Healing for Sale: Punjab’s Medical Marketplace

Pushpinder Singh Gill

In a land that once believed healing was an act of seva, the new religion seems to be billing. The citizens of Punjab now stand outside hospitals unsure whether they are patients or customers. In a culture that once offered water to strangers and prayers for the sick, health has become a receipt printed between fear and hope. From the glittering facades of corporate hospitals to the crumbling walls of government clinics, one question throbs like a wound: when did healing become a market?

Walk through any town or village and the paradox is glaring. On paper, Punjab’s healthcare landscape looks promising — the spread of Aam Aadmi Clinics, free diagnostics, telemedicine through eSanjeevani, and the announcement of the Mukh Mantri Sehat Bima Yojana, a scheme meant to bring cashless treatment to the poor. Yet, in reality, the scheme remains unimplemented, and Punjab’s earlier health plans — like the Bhagat Puran Singh Sehat Bima Yojana and the Sarbat Sehat Bima Yojana — lost steam to delays, corruption, and confusion. Health cards were distributed, claims were filed, promises were made. But hospitals complained of unpaid dues, patients found themselves caught between paperwork and illness, and the poor returned to private quacks who asked for cash and offered faith instead of medicine. Can a state that has repeatedly failed to sustain its own health missions be trusted to build a new one with sincerity?

Privatisation hasn’t just entered healthcare; it has devoured it. Across Punjab’s cities, towering hospitals now resemble luxury hotels, offering wellness packages and gourmet meals. Meanwhile, rural health centres struggle to provide even basic antibiotics. Patients with insurance are nudged toward unnecessary scans and extended hospital stays, while the poor are told, “Come back when you can pay.” In this ecosystem, every day of illness has a price tag. Corporate hospitals and insurance companies together have transformed human suffering into an economy. Doctors are often caught in this vortex — pressed to prescribe costly branded drugs, rewarded for pushing procedures, and punished for restraint. Yet, amid this commercial storm, countless ethical doctors continue to serve quietly, refusing to compromise their calling. Their compassion stands as a reminder that medicine was never meant to be merchandise. But when the system rewards billing over healing, can goodness alone survive?

The government sector, once the guardian of the poor, is gasping for breath. One doctor attends to hundreds of patients daily. Equipment lies idle for want of trained staff. The Aam Aadmi Clinics, though noble in idea, face chronic shortages of medicines, erratic working hours, and poor diagnostics. People queue up early morning, only to be turned away by noon. For a patient in distress, a locked clinic is more painful than the disease itself. Can universal healthcare exist in a state where the dispensary door closes before the day’s pain ends?

Telemedicine through eSanjeevani offers a glimpse of hope. Over a crore consultations have taken place nationally, and Punjab’s numbers are rising too. For minor ailments and follow-ups, the system works well. But the elderly farmer from Mansa cannot log in without help. The village mother without a smartphone cannot consult for her child’s fever. The urban poor often lack stable internet or digital literacy. When the click replaces the call, can technology truly heal? Who bridges the gap between access and understanding?

The ordinary patient today faces a labyrinth. At the hospital counter, the clerk asks for an insurance card; at the pharmacy, the chemist demands cash. Every step of recovery is lined with bills, forms, and approvals. The language of care has changed: reimbursement, empanelment, authorization. Behind each term lies a barrier, and behind every barrier, a cost. For the sick, it isn’t the disease that kills first — it’s the helplessness of navigating a system that speaks in receipts. What does dignity mean when it must stand in queue at the billing desk?

Punjab spends only around four to five percent of its budget on health — far below what is required for a functioning system. Out-of-pocket expenses remain over sixty percent, among the highest in India, forcing thousands into debt each year. Health insurance coverage is patchy, and even “cashless” schemes often demand advance deposits. In this climate, families sell land for surgery, pledge jewellery for medicine, and barter hope for survival. If health is the foundation of a nation’s strength, what kind of future does a state build when it invests more in roads than in recovery?

“Illness is what we experience, disease is what we study, and sickness is what society does to the ill,” said medical anthropologist Arthur Kleinman. His words echo through Punjab’s hospitals. The sickness of our system is not medical alone — it is moral. Doctors who wish to serve in rural areas face broken infrastructure and meagre pay. Many leave for better opportunities abroad, leaving the countryside in the hands of overworked or unqualified practitioners. Can we blame the healers who flee when healing itself has become a losing battle?

Kerala’s local health governance drastically reduced maternal and infant mortality. Thailand achieved near-universal health coverage with political resolve and community participation. Rwanda built one of Africa’s most inclusive healthcare networks through community insurance and accountability. These examples prove that intent can overcome scarcity. Yet, in Punjab, intent itself is the missing medicine. Why can’t a state with abundant resources and resilient people show the same will to heal?

The Mukh Mantri Sehat Bima Yojana, if implemented with integrity, could still mark a turning point. But the ghosts of past failures linger — delayed payments, inflated hospital bills, and private middlemen who profit from loopholes. What Punjab needs is not another “scheme” but a system that listens, audits, and enforces. District health committees must monitor delivery, patient rights must be enforceable, and hospital pricing must be transparent. Can a “cashless” promise work in a culture where honesty itself remains unpaid?

Medicines — the simplest instrument of healing — have become a tool of extortion. Pharmaceutical companies push expensive brands through persuasive marketing, while cheaper generics remain underused. The government must reclaim control over procurement and ensure that no one chooses between food and medicine. Can a society call itself humane when healing depends on affordability?

The people of Punjab are not blind to these realities. They are weary, but not hopeless. They remember another Punjab — one of faith, simplicity, and compassion. Civil groups, volunteers, and small charitable clinics still carry that flame. During the pandemic, these unseen heroes — not policies — kept hope alive. Community kitchens fed the hungry, and local doctors treated without charge. The moral energy that emerged from that crisis is proof that the spirit of seva still breathes beneath the dust of disillusionment. If the government could harness this spirit with transparency, fair monitoring, and consistent delivery, Punjab’s healthcare could be reborn. The blueprint exists; what’s missing is conviction.

The goal isn’t to dismantle private healthcare — it is to ensure that profit never tramples ethics. Regulation must protect both doctor and patient, ensuring that medicine remains a service, not a sale. eSanjeevani can reach where hospitals cannot, and Aam Aadmi Clinics can restore trust — if they are given strength, not slogans. But can technology and brickwork alone rebuild what moral erosion has destroyed?

Punjab’s revival must begin not in contracts or insurance clauses, but in conscience. A healthy state is not one that boasts of hospitals but one where a citizen can fall ill without fear. The question, then, is not about schemes or statistics. It is about the soul of a society that once equated healing with holiness. Will Punjab rise again to heal its people with courage, compassion, and integrity — or will it continue to let illness be traded like a commodity?

Until that choice is made, every heartbeat in the state carries the same silent question: who will guard our health when we cannot?