COVID-19 an infectious deadly disease which originated in China in 2019 has claimed many lives so far and even after a year it has not stopped its pace, it is still intensifying. It has brought distress to the entire world whether it's related to finance, health or some other serious issue. Healthcare personnel around the world are utilising their full potential to help the people get out of this pandemic.

Every major workforce has been affected by the pandemic. The gravity of the situation is intensifying. The beggars, street vendors are the worst affected. The only reason is the 'lack of money'. They are short of money and hence could not fulfill their necessities and in such a case, they can't think of spending a huge amount on treatment, if required. The rise in the cost of COVID treatment is compromising with the life of an individual. This article focuses on the cost of COVID treatment, the black marketing, conduct of private hospitals, comprising with the right to life and a large-scale effort put by NGOs to provide health essentials.

Cost of covid-19 treatment
Important resources for COVID treatment are Personal Protective Equipment (PPE kits), Ventilators, beds for the patient, COVID treatment centers, medicines, oxygen cylinders. But most of these resources are not available at fair value. Prices have gone through the roof. It has become difficult for a common man to afford all these resources. Losing jobs has already created a mental trauma for some and the high prices of these resources are taking a breath of people. These high prices are compromising people's life. Everyone wants to get rid of this pandemic, either because they are locked inside their homes and restricted to do their favourite leisure or because of the reason that they can't afford the cost of treatment of Corona, if required and failure to provide treatment may end the life of an individual.

In the starting months of COVID, its unpredictable nature had urged India to import PPE kits, ventilators and N-95 Masks. The cost of imported health infrastructure was high. The average cost of imported ventilators was 15 lakh which was later reduced to 2-10 lakh under 'Make in India' Similarly, the stock of PPE kits has grown from 2 lakh in the initial months of COVID to more than 89 lakh at present. And so the average cost of PPE kits has substantially come down from Rs.600 to about Rs.200 per kit. Besides Ventilators and PPE kits, the rates of N-95 Masks were also lowered under 'Make in India' initiative. The average rates have dropped from about Rs.40 to Rs.12 per mask.[1]

Treatment in private hospitals is a big deal for a common man. Everyone wants to avail good services. But at such a time increasing the prices is compromising with one's right to life. Such services should be provided at a fair price.

Starting with the first step i.e., Covid test (RT-PCR), the charges were too high from Rs 2400-4500 in the starting months which is not affordable to every class. However, the government of various states has slashed the rate of RTPCR test now for private labs. Rs 800 on average has been decided by all the states for the RT-PCR test.
Costs of RT-PCR tests in several states across India [2]:
            
State Submission of samples at Centres Swab Collection From Home
Maharashtra 600 800
Delhi 800 1200
UP 700 900
Gujarat 700 900
 
After a patient is tested positive and enters a hospital, the charges start with the room, even though the rent depends upon the classification of the hospital, still the cheapest room would cost around 1000-1500 a day.

The treatment for isolation beds is currently priced between ₹8,000 and ₹10,000. For ICU units without ventilators, the charges are fixed between ₹13,000 and ₹15,000. For ICU with ventilators, a bed costs between ₹15,000 and ₹18,000. All charges include PPE costs.[3] The price of oxygen concentrators ranges from Rs 40,000 to Rs 2,00,000. However, the normal oxygen cylinders are priced from Rs 8,000 to Rs 9,000.[4] Apart from this, the cost of the medicines which vary from person to person has also to be born by the patients besides the food expense. And finally, the treatment of COVID patient round up to 8 lakhs -10 lakhs, a huge amount for a common man.

Through the vaccination, India is heading towards a normal life. The cost of vaccine brings again the question. The government has capped the price for COVID vaccination centres so that they do not exceed the ceiling. The Covishield is charged at ₹780, Covaxin at ₹1,410, and Sputnik V at ₹1,145 in private hospitals.

These are the rates decided by the government but other than these high rates the patients are getting overcharged due to black marketing. The flourishing black market is fleecing helpless people. The people had to spend double or triple the amount than the original price for getting medicines and oxygen cylinder. The people had to drive around for a long time to get the required medical infrastructure just because it is unavailable in the hospital due to a surge in black marketing of medical infrastructure.

The people have to turn to black market to save the life of their family members. The antiviral drug remdesivir which is widely used to treat patients with severe symptoms in India is available at Rs 43000, the normal price of which is between Rs 1000-5400 for 100 milligram vial of drug.

Not only this the fleecing continues even at the time of cremations. Rs 15000-20000 are to be paid for cremation in some places. And if the families couldn't pay the high cremation fees, the dead bodies are dumped into the rivers. The Municipal corporation of Gurugram has taken a step in this regard and fixed a rate of ₹5,500 for cremating bodies.

Right to life
Nothing can be worse than compromising with life and in the current scenario, it seems that the cost of life is less than the cost of treatment. Health is a necessary condition while wealth is sufficient condition and the necessary condition is the most important. Article 21 which is a Fundamental Right is enshrined in the constitution gives the right to life. Right to life has a broader meaning.

Life is not confined to only mere existence but the basic elements which are important for existence. In this pandemic, the resources of treatment of COVID have become basic elements for individuals suffering from COVID. Working seems impossible without good health. And at this point of time, a COVID patient has to pay lakhs of amount for his health. A nation can't be saved by increasing the cost of health essentials.

People are scrambling for beds, ventilators and oxygen cylinders. In this crucial time of help the lack of proper medical facilities is amounting to passive euthanasia. Passive euthanasia is bringing about the death of an individual by omission of an act. And the passive euthanasia can be witnessed in the current situation, where the shortage of medical oxygen, which is vital for the survival of critical covid patient has taken many lives.

No person can take away the life of any individual. Creating an artificial shortage of medical infrastructure and selling the products at exorbitant rates is crossing all the limits of evilness. The only option that remains with the poor is to see their loved ones die as they can't spend lakhs of rupees on the treatment. The government of some states like Maharashtra and Haryana have asked to charge the insured patients according to their insurance policy. However, all the patients do not have insurance policy and uninsured patients would be suffering.

Right to life is the first fundamental right which a person enjoys by his birth. And an aggrieved person can claim compensation for violation of his fundamental right. Here the aggrieved person is the one who could not get timely treatment due to whatsoever reason. An aggrieved person or his family member (as the case may be) can approach the respective High Court under Article 226 and could claim monetary compensation from the respective government authority for the loss of life of a family member due to the shortage of oxygen, or due to failure of medical infrastructure.

 Supreme Court has given various judgement regarding right to life wherein it has been ensured that the patient is treated with full care. Supreme Court in the case 'Occupational Health and Safety Association Vs. Union of India held that the government hospital is duty-bound to provide timely medical treatment to the patient in need of such treatment at that particular time.

Also, the Supreme Court in Pt.Permanand Katara vs Union of India held that if the government hospital does not provide timely help to the patient in need of such treatment then it would amount to violation of right to life.

The Division Bench of the High Court of Bombay in a PIL titled 'Pratibha Shinde vs Principal Secretary' observed that it is the primary duty of the government to secure the welfare of the people in a welfare state and it is an obligation on the part of government to provide adequate medical facilities to the people in a welfare state. The preservation of human life is of paramount importance. The government has the duty to provide timely care to the patients in serious conditions as medical facilities and treatment cannot circumvent at any cost.

Considering the financial pressure on people, the government of few states have paid the bills of patients of government hospitals whom they have referred to private hospitals.
In India private hospitals are more in number as compared to government hospitals. But still few people prefer government hospitals because they can't afford to pay an exorbitant cost in private hospitals. Government hospitals are economically feasible as compared to private hospitals. But in recent times many have shifted to private hospitals. The only reason behind this is facilities, the pandemic has highlighted the lacunae in government hospitals.

The limited healthcare facilities, the shortage of specialised staff. The inadequate facilities and high cost, both of these are restricting patients from getting a healthy life. It needs to be ensured that the cost of treatment is kept low. However, the people of all strata cannot bear the cost of private hospitals. Keeping in mind the cost of treatment in private hospitals, the government capped the treatment prices to prevent patients from harassment. The government must come up with different policies for different strata wherein the poor must be treated free of cost. And for the middle and rich class, a reasonable cost should be implemented on all medical infrastructure from the covid test to the cremation.

Insurance under private hospitals
Hospitals are full of COVID patients, private hospitals which are unable to undertake regular surgeries due to COVID patients are experiencing financial pressure. Also, the insurance companies have declined to pay higher charges.

The private hospitals want to increase the rate of COVID test and the treatment as they are facing financial pressure. However, they are not allowed to do so since the government has capped the price. Some of the private hospitals, to tackle the issue of financial crisis have asked the patients to settle the bill in cash which means the insurance will not be accepted. Since the money through insurance cover will be less, the cash payment would help in betterment of the current condition of private hospitals.

The government need to look into this as people pay 18% tax on insurance policies, the most important policy of life, the health insurance policy at this crucial time is been rejected by private hospitals and is a very serious issue to be considered.

NGOs working for covid-19 relief
Out of pocket cost are preventing people from seeking care and so recognizing the need of hour a large-scale effort has been put by various NGOs for the COVID-19 relief by making all the possible help they could offer.

• On one hand where black marketing of medical infrastructure is at peak, the Sakina Foundation active in Telangana and different parts of India is providing covid relief measures by accepting donations in the form of oxygen cylinders, Remdesivir injections, covid medicines, masks, sanitizers, gloves, PPE, grocery.
   
• Chikka Foundation active in Delhi and Bihar is supplying ration, masks, soaps and providing meals to some daily wage workers and domestic help who have been rendered jobless in the current situation.
   
• HelpNow an NGO active in Delhi, Pune, Mumbai and Bangalore has the largest network of private ambulance. HelpNow provides a safe, 24x7 logistics network for transporting COVID patients, Drugs, Phlebotomists and healthcare workers.
   
• Pandemic which has cornered women from red-light areas and transgenders, certain NGOs are helping them in the humanitarian crisis. Apne aap women worldwide initiative, is providing meals, medicines, vaccinations, and safe housing for women and children living in red-light areas. And ParivarBayArea is supporting transgenders, who have been impacted by the second wave of COVID-19.

Apart from NGOs, Co-living space provider Zolostays, a startup has started an initiative where they would be creating bio-bubble facilities for people who are not comfortable about their safety in current environment. They are also assisting COVID patients to match plasma donors with patients.

Conclusion
The outbreak of the pandemic is playing with the lives of many. In the beginning, many might have considered that money won't be a constraint in a fight against the pandemic. But the scene is completely different. Some of the patients have stated that they could defeat corona but not the hospital bill.

The welfare of people lies in the hands of the legislature and the problem of black marketing has to be tackled with heavy hands. The government must establish an independent body which would ensure that the private labs strictly follow the capped price set by the government. The services shall be made available in a particular time frame.

The world is experiencing financial pressure, even though private businesses are profit-oriented but on moral grounds, treatment should be provided at a fair price. Laws guarantee Fundamental Rights to every citizen of the country. But in this crucial time, right to life is compromised. Everyone is looking forward to a time where the world would be Corona free but the hard truth is that it would last longer than expected.

References:

1. How the Domestic Medical Equipment Industry “Adapted, Evolved and Expanded” to meet COVID19 challenge in 2020
2. RT-PCR Covid Test Cost: State-Wise Prices At Private Labs, Govt Facilities
3. Private hospitals seek revision in prices of covid tests, treatment – PPE kits
4. Price of oxygen concentrator