Cost of COVID-19 critical care

Are private health facilities profiteering from pandemic?

Kampala, Uganda | RONALD MUSOKE | The high cost of critical care has become a major issue since the Delta variant of the Coronavirus swept through Uganda leaving behind thousands of deaths and financially deprived families.

When it hit, public hospitals where treatment is largely free or subsidized ran out of beds and patients resorted to expensive private hospitals.

Soon, caregivers started sharing tales of exorbitant bills they have paid to treat their critically ill relatives. In some private facilities, ill patients requiring High Dependence Unit (HDU) care are paying between Shs1-5 million (Approx. U$300 -1500) per day while those who need intensive care are paying between Shs 3-5 million.

Social media has been flooded with stories of some private hospitals asking patients to deposit assets like land titles before admission. In other hospitals, dead bodies have been impounded to force relatives to clear bills.

Joan Kilande says her family is unlikely to recover from the loss of her big brother and the financial ruin incurred during his treatment. He was the father figure.

Kilande fought back tears recently as she recounted her family’s ordeal during a virtual meeting organised by HEPS-Uganda, a Kampala-based health rights non-profit, on the cost of critical care of COVID-19 patients in Ugandan private hospitals.

Kilande told the forum of how in a space of two and half weeks, her family ended up paying up to Shs76 million (Approx.US$20,000) and how they hopped from one health facility to another.

At one point, they were paying Shs 4 million per day for ICU care exclusive of medicine.  But, just when it seemed like Kilande’s brother was winning the battle against COVID-19 and doctors even suggested that he be transferred to an offsite facility for physiotherapy, he died suddenly. The hospital, TMR International in Kampala, slapped them with a bill of Shs 76 million.

Kilande says although the patient’s employer paid a good percentage of the bill, the family could not raise the remainder of the balance. Her brother’s gratuity from the employer went to the hospital.

“This has left the entire family with nothing,” she said.

A youthful man recovering from COVID-19 also recently told The Independent that for the seven days he was at Medipal International Hospital in Kampala in June, he paid Shs10.5 million.

“Before they touch you, you have to deposit money with them,” he said. In his case it was Shs 5 million before any treatment started. His worst moment was when his oxygen levels fell below 80%. Normal level is usually 95% or higher. He was never in the ICU or even HDU.

Dennis Kibira, the executive director of HEPS-Uganda, describes such bills Ugandans have been paying as “catastrophic.”

Matters climaxed on June 24 when a right to health civil society (CSO) sued the government in the High Court in Kampala for failing to rein-in the private hospitals which are charging ‘exorbitant’ fees.

Moses Mulumba, the head of the CSO; the Centre for Health, Human Rights and Development (CEHURD), filed a case against the Attorney General, the Medical and Dental Practitioners Council and Dr. Jane Ruth Aceng, the Minister of Health.

In a speedy ruling, the court on July 8, ordered the Minister of Health and the Medical and Dental Practitioners Council to make regulations on fees chargeable by hospitals managing and treating COVID-19 patients.

But Mulumba remains pessimistic.

“Since there is no regulatory framework to rein-in hospitals, these high charges will continue,” he said.