consumables, which in certain parts have been marked up
08:18to 2,800 percent of the MRP.
08:21Let's really hope something comes out of this, something tangible and there is a fixed price or at least a
08:27cap on this.
08:28I thank both our guests for joining us.
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