Coexistence of public& private health systems in India: A review

Objective: To provide a brief review of the coexistence of the public and private healthcare systems in India. Method/Statistical Analysis: The researcher reviewed various secondary sources including journals, researcharticles and reports from other sources like all five-year plans of Govt of India, National Health Policy 2002 & 2017. This enabled the researcher to provide a detailed outlook of the healthcare scenario in India, pre and post independence conditions and public-private sector collaborations. In order to access the authentic data/information, the researcher has consulted various authentic databases, portals, books and documents like National Health Portal of India (www.nhp.gov.in), Open Government Data (OGD) Platform India (https://data.gov.in/sector/health), Health System Database at National Health Systems Resource Center (http://nhsrcindia.org/health-systems-database), The Imperial Gazetteer of India, Public Health in British India: Anglo-Indian Preventive Medicine, etc, which collectively span over a period of more than 16 decades from 1859 to 2020. The analysis method is descriptive, consisting of tables, graphs and textual representation. Findings: The public and the private healthcare sectors in India face certain challenges such as weak infrastructure including non-availability of drugs, lack of advanced laboratory facilities & equipment, a severely constrained health workforce, poorly financed public health system along with a poor delivery mechanism for health care for public health and high cost, significantly focused around bigger towns, mostly out-of-pocket for private health. Additionally, heightened demand for timely and affordable quality healthcare services and low penetration of health insurance in the country were also adding to the health burden. Thus, the country requires significant reforms to balance and address the quoted bottlenecks. The collaboration of the public and the private sector to provide better healthcare services has come up as an important alternative. Such collaboration would help in countering the challenges and make them more accountable. Application: This study finds applicability in academia and practice, as the findings of this study can be used to bridge the gap in existing knowledge regarding the assessment of the challenges facing public and private healthcare institutions when operating as standalone systems. Moreover, the findings can be applied to other developing countries where similar problems in the healthcare space are encountered. Keywords Healthcare; India; public health; private health; health insurance; RSBY; Ayushman Bharat; PMJAY; CGHS