The covid-19 crisis is being seen as a “demo moment” in parts of the Indian healthcare policy circles. We know that it takes a crisis to bring in deep reform—the 1991 liberalization is possibly the biggest example of this when the Narasimha Rao government used the terrible economic crisis to begin shedding the socialist chains that were chocking growth. Reform is difficult in the normal course because of the incumbents who prevent any change, but when there is a cliff in front of you, even the cynics and virtue signallers fall in line behind the reform.
The Indian health problem can be defined as the inability to provide the golden trinity of accessibility, affordability and quality healthcare to all the citizens. Various demand and supply side solutions have been tried, including a ₹5 lakh health cover for the poor through the PMJAY scheme, to turn the supply side weakness into a demand side push. But the friction in the system rests on a fragmented, agency-specific view of the healthcare landscape with high costs of verification—of both doctors and patients—that has an impact on the costs and disbursement of insurance.