Is NITI Aayog now working against the poor?

As the nation celebrates its 70th Independence Day examining its achievements and challenges, the NITI Aayog has proposed a plan to overcome one of the key challenges facing India - lack of equitable and affordable healthcare facilities for millions of poor Indians.

Since it comes from a public-funded body chaired by the prime minister himself, one would have assumed the plan would address the need for doctors capable of serving the poor and in rural areas.

But what the Aayog has recommended in its latest report on reforming medical education is going to please only profit makers in the private sector.

It wants the government to permit for-profit medical colleges as a solution to India's health woes.

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Not just this, the commission says there should be no cap on fees charged by private colleges.

The report dashes whatever hopes the poor have from the state-run health system in India.

In one stroke, the committee headed by the Aayog vice-chairman and three IAS officers has undone all the hard work put by health experts as well as parliamentary committees in recent years.

The Aayog has suggested a supremely weak regulatory system, and has even carved a role for itself in appointing medical regulators.

If accepted, these recommendations could send India's health system into a spiral of high cost care for majority of people.

At present, only not-for- profit organisations like trusts and societies are permitted to establish medical colleges.

Over the years, this system has become corrupt with the practice of capitation fee and sale of medical seats for amounts as high as Rs 1 crore.

The Aayog's weird logic is that the current ban on for-profit institutions has not prevented private institutions from extracting profits, so why not make profit legal and let private companies float medical colleges and make money.

Not just this, the panel says, there should be no cap on fees such medical education companies can charge as "a fee cap would discourage entry of private colleges thereby undermining the objective of rapid expansion of medical education".

Several empirical studies have documented negative impacts of existing private medical colleges.

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Private medical colleges are disproportionately concentrated in some states in the south and the west; students who are enrolled there come from affluent families and most end up in corporate hospitals to recover "investments" they make.

All this means high cost of service and care for people.

The situation would worsen when for-profit companies are allowed to run medical colleges.

The first movers in this game could be corporate hospitals themselves.

Will a doctor graduating from a corporate medical college be ever willing to work in a public health facility - be it urban or rural - or do research?

Will such a doctor be even aware of India's health problems and disease profile?

It is ironic that at a time when America is debating demerits of corporate universities thanks to the candidature of Donald Trump who runs for-profit Trump University, India with diverse health needs is contemplating private medical education companies.

The next could be for-profit engineering colleges and universities teaching humanities.

(Courtesy of Mail Today.)