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<p>The majority of the healthcare needs of Indians are met by the private sector, including hospitals, individual practitioners, and clinics. Unfortunately, the private healthcare industry has received minimal regulatory oversight, leading to unethical practices such as overtreatment, overcharging, denial of care, and lack of accountability. These gaps were highlighted during the COVID-19 pandemic when several such instances were consistently brought up. In Maharashtra, a detailed study of 100 COVID-related hospitalisation episodes found that 82.5% involved overcharging by private hospitals, with bills being frequently 400–500% above government-capped rates. For 93% of the families surveyed, the cost of treatment required taking loans, mortgaging of property, or sale of assets.</p><p>These experiences highlight not only the existing regulatory stalemate, but also deeper <i>failure of market-driven healthcare systems</i> to protect patients during conditions of vulnerability and crisis. Drawing on Karl Polanyi’s critique of <i>socially disembedded markets</i>, the article argues that the predominantly formalistic and minimalist approach to private healthcare regulation in India has remained grossly inadequate. It is contended that effective regulation must move beyond narrow legal and bureaucratic frameworks, toward socially responsive and interventionist forms of governance, which socially re-embed providers with democratic participation.</p><p>It further argues for a multi-level, system-wide approach that goes beyond legalistic frameworks to embrace participatory governance, and holds that no meaningful change is possible without the robust participation of civil society, patients, and ethically oriented medical professionals. This must be combined with implementing the Clinical Establishments Act 2010 in letter and spirit, upholding the Patients’ Rights Charter, establishing multi-stakeholder oversight bodies at district and state levels, and integrating private healthcare regulation into a broader movement towards publicly funded Universal Health Care.</p>

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Breaking the regulatory stalemate: Moving towards socially responsive regulation of private healthcare in India

  • 期刊论文

  • 发表日期：

    2026年6月17日

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  • Abhay Shukla

摘要

The majority of the healthcare needs of Indians are met by the private sector, including hospitals, individual practitioners, and clinics. Unfortunately, the private healthcare industry has received minimal regulatory oversight, leading to unethical practices such as overtreatment, overcharging, denial of care, and lack of accountability. These gaps were highlighted during the COVID-19 pandemic when several such instances were consistently brought up. In Maharashtra, a detailed study of 100 COVID-related hospitalisation episodes found that 82.5% involved overcharging by private hospitals, with bills being frequently 400–500% above government-capped rates. For 93% of the families surveyed, the cost of treatment required taking loans, mortgaging of property, or sale of assets.

These experiences highlight not only the existing regulatory stalemate, but also deeper failure of market-driven healthcare systems to protect patients during conditions of vulnerability and crisis. Drawing on Karl Polanyi’s critique of socially disembedded markets, the article argues that the predominantly formalistic and minimalist approach to private healthcare regulation in India has remained grossly inadequate. It is contended that effective regulation must move beyond narrow legal and bureaucratic frameworks, toward socially responsive and interventionist forms of governance, which socially re-embed providers with democratic participation.

It further argues for a multi-level, system-wide approach that goes beyond legalistic frameworks to embrace participatory governance, and holds that no meaningful change is possible without the robust participation of civil society, patients, and ethically oriented medical professionals. This must be combined with implementing the Clinical Establishments Act 2010 in letter and spirit, upholding the Patients’ Rights Charter, establishing multi-stakeholder oversight bodies at district and state levels, and integrating private healthcare regulation into a broader movement towards publicly funded Universal Health Care.