The Much Maligned Healthcare System of India

 

A sa part of the pharmaceutical industry for yrs, I got a chance to observe the functioning of healthcare system in India very closely. My job requirements took me to micro interiors, mofussil towns, tier 2-3 towns as well to the big cities like Mumbai, Ahmedabad, Chennai, Bangalore, Hyderabad etc. I was lucky to see the functioning of Primary Health Centres (PHC) that work in rural areas to big Corporate Hospitals operating in big cities. In the process I came across several great doctors who are legends in their fields, have been venerated and celebrated as teachers and immensely respected by their students as well as patients. I have been lucky to develop personal rapport with several specialists - contact good enough to get a response to my WhatsApp messages! Since 2018, I have undertaken several visits to the US and Canada. I got to experience the functioning of healthcare systems in both these 'developed' countries. I have a Canadian PR which entitles me to free medical consultation and medication. During the post-Covid period, I got a couple of vaccine booster shots in Canada. I also got myself examined by a GP, free of cost. There is virtually no private healthcare system available in Canada, barring probably dental and ophthalmic care. Availability of medicine is free -but exclusively thru the Govt healthcare system. Pharmacies (chemists for us Indians) mostly sell OTC products on their own for prescription drugs, one needs a proper prescription from an authorized medical service provider! During Covid, one could get rapid detection tests done for Covid from these pharmacies - first thing we did on landing in Canada October 2021 was to get ourselves tested for Covid at a pharmacy; only when the report came negative did, we enter our home! While traveling to the US, I have mostly been taking travel insurance, at great cost, indeed! Healthcare in the US is driven by health insurance and properly controlled by the profit motive. Cost of medicines is very high by Indian standards; a friend who works in a Pharmacy chain told me that medicine cost is high due to middlemen like Third Party Admin( PBM - Pharmacy Benefit Manager) who control pricing. A child I know was prescribed an anti-emetic medicine (for vomiting) and the small bottle cost $ 108- something that would have not cost more than Rs 50/- in Indian market. Another typical feature of Pharmacies is that these exist in chains like Apollo chain we have in India. Major pharmacy chains include CVS Health, Walgreens, Walmart, OptumRx, Rite Aid etc. Medicines are also available in grocery-based Pharmacies like Publix and Albertsons. Mostly, prescriptions are sent directly(electronically?) to the Pharmacy near your home and not handed over to the patient, unless the patient asks for it! In the US, private clinics for consulting doctors are available but one needs to book an appointment before a doctor can see you - and appointments are rarely available at short notice. People are known to book their routine medical check-ups months in advance! For emergencies one can go to designated Emergency Rooms (ER). In medical emergencies, immediate options include calling 911 for emergency medical services (EMS), visiting an emergency department (ER) for life-threatening conditions (e.g., chest pain, difficulty breathing, stroke symptoms), or using urgent care/walk-in clinics for minor, non-lifethreatening emergencies. Immediate bystander actions include checking the scene, calling 911, and performing CPR or first aid. I had a recent experience that made me sit up and compare the facilities and options we have in India with what I faced. Almost 3 weeks back, I was walking outside a Daycare facility when I saw a woman come out of the school with her toddler, may be 3 yrs old. Suddenly, the child broke contact with his mother and started running towards the main road-which has plenty of traffic. Before the poor mother could realize, the toddler almost reached the road. Seeing this, I ran to stop the child - I did manage to stop it but, in the process, I lost balance and fell on to the road, face down. I could hear a car screech to a halt but luckily, the child was safe. This led to some commotion as the child's mom, a couple of teachers from the school and the woman whose car had stopped near us - all came to help and pick me up. I had received some abrasions on my face, shoulder, and a few other spots. The teacher cleansed my facial abrasions and then someone volunteered to drop me at my residence, which was just 4-5 minutes away. At home, I checked my shoulder, my knees, and hands- there were plenty of scratches, abrasions, and some superficial wounds, but no active bleeding; I was ambulatory, was not dizzy or feeling nausea. However, my son did not wish to take any chances - so, off we went for a proper check-up of my 'wounds'! The first place he stopped was just 5- 7 minutes' drive from our home. He went in to learn about the procedure, leaving me in the car; the nurse on duty told that him that since I had some injury on face, they would not touch the patient. They advised an MRI scan or CT scan. Interestingly, my son requested the nurse to have a look at me but she just refused! In the meantime, my local friends called several medical/Urgent care facilities in the area. They only shared their minimum charges, ranging between 360 and 500 odd dollars! Finally, one of these centres suggested an Urgent Care centre in the vicinity which could look at my 'wounds'. We drove there and saw there were just 1-2 patients there; we were advised to fill up a Form first -reminded me of that immortal Munna Bhai MBBS dialogue about filling up of forms before a patient could be attended to! After a 10-minute wait, my name was called out and I walked into a cabin. After another 5-10 minutes, a nurse walked in, had a look at my scratches and abrasions, took my pulse, BP, temperature etc and walked out, saying she would be back soon! After a 15- minute wait, a gentleman walked in - he was a proper doctor who checked my vitals, checked my neurological responses, asked me to move 32 my limbs, eyes, tilt my neck etc. He very kind acknowledged that I appeared to be mostly ina undamaged condition and would not need an Ray etc. The wounds, however needed a cleans n dressing! My son asked him if I needed to g a tetanus shot - he was ok with it but sugges I take a tetanus shot with pertussis. I told the doc that I have a couple of well-known antibacter creams with me (Neosporin and Soframycin), he wanted to use another ointment - Mupirociт The nurse on duty took another 45 minutes cleanse and dress my abrasions. We were in tE Urgent Care facility for about two hours and fille at least two forms! The cost involved was $ 27 What hit me most was that the tetanus sho cost me $75, something that is given almost fre in most of the facilities in India! As I said earlier, I have seen the wa healthcare system operates in India. I have firsthand experience of getting patients admitte to Emergency Wards, in Govt institutions as we as private hospitals. Once a neighbour in Inde needed emergency care - the first hospital we reached gave him basic emergency care (form was filled up by a relative but by then patient was already receiving treatment); as the patien stabilized, the hospital advised us to take the patien to a specific Neuro speciality hospital. A patier with superficial injuries receives a quick chec up, dressing and discharge - no frills, even i Govt hospitals! Luckily, the dressing material, my injection and ointment were available within the Urgent Care centre -we experienced delays while buying medicine from one of the nearby pharmacies for my grandchild! Their excuse: "Your Rx has not been received yet. Please come again in an hour or two but please call before you come to pick up the medicine. You can also come tomorrow!"What a contrast from what we have in India - multiple retailers to choose from and home delivery facility available at no extra cost! Medicine delivery has become so simple and hassle free now in India. My regular chemist arranges home delivery of my medicine every month - the Rx is shared over WhatsApp; he shares the invoice with 10% discount mentioned over WhatsApp and I make the payment on-line! Real convenience! Today, we have several Medicine Delivery Apps available to make life easy! After this experience, I interacted with several doctors I know (Physicians, orthopaedics, neurologist etc with private practice), over phone. Most of them are aware of the major deficiencies in the highly bureaucratised US Healthcare system. Most of them are aware of the Insurance dependency in any healthcare procedure in the US- and the costs are enormous! Most of the Indian doctors in their 40s and fifties today have had their education in Govt funded/ owned/ supported Medical Colleges. They have worked in Govt/ Municipal/ Public sector hospitals and have 'done their rounds' there, before starting their private practice. Even today, we have a massive public sector component in our healthcare sector. Every city has Govt Hospitals, every small town has PHCs and civil dispensaries where consultation is free or near free. Availability of doctors is relatively easier - very rarely do our doctors having waiting lists stretching up for weeks. I know of a relative in Canada who could not get an appointment with a specialist for six months! Medicine availability is comparatively less costly, and easier in India. We have excellent availability of 'generic' medicines from reputed companies that come at a fraction of the cost the branded ones from same companies come! Govt of India has invested heavily in improving health infrastructure over the last 10 years. Sixteen new AlIMS Hospitals have been opened across India. These offer highly subsidized or free treatment, especially for BPL (Below Poverty Line) patients, Ayushman Bharat beneficiaries, and in emergencies, with basic services and essential medicines often free; however, costs for advanced diagnostics and implants may need to be paid by the patients. The PMJAY (Pradhan Mantri Jan Arogya Yojna) was rolled out by the Prime Minister on September 23, 2018. This health insurance scheme covers about fifty crore citizens in India and ensures a Rs. 5 lakh health insurance coverage per year to every cardholder. Ayushman card, earlier issued free to people from weaker social and economic status, has now been made available for all senior citizens above 70 years of age, irrespective of their socioeconomic background. Govt of India has established almost 17,000 Jan Aushadhi Kendras across India under the Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) as of June 2025. The scheme aims to make quality generic medicines accessible to the public at prices that are 50% to 90% lower than branded equivalents. In addition to the 'modern' Allopathic clinics and hospital, every city and town has 'dispensaries' dealing with 'alternative' systems of healthcare (Ayurveda, Homeopathy, Siddha, and Unani). We have doctors qualified in these alternate systems manning these dispensaries/ hospitals. In fact, to my mind, doctors from these alternative systems satisfy the primary care requirements of a large segment of population, reducing the burden from the more elitist 'modern' Allopathic segment! Indian culture values charity - every city and town boasts of Charitable hospitals and 'dispensaries' run free by philanthropists or Trusts set up by rich people or by religious organizations. The Rama Krishna Mission, Sathya Sai Baba Mission, Aanandmoyee Maa group etc run several hospitals across India that provide free healthcare service. Now, even private sector hospitals like the Narayana Group of Bangalore are chipping in. While not entirely free for all, these provide affordable, high-quality care, including specialized, low-cost heart surgeries and free mobile medical units. There are specific schemes run by Govt for employees - CGHS, ESIC etc Twin Dangers that loom ahead: Post privatization in India, medical education has become exorbitantly costly and those who can afford, are investing in it as a business opportunity. People are sending their wards to exotic locales like Ukraine, Bangladesh, Iran, Kazakhstan, Kyrgyzstan, Uzbekistan, the Philippines, and Georgia. 40-50 years back, people with the right kind of political connections would send their wards to Russia but such degrees rarely used to be treated at par with Indian medical degrees. The cost push becomes a shove when it comes to PG Degrees and Super Specialization. Healthcare today is also facing the danger of corporatisation. We have rumours of doctors being pushed to maintain high bed occupancy ratios and even unnecessary hospitalization/ procedures. Likewise, cost of diagnostics, medicine, equipment - every aspect is in the gambit of Return on Investment calculation! The Trinity of Insurance, Pharma and Foreign Capital in Indian Hospitals is already pushing costs North. Healthcare is not a luxury but as much a necessity as food and air are. Our governments just cannot allow unbridled profit harvesting fr healthcare. The sooner our authorities realize t that much better it shall be for the common Inda Fact remains that as on date, the much-maligne much criticized Indian Healthcare system is more patient friendly (and pocket friendly)t what I saw of the US and even Canada. Our Ind doctors work hard, are available for patients free and see more patients in a day than wha 'consultant' in US sees in a week! There, no do are grey areas where better regulation is require self-medication, for example) but overall, God B our doctors and our healthcare system! For a coun as huge and diverse as India, the needs healthcare infrastructure are high -especially sirg we have a burgeoning population of 1.4 billion cater to. Much more needs to be done. Yes, the are several moles and warts in the system tha times choke the very purpose of a schem However, the deviations, misuse and shortcuts a more a commentary on lack of national charac in Indians overall than a failure of the system. system is above misuse, including the one in US But my considered opinion is that India has a robu healthcare system that is better than systems several other countries.

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The views expressed in the Article above are Sanjeev Munshi views and kashmiribhatta.in is not in any way responsible for the opinions expressed in the above article. The article belongs to its respective owner or owners and this site does not claim any right over it. Copyright Disclaimer under section 107 of the Copyright Act of 1976, allowance is made for "fair use" for purposes such as criticism, comment, news reporting, teaching, scholarship, education, and research. Fair use is a use permitted by copyright statute that might otherwise be infringing."

Courtesy:    Sanjeev Munshi  and Koshur Samachar- March, 2026