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Is forcing private labs to make Covid-19 tests free the only way to stop spread of infection?

The Supreme Court directed the central government to make Covid-19 testing by private laboratories free of charge Wednesday.

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The Supreme Court directed the central government to make Covid-19 testing by private laboratories free of charge Wednesday. The court said private healthcare sector in India has played an important role in checking the spread of coronavirus epidemic, and urged them to extend “philanthropic services in the hour of national crisis”. Previously, a test cost ₹4,500 approximately, which the petitioner said was unaffordable for most people.

ThePrint asks: Is forcing private labs to make Covid-19 tests free the only way to stop spread of infection?

Let’s remember a private hospital or lab needs to make money or it dies out

Former health secretary Keshav DesirajuKeshav Desiraju
Former health secretary

The Supreme Court’s directive for free Covid-19 testing in private labs can only work if the central government takes it upon itself to underwrite the costs for testing. In that case, a lot more data will also be available to track the virus.

However, to say private healthcare entities “have” to make testing free is going to push their backs up against the wall.

So far, private labs have come to the forefront of the fight against the epidemic and risen to the occasion. But let’s remember that a private hospital or lab is a profit-making entity; it needs to make money or it dies out. If it is to solely bear the costs of free tests, I predict many will either stop testing or shut down completely, which would also complicate their role in the fight against coronavirus. What could also end up happening is that private labs will make patients pay for the materials needed for the test and not the actual test, thereby making it appear as it is free.

That said, if there is a government mechanism for reimbursing private entities for the tests at the ready, then I believe the Supreme Court’s order can work well.

SC’s humanitarian outlook is good, but a practical approach is need to fight this pandemic

Dr. Anoop Misra
Chairman at Fortis, C-Doc

Forcing private labs to make coronavirus tests free is may be counterproductive. I predict that many private labs will shut this operation and stop testing given that the testing kit costs about Rs. 3,000 itself, and a private lab has separate investments and additional operating costs just to be able to function. Also, there is not much assurance over when government will reimburse the labs.

There is another alternative. If the government were to provide the kits free of cost, cover the costs of personal protective equipment (PPE) and for initial set for testing, then the test can be administered by private labs at about Rs. 500 per person. In my opinion, this a very affordable amount even for lower social-economic strata because people are willingly go to a quack and pay the same amount anyway.

This will not only ramp up testing but make it accessible as well. At the moment, the government facilities are seemingly difficult to approach or access.

The Supreme Court’s order comes from a place of humanitarian good, which I understand. However, if we want to take a practical approach in fighting this pandemic and have any shot at successfully defeating it, this is not the way.

The Supreme Court should have clarified if the private sector will be compensated by government

Amir Ullah Khan
Professor of Health Economics at Indian School of Public Policy

It’s pointless to ask private labs to provide free tests. The Supreme Court order is vague. It should have clarified if the private sector will be compensated by the state. But the court is working on the assumption of philanthropic spirit. Even if some labs and hospitals are inspired to make tests free, can the vulnerable public count on such charitable acts that cannot be easily monitored?

Across the world, there is either a straightforward nationalisation of private facilities in Spain or the renting of private beds in the UK. The UK’s NHS has further decided to go on a serious partnership with big pharma to produce test kits. We, in India, have been dragging our feet since early February. We need to bring in all private labs that can produce PPEs, test kits and ventilators and cover the costs necessary to ramp up facilities. Only then we can be prepared when Covid-19 peaks in May or early in June.

We need swift executive action to carry out large number of tests every day. Each private and public facility should test, sign up to ICMR guidelines and issue a simple result sheet that can be digitsed and sent across to various databases. The government, at the centre or the state, should pay a bare minimum amount for each result. We must ensure all hands are on deck in tackling the biggest health emergency.

Private labs are barely able to recover costs even from Rs 4500 per test

Dr. Arjun Dang
CEO, Dr. Dangs Lab

We endorse the Supreme Court’s judgement, which aims at increasing accessibility to Covid-19 testing and makes it accessible for the common person. Earlier, private lab charges were capped at ₹4,500 for each test, even as it is free at government medical facilities.

The Supreme Court bench has also identified the critical role played by private hospitals and labs in containing the scale of the coronavirus pandemic. The bench has made a call to these institutions to undertake “philanthropic services in the hour of national crisis.”

However, for private labs, there are numerous fixed costs such as reagents, consumables, skilled manpower and infrastructure specifics. The coronavirus pandemic also calls for immense infection control measures like personal protective equipment, viral transport media and the need to keep sanitation and employee safety in mind at every step. Private labs are barely able to recover costs even from the government mandated cost of Rs 4500.

Keeping this in mind, we hope the government comes up with modalities so that testing in private laboratories remains sustainable. We are currently following the Supreme Court’s orders and doing the test free of cost while awaiting further clarity from the government.

Also read: Can India balance its domestic pharma needs and also be a global player in Covid-19 fight?

Pia Krishnankutty, journalist at ThePrint

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  1. Rapid testing should be free whose price is Rs400 and the other testing should be paid by patients whose price is Rs4500

  2. This is yet another overreach by judges, who have neither the expertise nor the authority to issue these nationwide ‘fatwas’. Consider that a single lawyer filed a PIL and a couple of sympathetic judges then pass a nationwide order – bypassing the people and the experts. This is yet another example of judges issuing rulings designed to make them look good without any understanding of the implications. In its simplest form, it will reduce the availability of testing as labs will stop doing the tests. A more reasoned policy can only come from a decision that creates a public-private partnership through appropriate legislation (or ordinance if it is urgent). We have a long history of courts damaging life of millions by judgments that are cheered by a tiny elite section of the society.

  3. Paraye ghar se Brahmin bithana, charity at someone else’s expense. For reasons that remain unclear, India seems most reluctant to test. When private institutions are available and when the process itself is becoming so much faster, that should change. These are tough times for the economy. Private hospitals are suffering because a lot of normal work / surgeries are on hold. There is Zero justification for compelling any of them to test for free. The only compulsion one would support – although it should not become necessary at such a time – is official pressure to ensure there is no gouging. 2. The government has a duty to the people at such a time. God knows it is raising enough money by way of taxes and borrowing all that households save. It is one thing for private individuals and institutions to support those who are in need by arranging food, dry rations, etc. However, large monetary donations to the government itself does not get my vote. The amounts are not transformative, but they send out a signal of fiscal distress.

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