Despite the implementation of National Rural Health Mission over a period of nine years since 2005, the public health system in the country continues to face formidable challenges. In the context of plans for rolling out “Universal Health Care” in the country, this paper analyzes the social, economic, and political origins of the major challenges facing public hospitals in India. The view taken therein holds the class nature of the ruling classes in the country and the development paradigm pursued by them as being at the root of the present problems being faced by public hospitals. The suggested solutions are in tune with these realities. 1. Introduction Some authors have described the big modern day hospitals as “monuments to disease.” Indeed, this is what they will be so long as they function as institutions only for curative care, detached from the larger social, economic, cultural, and political context of the people’s lives which largely determines their health. Unfortunately, even this curative care has become unaffordable to many common people due to the policy framework governing health sector in the country. The fact is that public hospitals have become increasingly detached from the larger context in which medicine operates. If the public hospitals are to be made responsive to the health needs of the people, then problems facing these institutions ought to be located in the broader conditions (we may call these structural problems) that influence their functioning, rather than locating these in their inner working alone. This also implies that the solutions to these problems ought to be socially oriented rather than being guided by narrow managerial or technocentric approaches. Public sector healthcare shall continue having its relevance for a long time in order to reach out healthcare to vast sections of underserved populations in developing countries like India. In the context that the 12th Five-Year Plan Document has rolled out an ambitious scheme to achieve “Universal Health Care” in the country, this review sets out the following objectives before itself:(i)elucidate the more important challenges facing public hospitals in India and document their enormity;(ii)understand the social, economic, and political sources/factors leading to the emergence of these challenges;(iii)in accordance with the aforementioned analysis, propose solutions that are feasible within the present political and economic system.For the purpose of this paper, a public hospital shall include the most peripheral PHC (primary health center) to a tertiary care hospital
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