Mumbai: Only a fifth of the patients in Maharashtra visit public hospitals for help, according to the recently released National Statistical Office (NSO) 80th round household consumption on health.The public-to-private division is not so lopsided in any other Indian state even though Maharashtra, one of the affluent states, has over 30 govt medical and dental colleges.According to the data, 77% of all hospitalisations in Maharashtra are in the private sector and 18.6% in public hospitals. “The 18.6% turnout is the lowest rate in the country,” said Dr Abhay Shukla of Jan Swasthya Abhiyan (JSA), “and it exposes Maharashtra’s failed policy of healthcare privatisation”.Public hospitalisations stand at 43% in Tamil Nadu, 45.3% in Rajasthan, 58.8% in West Bengal, and 64.7% in Goa while the all-India average is 36.7%.Maharashtra also has high health inflation rates and high out-of-pocket expenses for patients. As per the latest NSO survey, the average cost of a private hospitalisation in rural Maharashtra stands at Rs 44,580, while urban hospitalisations is at Rs 67,831.A comparison with the 2017-18 survey — where rural private hospitalisation costs were Rs 23,821 and urban costs were Rs 42,540 — reveals high inflation. In rural areas, there is a 87% rise in hospitalisation expenses.“When we consider that cumulative inflation during the 2018–2025 period was approximately 43%, it becomes clear that private hospitalisation costs in Maharashtra have risen at nearly double the rate of general inflation. This indicates a major and unjustifiable hiking of costs by the unregulated, profit-driven private sector, linked with lack of regulation of their rates,” said Dr Shukla.The govt document also revealed that rural public hospitalisation in Maharashtra entailed an average out-of-pocket spend of Rs 8,080 (up from Rs 5,606 in 2018), and an urban public hospitalisation costs Rs 8,364 (up from Rs 7,189 in 2018).Most of the expenditure is on the private purchase of medicines and diagnostic tests even though people are supposed to get free healthcare at govt facilities.The NSO data also reveals that govt health insurance schemes such as central government’s Pradhan Mantri Jan Arogya Yojana (PMJAY) and state’s Mahatma Phule Yojana (MJPJAY) fail to provide adequate financial protection. On paper, everyone is covered for hospitalisations up to Rs 5 lakh.Yet, the NSO findings show, the average total hospitalisation spending in Maharashtra (across both public and private sectors, rural and urban regions) is Rs 44,778, and out of this, Rs 40,495 is still being borne by the people from their own pockets. This means that 90% of hospitalisation costs in Maharashtra are paid for by the people themselves.“Despite the traumatic lessons of the Covid-19 pandemic—where Maharashtra recorded the highest number of deaths in the country—the current state govt seems to have learned nothing. Public health continues to be grossly neglected, while privatisation has been accelerated,” said Dr Shukla. The need of the hour is an expansion of public systems, combined with strict regulation of the private healthcare sector.
