Consultation fee hike causing dismay among the patients

In recent months, some of the consultants and specialists in Myanmar increase their consultation fees in the private hospitals in Myanmar. This causes some dismay among their patients who find it more and more difficult to find money to pay for the increasing health care cost.

Last year, in tandem with the increase in general consumer prices, consultation fees of doctors, consultants and specialist also increased. Although some of the prices of commodities and food already fall down a little, the consultation fee remain high. “When I go and see doctor, I have to pay about 4,000 kyat (US$ 4). This is just for simple illness like common cold. I earn only 2,000 kyat (US$ 2) a day. The fee is too much for me. But I have no choice. If I don’t go and see doctor, I cannot go to work. If I don’t have money, I have to borrow from somebody. Now the other prices are falling. Doctors should also reduce the consultation fee a bit,” said one of the female workers who work in a factory from Hlaingtharyar Township, Yangon.

“I have to see the consultant regularly. In private clinics, the specialists charge around 5,500 kyat to 7,000 kyat per consultation (US$ 5.50 to US$ 7). In the past, when the consultation fees are not as high as now, this is not a problem. However, now the fee is very high, and it is becoming a burden for somebody like me who has t see the specialist regularly. With investigation and drug cost, I have to pay around 40,000 kyat (US$ 40) per visit to a doctor. I have to go to the clinic every two weeks. If the doctors could reduce the fee a little, it will be very good. If the fee is lower, the health care for the basic class citizens will be better,” said U Sein Win who is working in a private company in Yangon.

According to some experts, the reason for increase consultation fees is mainly due to increase in the population as well as increase in the percentage of sick people, which is higher than increase in the number of doctors and specialists. Due to the hiking health care cost, a few of the private companies are starting to set up health care fund for their employees.

According to Dr. Maung Maung Lay, the consultation fee of doctors and specialists in Myanmar is much lower compared to neighboring countries. He continued “However, even at this fee, most patients cannot afford a visit. The income of the general population is also quite low compared to the neighboring countries. If the doctors and specialists could reduce the fee, it will have a great benefit to the general population.”

Some of the rich people go to neighboring countries like Thailand and Singapore for diseases that can be treated in Myanmar. They have to pay higher prices than in Myanmar. The reason, they say, is because they do not get enough attention from specialists in Myanmar. “For such kind of patients, the specialists should pay more attention and time. They should also be charged more than the ordinary patients. For such kind of patients, even consultation fee ten times higher is not a problem. By giving more time and attention and charging them much more for these rich patients, the specialists could provide health care to general population at a much lower fees”, suggest one business man from Yangon.

In some private clinics, some specialists order investigations and prescribe medicine unnecessarily to patients. They also get paid commission for ordering X-rays, ultrasound, CT scan, MRI or any lab investigations. “The specialists should avoid ordering unnecessary investigations and prescribing medicine unnecessarily. Getting commission from investigations is also unethical”, said one doctor turned journalist from Yangon.

Private clinics and hospitals should also avoid charging excessive fees to their customers, according to experts. Dr. Kyaw Oo, who is working at Mandalay General Hospital, said “At this time, due to higher cost of health care, more and more people could not afford to see doctor when they get ill. It is more and more difficult for patient who cannot afford the doctor fees. Every doctor should charge only the reasonable fee to their patients depending on the patient’s financial condition.”

However, there are also some doctors and specialists who don’t charge excessive fees from poor patients. Some even provide free consultation to poor patients, and donating medicine to these poor patients. Dr. Khin Marlar, who charge only 300 to 500 kyat per patient (only US$ 0.30 to 0.50) for both consultation and medicine, said “The reason I open this clinic is for those poor people who could not afford to pay the high doctor fee. By charging only small fee, they could afford to see the doctor. This is better than just going to the pharmacy and asks for the medicine. There should be more clinics that charge low fees to the poor patients. Doctors should think for the patients. I have been opening the clinic for more than 20 years already. Some of the patients even come from very far away townships to my clinic. I do not charge for consultation. Consultation is free here. I add only very little profit to the medicine just to cover the cost of the clinic. I tried my best to help the patients. If I could not cure, I will refer to the specialists.”

In recent years, there also appear some clinics that provide free health care to the poor patients. However, these are very few.

The charges from private clinics are higher every year. Compared to 2007, the fee charge by private clinics and private hospitals in Myanmar is higher 15 to 20 per cent in 2008.

One doctor turned journalist said “Ordinary consultation fee is increased from 3,000 to 5,000 kyat. For special consultation fee, some specialists charge more than 10,000 kyat. This is nonsense. This special fee is now increased to 30,000 kyat. For rich people, 30,000 kyat is nothing. But for ordinary people, 3,000 to 5,000 kyat price hike is too much. Most ordinary people cannot afford this money.”

“To reduce consultation fee is not possible if only one or two doctors do it. If all doctors lower the consultation fee, it is possible. We also do our best to help people. However, only one sector cannot do anything much”, defended one specialist from Yangon.

One of the patients said private clinics and hospitals should also avoid unnecessary investigations and treatment while at the same time reducing the cost of medical treatment. “Last week, my elder brother had fits. We brought him to one of the private specialist clinics. They gave him a tranquilizer and medicine for two days. They asked him whether he wanted to be admitted to the hospital. When he said no, they charged us 60,000 kyat for a few hours’ stay in the hospital”, said one resident of Yangon.

At the time when everything is expensive and money is difficult to earn, most patients in Myanmar think raising specialist consultation fees is not appropriate, and private clinics and hospitals should do their best to reduce cost of treatment for the patients.

Source: Weekly Eleven News Journal

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