State and health markets in times of a Pandemic: Lecture by Prof. Purnendra Prasad

COVID-19 brought to the fore a need to strengthen fragile public institutions and their infrastructure to tackle enduring forms of structural precarity, reduce the growing inequalities, and expand access to public goods such as healthcare, education and housing. What has been the state’s response? This talk attempts to explain three broad trends that underpinned the relationship between the state, market and health care: First, the state has moved away from its welfare and health provisioning role to a regulatory function which involves shifting the resources, authority and responsibility to diverse public and private actors. Second, as big businesses have strengthened their alliance with the state, corporate medical power is now entrenched in every segment of the health industry. In the name of pandemic, the state has opened up fresh frontiers of privatisation and corporatisation of health care extending to non-metropolitan cities and small towns. Third, the above two processes would increasingly lead to further individualisation and financialization of health care in India. I argue that addressing health inequalities and the exclusion of lower classes, castes and genders from access to health care depends on how counter hegemonic movements develop in the current context.