The existence of railway hospitals

In a way, Indian Railways already allows for competition. In addition to 125 railway hospitals, 133 private hospitals are recognised for treatment

Dr Robert Gillespie has a book (2006) titled The Train Doctors, A Detailed History of Railway Surgeons. This is about USA, but principles of railway development are similar everywhere in the world. “As the nineteenth century unfolded, few employers offered any kind of employee benefit packages. Workers had to secure medical care privately and at their own expense. Businesses only paid physicians to perform pre-employment physical exams or to assist them with matters of work site hygiene. 

Railroads developed into an exception to this rule, in part due to the inordinate number of injuries sustained by employees, passengers and bystanders.