NEW DELHI, Dec. 20 -- Obtaining informed consent, usage-based billing, and the public display of charges are among the Centre's latest guidelines to regulate the use of high-cost ventilators in private hospitals. Guidelines for Transparency in Ventilator Usage by Private Hospitals, posted on the Directorate General of Health Services website recently, and reviewed by Mint, aim to ensure that this life-saving treatment is used ethically and not as a tool for financial exploitation. "The government aims to restore trust in the private healthcare system and ensure that critical care does not remain a challenge or a source of financial distress," said an official close to the development, on the condition of anonymity. "Hospitals must justify ventilator use exceeding 14 days through internal reviews and expert committees, creating a strict paper trail for government inspection. Additionally, facilities have to establish time-bound grievance systems, allowing families to formally report billing discrepancies," the official added. This move assumes significance given that the Indian ventilator market, valued at $207 million in 2024, is projected to reach $351.12 million by 2032, according to global market research firm Credence Research Inc. "A key challenge in India's health system is the asymmetry of information and bargaining power: hospitals and doctors possess far greater knowledge and leverage than patients," said Indu Bhushan, founding chief executive of Ayushman Bharat and senior associate, Johns Hopkins University, adding that greater transparency would help level the playing field and ultimately lead to better health outcomes. Bhushan acknowledged that public grievances about inflated bills in private hospitals are often well-founded. "Globally, intensive care unit (ICU) care requires explicit informed consent and is subject to rigorous audits to deter unnecessary procedures. India has historically lacked such enforcement," he observed, adding that while India often has robust regulations on paper, the persistent weakness lies in implementation. Mint's emailed queries to the health ministry spokesperson remained unanswered. The new guidelines are grounded in core bioethical principles, including autonomy (respecting patient choices and informed consent), beneficence (acting in the best interest of the patient), non-maleficence (avoiding harm through unnecessary or prolonged interventions), and justice (ensuring fair and equitable access to ventilator support). A key pillar of the rules is mandatory informed consent. Doctors must obtain explicit consent from a patient's caregivers or legal representatives before initiating mechanical ventilation. "This process must include a detailed explanation of the clinical need, expected outcomes, potential risks, and limitations of the procedure [and] clarification of the nature of invasive or non-invasive ventilation," the document said. The document added that the daily cost of ventilator support and associated ICU care must be disclosed to caregivers at the time of consent, ensuring families are financially prepared. To curb inflated billing and hidden costs, the government has introduced standardized and transparent pricing structures. Private hospitals must implement uniform ventilator charges across departments to eliminate discrepancies. They must also maintain itemized pricing for consumables used during ventilatory care-such as circuits, humidifiers and filters....