Commercialisation vs Care: India’s Healthcare at an Ethical Crossroads

India’s healthcare system has long drawn moral authority from a tradition of service, compassion, and public trust. Yet today, that moral core is under strain. Medical colleges and hospitals — once seen as sanctuaries of healing — are increasingly perceived as commercial enterprises, where financial considerations often outweigh patient welfare. The unease is no longer anecdotal; it reflects a deeper ethical crisis that threatens the foundations of the doctor–patient relationship.

The Hippocratic ideal and the reality of market-driven medicine

At the heart of medical practice lies the Hippocratic Oath — the promise to act in the patient’s best interest and to “do no harm”. In today’s aggressively commercialised healthcare environment, this principle is being steadily diluted. Treatment decisions are increasingly influenced by revenue targets, insurance reimbursement structures, and corporate pressures rather than clinical necessity.

Excessive diagnostic tests, avoidable procedures, prolonged hospital stays, and inflated billing have become common patient grievances. As hospitals adopt corporate management models, patients risk being reduced to revenue streams rather than human beings seeking care. The result is an erosion of trust — a loss far more damaging than any financial inefficiency.

The hospital–insurance nexus and its human cost

Equally troubling is the growing alignment between hospitals and insurance companies. In theory, insurance is meant to protect patients from financial catastrophe. In practice, many patients — especially from poor and middle-class households — find themselves trapped in a maze of delayed approvals, partial reimbursements, and outright claim denials.

This nexus often shifts the burden of cost and uncertainty onto patients at their most vulnerable moments. Healthcare, in such circumstances, begins to resemble a battleground rather than a public good, where negotiating power matters more than medical need.

Medicines as commodities, not cures

Another ethical fault line lies in prescribing practices. Reports of unnecessary, overpriced, or even spurious medicines being prescribed for commercial gain are deeply concerning. Such practices not only inflate healthcare costs but also endanger public health by exposing patients to avoidable risks.

When prescriptions are driven by incentives rather than evidence, the integrity of medical decision-making is compromised. This problem demands urgent regulatory scrutiny, not only to protect patients but also to safeguard the credibility of the medical profession itself.

Regulators: procedural compliance versus moral accountability

India has no shortage of regulatory institutions. Bodies such as the “National Medical Commission”, “National Accreditation Board for Hospitals”, and State Medical Councils were created to uphold standards and enforce accountability.

Yet their functioning is often perceived as procedural rather than principled. Accreditation checklists and licensing norms, while necessary, cannot substitute for ethical governance. When oversight mechanisms fail to act decisively against malpractice or exploitation, public confidence inevitably erodes.

The silence of rights watchdogs

Even institutions tasked with safeguarding citizens’ rights must introspect. Delayed or muted responses from bodies such as the “National Human Rights Commission” and State Human Rights Commissions in cases of medical exploitation deepen public despair. When democratic safeguards appear indifferent, trust in both healthcare and governance weakens.

Healthcare malpractice is not merely a consumer grievance; it is a human rights concern. Treating it as anything less diminishes the seriousness of the harm inflicted.

Healthcare as a State responsibility, not a market luxury

Healthcare is not a privilege reserved for those who can afford it; it is a fundamental responsibility of the State. The “Government of India”, along with state governments, must act decisively to restore ethical discipline in medicine.

This requires more than policy statements. Stronger legislation, transparent oversight, and unwavering accountability are essential to curb exploitative practices and rebuild trust. Regulatory silence, in this context, amounts to complicity.

What needs to change — urgently

To arrest the ethical decline, several concrete steps are imperative:

• Audit the nexus between pharmaceutical companies and hospital prescribing practices.
• Enforce a legally binding “Patient’s Bill of Rights,” prominently displayed and actively implemented in every medical facility.
• Establish independent grievance redressal cells capable of resolving cases of medical exploitation swiftly and transparently.

Reclaiming the moral authority of Indian medicine

India’s medical community has earned global respect for its skill, dedication, and service ethos. Preserving that legacy now requires confronting uncomfortable truths about commercialisation and accountability. Ethics, empathy, and human dignity must be restored as the organising principles of healthcare.

If regulators and policymakers continue to prioritise procedural accreditation over principled governance, the damage to public trust may become irreversible. The choice before India is stark: allow medicine to drift further into market logic, or reaffirm it as a moral vocation rooted in care. The future credibility of the healthcare system depends on making the right call — now.