Ideas of India Nachiket Mor on Rethinking India's Healthcare System
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Feb 12, 2026 Nachiket Mor, a health economist working on system design and reform, discusses India’s layered public and fragmented private healthcare. He talks about policy design failures, upgrading community health workers, why patients move to private care, purchaser–provider splits, insurance design, and using pharmacies and telemedicine to expand access.
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Use Purchasers To Improve Accountability
- Separate purchasing from provision by creating autonomous purchasers to buy care on an arm's-length basis from providers.
- Hold providers accountable for community outcomes instead of micromanaging individual actions.
Public Hospital Innovation Example
- Dr. Amira Fernandez ran a government hospital where professional satisfaction and innovation thrived despite public setting constraints.
- She cut premature neonatal mortality drastically by training relatives as neonatal nurses and building a human milk bank.
Pharmacies As Primary Care Channels
- Pharmacies are ubiquitous and de facto first-contact providers; they can be repurposed as regulated primary-care channels.
- Pairing pharmacies with telemedicine and training converts them into supervised gateways for chronic and routine care.