Healthcare in India

Although the Indian pharmaceutical industry has played an important role in the development of generic medicines, it is not clear whether drug development, which is dominated by the private sector, is informed of the disease burden and public health priorities. An attempt is made to address this question by juxtaposing the therapeutic focus of the drugs approved for marketing and the new chemical entities in the pipeline with the disease burden across age groups.

The National Health Policy, 2017 can be credited for an alternative vision towards the development of the health sector in India, but it falls short of expectations on certain counts. The core idea of strategic purchasing from the private sector is relevant, but can be incompatible with the existence of a robust public sector, particularly when reforms for enhancing the competitiveness of the public sector are undermined. Thus, the NHP essentially reopens the fundamental debate regarding the role of social choice mechanisms while deciding upon policy instruments and desirable outcomes. This has profound implications for the political economy of the health sector and can unintentionally catapult health as a salient feature in electoral politics.

The announcement of the National Health Protection Scheme provides us with an opportunity to see how its predecessor Rashtriya Swasthya Bima Yojana and other publicly funded health insurance schemes have fared so far. The experiences of PFHIS indicate that targeted health insurance coupled with a healthcare delivery system dominated by “for profit” private providers failed to address the issues of access and financial risk protection. They possibly displace resources that can be utilised for strengthening a public health system.

In 2007, the Delhi High Court ordered all private hospitals in Delhi having the free treatment condition for economically weaker section patients in their lease deed to provide free treatment to 10% poor inpatients and 25% poor outpatients. This article analyses the monthly reports of “percentage bed occupancy” of the ews beds in 34 private hospitals from 2012–13 to 2015–16. The bed occupancy of 41% hospitals was below 10% and only two hospitals featured more than 30%. A number of loopholes need to be plugged by the custodian of the public properties, which is the state in this case, to ensure that the public partners who are the poor patients are welcomed and provided non-discriminatory health services without any fee.

The Surrogacy (Regulation) Bill, 2016 marks a significant shift in the discourse on commercialisation of surrogacy. This article explores issues of altruism, repugnance, paternalism, marketability, exploitation, and assumptions of the moral inviolability of motherhood, with respect to surrogacy in India. It offers close perspectives on the ramifications of altruism in assisted reproduction based on field research and interviews conducted in the cities of Kolkata, Mumbai, Pune, Anand, and Howrah.