The document discusses the decline of middle-class healthcare options in India since the 1990s, resulting in a divided system catering only to the rich and the poor. It suggests that the middle class should either adapt to lower-cost services or advocate for systemic changes, such as excluding healthcare from consumer courts, but notes their reluctance to do so. The author emphasizes the unrealistic expectations of the middle class regarding healthcare costs and the importance of questioning the quality and accessibility of government hospitals.

1. The Missing Middle class from the Indian Healthcare!
By Dr.Mahboob Khan
Till 1990s, we have three types of Hospitals in India
1. For the Rich
2. For the Middle Class
3. For the Poor After 1990s Because of Consumer Courts and Clinical
Establishment Acts and Ratings and Media Trials, the hospitals for middle class
have been shut down or converted to hospitals for rich So At present we have
only two types of Hospitals
1. For the Rich
2. For the Poor So The middle class goes to the hospital for Rich and then cry
What are the solutions
1. Middle Class go to Hospitals for Poor and don't expect the luxury and get
used to the No Frills Service This requires a change in Mindset of Middle Class
2. Middle Class start a movement to demand
(a) Exclusion of Healthcare from Consumer Courts
(b) Repeal of CEA
(c) Repeal of Rating etc This also requires a change in mindset of middle class
Sadly Middle class does not do either of these two solutions Instead They
want the Hospital for Rich to Charge them less. Which is not possible Or They
want the Hospital for Poor to give them luxury. Which is also not possible.
Rise of health insurers into the healthcare industry since the early 2000s have
also significantly contributed here. When insurance payouts are linked with
quality standards organisations such as the NABH, the corresponding rise in costs
is reflected on the non-insured as well.

2. One of my colleague from Manipal Hospitals keeps talking on this important
subject The Missing Middle You have very beautifully analysed the issue People
go to private hospitals and take special rooms thinking it's just room rent which
is more not realising everything from X rays to lab to professional fees to
operation theatre fees is many X times cost and when bill comes they are
shattered.
Entitlement. Freebie culture. subsidies. Vote bank politics. Greed. Expecting
without contribution to economy/soceity. Lack of Population control or family
planning. Ruined everything.
Why every one want to go to private hospital???
There are plenty of government hospitals in India who has lakhs of good doctors,
who feel day and night for you people only.
2. How many of you questioned poor service timing in government hospitals???
How many of you questioned the government for the less staff compared to
number of people visiting there?? How many of you demanded to increase or
built infrastructure of government hospitals, PHC, CHCs???
3. Why every one want to excel private sector except hospitals??? If private is a
problem sector is a problem what is the solution??
4.Government and private sector both have their merits and demerits. So chill.
PS-The day politicians and bureaucrats of that area started taking services of local
government school and hospital, They Will automatically become good.