Health care institutions in West Bengal are in a state of flux, with new privatisation initiatives proposed by the World Bank posing a direct contrast to still-existing not-for-profit, traditional health systems. This essay based on a field study in West Bengal's Birbhum district looks at the dichotomy that prevails in rural health care initiatives, the juxtaposition of private vs public health care systems, and probes the villagers' resistance to innovations and the enduring popularity of traditional institutions.