Is free healthcare a sustainable solution to improve healthcare equity in India?


To me, the concept of sustainability is as simple as ‘Give More, Take Less’. Give back to society in multi-folds than what you have received. Application of this methodology with consistency is a sure way to stabilise and become sustainable eventually.

Before shedding some light on the sustainable solution to improve India's healthcare equity, understanding the country's current scenario and the prime contributor – medical education—to make this dream come true, is a crucial and pressing priority. A good and sufficient number of medical students is equivalent to a bright healthcare system. Any shortage in this ratio will lead to a steep downfall.

A quick look at the present scenario of medical education in India

* There are only 550 medical colleges comprising of 90,000 seats in India, as against an average of over five lakh students who qualify in NEET every year. Hence, only 10 per cent of medical aspirants qualifying NEET get admission into medical colleges

* There is 76 per cent shortage in availability of medical specialists in rural India

*  High cost of undergraduate medical education (five years) in private Institutions range from Rs 1 to 5 crore

*  73 per cent of India’s rural population accesses only 25 per cent of the country’s healthcare infrastructure

*  55 million people are pushed into poverty annually due to healthcare cost

This disparity is growing at a faster pace rather than witnessing a decline while observing the phenomenal growth and economic development of the country.

Why is healthcare inaccessible and unaffordable to the larger chunk of the population in a country which treats doctors as living gods? Vaidyas – the ancient Indian doctors—were referred to as the embodiment of god and they never charged a penny to anyone for providing healthcare. They were part of a system patronised by the kings and wealthy individuals of the society. Each village had several temples and each temple had a vaidya associated with it along with a midwife. They took the responsibility to look after the welfare of the people in that village.

In India, nutrition, education and healthcare were never sold. According to ancient Indian ideals, these three fundamentals of life must not be sold or bought. The day monetisation took the upper hand, the country started declining in its glory and culture, resulting in the disappearance of humanity from the hearts of people.

When education is bought, it is obvious that the expertise born out of consuming it will be sold. Receiving medical education has become an affair of the elite class. True talent hidden in the rural pockets of India goes wasted every year, as the rural children find it impossible to have access to this education. Imparting free education and providing a platform to these students will only lead to a generation of noble and able medical professionals with compassionate hearts filled with gratitude. These individuals will then give back to society without expecting much in return as they have received everything from society without having to shell a single penny out of their own pockets.

Now, a question might arise in the minds of many about the practicality and perpetuity of this particular vision. Prior to admission, a condition must be posed to every candidate – to serve any of the medical institutions established by us, located in rural lands, the same number of years they spend in the college for the course. Sensitising and encouraging children is the need of the hour.

The Sri Madhusudan Sai Institute of Medical Sciences and Research, Sathya Sai Grama, Karnataka, will be the first medical college in India imparting values-based medical education completely free of cost, inspiring youth to serve the rural society and contribute towards universal health, with love and compassion as the guiding tenets. With state-of-the-art facilities, the institute will ensure the delivery of world-class education and infrastructure to the students.

In the upcoming decade, around 600,000 doctors in the United States of America are retiring. These medical practitioners, rich with experience will be replaced by the next set of doctors, mostly migrants from India and Asian countries due to the high pay scale. With a doctor to patient ratio in rural India – 1:11,082, as compared to 1:1,511 pan India, and 1:1,000 as per WHO norms, in a decade, the country is drastically going to lose doctors and nurses swiftly, creating more scarcity in the existing number. To avoid this catastrophe, education must be imparted free and bind medical professionals with some kind of obligation to serve society. Otherwise, we are heading towards a health crisis.

To overcome this crisis, such institutes will prove to be the lighthouses and saviours to create men and women of sacrifice and compassionate hearts, who will bear the responsibility for the welfare of the country and plunge themselves into the society for its upliftment.


There are two parts to achieve sustainability – jana (people) and dhana (wealth). Generally, wealth is sought after to achieve this goal, neglecting the important factor i.e., people. And when we say people or manpower, the right kind of people are necessary. Government has enough resources yet falls short in implementing changes and is considered less effective. The main cause behind this is the lack of the right people. Similarly, NGOs with tonnes of inspiring people fail to achieve sustainability due to a lack of funds. Therefore, training students to become teachers, doctors, nurses, and paramedics by providing them absolutely free of cost values-based education is only considered to be one side of the coin.

The other side is sustainability and resources, and today the world is richer than it ever was in history. The world GDP stands as tall as 100 trillion dollars. There are enough good people to support noble endeavours of providing free nutrition, healthcare and education. Humanity is still breathing and alive feebly. It needs to be rekindled and more people must be made aware and inspired. The stronger must support the weaker and the weaker must survive. ‘survival of the fittest’ was the rule till now. The times have changed and the rule needs an amendment – ‘survival of the weakest and poorest’. The tripartite model is the solution to sustainability – sarkara (government), samaja (society) and sanstha (organisation). When all three join their hands, anything can be achieved.

(Sadguru Sri Madhusudan Sai is the founder of Sri Sathya Sai University for Human Excellence. The opinions expressed in this article are those of the author's and do not purport to reflect the opinions or views of THE WEEK.