KPME: The Law that Paralyzed Karnataka

By the Editor: Siddharth Sehgal

There are lot of things of gravity and importance that are going on in the country right now, at least more important than the movie Padmavati. KPME or Karnataka Private Medical Establishments (KPME) Act is one such piece of legislation of the state government that has effectively paralyzed the medical services in Karnataka. The latest development is that representative of doctors such as IMA are holding talks with the government which resulted in removal of certain harsh measures but much of what constitutes this bill remains unacceptable to the doctors. The KPME bill is designed after west Bengal where there is no such thing as private practice, the party has the say in everything but that doesn’t mean the health system is top notch in the country.

For those who are not familiar with KPME, it’s a law that requires all private practitioners from big hospitals to small dispensaries that operate in our neighborhoods to register with the state government and operate under a rate chart that will be decided by the authorities. The government will act as a watchdog against all the wrongdoings and will make payments of bills in case a patient is unable to pay. Now the government and lots of left wing media outlets says this bill is introduced for the safeguard of patients and their rights but knowingly or unknowingly they are denting the medical care in Karnataka. If a doctor or a hospital says no to releasing a dead body just because the relatives doesn’t have the money to pay the bill, that is a humanitarian concern and authorities have to make sure such individuals or institutions are held accountable but I don’t think all or even majority of the private practitioners in Karnataka are acting in such inhumane way. The situation is fluid and we’d have to see which way this fight goes but given the resistance from doctors, I don’t think government will have its way.

Now coming to what’s wrong with KPME, I’d say a lot. First, you might be thinking all hospitals will be covered under this law in Karnataka, wrong. Government hospitals and doctors don’t fall under this amendment. It does not apply equally to everyone, so if a government doctor or hospital fall shorts of its duties KPME does not cover it and if 60-70 percent of patients in Karnataka goes to a private practitioner for their health concerns, what does that tell you? Meaning, despite being dirt cheap or free of cost, people don’t want to go to a government hospital. Second, the rate card, the cost of operating a clinic is different in different areas. In a rural setting it might be a little less and in urban may be a little more. Now it could be that Mr. Siddaramaiah does not know this but private practitioners also have to pay salaries to their staff, they also have dues like rent, water, electricity bills etc. Such operating costs may not be feasible under a government rate card. Government hospitals despite their pitfalls are backed by the government and taxpayers money which is why they don’t have to worry more or less about these things; this is a huge flaw of this act.

Third, the government will clear the bills submitted by private institutions, in case a patient is poor, doctor will submit a bill of payment to the government body that will be administering KPME and get a payment BUT those who are familiar with government’s modulus operandi in any sphere knows how slow and excruciating this process can be. Given the volumes that will come in, the clearing time may run in months or even a year and mind you government can withhold or recover an amount if they don’t agree with the bill. Fourth, if the medical practice becomes unfeasible for private players or if a medical grad or a doctor thinks he is underpaid, they might decide to leave the state. Has the government seen this possibility? Fifth, if Karnataka had been an epitome of transparency and good governance than it wouldn’t have been a problem but given the corruption in the ranks of its officials right from the very top to the very bottom, who is to say this act will not be turned into an extortion ring. If a corrupt babu can threaten to cancel the registration of a small time doctor or impose an unfair penalty on him if he doesn’t pay up than what happens? Who will do the justice? Sixth, the burden on taxpayers, the costs of KPME will be ultimately bore by the taxpayers, the money has to come from somewhere and it will comedown to the public to open their wallets, the cost of KPME may shoot up the cost of living and make the medical costs to the government more expensive than they are now.

These are just few points; there are many more reasons why KPME should not be forced on the doctors. The protesting doctors and medical personnel in Karnataka are right in their demands. Congress government should strive to improve government facilities and not regulate the doctors, nurses and people in the medical field who are rightfully dispensing their duties. Taking away the bread and butter of doctors in Karnataka will not fix the health system.

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