India’s healthcare system, long associated with compassion, service, and professional integrity, is today facing a deep ethical crisis. Medical colleges and hospitals — once seen as sanctuaries of healing — are increasingly perceived as commercial enterprises where profit considerations overshadow patient welfare. This erosion of trust strikes at the core of medical practice and raises uncomfortable questions about governance, regulation, and the State’s responsibility to protect citizens’ health.
From healing vocation to commercial enterprise
At the heart of medicine lies the Hippocratic Oath, which obliges doctors to act solely in the patient’s best interest. However, aggressive commercialisation has diluted this moral compass. Treatment decisions are increasingly influenced by revenue targets rather than medical necessity. Excessive diagnostic tests, avoidable procedures, and inflated hospital bills have become common complaints, weakening the doctor–patient relationship that once formed the ethical backbone of healthcare.
Hospitals, particularly in the private sector, are often structured and managed like corporate entities, where patients risk being reduced to revenue streams. This shift has transformed healthcare encounters into transactions, undermining the dignity and vulnerability inherent in illness.
The insurance–hospital nexus and patient vulnerability
Equally troubling is the growing alignment between hospitals and insurance companies. Instead of acting as financial protection, insurance mechanisms frequently trap patients between delayed authorisations, partial reimbursements, and claim rejections. Poor and middle-class families are especially vulnerable, often exhausting savings or incurring debt despite being “insured”.
Healthcare, in such cases, becomes a battlefield where bureaucratic procedures and commercial interests outweigh urgency and compassion. The social purpose of insurance — risk pooling and financial security — is diluted by opacity and misaligned incentives.
Spurious medicines and unethical prescriptions
Another serious concern is the circulation of unnecessary or spurious medicines, prescribed not for therapeutic benefit but for commercial gain. Such practices not only burden patients financially but also endanger public health by promoting irrational drug use and antimicrobial resistance. This dimension of exploitation demands urgent regulatory scrutiny, as it directly affects health outcomes beyond individual patients.
Regulators: procedural oversight without moral authority?
India has established multiple institutions to safeguard standards and accountability, including the , , and State Medical Councils. Yet their interventions often appear procedural rather than principled.
Accreditation and licensing cannot substitute for ethical governance. When violations are met with delayed inquiries or mild penalties, public confidence erodes. Oversight that focuses on paperwork while ignoring systemic exploitation risks legitimising unethical conduct.
Human rights institutions and democratic trust
Institutions such as the and State Human Rights Commissions also face scrutiny. Delayed or muted responses to cases of medical exploitation deepen public despair and weaken trust in democratic safeguards. When access to ethical healthcare is compromised, the issue transcends professional misconduct and enters the domain of human rights.
Healthcare as a State responsibility
Healthcare is not a privilege; it is a fundamental responsibility of the State. The and state governments must act decisively to restore ethical discipline within the medical profession. Market forces alone cannot be entrusted with protecting patient dignity, especially in a sector marked by information asymmetry and vulnerability.
Stronger legislation, transparent oversight, and credible enforcement are no longer optional. They are essential to rebuild trust and ensure that healthcare serves its social purpose.
What reforms are urgently needed?
Key corrective measures frequently proposed include:
- Auditing the nexus between pharmaceutical companies and hospital prescription practices.
- Enforcing a legally binding “Patient’s Bill of Rights,” prominently displayed in every medical facility.
- Establishing independent and time-bound grievance redressal cells for cases of medical exploitation.
These steps would signal a shift from symbolic regulation to substantive accountability.
Reclaiming the moral core of medicine
India’s medical community continues to be admired globally for its skill and dedication. Reclaiming that legacy requires placing ethics, empathy, and human dignity back at the centre of healthcare delivery. Regulatory silence in the face of exploitation is not neutrality — it is a betrayal of public trust.
What to note for Prelims?
- Roles of National Medical Commission and NABH.
- Concept of Patient’s Bill of Rights.
- Healthcare as a State responsibility.
What to note for Mains?
- Ethical challenges arising from commercialisation of healthcare.
- Limits of accreditation-based regulation in healthcare governance.
- Role of human rights institutions in protecting patient dignity.
- Policy measures needed to restore trust in India’s healthcare system.
