New Order

---

A doctor takes a swab sample, The Test of a stay in a Covid-19 coronavirus-drive inside the Dharavi slums

Thyrocare, a private diagnostic laboratories in India, had just begun the audit for Covid-19, when the Supreme court ordered that all tests Are performed free of charge.

"We thought The Order would say, the rich would pay, and the government would pay for the poor," says Arokiaswamy Velumani, Thyrocare founder.

At 4500 rupees ($59; £47), it's not a cheap test. But The Court did not clarify whether and how the private laboratories would be reimbursed. Panic stricken,

A concerned Federal government asked to reconsider, The Court - which she did.

According to the New Order , issued on 13. April, the government reimburses private laboratories for testing of 500 million people, covered by a flagship of the public Health Insurance . The rest would pay.

But the volte-face not triggered a bigger question: can India scale-up Tests for Covid-19, if it is free?

A high Price -tag

India's pay - 15,712 active cases and 507 deaths Are relatively low for a country of 1. 3 billion, Many believe that this is because it still had Tests to Little - as of Sunday, it 3,86,791.

But the up-scaling is a challenge. The Indian Council of Medical Research (ICMR) has approved only a self-prepared Test kit, So Far , the imports was delayed, because a global increase in demand and the protection of equipment and medical staff necessary to perform tests Are scarce. Also, The Sheer size of The Indian population, and the resources needed to reach every corner of the country, is a real challenge.

All of the testing has to be expensive. It is free of charge in government hospitals and laboratories, and for months they were the only ones allowed to test for coronavirus. But soon private players had been clamped, in order to support India's under-funded and struggling health.

the government of The Price for a test at 4,500 rupees to home, or 3,500 rupees in a hospital, capped, on the basis of the recommendations of a Commission of experts.

But the figure says Malini Aisola, of the All India Drug Action Network, a watchdog a health care system that is "arbitrary". When he calculated the cost, it worked out to about 700 rupees.

"If the Private Sector was part of The Process of decision-making on the cost, the government should Aisola the release of collapse", argues Ms.

owners say the private lab, it is a fair Price . "The supply chains Are clogged - all of the work on advance payments," said Zoya Brar, founder and CEO of Core diagnostics.

she says that the basic-RT-PCR-kit - widely used to diagnosis of HIV and Influenza cost around 1,200 rupees. And this is supplemented with a extraction kit, to pull DNA and RNA, another type of genetic code, from the sample.

“This is scarce and when it is available, we can get it for around 1,000 rupees, which is a blessing. "And Then , she adds, there Are the overhead costs - Personal protective equipment (PPE) for employees; employees; and the costs of operating The Lab as a whole.

Thyrocare Dr Velumani says he is also paying higher salaries than usual, as staff Are put under pressure to stop working, by their Families , the fear, you can a virus is a contract.

The case for a free Test

now, the Indians Are always checked on, only when a doctor advises you to do so. But the long wait at the state hospitals, and the cost in the private those who show symptoms could deter even up.

"If you want to have a pandemic, you can't test determined by the cost," says Jayati Ghosh , an Economics professor at the Delhi and Jawaharlal Nehru University.

And make it only for the poorest Indians do not help, either, according to some economists.

"There is a large proportion of people just above the poverty line, to fight the also and there Are middle-class workers who have been fired and can't afford to pay for their Families to have tested," says Vivek Dehejia, an economist.

even more important, is the asymptomatic nature of The Virus in many people that India may soon have no choice But to start test mass.

"If you really want to push-up-Tests-rates in the whole country, you can not expect that everyone says to pay out of pocket for themselves and their Families , particularly if they do not show any symptoms," Mr Dehejia.

Singapore and South Korea have both been praised for their aggressive test, which will be financed by the government. Vietnam, perhaps more comparable with India, focuses more on the Isolation of infected people, But the government is still footing The Bill for the exam.

"you can't contain The Virus unless you know who you Are ," said Prof Ghosh. “It is therefore in your interest to ensure that there is universal access [to The Test ]. "

Who should pay?

Economists, spoke with The Bbc a number of proposals - including employers chipping in, and the insurance covers it agree, But all of the rails, that the government should do more.

Already, it is paying for The Lion 's share of the examination, however, Mr Dehejia said, it should "promote and subsidize free-of-charge test".

“don't rely on private charity to you from an international Public Health emergency. "

But India's Health Sector is poorly funded - it receives only about 1. 3% of the Gdp and is largely unregulated. Health Insurance is not mandatory, and The Market is Fragmented - Most of the policies cover the costs of the hospital, But not the diagnosis or medication.

And now, with the private hospitals in The Mix , it will test more difficult for the government to retain control of his strategy. A prominent hospital chain has done only what to recommend in contradiction to current guidelines, the examination is only for those with symptoms or have come in contact with a positive case.

of course, testing could be cheaper, as more homegrown-approved kits, and the supply exceeds the demand. Some States Are also experimenting with standardized collection - such as mobile-centres or kiosks, which means that less PPE-suits, and lower transportation costs.

India is the pool-testing that involves collecting a large number of samples and their examination in a slip. If The Test is negative, no one has The Virus , But if it is positive, anyone who gave a sample shall be individually examined.

"It definitely says a good way to reduce costs - so long as it is done efficiently and intelligently," says Dr. Brar.

But the immediate solution, she says, is, perhaps, the prices regulate.

“If you can, fix The Price of raw materials, to the entire Price . "

Source of news: bbc.com