儘管設置了治療費用上限，新冠仍使80%的印度患者家庭陷入困境_風聞

capped Covid treatment charges. Yet, more than 80% of families would be financially crippled by a single member undergoing Covid treatment. That’s because even at the capped charges, bills for even ten days of treatment work out to several times their monthly expenditure, an analysis of the charges and official data on monthly expenditures shows.

新德里：由於新冠治療的高昂費用引發的憤怒日益加劇，大多數邦都對新冠治療費用設定了上限。然而，超過80%的家庭會因為一名成員接受新冠治療而陷入經濟困境。一項收費分析和月度支出的官方數據顯示，按照上限收費，十天的治療費用將是每月支出的好幾倍。

For instance, according to the latest household expenditure report of 2017-18 put out by the National Statistical Office, in Delhi, which has among the highest monthly per capita expenditures in the country, for 80% of the population monthly spend per person is below Rs 5,000 or Rs 25,000 for a family of five. The lowest priced isolation bed in a non-accredited hospital in the Capital would cost Rs 80,000 for ten days of treatment, more than three times the monthly spending of 80% of the population. For a patient with severe Covid in ICU care with ventilator support, the bill could be several lakh as the treatment could stretch for two to three weeks or more.

例如,根據國家統計辦公室公佈的最新的2017-2018家庭支出報告,在德里（印度月人均支出最高的城市之一），80%的人口人均每月花5000，五口之家不超過25000盧比。德里非認證醫院的最低價格隔離牀，10天的治療費用為8萬盧比，是80%五口之家每月費用的三倍多。對於在重症監護室接受呼吸機治療的重症新冠患者來説，由於治療時間可能會延長兩到三週甚至更長，費用可能會達到數十萬盧比。

TOI put together the capped prices for isolation beds, ICU beds without ventilator and those with ventilator in 20 states and compared the cost of ten days’ treatment with the latest report on monthly per capita expenditure in each state. It shows that even with price caps, the treatment is unaffordable for 80% of the population. In all states, the treatment is free of cost in go nment hospitals. However, even in non-Covid times, the go nment share of inpatients in the country is at best about 42%. With reports of poor conditions in go nments hospitals running to full capacity and wide publicity regarding bureaucrats and politicians choosing private hospitals for Covid treatment, there was a greater clamour for beds in private hospitals.

《印度時報》彙總了20個邦的隔離病牀、沒有呼吸機的ICU病牀和有呼吸機的病牀的上限價格，並將10天的治療費用與每個邦月度人均支出的最新報告進行了比較。結果顯示，即使設置了價格上限，80%的人口也負擔不起治療費用。在這些邦，在公立醫院，治療都是免費的。然而，即使在非疫情時代，住院病人的報銷比例最多也只有42%左右。有報道説，公立醫院的條件很差，已經滿負荷運轉，官*員和政客選擇私立醫院接受新冠治療的情況得到廣泛宣傳，因此，對私立醫院牀位的需求越來越高。

In many states like Gujarat, West Bengal and Kerala, the fixed rates are for patients referred by the go nment or for those covered by go nment health schemes, where the go nment picks up the tab. Typically, only people with connections get referred through the go nment to private hospitals, while others do not have a choice. In states like Karnataka, Odisha and Telangana, the price caps are applicable to all patients going to private hospitals. Despite the price caps, there are exclusions which differ from state to state, such as PPE cost, high-end investigations like CT and MRI, drugs, or specialist charges. Private hospitals have also come up with ways to evade price cap such as charging rack rates for the days before a person is confirmed as Covid positive and doing the same for the days after the person tests negative but remains admitted for post-Covid complications. In many states like Delhi, there is no mechanism to ensure implementation of the caps despite a large number of complaints of overcharging.

在古吉拉特邦、西孟加拉邦和喀拉拉邦等許多邦，固定費率適用於公立醫院轉診的病人或可享受政府醫療計劃的人，費用由政府承擔。一般來説，只有有關係的人才會從公立醫院轉到私立醫院，而其他人沒有選擇。在卡納塔克邦、奧里薩邦和泰倫加納邦，價格上限適用於所有去私立醫院就醫的病人。儘管有價格上限，但各邦的例外情況有所不同，比如防護裝備成本、CT和MRI等高端檢查、藥物或專家收費。私立醫院也想出了規避價格上限的方法，比如對確診陽性的病人收取高額費用，對確診為陰性但仍因新冠併發症入院的病人收取高額費用。在許多邦，比如德里，儘管存在大量收費過高的投訴，卻沒有機制來確保實施收費上限。

One of the UN’s sustainable development goals is to prevent “catastrophic spending” on health, which can impoverish families. If the share of health expenditure in the total annual household expenditure is more than 10% to 25%, it is considered catastrophic. In all states, just treatment for moderate Covid in isolation beds for 10 days with the capped rates is well above the 25% threshold for 80% of households. While in states like Delhi, Kerala and Punjab with high household monthly expenditure, ICU treatment for severe Covid could be 50%-80% of annual household spend, in most other states it could be equivalent to an entire year’s household expenditure, or even double what a family would spend in two years.

聯合國可持續發展目標之一是防止醫療保健方面的“災難性支出”，這可能使家庭陷入貧困。如果醫療支出在家庭年度支出總額中所佔比例超過10%-25%，就被認為是災難性的。在所有邦，只對中度新冠患者進行10天的隔離治療，按照上限收費也遠遠高於80%家庭25%的月度支出。在德里、喀拉拉邦和旁遮普邦等家庭月支出較高的邦，重症新冠患者的ICU治療費用可能佔家庭全年支出的50%-80%，而在其他大多數邦，這可能相當於家庭全年支出，甚至是家庭兩年支出的兩倍。

譯文來源：三泰虎 http://www.santaihu.com/p/51037.html 譯者：Jessica.Wu