Weak public healthcare could let India’s development drive down

livemint.com:

₹89 for hospitalization and about ₹180 for other health needs, with urban estimates of ₹123 and ₹258 not much higher. This is not a sign of us being a very healthy lot with a paltry medical-expense burden. That we know of hospital bills thousands of times larger only points to how easily averages can mislead us.

Look closer: HCES data split up into equal slabs will show that the top 5% spend more than 100 times the lowest 5% on hospital care. If we took finer fractiles—such as percentiles, to compare the richest 1% with the poorest—then the difference would be even more stark. While huge gaps are also visible on a few other counts, such as rent, the medical contrast is one that should make us squirm the most.

In a way, it’s at the core of our inequality, as covid reminded us. Equal access to healthcare is a key component of an equitable social set-up and our failure on this front is rivalled only by the dismal state of our public education. For even basic health services, those of us who struggle to make ends meet also find we must turn to the private sector.

Most bills are paid out of our pockets, and although bill backstops are available, what we have by way of a state-run apparatus to keep us healthy is an apology of a system. As proof, think of public figures openly opting for pricey private alternatives, a preference that invites no scandal because even hard-up voters understand it. Thankfully, medicines are mostly cheap in India, but private services are not, with the result that getting well is costly for most people.