₹77,000 a Day per Bed: Why Healthcare Feels Out of Reach in India?
Something unusual is happening in India’s hospitals. On the surface, it looks like progress—record profits, soaring revenues, and international investors lining up to pour money into the sector. Headlines proudly declare that India’s healthcare industry is “booming.”
But step into a government hospital and you’ll find patients lying on floors because beds are full. Visit a private hospital and families whisper in corridors about bills running into lakhs. Scroll through social media, and you’ll see desperate appeals for blood, oxygen, or money for life-saving surgeries.
This is the paradox: while hospitals are celebrating record profits, ordinary Indians are struggling harder than ever to access affordable care.
The ₹77,000 Bed
A Private Hospital, which has one of the country’s largest hospital chains. In FY23, it earned more than ₹77,000 per bed, per day. At that rate, a 200-bed hospital could generate ₹15–16 crore in monthly revenue.
So what explains these staggering numbers? The answer lies in a business metric most patients have never heard of: ARPOB—Average Revenue Per Occupied Bed.
Just as hotels calculate revenue per room, hospitals calculate revenue per bed. But the difference in patient categories is enormous.
- A dengue case might bring in only ₹1,000 a day.
- A cardiac surgery can generate over ₹1.5 lakh per day.
Same bed, two drastically different outcomes.
This arithmetic has quietly reshaped priorities inside India’s private hospitals. High-end, high-ticket procedures like robotic surgeries, transplants, and cancer treatments dominate. Meanwhile, essential but lower-revenue areas—pediatrics, psychiatry, emergency medicine—fade into neglect.
When Investors Replace Doctors
The shift isn’t only medical. It’s financial. Today, many of India’s largest hospital chains are controlled not by doctors but by private equity firms.
- Blackstone (US) owns a majority stake in Care Hospitals.
- KKR has invested heavily in Radiant and Max.
- Temasek (Singapore) and Ontario Teachers’ Pension Plan (Canada) hold large positions in Manipal and Apollo.
For these investors, hospitals are assets—bought, scaled, and sold for profit.
The playbook is straightforward:
- Acquire a hospital at a modest valuation.
- Boost ARPOB within three to four years by prioritizing high-value cases.
- Exit at a far higher valuation, reaping massive returns.
The billions flowing into Indian healthcare are not charity. They are investments chasing profit.
The Playbook in Action
To raise ARPOB quickly, hospitals adopt three strategies:
- Clinical Re-engineering: Everyday care is de-prioritized, while lucrative specialties—oncology, IVF, cardiac care—get premium infrastructure.
- Bed Optimization: Beds are reserved for high-margin cases, while “less profitable” patients face waiting lists or redirection.
- Doctor Incentives: Salaries and bonuses are tied to revenue generated, pushing doctors toward recommending high-value procedures.
The result? Hospitals morph into revenue-maximizing machines. Patients aren’t people—they’re potential invoices.
The American Warning
This isn’t just theory. In the U.S., private equity has already transformed healthcare—with disastrous results.
- A 2021 study by JAMA found that private equity ownership often led to higher charges, aggressive billing, and worse patient outcomes.
- Rural America lost 136 hospitals between 2010 and 2021—many of them closed after private equity takeovers deemed them “unprofitable.”
- Medical debt is now the largest source of personal bankruptcy in the U.S., affecting more than 100 million Americans.
These very same firms—Blackstone, KKR, Apollo—are now replicating their playbook in India.
India’s Unique Vulnerability
India’s challenges make the risks even more severe.
- 70% of India’s population lives in rural areas, yet 60% of hospital beds are concentrated in just seven cities.
- According to the World Bank, India spends only 2.1% of GDP on healthcare, far below the global average of 6%.
- Out-of-pocket spending remains shockingly high—over 55% of all medical expenses are borne directly by patients.
This means private hospitals aren’t just an option—they’re often the only option. And if those hospitals chase profits above patients, millions are left stranded.
The Doctor Drain
Another ripple effect: talent flight.
- A government hospital doctor earns about ₹80,000–1,00,000 per month.
- A private hospital, backed by investor funds, can offer three to four times more.
Unsurprisingly, the best-trained doctors migrate to private chains. The public system—where the poor and middle class turn first—loses its backbone.
An Irreversible Shift?
Once a hospital is engineered for high-margin care, reversing course is nearly impossible.
- Investors won’t accept lower profits.
- Doctors won’t accept lower salaries.
- Infrastructure built for robotic surgeries cannot be easily repurposed for primary care.
Even if the government tries to intervene, who buys hospitals back at inflated valuations? Who convinces investors to compromise returns?
India’s healthcare system is being re-engineered—possibly permanently.
Patients or Profits?
The soul of healthcare lies in healing. But when investors dominate, healing becomes secondary to revenue. If your ARPOB isn’t high enough, the system has no space for you.
India now stands at a crossroads. Will hospitals remain sanctuaries of care, or will they become factories of profit?
Because the real question is no longer about hospitals or investors. It’s about us, the patients. When we step into a hospital tomorrow, will we be seen as lives to save—or numbers on a balance sheet?
A Call for Reform
The story doesn’t have to end this way. India still has the power to protect its healthcare future.
- Cap Investor Control: Limit private equity ownership in critical healthcare infrastructure.
- Transparent Pricing: Mandate upfront disclosure of treatment costs and regulate unfair billing practices.
- Strengthen Public Healthcare: Raise public spending to at least 3% of GDP, improve doctor-patient ratios, and expand rural hospital networks.
- Retain Talent: Offer competitive pay, training, and research opportunities to keep doctors in the public system.
- Balanced Infrastructure: Incentivize private players to expand outside metros through tax breaks and subsidies.
Healthcare is not real estate. It is a public good, a human right. If India allows hospitals to turn fully into profit centers, millions will pay the price—not just in money, but in lives.
The time to act is now. Because a healthcare system built only for profit is a system that will eventually fail the very people it was meant to serve.
Disclaimer:
This article is intended for informational and educational purposes only. The analysis presented is based on publicly available data, industry reports, and expert commentary. It does not represent medical, financial, or investment advice. The views expressed are solely those of the author and are not meant to target or discredit any specific hospital, institution, or individual. Readers are encouraged to verify facts independently and consult professionals for guidance on healthcare or financial decisions.
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