Intended for healthcare professionals

Rapid response to:

Editorials

The private health sector in India

BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7526.1157 (Published 17 November 2005) Cite this as: BMJ 2005;331:1157

Rapid Response:

Single Level Health Care Is the Only Solution

I have read with interest not only the entire article by Drs. Sengupta and Nundy, and the press reactions to it in India, but also the responses posted in BMJ so far. I need to point out to those who still believe in the much-discredited "trickle down" effects of money supply, that in the prevalent Indian system rarely allows the government to collect legitimate tax dues from the rich and the privileged. Therefore and especially, there cannot be even the smallest hope of any public good coming of medical tourism in India, no matter how profitable it might be to the service providers.

The fact that the state medical machinery so miserably fails in India--and similar systems do only marginally better in UK or the United States--has to do with the simple reality that the wealthy and the influential sections of the public have no interest in it. In the absence of the country's powerful folks' direct dependence on a healthy public system there can be only the dimmest hope for improvement. One need hardly over emphasize the obvious reality that the opinions and self-interests of the influential and the wealthy always sway government policies and priorities. The only solution is a single level, universal health care system with no individual either unqualified for it nor exempt from it. If the privileged section of the population is still unsatisfied with the national arrangement, it can always buy services from commercial providers outside of the country--as many such Indians even now do.

Having lived in Canada long enough to know what it was like before our one-payer health system--warts and all-came into existence, I know too well what the other options are like.

truly,

Shyamal Bagchee

Competing interests:
None declared

Competing interests: No competing interests

20 November 2005
Shyamal Bagchee
Professor, Univ of Alberta
Edmonton, AB, Canada T6G 2E5