Private health sector in India

Editor—The editorial by Sengupta and Nundy on the private health sector in India raises interesting issues.¹,² People who still believe in the much discredited “trickle down” effects of money supply need to know that the Indian system rarely allows the government to collect legitimate taxes from rich and privileged people. Therefore and especially, there cannot be even the smallest hope of any public good coming of medical tourism in India, no matter how profitable it might be to the service providers.

The fact that the state medical machinery so miserably fails in India—and similar systems do only marginally better in the United Kingdom or the United States—has to do with the simple reality that the wealthy and the influential sections of the public have no interest in it. In the absence of the country's powerful folks' direct dependence on a healthy public system there can be only the dimmest hope for improvement. The opinions and self interest of the influential and the wealthy always sway government policies and priorities. The only solution is a single level, universal healthcare system with no one unqualified for it or exempt from it. If the privileged section of the population is still dissatisfied with the national arrangement, it can always buy services from commercial providers outside of the country—as many such Indians even now do.

Having lived in Canada long enough to know what it was like before our one-payer health system came into existence, I know too well what the other options are like.