尽管设置了治疗费用上限，新冠仍使80%的印度患者家庭陷入困境

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：由于新冠治疗的高昂费用引发的愤怒日益加剧，大多数邦都对新冠治疗费用设定了上限。然而，超过80%的家庭会因为一名成员接受新冠治疗而陷入经济困境。一项收费分析和月度支出的官方数据显示，按照上限收费，十天的治疗费用将是每月支出的好几倍。

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,根据国家统计办公室公布的最新的2017-2018家庭支出报告,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5000，五口之家不超过25000卢比。德里非认证医院的最低价格隔离床，10天的治疗费用为8万卢比，是80%五口之家每月费用的三倍多。对于在重症监护室接受呼吸机治疗的重症新冠患者来说，由于治疗时间可能会延长两到三周甚至更长，费用可能会达到数十万卢比。

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.

《印度时报》汇总了20个邦的隔离病床、没有呼吸机的ICU病床和有呼吸机的病床的上限价格，并将10天的治疗费用与每个邦月度人均支出的最新报告进行了比较。结果显示，即使设置了价格上限，80%的人口也负担不起治疗费用。在这些邦，在公立医院，治疗都是免费的。然而，即使在非疫情时代，住院病人的报销比例最多也只有42%左右。有报道说，公立医院的条件很差，已经满负荷运转，官*员和政客选择私立医院接受新冠治疗的情况得到广泛宣传，因此，对私立医院床位的需求越来越高。

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许多邦，固定费率适用于公立医院转诊的病人或可享受政府医疗计划的人，费用由政府承担。一般来说，只有有关系的人才会从公立医院转到私立医院，而其他人没有选择。在卡纳塔克邦、奥里萨邦和泰伦加纳邦，价格上限适用于所有去私立医院就医的病人。尽管有价格上限，但各邦的例外情况有所不同，比如防护装备成本、CT和MRI等高端检查、药物或专家收费。私立医院也想出了规避价格上限的方法，比如对确诊阳性的病人收取高额费用，对确诊为阴性但仍因新冠并发症入院的病人收取高额费用。在许多邦，比如德里，尽管存在大量收费过高的投诉，却没有机制来确保实施收费上限。

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.

联合国可持续发展目标之一是防止医疗保健方面的“灾难性支出”，这可能使家庭陷入贫困。如果医疗支出在家庭年度支出总额中所占比例超过10%-25%，就被认为是灾难性的。在所有邦，只对中度新冠患者进行10天的隔离治疗，按照上限收费也远远高于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较高的邦，重症新冠患者的ICU治疗费用可能占家庭全年支出的50%-80%，而在其他大多数邦，这可能相当于家庭全年支出，甚至是家庭两年支出的两倍。

译文来源：三泰虎 http://www.santaihu.com/p/51037.html 译者：Jessica.Wu