Dialysis rate hike in Pune could cut sessions by nearly one-third

Activists claim the civic body ignored a panel’s recommendations and approved higher rates through a second committee. Representation Pic/istock

The Pune Municipal Corporation (PMC) health department is facing criticism for recommending a hike in dialysis treatment rates under its Urban Poor Medical Assistance Scheme. However, PMC health officials have denied claims of any misunderstanding among citizen activists. Citizen activists argue that the proposed hike could place an additional burden on the civic health budget and result in significant out-of-pocket expenses for economically weaker patients.

Vivek Velankar, president of Sajag Nagrik Manch, has issued a detailed notice to the PMC Municipal Commissioner. In it, he alleges that the newly appointed committee disregarded the recommendations of a previous expert panel and arbitrarily increased the per-session dialysis rate. He has demanded an immediate rollback of the revised rates.

PMC operates two key health schemes: the Urban Poor Medical Assistance Scheme and the Contributory Medical Aid Scheme, which cater to current and retired staff, corporators, and residents of slums and low-income areas. Dialysis services are offered through eight civic centres run in partnership with private entities, as well as 37 empanelled private hospitals.

Dialysis rates, however, vary significantly among these centres. While hospitals such as Ruby Hall, Poona Hospital, and Krishna Hospital charge around Rs 1350 per session, others like Ratna Hospital demand up to Rs 2900. PMC reimburses hospitals based on their individual rates, leading to inconsistencies in expenditure and inequities in service delivery.

To resolve the issue, PMC's health department, with approval from the then additional commissioner, formed an expert committee on January 19, 2024, to rationalise dialysis charges. The committee, which included senior experts and a Government of India advisor, submitted its report on March 13. It recommended a maximum rate of R1130 at PMC-private centres and Rs 1350 at empanelled hospitals, inclusive of all consumables, ensuring quality and financial sustainability.

PMC Assistant Health Officer Dr Sanjeev Wagare said, "I suggest that activists study the recommendations properly. Earlier, dialysis was charged at R1350, with additional fees for the dialyser, tubing, and necessary injections. The committee proposed a uniform rate of R1950 that includes all these charges. The committee also included officials from Sassoon Hospital and private hospitals."

Velankar, however, criticised the PMC for what he described as a "shocking U-turn." He said, "Despite having a comprehensive expert report, PMC's health department constituted a second committee on November 22, 2024 - eight months later. This new committee ignored the previous findings and proposed a steep hike, setting the dialysis rate at Rs 1950, nearly 50 per cent more than what was earlier recommended."

He further pointed out that many major hospitals, including Ruby Hall and Poona Hospital, continue to charge Rs 1350 per session, questioning the need for any increase. "The new rate seems designed to benefit a few private hospitals that charge higher fees. It's a misuse of public funds and a blow to poor patients," he said.

Under the existing scheme, PMC allocates upzx to R2 lakh annually per patient for dialysis. At the earlier rate of Rs 1350, a patient could undergo around 148 sessions a year. With the new rate of Rs 1950, the same budget would only cover approximately 102 sessions - a reduction of 46 sessions annually.

Once the Rs 2 lakh cap is exhausted, patients would have to bear the remaining costs themselves. For low-income families, this could result in treatment discontinuation or severe financial distress. "The financial burden of these inflated rates will ultimately be borne by taxpayers and the civic health budget," Velankar added.

Sajag Nagrik Manch has urged the PMC commissioner to reject the second committee's recommendations, citing the economic harm it would cause. They called for the immediate adoption of the first committee's rational, data-backed proposals, asserting that the revised rates are unnecessary, unjust, and harmful to both the civic body and the urban poor.