Healthcare is a fundamental right crucial for individual dignity and welfare. Article 47 of the Indian Constitution highlights the State’s responsibility to ensure public health, affirming the commitment to provide equitable access to healthcare for all citizens.

Adverse impact of marketisation of healthcare system 

1. Inequity in access: creates a dual healthcare system where wealthy individuals can access, afford and avail healthcare, while the poor rely on underfunded public healthcare.
2. Rural-urban divide as only 30% healthcare infrastructure serves 70% rural population, leaving rural areas underserved.
3. Rising cost and affordability: Eg. 47.1% of total healthcare spending in India is out-of-pocket expenditure (National Health Accounts 2019-2020).
4. Commodification of Healthcare: Eg. doctors prescribing unnecessary tests and medicines just to increase profit.
5. Limited Focus on Preventive Care: Market-driven systems prioritize curative care over preventive measures, leading to under-investment in public health.

Role of state in containing marketisation of healthcare 

1. Regulation of Healthcare Costs: The state can cap treatment prices, regulate drug prices (e.g., India’s National Pharmaceutical Pricing Authority), and ensure that essential medicines remain affordable.
2. Strengthening Public Healthcare: The government can expand and improve public health infrastructure to provide low-cost or free services, reducing dependency on private healthcare providers.
3. Universal Healthcare Schemes: Programs like Ayushman Bharat in India help reduce out-of-pocket expenses for poor citizens by providing free access to essential health services.
4. Health Insurance Regulation: The state can ensure that private health insurance schemes are affordable, transparent, and provide adequate coverage without discrimination or exploitation.
5. Public Health Campaigns: The state plays a key role in promoting preventive healthcare, vaccination drives, and awareness programs to reduce the burden of disease and reliance on expensive treatments.
6. Subsidizing Essential Health Services
   1. The government should provide subsidies for essential drugs and healthcare services to make them more affordable for the general public. Eg. Jan Aushadhi Stores
   2. Provide free preventive healthcare services such as immunizations, maternal and child care, and routine health checkups to reduce out-of-pocket expenditure.

Measures to Enhance Public Healthcare at the Grassroots Level

1. Decentralization of Healthcare Governance: Empower local governing bodies like Panchayati Raj Institutions (PRIs) and urban local bodies to take charge of healthcare delivery at the local level. This would ensure more responsive and need-based healthcare.
2. Public-Private Partnerships (PPP): NITI Aayog in its report ‘Reimagining Healthcare In India Through Blended Finance’ Encouraged  partnerships between the government and private healthcare providers for the supply of healthcare equipment, medicines, and mobile health units in rural areas.
3. Health Education and Community Participation: Launch health literacy programs and engage local communities in healthcare planning by forming village health committees to monitor programs. Eg. ASHA and Anganwadi workers can be leveraged.
4. Increased Budget Allocation for Public Health to improve infrastructure, recruit more healthcare workers, and ensure the continuous supply of medicines. Allocate funds specifically for underserved areas, ensuring equitable distribution of healthcare resources across the country.
5. Focus on Preventive Healthcare:  Prioritize preventive healthcare measures, such as improving sanitation, clean drinking water access, and widespread vaccination campaigns.
6. Implement nutrition programs targeting maternal health and child development to reduce the incidence of malnutrition and related diseases.
7. Technological Integration: Use telemedicine, mobile health apps, and electronic health records to enhance remote care access and continuity. Eg: Practo, eSanjeevani.

As the saying goes, “Health is wealth, not wealth in health,” emphasizing the importance of accessible health care. By focusing on public investment and community health initiatives, the state can ensure health remains a fundamental right, not a commodity.