Sunil Jose (name changed), a private company employee in Kozhikode, recently took his daughter to a corporate-run hospital in the city after she complained of fever, cold, and headache. The doctor suggested a battery of medical tests to diagnose her condition.

Jose tried to find out the tentative bill amount. “Without batting an eyelid, the staff said the costs could be around ₹10,000! I managed to flee from there, making some flimsy excuse,” he says.

Jose then went to another health-care institution in the cooperative sector, where the total bill for treatment didn’t exceed ₹1,000. There were fewer medical tests, too.

The episode is reflective of some of the paradoxes in the much-celebrated Kerala model of health care—a large number of people depending on private hospitals or those offering specialty treatment even for minor illnesses, and incurring an exorbitant out-of-pocket expenditure on health, say those in the health-care sector.

Along with this, global private equity firms are investing heavily in the State’s private hospitals, both big and small, sparking off concerns about the way ahead. Parallelly, a large number of small private hospitals, which offered affordable health care, especially in the rural areas, have been winding up or scaling down their operations over the years.