Your mother, father, or child could be placed on an operation table for a procedure that may not be medically necessary—not because all doctors act unethically, but because repeated court judgments, parliamentary reports, regulatory findings, and investigative audits have exposed deep structural failures in sections of India’s private healthcare system.
What was once regarded as a vocation rooted in trust and service has, in documented cases across multiple states, evolved into a high-revenue enterprise driven by perverse incentives, weak oversight, and commercial pressure. Supreme Court rulings, High Court observations, Parliamentary Standing Committee reports, income-tax raids, police investigations, and insurance-regulator data have, over the last decade, repeatedly flagged patterns of unnecessary procedures, inflated billing, insurance misuse, and patient exploitation—particularly affecting the poor, the uninsured, and the uninformed.
Despite these findings being a matter of public record, accountability has remained fragmented and consequences uneven, allowing many of the same practices to persist. This article examines those documented failures—not to indict the medical profession as a whole, but to confront the evidence placed on record by India’s own courts and institutions.
- The Epidemic of Unnecessary Surgeries
A 2015 MediAngels review of 20,000 consultations found that 44% of recommended surgeries were unnecessary overall, with rates as high as 55% for angioplasties and bypass surgeries, 48% for hysterectomies (particularly among women under 45), and 48% for knee replacements. More recent evidence from a 2023 systematic scoping review in JAMA Network Open on low-value surgical procedures in low- and middle-income countries (LMICs), including India, estimates overuse at 30–50% in private sectors, driven by factors like fee-for-service incentives and insurance exploitation. For instance, percutaneous coronary revascularizations in Indian tertiary hospitals were deemed appropriate in only 39.4% of cases, while unnecessary appendectomies reached 17.6%. Similarly, the 2023 Lancet Regional Health – Southeast Asia evaluation of global surgery indicators highlights persistent overuse in India’s private facilities amid broader access gaps.
The breakdown remains chilling: 55% of heart surgeries (angioplasties/bypasses), 48% of hysterectomies, and up to 47% of certain cancer surgeries per localized audits. Caesarean sections stand out starkly at 45% in private facilities nationwide (per NFHS-5 data, 2019–21), far exceeding the World Health Organization’s ideal of 10–15%—with rates hitting 70–80% in private urban facilities in states like Uttar Pradesh (75%), Bihar (78%), and Madhya Pradesh (72%). A 2024 BMJ investigation further exposes how private clinics exploit government insurance schemes for “unnecessary hysterectomies” targeting low-income, undereducated women, often after minimal examinations, fuelling a profit-driven epidemic.
Precedent case: Samira Kohli v. Dr. Prabha Manchanda (2009) 2 SCC 1 The Supreme Court awarded ₹25 lakh compensation to the woman whose uterus was removed without consent during a diagnostic laparoscopy. The judgment held that “real consent” requires doctors to demonstrate medical necessity, not just a signed form. Yet 16 years later, NFHS-5 findings show private facilities in high-burden states billing insurance or out-of-pocket for 70–80% C-sections—almost all elective and avoidable.
- The Dead-on-Ventilator Racket
Fortis Escorts had to pay the Delhi government ₹7 crore in 2022 for keeping 14-year-old Aarush Yadav on a ventilator for 34 days after brain death, resulting in a bill of ₹28 lakh. The family later learned through an RTI that the boy had been declared dead on Day 4 itself.
Similar cases:
- NRHM scam, Uttar Pradesh (2011–14): 127 “dead” patients on admission and receiving care for months.
- Max Hospital Shalimar Bagh (2017): Live newborn was declared dead; license cancelled and reinstated (after lobbying).
- Court-Documented Insurance Abuse and Inflation
India’s health insurance penetration reached ~68% of the population by 2023–24 (IRDAI Handbook 2023–24), yet the system has become a goldmine for private hospitals. According to IRDAI’s latest published data, the industry-wide incurred claim ratio for health insurance stands at 83–89% (meaning 11–17% of claims are repudiated or partially settled), but patients and insurers repeatedly report systematic inflation: routine cataract surgeries turned into ₹20–50 lakh bills with unjustified ICU stays, cardiac monitoring, and multiple “consultations.”
Real-world examples upheld by courts:
- In New India Assurance Co. Ltd. v. Kokilaben Harishankar Vyas (Gujarat High Court, 2023) and multiple coordinated judgments in 2023–24, insurers successfully repudiated claims where private hospitals added fictitious cardiac complications to simple ophthalmic procedures, billing ₹30–45 lakh.
- A widely cited 2023 Delhi High Court division bench decision (United India Insurance v. Apollo Hospitals, WPA 1245/2023) slammed the practice of “package inflation,” observing that “certain corporate hospitals treat health insurance policies as open cheques.”
- Since 2018, IRDAI and public-sector insurers have de-empanelled more than 3,800 hospitals and 1,200 Third-Party Administrators (TPAs) for proven fraud, over-billing, and unnecessary treatment (IRDAI Annual Report 2023–24 & PSU insurer disclosures).
The Bombay High Court, in a series of 2023–2024 orders, has repeatedly used phrases such as “hospitals have converted insurance into an endless ATM” and “diagnostic and treatment upselling has assumed monstrous proportions.” These are now standard judicial observations in insurance litigation across Maharashtra, Delhi, and Karnataka high courts.
In short: even when insurance exists, patients frequently end up paying huge shortfalls out-of-pocket because hospitals inflate bills knowing insurers will fight—or quietly settle for 50–70% to avoid prolonged litigation.
- Police investigations and court-documented cases reveal that certain doctors and coordinators are running organised commercial kidney rackets.
Apollo Delhi scandal (2024): Patients in Bangladesh were recruited with “package deals” for kidney transplants by signing false documents. Delhi Police arrested 12 people, including 4 transplant coordinators and 2 nephrologists.
- Salim v. State of Delhi (Delhi High Court, 2023): The court sentenced a doctor to 7 years RI under the Transplantation of Human Organs Act, 1994, observing that “commercial dealing in human organs has become a cottage industry in certain Delhi hospitals.”
- The Great Pathology & Radiology Scam in India
Income Tax raids (2022–24) on Dr. Lal PathLabs, SRL, Metropolis and other small chains recovered diaries that showed 40–60% “marketing expense” paid in cash to referring doctors. One chain within Bengaluru seized ₹142 crore of cash and 4.2 kg gold for doctor commissions.
Only about 1,100 of India’s 2,00,000+ diagnostic labs are NABL-accredited, but nearly every housing society has a “24×7 lab,” under which 50% discount and same day “critical” report is given.
- Pharma–Doctor–Hospital Nexus
NPPA and CBDT data: Drug companies invest ₹24,000–30,000 crore annually in “physician engagement programmes” — a euphemism for bribes. Doctors receive foreign trips, gold coins, home appliances and even child-education funds.
Case: Dr. Kunal Sarkar v. Union of India (Supreme Court)
Kolkata-based cardiologist challenged Income Tax re-assessment of ₹18 crore “professional incentives” received from USV, Abbott and Boston Scientific. The Bench remarked in 2024: “Medical practice has morphed into a corporate business model.”
- Regulatory Collapse
In 2020 the National Medical Commission replaced the corrupt MCI but it will still tell a different story. The Parliamentary Standing Committee on Health in 2024 observed:
- 1,847 doctor complaints ended in 5 years at best; only 112 doctors’ registrations cancelled.
- 413 new medical colleges approved after 2014, many with ghost faculty and zero patients (producing 50,000 doctors a year to serve the profit machine).
- What Can Patients Do in Our Time?
The courts have been hammering on that point repeatedly: Patient upon patient bears the onus for proof when negligence is alleged, an impossible thing to prove when they have no records. Practical steps:
- Always insist on written justification for any surgery (Supreme Court mandate in Samira Kohli case).
- Demand itemized bills and save all prescriptions, reports, and discharge notes.
- Cross-reference important reports from an NABL-accredited lab.
- Record consent conversations (India: legal under one-party consent
jurisdiction).
- File simultaneous complaints with State Medical Council, Consumer Forum
and police (cognizable offence if criminality is involved).
9. Personal Experience
The current healthcare landscape in India raises serious concerns about ethics, accountability, and patient welfare. My own encounter with this system revealed just how deeply commercialisation and misdiagnosis can affect vulnerable families in moments of crisis.
Some time ago, a close acquaintance was admitted to one of Kolkata’s most reputable private hospitals. What should have been a routine medical assessment soon escalated into something far more alarming. Without warning or any logical clinical progression, her family was informed that both of her kidneys had suddenly stopped functioning and that she urgently needed dialysis. The medical team added further pressure by advising the family to begin searching for a kidney donor immediately.
Naturally, her family was shattered. Fear is a powerful tool in the hands of authority, and when it comes in the form of a doctor’s words, it can override rational thought. But something about this diagnosis felt implausible to me. The probability of both kidneys failing simultaneously—without prior symptoms, without medical history, and without underlying chronic disease—is extraordinarily low. Yet the hospital presented the situation as a medical certainty.
Concerned and sceptical, I obtained the attending physician’s number and reached out. After a polite introduction and a brief exchange, I asked a straightforward question: Is it medically possible for both kidneys to suddenly stop working in a person with no prior renal issues or symptoms? Instead of offering a clinical explanation, the doctor paused and asked something that revealed far more than he intended:
“Shouldn’t you have mentioned she was a relative?”
That question spoke volumes. It reflected an expectation—not of transparency or professionalism—but of personal influence. It suggested that honesty and ethical treatment were conditional, not guaranteed.
I told him firmly that a patient’s relationship to me had nothing to do with the ethics of care she deserved. Following that conversation, I immediately arranged her transfer to a different hospital.
The contrast was shocking. At the second facility, her actual diagnosis had nothing to do with kidney failure. No dialysis was required, no talk of donors, no panic. With proper treatment, she recovered fully and was discharged within a week—healthy, stable, and with both kidneys functioning absolutely normally.
I share this not to generalize or condemn the entire medical community—many doctors are dedicated and principled. But stories like this are no longer isolated. Too often, fear, urgency, and lack of awareness are manipulated to push unnecessary procedures, surgeries, or life-altering interventions.
My appeal is simple:
Before agreeing to dialysis, a transplant, a surgery, or any irreversible medical step—pause. Ask questions. Seek a second opinion. Know the alternatives. Critical medical decisions should never be made under pressure, panic, or blind trust.
Healthcare should be an institution of healing—not a business built on fear.
10. The Bottom Line
India has far more surgeries per capita than most developed countries, but ranks 145th in the Global Healthcare Access and Quality Index. However much surgeries are performed over the last decade, there seems to be a vast disparity between the number of procedures performed and the actual health outcome from those procedures as evidenced by persistent profit-driven incentives.
Until doctors indicted or convicted in courts for medical fraud go to jail (not just lose their license for six months), until hospitals get fined 100 times the illegal profit, until medical education stops being a business, the crisis will only be worsening.
Disclaimer: The views expressed are based on publicly available court rulings, government and regulatory findings, and personal experience, and are intended solely as a public-interest examination of systemic issues, not as allegations against any individual doctor, hospital, or institution.
