A hiatus exists between the five-star ( or seven star?) health care provided at exorbitant costs by the elite hospitals-usually outside the reach of the majority of the people-and the facilities available in public hospitals and dispensaries.That inveterate iconoclast, Ivan Illich, had long ago commented that the medical system has itself become a health hazard.The World Health Organisation has recently painted a grim picture about the availability of life saving drugs across the counter.Alongside islands of prosperity exist a vast hinterland where your doctor, or the person masquerading as one, is lured more by lucre than the need to abide by the Hippocratic Oath.The very best of medical education, subsidised at a huge cost to the national exchequer,is often wasted when the best of the country’s professional talent- and about that, there is no dearth of international recognition, if that is what one is looking for–thus goes waste with a kind of criminal profligacy which the “profit above all” ethic of out-and-out capitalism and consumerism inculcates through an educational system which even today is heavily tilted in favour of those who can afford to indulge in its luxuries. Years ago, the Voluntary Health Association, under the indefatigable Dr Meira Shiva, had come up with the prescient observation that several meaningful attempts like “Where there is no doctor” had been ignored by a somnolent state.The other issue, often talked about but usually ignored, is the lack of accountability.The credibility gap between stated intentions and the reality on the ground is there for all to see- but what can one do about what can be called the conspiracy of deliberate myopia? Those who consider privatisation to be the answer ignore the fact that the huge investments that are made are not channelised towards developing a solid health infrastructure.Conscientious doctors apart, most of our practitioners do little to wake up the sleeping Goliath, lost as they are in the labyrinth of ‘protocol’.That India’s achievements cannot be belittled even by the most cynical of commentators is as true as is the fact that the overall social framework is itself so unfortunately bereft of egalitarian values.