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Senior physicians of modern medicine in India play a key role in shaping policies and public opinion and institutional management. This paper explores their perceptions of medical tourism (MT) within India which is a complex process involving international demands and policy shifts from service to commercialisation of health care for trade, gross domestic profit, and foreign exchange. Through interviews of 91 physicians in tertiary care hospitals in three cities of India, this paper explores four areas of concern: their understanding of MT, their views of the hospitals they work in, perceptions of the value and place of MT in their hospital and their views on the implications of MT for medical care in the country. An overwhelming majority (90%) of physicians in the private tertiary sector and 74.3 percent in the public tertiary sector see huge scope for MT in the private tertiary sector in India. The private tertiary sector physicians were concerned about their patients alone and felt that health of the poor was the responsibility of the state. The public tertiary sector physicians’ however, were sensitive to the problems of the common man and felt responsible. Even though the glamour of hi-tech associated with MT dazzled them, only 35.8 percent wanted MT in their hospitals and a total of 56 percent of them said MT cannot be a public sector priority. 10 percent in the private sector expressed reservations towards MT while the rest demanded state subsidies for MT. The disconnect between their concern for the common man and professionals views on MT was due to the lack of appreciation of the continuum between commercialisation, the denial of resources to public hospitals and shift of subsidies to the private sector. The paper highlights the differences and similarities in the perceptions and context of the two sets of physicians, presents evidence, that questions the support for MT and finally analyzes some key implications of MT on Indian health services, ethical issues emerging out of that and the need for understanding the linkages between public and private sectors for a more effective intervention for an equitable medical care policy.

This article locates health care and technology within the shifts in capitalist evolution from welfare to neoliberal development and examines why the concept of Comprehensive Primary health care has been distorted by the market to varying extents globally. Its focus is on India’s planning process where the thrust is to transform health services into commodities and tools of extraction of profit to which all levels of health care are subordinated. Since the 1990s, all Plans, official planning committees and legislations are meant to mould services in this direction. Instead of an integrated health service with primary health care getting support from the secondary and tertiary, the current thrust of the planning process has been to fragment health service into independent components—UHC, tertiary care and NRHM—in the name of providing rural and urban health services. In each of these strategies, public–private partnerships, commercialisation and appropriation of the public resources are the dominant trends. UHC thus no more remains the state-led integrated and inclusive service but a Trojan horse of the neoliberal strategy.