The other approach is a more drastic legislative approach, as underlined by Rajasthan’s bill, which accords with the Congress manifesto of 2019 that proposed a Right to Healthcare Act based on increasing public health spending to 3% of the Gross Domestic Product by 2023-24 and strengthening public infrastructure. Despite its drawbacks and implementation challenges, the legislative approach is crucial in holding the government accountable for health care failures and raising public awareness of health rights, which are currently lacking.

Doctors have primarily objected to a provision in the bill that requires private health care providers to deliver emergency medical care without prepayment. Although the bill outlines government obligations, such as resource mobilisation, it does not address the issue of compensating private players for providing free services, or the mode to do so.

The state government must assuage these concerns, not just by incorporating explicit reimbursement provisions, but by envisaging a robust system to consultatively decide rates and revise them periodically, as well as embedding solid reimbursement processes and timelines. These could be implemented through the existing government health insurance apparatus. While a detailed exposition of reimbursement terms has to be left to the rules that will be promulgated in due course, the state government must look to reaffirm its commitment to a gainful private-public collaboration through amendments in the bill, rather than alienating the medical community. Further, the administrative organs conceived in the bill, such as state and district health authorities, are bureaucratically heavy and will do well with a greater representation from the patient community.

But a rollback is unwarranted, especially because the current outrage is overblown. Here’s why. One, the bill is unprecedented in its embrace of a holistic definition of health beyond mere health care, encompassing important social determinants of health such as nutrition. Such an approach when adopted legislatively can be pioneering.

Two, nowhere in any universal health care system is emergency medical attention left to the vagaries of the market, and this has already been upheld in past judicial rulings (Parmanand Katara v Union of India). Some years ago, similar protests were evoked by the Clinical Establishments Act 2010, which required clinical establishments to stabilise all incoming emergency cases. No such sweeping provisions have been made in the current bill.

Three, the bill guarantees safe and quality health care, and mandates the State to establish quality standards. Accountability in this area has been lacking in both the public and private sectors. Other promising aspects of the bill include the right to health information, confidentiality, grievance redressal, and freedom from medico-legal issues.

Fair health systems prioritise health utility and equity, not provider profits. Even liberal universal health care systems, such as Switzerland, legislate health care providers to ensure equitable health care. The bill can be a useful step in that direction. The medical fraternity has strong moral stakes in improving health equity and should not object to medical practice being brought under the rightful legislative fold. However, it is incumbent on the State to ensure that their healers are not denied their rightful due.

Dr Soham D Bhaduri is a health policy and leadership specialist, and chief editor of The Indian Practitioner

The views expressed are personal