The year 2018 ushered in a new era for universal healthcare in India with the announcement of the world’s largest health insurance scheme, The Pradhan Mantri Jan Aarogya Yojana—giving financial assistance for hospital care for the most vulnerable population. However, to utilise the benefits, the key missing piece was the hospital itself. India’s healthcare infrastructure remains skewed towards top cities while Tier II and Tier III townships—the India that is Bharat, which houses a majority of the beneficiaries—find themselves handicapped. India has 1.4 beds/ 1000 . Further, c.70 percent of total beds in India are concentrated in urban centre that houses just about 35 percent of the total country’s population.
India’s hinterland suffers from an acute supply side problem which includes a lack of proper hospital infrastructure, doctors, nurses and paramedics—each feeding and creating a vicious cycle. An individual has little choice but to travel far to access any form of secondary clinical care. Rural health statistics show that 50 percent of the states do not have even one central hospital per district. Of the 36 states and union territories—for which data is available—18 do not have a hospital in each district. This defeats the purpose of universal healthcare that the government set out to achieve under the National Health Mission.