After Environment Minister Jairam Ramesh’s advocacy of public sector in biotechnology research in agriculture, it is the turn of health minister Gulam Nabi Azad to make a pitch for expanding public sector.

“The poor and the lower middle class strata of our society require state intervention to provide them protection against high cost of medical care,” Azad told a conference organized by the Planning Commission on Tuesday.

“In the absence of such an option, it is seen that private health care costs have had a devastating impact on household incomes,” he said, noting that more than 3 crore persons get impoverished every year on account of out-of-pocket medical expenditure. Having allowed the private sector to have a dominant presence in healthcare, it was time India made a big expansion in public investment in providing healthcare, he said.

Notably, Azad’s colleague Jairam Ramesh had recently took the rap from some members of the Cabinet for his stand that India could not rely on private biotech research in agriculture.

It’s unclear if Azad’s advocacy of public sector will meet the same fate or is a statement of official policy.

Azad also called for a “regulatory framework” for protecting against the malpractices of the private healthcare providers.

“We have recently tabled in the Parliament the Clinical Establishment Act… to provide a framework within which the private sector can collaborate with the public sector in a responsible manner," he said.

He said that his ministry did also recognize the need for private participation, such as “a number of models under which diagnostics such as laboratory services, X-ray, CT and MRI and other high end equipments/services can be outsourced.”

“(Public-private) partnerships have not only enabled a choice of treatment but also reduced pressure on public hospitals which are now being used by the poor who are neither covered by insurance nor can afford private health care costs.”

India’s public investment in health is about 1% of the GDP, unlike most other countries that spend 3% to 10% of their GDP on health. To redress the balance, about Rs 8000 crore had been allocated for National Rural Health Mission and over Rs 10,000 crore would be spent in the next 2-3 years on setting up six AIIMS-like institutions in under-served areas.

Azad also mentioned that Rs.1300 crores being invested in government medical colleges and Rs.1200 crores in establishing 250 nursing schools.