“Commercialisation of Health Services: A Recipe for Disaster”

• Sujatha Rao, former Union Secretary of the Health Ministry, criticizes the intensified privatisation of health care in India.
• The Union government in 2020 proposed district hospitals to be attached with private medical colleges in a public-private partnership (PPP) mode.
• Rao shares her views on the perils of increased privatisation of health care in India.
• In July 2024, Madhya Pradesh government issued a notification to privatise 10 district hospitals with 25% of beds reserved for paying patients.
• The privatisation is the fourth attempt to hand over public facilities to private parties in Madhya Pradesh.
• The private sector cannot provide free care unless it establishes a medical college charging hefty capitation to cross subsidise.
• The hybrid model is unworkable, as seen in Chittoor in Andhra Pradesh and elsewhere where the private party was allowed to establish a medical college by attaching the 300-bed district hospital.
• The private party could have had an MOU with the government and paid fees for using the hospital for training purposes.
• The U.S. model of managed care is based on an insurance model, which is seen to have a selection bias, deny critical and timely care, create several barriers, and do not help contain the cost of care.
• The privatisation of health care in India is the most privatised but is unregulated, making access to good quality care a privilege.
• The Indian State has become unfair and unjust, with a fifth of its citizens unable to avail medical care due to their inability to pay.