Book Review | What Ails Private Hospitals: A Full Diagnosis

Even in a crowded field of contenders, it is hard to find an institution of public life as widely despised, by the infirm and healthy alike, as the private hospital. Any sickness, even under the best of circumstances, inspires trepidation, but the sort of nightmare scenarios thrown up by privatised healthcare in this country bear little elaboration—constituting, as they do, their own distinct subgenre within the widening catalogue of urban horror stories in modern India. Journalist Abantika Ghosh, whose first book documented the country’s health infrastructure under lockdown, frames Games Hospitals Play as both a guide to navigating the intentionally labyrinthine and intimidating bureaucracy of receiving private healthcare, as well as a fastidiously researched, if prosaic, overview of how its mechanisms function.

In setting about the unenviable task of explaining the wide tangle of acronyms, medical procedures and legislations undergirding the system, Ghosh’s book underlines the gulf in information that shapes the relationship between hospitals and their patients in India today. The system, she is hardly the first to argue, thrives off the anxiety produced by such asymmetry, preying on the desperate. The author sets about explaining each of these processes layer by layer, drawing on patient testimonies, mostly anonymous sources from within the healthcare world, court records, academic research, as well as her own experience reporting from the frontlines of India’s hospitals.

The tone of this book is neutral and empirical, but sometimes the facts alone can make for polemical reading. The narrative moves across the myriad ways hospitals inflate patient bills, through the overcounting of consumables like syringes and gauze to extraneous testing, the duplicitous pricing of drugs, and arbitrary, Uber-like surge pricing on beds and surgical treatment. As across many facets of the privatising world, the healthcare industry’s ability to extract profit from matters of public necessity, as well as the legalisation of these malpractices, is rendered with impressive moral clarity.

Minor inconsistencies, an occasional overcooking of a point, raise an eyebrow: An otherwise sharp section describing the outrageous prospect of Apex Laboratories, the manufacturers of the well-known multivitamin ‘Zincovit’, appealing to the income tax court to write off nearly 5 crore rupees’ worth of kickbacks and gifts to doctors who recommended the drug to patients during Covid devolves into the much weaker, relatively insubstantial links between Zinc supplements and the deadly outbreak of mucormyosis, also known as ‘black fungus’, during the second wave. In other sections, the writing starts to flag, burdened by its linear prose, heavy on numbers and acronyms.

Yet these inconsistencies aside, there is likely to be a large number of readers who will look to this book with gratitude. Concise yet unsparing in its diagnosis of the epidemic of privatisation, it also doubles as a useful, methodical guide to anyone unfortunate enough to find themselves in the circumstances to require it.

Games Hospitals Play: Decoding Your Private Healthcare Experience

By Abantika Ghosh

Bloomsbury

pp. 204; Rs 699