A significant portion of India’s population relies on private healthcare due to inadequate public infrastructure. Over 60% of healthcare costs in India are borne out-of-pocket, i.e. by the patient’s themselves, pushing millions into poverty each year. The Clinical Establishments (Registration and Regulation) Act, 2010, along with its 2012 rules, provides a framework to regulate private healthcare providers, including rate standardization. Yet, its provisions remain largely unimplemented.
A sizable number of 102 doctors, public health practitioners, and healthcare experts have come together to demand the urgent regulation of private healthcare costs in India, along with implementation of patients’ rights across all clinical establishments. In a detailed expert testimonial endorsed by the Forum for Equity in Health, these professionals emphasize the need for fair, transparent, and standardized healthcare pricing to alleviate the financial burden on patients.
The expert testimonial supports an ongoing Public Interest Litigation in the Supreme Court filed by Jan Swasthya Abhiyan, which urges that the central government must enforce a regulated fee structure for private healthcare under Rule 9 of the Clinical Establishment Rules, 2012. In this legal debate, health activists have demanded implementation of existing rules for regulation of private healthcare, which is being strongly contested by lobbies for commercial private healthcare.
A call for judicial intervention and implementation of health rights
This call to action highlights a harsh reality: with inadequate public health infrastructure, a significant portion of the population is compelled to rely on private medical care. The exorbitant and often arbitrary charges in private hospitals lead to economic distress, pushing countless families into poverty.
The signatories of the testimonial represent a very wide cross-section of India’s healthcare professionals, encompassing practitioners from primary, secondary, and tertiary care institutions; small private clinics; large corporate hospitals; charitable trust hospitals; and non-governmental organizations in both rural and urban areas.
They include young professionals, mid-career specialists, and senior experts with decades of experience. This united voice reflects a broad consensus among healthcare providers that urgent action is needed to address the inequities and lack of regulation in India’s private healthcare system.
The case for standardization of rates
The Clinical Establishments (Registration and Regulation) Act, 2010, along with its 2012 rules, provides a framework for regulating private healthcare providers. However, key aspects such as rate standardization, minimum standards, and transparency remain largely unimplemented. This is despite the widespread experiences of overcharging in private hospitals which was highlighted during the COVID pandemic.
The healthcare experts argue that standardized pricing is not only technically feasible but has already been demonstrated successfully in schemes like the Central Government Health Scheme (CGHS) and Ayushman Bharat–PMJAY.
For example, CGHS uses uniform pricing for over 1,850 medical procedures, benefiting millions of government employees and retirees across India. Similarly, Ayushman Bharat has empaneled over 28,000 hospitals to provide treatments for nearly 2,000 procedures at fixed rates. Drawing inspiration from these programs and international examples like Japan’s uniform fee schedule, the experts advocate that such a framework is not just desirable but also feasible and crucial for protecting patients from arbitrary and exorbitant charges.
Unethical practices and uneven playing field
The testimonial highlights widespread unethical practices in private healthcare, such as inflated pricing, kickbacks for referrals, and arbitrary billing. These practices disproportionately affect patients and undermine ethical practitioners. Standardized pricing would create a fairer, more transparent healthcare system by eliminating referral kickbacks and other corrupt practices, allowing ethical private practitioners to compete on a level playing field, and reducing the financial burden on patients.
By ensuring rational pricing for core medical procedures, the sector can curb profiteering while fostering trust between patients and providers.
Pointing the way forward
The Forum for Equity in Health and other signatories propose the following measures:
- Display and implementation of Patients’ rights: All clinical establishments must display the Patients’ Rights Charter circulated by the Union Health Ministry in local languages.
- Transparent pricing: Healthcare providers must prominently display the rates for key procedures to facilitate informed patient decisions.
- Standardized core procedure costs: While allowing flexibility for additional amenities or special requirements, core medical procedures must have fixed rates to curb overcharging.
- Grievance redressal mechanisms: Effective systems must be established to address patient concerns promptly.
- Support for small and not-for-profit establishments: The standardization process should account for the unique challenges faced by small clinics, charitable hospitals, and non-profit organizations.
Signatories from across the country have reaffirmed that healthcare must be treated as a social good, not a commodity for profit. They stress the urgent need for a robust public health system bolstered by effective regulations for the private sector. The testimonial further emphasizes that the constitutional right to health cannot be realized without addressing the financial inequities perpetuated by unregulated private healthcare practices.
The document concludes with an unequivocal message: healthcare is a fundamental right, not a privilege. To realize this, policymakers, the judiciary, and society must act decisively to regulate private healthcare costs, enforce the Patients’ Rights Charter, and strengthen public health infrastructure.
“It is time to fortify the public health system, regulate private healthcare practices, and ensure that every Indian has access to affordable, equitable, and ethical medical care,” the testimonial declares.
By implementing standardized rates and ensuring patients’ rights, the country can move closer to a fair, equitable, and accessible healthcare system.
To read and sign the full testimonial please click here.
This article is written on behalf of Forum for Equity in Health.
Edited by Parth Sharma.
Image by Janvi Bokoliya.
