In large parts of the country, particularly in central and eastern India and in tribal belts, he said public health system is "not abysmal but has collapsed".
"Indebtedness caused by private health sector is one of the primary determinants of rural poverty. In terms of health poverty, the indicators are getting worse. Seventy per cent of the expenditure in health in India is private expenditure.
"The enormous burden of this expenditure is coming on to the rural families particularly, which is leading to heightened indebtedness and vulnerability along the poverty canvass," the Union Rural Development Minister said at 'The Week Health Summit' here.
He also said health indicators in most parts of the world have reached where they are not because of technological advances in medical area but because of basic improvements in water supply and sanitation.
"My experience has taught me that answer to public health lies outside medical fraternity and sooner we recognise social and political determinants, the better off we would be," Ramesh said
"We have recognised the linkage between the quality of water that we drink and health outcomes but I am sad that sanitation is no where being near the nation's agenda," he said.
He was of the view that until the basics of public health is fixed, the country continued to be confronted with the "paradox" of the country having a growing tertiary health sector but a "woefully underdeveloped, underfunded, undermanaged and poorly organised" primary health sector.
Claiming that 80 per cent of cost incurred on the health care is to be borne by patients themselves, Biocon Chairman Kiran Mazumdar-Shaw said the burden of health care is being passed to patients as the country spends less than one per cent of its GDP on the healthcare.
"Availability and accessibility to health care remain a critical factor," Mazumdar-Shaw said.
