In recent years, India has made significant strides in domestic manufacturing of high-end medical equipment, including Magnetic Resonance Imaging (MRI) machines. Under initiatives like the Production Linked Incentive (PLI) scheme, the government is actively encouraging local production of devices that were once predominantly imported from countries such as Germany. Siemens Healthineers, a global leader in MRI technology—with historical milestones like producing one of the first MRI images in Germany in 1978—is emblematic of this shift. The company, alongside other international players like GE Healthcare, Canon Medical Systems, and Philips Healthcare, now maintains R&D facilities in India. In theory, such domestic production should translate into lower costs, increased accessibility, and enhanced healthcare outcomes for the masses. However, a closer look at the current scenario reveals a paradox: despite these advancements, MRI scans in India remain prohibitively expensive for many.
India’s Push for Domestic Manufacturing
The Indian government’s PLI scheme is designed to position the country as a global hub for innovation, manufacturing, and exports in the medical device sector. By boosting local production of MRI machines and other critical diagnostic tools, the scheme aims to reduce reliance on imports and create new jobs. Siemens Healthineers, for instance, has leveraged its international expertise and localized R&D capabilities to tailor its advanced products—such as the MAGNETOM Terra (a 7T MRI scanner) and MAGNETOM Free.Max—to meet both global standards and local needs. In theory, this domestic shift should help reduce costs and improve accessibility. Yet, the reality on the ground tells a different story.
The Double-Edged Sword of GST and Service Charges
One of the most critical factors driving up the cost of MRI scans in India is the heavy imposition of the Goods and Services Tax (GST). The GST is applied at multiple stages:
– On the Equipment: Even as MRI machines are now manufactured domestically—sometimes with technology and expertise imported from Germany—they attract substantial GST. This increases the base cost of the equipment.
– On the Diagnostic Services: When an individual undergoes an MRI scan, the service itself is taxed. Thus, a patient not only bears the indirect cost of a high-priced machine but also faces additional charges when the service is rendered.
This dual-layer of taxation means that while the manufacturing costs may be reduced through domestic production, the final price that a patient has to pay can range anywhere from ₹3,000 to ₹25,000. For a significant segment of the Indian population, where access to basic healthcare remains a distant dream, such prices render advanced diagnostics like MRI scans a luxury rather than a routine necessity.
A Stark Contrast: Community-Led Affordable Healthcare
Amid these high costs, community initiatives—particularly those driven by Sikh institutions—offer a striking counter-narrative. Two exemplary models have emerged:
– Gurdwara Bangla Sahib Diagnostic Facility: Set to begin operations in December, this facility under the Delhi Sikh Gurdwara Management Committee (DSGMC) promises MRI scans at an astonishingly low cost of just ₹50. Additionally, a dialysis center at Guru Harkrishan Hospital on the gurdwara premises will offer dialysis at only ₹600 per session. Such initiatives highlight a deep commitment to public service, ensuring that even advanced diagnostic procedures are accessible to the common man.
– Chaar Sahib Zade MRI & CT Scan Centre at Guru Nanak Khalsa College, Mumbai: This center offers MRI and CT scans for as little as ₹10—a drastic reduction from the standard cost of ₹10,000 to ₹12,000 seen elsewhere. The facility, equipped with Siemens’ advanced equipment, embodies the principle of “Tera Tera” (service to all), a value deeply rooted in Sikh tradition. It even extends its outreach by offering discounted medicines through an on-site chemist shop.
These initiatives are not merely about low pricing; they represent a long-standing tradition within the Sikh community of providing food, shelter, and healthcare to those in need. Their history of community service—whether through langar (community kitchens) or free medical camps—underscores a model of care driven by compassion and accessibility, starkly contrasting with the profit-driven practices prevalent in many modern healthcare setups.
Discrepancies in Policy and Practice
Despite the promising push for domestic manufacturing, several systemic issues keep MRI diagnostics out of reach for many Indians:
– Policy Shortcomings: The very policies intended to bolster domestic production do not address the entire supply chain. While production is ramping up, the high GST rates and layered taxation mean that cost savings at the manufacturing level are not passed on to the end user.
– Regulatory Environment: Price regulation in the healthcare sector remains lax. Without stringent controls, private diagnostic centers and hospitals are free to set prices that reflect not just production costs but also high profit margins.
– Healthcare Inequity: With a large portion of the population still struggling to access basic healthcare, advanced diagnostics like MRIs become an unaffordable luxury. The heavy taxation on both the equipment and the service exacerbates this inequity.
Who Is to Blame?
Assigning blame in such a complex scenario is not straightforward. However, several key stakeholders share responsibility:
– Government Policy Makers: The intent behind the PLI scheme and domestic manufacturing is commendable, but the failure to reform the taxation and regulatory framework means that cost savings do not benefit the average citizen. Excessive GST on both machinery and services creates a double financial burden.
– Private Healthcare Providers: Many hospitals and diagnostic centers operate on a profit-maximization model. Instead of leveraging the potential cost reductions from domestic manufacturing, they often mark up prices, making advanced diagnostics unaffordable for the majority.
– Regulatory Authorities: The lack of stringent controls on healthcare pricing and the absence of mechanisms to ensure that technological advancements lead to improved accessibility reflect systemic oversight failures.
In contrast, community-led initiatives by Sikh organizations demonstrate that when service and compassion drive healthcare, affordability can be achieved. Their model offers a compelling alternative—one that prioritizes public well-being over profit margins.
Conclusion
India’s endeavor to boost domestic manufacturing of MRI machines is a critical step towards technological self-reliance and economic growth. Yet, the paradox of high costs for MRI diagnostics, driven by heavy GST and profit-oriented practices, highlights a broader failure in ensuring equitable access to healthcare. While policy measures like the PLI scheme are a move in the right direction, they need to be complemented by reforms in taxation, regulation, and pricing strategies. The stark contrast provided by Sikh-led initiatives—offering MRIs for as low as ₹10 or ₹50—serves as both a critique and an inspiration. It underscores that when healthcare is seen as a public service rather than a commodity, even advanced diagnostic procedures can be made accessible to all. Ultimately, bridging this gap will require coordinated efforts from government bodies, regulatory authorities, and the private sector alike to ensure that technology benefits every citizen, not just a privileged few.
Surjitt Sahani
