View: Free market is great but not when a patient’s survival depends on it

The Covid-19 pandemic has created a strange situation. We have come to adore doctors as frontline warriors who put their lives on the line to save others, but we loathe hospitals. This is especially true for corporate hospitals, now perceived by many as businesses that are only interested in the cash flow.
Although government hospitals have redeemed themselves to some extent in this pandemic by taking on most of the burden of care, they are still hamstrung by the lack of investment in basic facilities and staff. In one government hospital in Hyderabad, for instance, nurses used cut tree branches to hang intravenous bottles because there weren’t enough IV poles around. Issues like these are largely responsible for many in the middle classes staying away from government hospitals.

But it is the perception of the corporate hospital that has taken a beating. They are seen as institutions where your chances of surviving a virus attack are directly proportionate to the size of your bank balance. Many of them are charging anywhere between Rs 80,000 and Rs 1.2 lakh per day for Covid-19 treatment. Even in states where prices have been capped, some hospitals are simply flouting it as there is no enforcement.

One can, of course, argue that when you call a hospital ‘corporate’, you are presupposing that it is a business, and a good business will always look after the interests of its shareholders. Which means that if, in a worldwide pandemic, demand for hospital beds skyrockets, the hospital is doing nothing immoral in providing beds to only those who can afford to pay for them. Because hospital care is a service and nothing more. The customer comes to you, you quote a price and if the customer has the resources, a deal is struck. If not, the customer moves on to the next service provider. This is the classic free market argument.

Besides, it was well-known even before the pandemic struck that beds in corporate hospitals came with a hefty price tag. Nothing has changed since the pandemic, and it could be argued, therefore, that there is no reason to boil over with rage when you see a bloated bill.

But perhaps it is time to bring in changes given that we are facing a global medical emergency over which one has no control. It is not as if you spent a lifetime smoking, contracted lung cancer, asked a hospital to save your life and then accused it of profiteering when you saw the bill. In a pandemic like Covid-19, people are dying simply because they had a casual conversation with a colleague, or a taxi driver refused to wear a mask, or a stranger in a grocery store sneezed.

There are just too many people who are vulnerable for the pandemic to be treated as just another day at the hospital. It is unfair to create a situation where the nearest healthcare facility for a person infected with Covid-19 is a corporate hospital, but if he or she chooses to go there, there is a chance of going bankrupt or worse, into debt. No one should be made to choose between possible death and seeing his or her life’s savings vanish in days.

Also, the free market argument collapses because the virus attack has skewed the market in favour of the supplier.

Former attorney general of Florida, Charlie Crist, had defended new price gouging laws enacted in 2004 immediately after a hurricane caused widespread damage by saying this: “This is not the normal free market situation where willing buyers freely elect to enter into a marketplace and meet willing sellers, where the price is agreed upon based on supply and demand. In an emergency, buyers under duress have no freedom. Their purchases of necessities like safe lodging are forced.”

These words, written in a local Florida newspaper 16 years ago, ring true in India amid the Covid-19 crisis. And for the record, Crist was a Republican who, in normal circumstances, would have sworn by the free market.

This is of course not to say that we should completely give up on the free market. There is no doubt that it is still one of the best ways to organise production and distribution.

But we need to ask ourselves what kind of society we want to build in the future. Do we want to build a society where we value human life only in terms of bank balance? Should market forces of demand and supply drive all aspects of our lives or are there certain aspects where one needs to draw a line?

For instance, no one grudges a businessman’s capacity to buy a car worth lakhs of rupees when many people have to think twice before taking a cab ride. But it is a completely different story if the businessman has a better chance at surviving the pandemic because he has financial resources.
It is wrong to create a situation where a pandemic hits everyone, but some have a better chance at surviving it.

DISCLAIMER : Views expressed above are the author's own.