Dr V P Singh, Well being Information, ET HealthWorld


Pricing Liquid Medical Oxygen: Dr V P SinghBy Dr V P Singh
(Professor of Economics – Director PGDM, Nice Lakes Institute of Administration, Gurgaon)

As public ache rises, panic reactions start. Panic reactions very often bypass rationality – sociological or financial or each. The menace of the second wave of Covid-19 appears to be leading to the identical. Public response could develop into emotional and irrational however governments are anticipated to take clever steps. Sadly, the governments – at state stage in addition to on the Centre appear to be at their wits finish to manage the injury. Courts have been passing orders and governments haven’t been in a position to comply. Rigidities of economics forestall reaching sociological targets.

Some Chief Ministers have declared free medical aid to be supplied. Courts have ordered provide of vaccines, medicines and oxygen. Nonetheless the medicines, hospital beds, medical oxygen, ambulances, docs and nurses, cryogenic vehicles – each enter appears to be in brief provide to provide satisfactory amount and high quality of medical care. The time period ‘liquid oxygen’ is tormenting the households. The societal stress is driving the policymakers away from financial sense. The case of placing a value cap on Liquid Medical Oxygen (LMO) to make sure elevated provide, comes as an proof of coverage makers ignoring the economics that determines costs and manufacturing efficiencies.

Rising demand for Liquid Medical Oxygen

Exponential rise of Covid-19 instances resulted in surge of demand for medical infrastructure together with Liquid Medical Oxygen(LMO). The 700 TPD pre-Covid interval demand for LMO throughout the nation elevated to 2800 TPD by September 2020. Within the second wave of Corona, the demand has risen to 7000 TPD. Delhi alone has demanded 700 TPD. Such steep rise in demand is bound to buoy value because the industry faces constraints in elevating manufacturing in such a brief run. Hospitals have complained of producers charging exorbitant costs – in vary of Rs 35 – 45 per CUM towards the stipulated value of Rs 17.49 per CUM established in 2018. Fundamental economics says that to be able to deliver the value down the provision must be elevated. Appropriate incentives must be given to the prevailing and potential suppliers for appearing quick and mobilising assets to shortly increase the provision. As a substitute, in September 2020, the National Pharmaceutical Pricing Authority (NPPA), Division of Prescription drugs, Govt. of India, put a cap of Rs 15.25 per CUM on ex-factory value on the producer stage.

Worth caps enhance Demand not the Provide

NPPA most likely believed that low costs will make LMO extra inexpensive enabling individuals to purchase extra and thus suppliers will provide extra. Therefore, it took the brief lower of bringing the value down with a value cap. Would it not guarantee satisfactory availability of LMO? Unlikely it seems. One could not realise however discount in value is an incentive for rising the demand however the requirement is to extend provide. In actual fact, decreasing costs is a disincentive to provide extra. Provide curve of an excellent is an upward sloping curve, displaying that suppliers will provide extra if market costs rise. In case value falls, the suppliers cut back the provision. Have a look at OPEC, when oil costs are excessive then oil producing nations have a tendency to provide extra. As costs fall, the identical nations begin asserting manufacturing cuts.Ignorant Public Sadly Welcomes Worth Caps

The general public usually welcomes value discount, as they should pay lesser for the great available in the market. Nonetheless, that can maintain good if provided that the product reaches the market. Producers is not going to deliver provides to the market at low costs. In actual fact, it triggers black advertising and marketing that breeds extra corruption. Reviews of hoarding and black advertising and marketing have flooded the social media area as of late. Public basically wouldn’t perceive the dynamics of financial forces however the authorities is anticipated to know. In a pandemic state of affairs, social issues outweigh financial rationality and governments, in a parental avatar, usually fall prey to the temptation of a fast resolution that will elude financial sense.

Worth Caps result in rise in Enter Costs

Such knee jerk reactions usually ignore one other necessary dimension of market play – the price of manufacturing. As demand for a product will increase, the demand for its inputs additionally will increase, thus elevating enter costs and price of manufacturing. Rise in costs of land, cement, metal, and many others. is witnessed at any time when demand for homes will increase. In case of LMO, the leases for cryogenic tankers, cylinders and different enter costs will enhance thus rising the general price for the producer. If the enter costs are rising whereas output value is lowered then the margin for producer falls. Decrease margins will act as disincentive to provide extra.

Distrust between Centre and State Governments

The Central authorities has taken some commendable steps to enhance the provision of LMO. Diverting the hitherto liquid oxygen provide going for industrial use to medical utilization is one in every of such steps. Demand from industrial utilization constituted round 70-80 % of the manufacturing capability of liquid oxygen within the pre-Covid interval. Now, about 60 per cent of the manufacturing is earmarked for medical utilization. This creates unfavorable influence on industries like metal, chemical substances and fertilizers, paper and pulp, fabrication, refineries and Glass and many others., which constituted the commercial demand. Furthermore, unfavorable influence could also be felt on the downstream industries like automotive trade, actual property and development too.

The opposite steps like floating tender for importing 50,000 tonnes of medical oxygen and development of Strain Swing Adsorption Crops (PSA) at 100 hospitals are welcome although these provides will take greater than a few weeks to succeed in the sufferers. Take into account ‘Availability of LMO to the sufferers’ as output (Q). ‘Central Authorities initiatives’ and ‘State authorities initiatives’ as two inputs. The output Q is maximised provided that the 2 inputs mix in the very best method. In any other case, the potential output stays only a determine that is still elusive. The state governments in Delhi, Maharashtra, West Bengal and Punjab, and many others are at loggerhead with the central authorities.

How would they mix effectively to provide the specified output?

The nation wants quick enhance in provides of LMO. Non-public enterprise must be triggered to behave quick in any respect the degrees of provide chain. Non-public enterprise will reply to acceptable value indicators available in the market. As an example, RIL is offering LMO to Madhya Pradesh (30 tonnes) and Maharashtra (100 tonnes) at zero price. This exhibits that such firms do have functionality to extend the provision in a brief interval. Given an acceptable value, the provides will be truly elevated. On condition that journey trade may have curbs and the demand for liquid fuels could stay low, the non-public sector refineries can present important enhance within the provide of LMO. Greater LMO value could seem burdensome on the sufferers however that may be taken care of via acceptable subsidy. The Direct Profit Transfers (DBT) utilized in case of LPG and fertilizers will be utilized in case of LMO too. As a substitute of placing a value ceiling decrease stage than the value established in 2018, NPPA ought to present enticing pricing and allow extra sufferers to breathe with ease towards the Covid menace.

(DISCLAIMER: The views expressed are solely of the writer and ETHealthworld.com doesn’t essentially subscribe to it. ETHealthworld.com shall not be accountable for any injury precipitated to any particular person/organisation immediately or not directly).

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