Healthcare is a public good, not a market commodity. However, increasing privatisation and corporatisation of healthcare in India are threatening the principles of universality and equity. Critically examine with suitable examples.

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Introduction Healthcare, by its nature, has strong public good characteristics and is central to equity and social justice. However, the growing privatisation and corporatisation of healthcare in India has raised concerns about access, affordability, and universality.

Trends in Privatisation and Corporatisation

Rapid expansion of private hospitals and corporate chains in urban areas
Public health spending remains low (~2% of GDP), increasing reliance on out-of-pocket expenditure (OOPE)
Growth of insurance-driven models such as PM-JAY with significant private sector participation

Threats to Universality and Equity

Affordability Issues
- High treatment costs in private hospitals lead to catastrophic health expenditure
- Example: Expensive procedures in corporate hospitals pushing families into poverty
Unequal Access
- Private sector concentrated in urban and profitable regions, neglecting rural and remote areas
Profit-driven Care
- Incentives for overdiagnosis, unnecessary procedures, and higher billing
- Example: Reports of inflated bills during COVID-19 treatment
Exclusion of Vulnerable Groups
- Poor and marginalised face barriers due to insurance gaps and informal employment
Weak Regulation
- Inadequate enforcement of price caps and standard treatment guidelines

Positive Aspects

Enhances capacity, technology, and specialised care
Reduces burden on overstretched public hospitals
Public-private partnerships (PPPs) can improve service delivery if well-regulated

Way Forward

Increase public health expenditure and strengthen primary healthcare (e.g., Health and Wellness Centres)
Ensure effective regulation and price standardisation
Strengthen public sector infrastructure to ensure universal access
Improve design of insurance schemes to prevent exclusion and fraud
Promote ethical standards and accountability in private healthcare

Conclusion While private participation is inevitable, unchecked corporatisation risks undermining equity and universality. A balanced approach with a strong public health system and robust regulation is essential to uphold healthcare as a public good.

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