Excellent podcast. Agree mostly with Ajay. Adding a few points here that are complementary to his approach.

1. The private vs. public sector is a false debate that we have indulged in, in India, for too long. In countries with poor institutions, both do poorly. E.g. India. https://twitter.com/pujamehra/status/1266727621556965376

2. In countries with more developed institutions, both private and public sectors play important and complementary roles. E.g. Nordic countries.

3. There are two factors that keep institutions poor: political economy and state capacity (SC).

4. While Ajay stresses on the lack of SC in India, the political economy has played an important role in keeping SC low. He touches upon this towards the end, saying that citizens need to get back control on their representatives.

But there is an institutional problem here too.

5. The problem is that our political systems (electoral and non-electoral) have become too expensive and unregulated and this encourages rent-seeking in every conceivable way in every sector. This includes the healthcare sector discussed in this podcast.

6. This rent-seeking approach deliberately keeps private sector regulations lax or non-existent AND public sector inefficient through bad incentive structures.

7. This is a low level institutional trap where the political system has no interest in developing state capacity.

8. So, together with the legal, regulatory and other institutional reforms that Ajay stresses, unless there are reforms in political funding, these institutional weaknesses and poor state capacity will not be eradicated.