Access to affordable healthcare remains a significant challenge in low and middle-income states like Kashmir. However, there are concerns about potential profit-driven practices and ethical considerations that need to be addressed.   However, the impact of corporate hospitals in these regions has raised several concerns on the inflation of medical bills through high-cost treatments, unnecessary investigations, interventions, and ICU utilization leading to inflated medical bills. Healthcare, being a fundamental human right, is essential for improving the overall well-being and life expectancy of the population. Low and middle-income states face an uphill battle in providing affordable and accessible healthcare to their populations. In regions like Kashmir, the challenges on healthcare disparities in Kashmir are exacerbated due to socio-economic disparities, geographic constraints, and political instability. Kashmir, a union territory in India, represents the healthcare challenges faced by many low-middle-income regions. Inadequate infrastructure, limited healthcare facilities, and a shortage of medical professionals often lead to suboptimal healthcare outcomes.

The disparity in healthcare access is evident, with rural areas and marginalized communities facing the brunt of these issues. The Government plays a significant role in providing healthcare services in low-middle-income states like ours. However, the healthcare infrastructure is often overburdened and underfunded, leading to long waiting times, inadequate facilities, and shortages of essential medicines and equipment. Access to affordable healthcare services is essential to ensure that the population receives timely and appropriate medical care. High healthcare costs often act as a barrier to seeking medical attention, resulting in delayed or suboptimal treatment.

Emergence of Corporate Hospitals and Their Role in Filling the gaps in Healthcare

Corporate hospitals typically invest in infrastructure have gained prominence worldwide due to their ability to provide state-of-the-art medical facilities, modern equipment, specialized medical expertise, rigorous quality control, and adherence to international standards of care leading to better patient outcomes and increased satisfaction. The establishment of corporate hospitals in underserved areas can significantly improve healthcare access. Their presence in low-middle-income states like Kashmir can potentially transform the healthcare landscape where the healthcare infrastructure may be lacking. Patients can access advanced diagnostics and treatments, reducing the need to travel long distances to receive specialized care. The establishment of corporate hospitals creates job opportunities for the local population. This can have a positive impact on the economy and help reduce unemployment rates. On the flip side it attracts an exodus of specialized doctors from the public sector which can raise issues and review on staff retention policy of state run medical institutions.

 Challenges on unnecessary Investigations’ unwarranted Interventions

Some critics argue that corporate hospitals might encourage unwarranted interventions, such as surgeries, procedures, or treatments, to generate more revenue. This can lead to patients receiving treatments that are not medically necessary.. One of the main criticisms faced by Corporate hospitals are their  profit-driven practices , which can lead to concerns about overpricing and overprescribing medical tests, investigations, unnecessary procedures, and overutilization of medical resources to maximize profits. This practice can exacerbate the problem of high-cost treatment and may lead to unnecessary financial burdens on patients.

Price variation, high-cost treatment and the cost of medical procedures are often a barrier to healthcare access. Corporate hospitals may charge significantly more for medical procedures, than any other private hospitals and or with Golden card facility making them unaffordable for a large section of the population. These facilities tend to charge significantly higher fees for their services compared to government hospitals and smaller private clinics. This can put a strain on patients who may already be financially vulnerable.

There can be a significant variation in the prices of medical procedures even in between corporate hospitals, with a lack of transparency in billing practices. This can result in patients being charged exorbitant amounts for treatment driving up the overall cost of treatment. This practice can be financially burdensome for patients and healthcare systems that do more harm than good, both medically and financially.HDU and ICU care is expensive, and some corporate hospitals have been accused of admitting patients to the ICU when it is not medically required, solely to inflate the bill contributing to the overall dissatisfaction on ICU Utilization and Bill Inflation .This unethical practice adds to the financial burden on patients and their families.

The pursuit of profit sometimes leads to ethical dilemmas, as hospitals may prioritize financial gains over patient welfare. This ethical concern is particularly relevant in low-middle-income states where vulnerable populations may be at risk of exploitation. Many corporate hospitals often rely on private health insurance, most of these hospitals are not empanelled under PM-JAY the world's largest health insurance/ assurance scheme which this deprivation can exclude a significant portion of the population from availing their services.

Addressing the Problems

The way forward is a regulatory framework. Effective regulation of healthcare pricing and billing practices is crucial to address the problems associated with high-cost treatment and bill inflation. Corporate hospitals should adhere to strict ethical guidelines to ensure that the welfare of patients is the top priority, rather than profit maximization. Corporate hospitals must prioritize ethical medical practices over financial gain. Establishing a strong ethical code within the organization and incentivizing doctors and staff to prioritize patient well-being can mitigate unnecessary interventions and ICU admissions. I don’t know whether any such supervision or accountability is operative in our land to address these concerns. Government bodies and healthcare regulators must ensure that corporate hospitals are held accountable for their pricing and billing practices. Transparent pricing models can help curb excessive charges.

Public-Private partnerships, collaboration between corporate hospitals and Government healthcare facilities can help provide affordable care to a wider population. The development of affordable healthcare models, such as not for profit state of art hospital for high-cost healthcare like “cancer care,” under one roof to improve healthcare access in a low-middle-income territory like Kashmir Such partnerships can ensure that a certain percentage of beds and services are reserved for economically disadvantaged patients at subsidized rates. Widening the scope and encouraging the use of health insurance and government healthcare schemes can help alleviate the financial burden on patients. Government programs that cover medical expenses for low-income individuals can be expanded and promoted.

The healthcare landscape in Kashmir, like many low-middle-income states, has several challenges, including a lack of affordable healthcare options which sometimes compels them to move outside to seek treatment. Corporate hospitals have the potential to bridge the healthcare gap in low-middle-income states like Kashmir by providing advanced medical infrastructure, expertise, and quality of care. However, challenges related to profit-driven practices, high-cost treatment, unnecessary investigations, interventions, and bill inflation must be addressed. A holistic approach that combines effective regulation, ethical guidelines, and public-private partnerships is essential to ensure that corporate hospitals contribute positively to the healthcare landscape while prioritizing patient welfare over financial gains. The ultimate goal should be to strike a balance between providing high-quality healthcare and making it affordable and accessible healthcare to all, irrespective of their socio-economic states. By addressing these challenges, corporate hospitals can contribute to a healthier and more equitable future for low and middle-income states like Kashmir.

 (The author is certified professional in Healthcare Quality, National and International Expert on Healthcare standards, policy planning and reforms. He can be reached at: drfiazfazili@gmail.com)