Harsh Mander: The plunder and loot by private healthcare in India

Paul Farmer in Pathologies of Power speaks evocatively of the crossroads at which humankind today finds itself. Healthcare, he observes, can be considered either a “commodity to be sold” or “a basic social right”. It cannot be both at the same time. Which of these pathways we will choose, he declares, is the highly consequential choice that people of goodwill must make “in these dangerous times”. He terms this as “the great drama” of our times.

As this “great drama” plays out in the world today, what choice are policymakers making?

The majority are opting for a significant, even paramount, role for for-profit private health providers in universal healthcare and the statutory right to health care. Their assumption is that the private sector will bring in efficiency, choice, high-quality healthcare and by bridging the resource gaps in public health systems, it will enhance the access of excluded groups. The result of these policy choices is a retreat of the state from direct healthcare provisioning, the crumbling of even the aspiration of a welfare state and the largescale transfer of scarce public funds to the private medical sector.

In this essay, I interrogate the legitimacy of these assumptions. The question I ask is whether there is not inherent in...

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