Rusted gates brought us to what would have been a marvelous compound 150 years ago. A potion of mold and grime caked crumbling concrete and stone facades around poorly re-painted metal window frames. Some had glass in them. Poorly constructed tin roofed structures dotted a waiting area drowned in the cacophony of perpetual honks and horns of Mumbai traffic. Hundreds of patients swarmed in the outdoor waiting area. Some in wheelchairs, some bandaged, some sleeping on a ground still damp from monsoon rains. Walking through halls of the old Victorian structure felt reminiscent of an English college in the early 1900s, including the absence of air conditioning.

We visited three government hospitals during our time in Mumbai: Tata Memorial, Nair, and King Edwards Memorial. While some wards may look like a setting for a Stephen King novel, sadly many observations of Indian healthcare stop with aesthetics. Digging a bit deeper, it turns out these hospitals have quite a bit they can teach the West.

India provides healthcare to a staggering number of its citizens at an equally staggering low cost, and does so across a wide range of offerings: from orthopedics to oncology. India provides care to its 1.3 billions citizens through a network of 60,000 hospitals, with one government hospital bed for every 2000 citizens, and one state-run hospital for every 90,000 people. King Edwards Memorial Hospital’s emergency department sees over 1000 patients a day, and the typical government hospital ward sees more than 200 patients a day. While patients often have to share beds and wait hours to see a physician, these patients eventually do receive care.

Despite this patient inflow, India spends only 4.3% of GDP on healthcare. An outpatient visit can cost as little as $2, and an inpatient stay $6 per night. Even at the nicest hospital in Mumbai where Bollywood stars receive care, a night in a private room can cost as little as a three star hotel in the United States (in contrast a night in Elly’s ICU in Washington D.C. starts at $10,000). In conversations with Indian clinicians validated by businessmen we spoke to in Mumbai, most Indians do not go overseas for their healthcare. While the poor cannot access the private hospitals the elite receive services at, even the poorest have access to specialty healthcare, such as the oncology services offered at Tata Memorial Hospital in Mumbai.

Healthcare in India still has a long way to go: Health shocks send populations the size of Australia below the poverty line each year, and Bain and Company estimates that India will need an additional two millions beds to accommodate patients in the next ten years in addition to 3 trillion dollars in additional expenditure. However, India serves as a great example of how a resource constrained health system can serve its population.