Healthcare Referral, Market Imperfection and Health Policies in India: A Populist Argument

Though Indian health policies have highlighted the importance of healthcare referral for years, India lacks a formal, regulated healthcare referral mechanism. Under the backdrop of the rise in populist arguments across the globe and the aftermath of the COVID-19 pandemic, this essay critically discusses the positioning of healthcare referral systems in achieving universal health coverage in India from populist policy perspectives. A critical review of journal articles, Indian health policies, programmes and referral practices is conducted to comprehend the resulting market imperfection in India and to provide a background for theorising and further empirical analysis. Populism is ubiquitous in Indian health policies, though distinctly in rural and urban systems. While public healthcare institutions are characterised by a lack of human resources and poor infrastructure, in order to address health inequity, the government is inviting increasing participation from private market players. However, private caregivers are alleged to be profit-seeking. Information asymmetry, lack of regulations, weak monitoring frameworks and unstructured referral networks foster market imperfections, leading to suboptimal health outcomes. This essay, in its unique effort, analyses the existence of populist health policies in India and explains their failure without a proper healthcare referral mechanism.