Supreme Court Slams States for Inaction on Affordable Healthcare

The Supreme Court on Tuesday showed serious concern about the failure of state governments to make medical care and infrastructure affordable, highlighting specifically the exorbitant prices of medicines. The Court slammed the states for not ensuring the availability of essential medicines at affordable rates, especially for economically weaker segments of society.

These findings were reported at the hearing of a Public Interest Litigation (PIL) brought by a petitioner who had expressed concerns over private hospitals pressuring patients and their relatives to buy medicines, implants, and other medical items from in-house pharmacies at exorbitant prices. The petition complained of the unjustified mark-ups on vital medical items, further loading vulnerable populations.

A bench of Justices Surya Kant and N Kotiswar Singh censured this practice, terming it as exploitative and unjust to patients at their weakest moments. The judges emphasized that the affordability of essential drugs must be kept reasonable and affordable, especially for lower-middle-class citizens availing of public healthcare facilities.

Following the objections of the Court, some state governments, such as Odisha, Arunachal Pradesh, Chhattisgarh, Bihar, Tamil Nadu, Himachal Pradesh, and Rajasthan, filed counter-affidavits. They claimed that they were following the central government's price control measures for essential drugs and were making efforts to make them available at reasonable prices.

But the Supreme Court raised a doubt if the regulations were really being implemented properly at the state level. The Court observed that even after price control measures from the central government, several states were finding it difficult to deliver essential medicines at reasonable prices, especially in rural and economically underdeveloped pockets. The judges asked state governments to be more proactive in addressing the gap in healthcare accessibility and enhancing the affordability of essential medicines.

The Court has asked the central government and state governments to file complete reports regarding action being taken for solving this problem. The case will be re-examined in the upcoming weeks, and the Supreme Court is insisting upon a speedy yet effective solution towards making healthcare more affordable throughout the nation.

Further, the Supreme Court declined to pass compulsory orders to regulate private hospital medicine prices and consumables but motivated state governments and Union Territories (UTs) to formulate right policies to stop overcharging and supposed exploitation. The bench also recognized that cheap healthcare is an inherent right according to Article 21 of the Constitution, and price regulation of private hospitals lies in the ambit of policy. The Court stressed the need to strike a balance between protecting patient welfare and maintaining private sector participation in healthcare.

“It would not be appropriate for the Court to impose mandatory regulations that could hinder private hospitals, but at the same time, states must be made aware of the issue of excessive charges and alleged exploitation,” the Court stated.

The judges also noted that India’s growing population and increasing healthcare demands necessitate private sector involvement. “State governments have been unable to provide sufficient medical infrastructure to cater to all patients, which has led to private entities stepping in to fill the gap,” the Court observed. It further noted that even state governments depend on private hospitals for delivering basic and specialized healthcare services.
Given these factors, the bench suggested that imposing blanket regulations on private hospitals might not be the best approach. “Should the government introduce a policy that controls every aspect of private hospitals? Should state policies have specific clauses to control the prices of drugs and medical consumables?" the bench asked, pointing towards the necessity of a balanced policy framework.

The petition, initially filed by Siddharth Dalmia in 2018, prayed for intervention against private hospitals forcing patients to buy medicines and medical equipment from in-house or authorized pharmacies at higher prices. Dalmia contended that such practices constituted financial exploitation of patients and prayed for the intervention of the Court under Article 21. He prayed for directives to ban such hospital-mandated buying and sought policy reforms to tackle the issue.

The central government countered by making it clear that patients were not being compelled to purchase medicines only from hospital pharmacies and that healthcare policies are a matter of individual states. State governments and UTs explained their existing healthcare structures, with references to such schemes as Amrit Shops and Jan Aushadhi stores in government hospitals that provide medicines at reduced prices. They also referred to the Drug Price Control Order (DPCO) that controls prices of essential drugs. A few states further brought to attention welfare initiatives like cashless treatment schemes specific to given groups.

Realizing that public health, sanitation, hospitals, and dispensaries are mostly under state jurisdiction, the Supreme Court ultimately declined to make binding orders. The Court did, however, place emphasis upon ensuring redress concerning excessive medical expenses and encouraged state governments and UTs to frame policies regarding fairness and affordability in healthcare services.

Finally disposing of the petition, the Court directed state governments to assess the question and weigh policy steps to keep patient exploitation from happening in private hospitals.

(Input from various media sources)

(Rehash/Sai Sindhuja K/MSM)