Private health sector in India

Editor—Sengupta and Nundy's editorial makes good reading, but I do not see any connection between the burgeoning private healthcare sector in India and the abysmal condition of the government healthcare system.¹

To say that private healthcare is growing at the cost of public health care is unfair. While public spending on health care has been dropping, during the first half of the 1990s, India's defence budget grew at 1.5% yearly in real terms. Since 1996-7, the defence budget has been growing at 10% yearly in real terms.² Would it not be appropriate to say that defence spending is growing at the cost of public health care?

Patients from other countries and patients from eastern India go to south India for treatment at private institutions since these are perceived to offer better treatment than their counterparts in eastern India. The levying of a tax on hospital bills of foreign patients, to be credited to a “fund for the poor,” or diverting a portion of the revenue earned from medical tourism to the government to be spent on health care would not work. Patients from eastern India should then contribute to the coffers of the state governments in south India. Also, in all probability this revenue will end being spent on defence.

Private health care in India is expensive for Indian patients: 28-30% of the project cost of a 100 bed hospital and upwards relates to recurrent expenditure on medical equipment. Maintenance costs and import duties for such equipment are high. The saying in private hospitals is: “Spend in US dollars and earn in Indian rupees.”

Private health care is there for those who can afford it. Berating private health care for not assuming the government's role in providing health care to its citizens is not the solution.