What’s the real cost of living and dying in a hospital in India? Well, it’s a thin line between a patient’s luck and the physician’s acumen, where the battle for life often comes at a steep financial price. Is treating the sick merely a business proposition? Does the Hippocratic Oath mean nothing to the medicos once they enter the profession?

Why should a third of the population in the country be pushed into poverty by healthcare costs? These questions are explicitly discussed than in Dr Sumanth C Raman’s latest book Sick Business: The Truth Behind Healthcare in India, which lays bare the functionings of the Indian medical system.

It is a chilling portrait of how the healthcare system—private and government—in our country works; how rigged the system is; and the emotional turmoil that both patients and doctors face. It’s a wakeup call to reassess all the small steps and the giant leaps that are needed to fix the system.

To begin with, Sick Business provides a grim picture of the healthcare system with its no-holds-barred interviews and riveting accounts. There are confessions by doctors, healthcare professionals, pharma executives and patients—all functioning as a clarion call to fix the gaps that exist in the system. These aren’t stories that we aren’t already aware of, nor are these revelations that come as eye-openers. By putting together all the anecdotal narratives, and backing them with compelling data, however, Dr Raman exposes the pristine white coat and asked some hard-hitting questions.

For instance, he questions the education system, and writes how doctors are not tested on how they would manage specific conditions as examinations tend to focus only on theory. He questions why there are very few patient bodies or consumer groups in India that take up the cause of patients’ safety and demand accountability from their healthcare provider. He is as irked by patients’ demands for over-diagnosis as he is with the silent epidemic of surgeries. With this book, Dr Raman isn’t offering any magic potion nor is he demanding sweeping changes. Rather, he offers some thoughtful suggestions that are the need of the hour.

He doesn’t shy away from calling a spade a spade. The book covers various issues—over-testing by doctors, patients feeling dejected when tests are not ordered, doctors rushing to meet hospital targets, challenges in rural areas, malpractices, and medical negligence.

If you thought the pharma industry is neck deep in kick backs, this book reveals that the medical devices industry is submerged in it. In Dr Raman’s words, “Multiple industry sources tell me that it is extremely rare to find a hospital or an orthopaedic surgeon in India who does not get a cut from the implants they place inside patients’ bodies.” Some of the other equally interesting insights include how the nexus is further deep in specialities such as diabetes, with its massive patient population and expensive insulin; cardiology with its long-term care needs; and oncology and rheumatology with their high-cost drugs. Health insurance, technological advancements such as Artificial Intelligence, Covid-19 and its impact are other key aspects that the book touches upon to highlight how the healthcare system has changed over the years.

Sick Business is an honest attempt at bringing to light an overburdened public healthcare system, and the expensive private treatments. It’s a book that’s struggling to find balance between hope and peril. So, the next time they ask you about inserting a stent or a knee replacement, think again. If you have read Sick Business, chances are that you will reevaluate your medical options.