Mumbai, the capital of the western Indian state of Maharashtra, is also the commercial capital of India and one of the most expensive cities in the entire world.
Predictably healthcare in that city is also prohibitive. And now come reports the cost of medical education too is going through the roof in that state, earning the invidious distinction of topping the country on that front.
Over the past three years, the average fees paid by an aspiring doctor has more than doubled.
Across India, while fees in private unaided medical colleges are still way below Rs 3 lakh, the Nagpur-based NKP Salve institute charges Rs 4.75 lakh, the highest in the country. Karnataka may have the largest pool of medical seats in India but Maharashtra by far charges the highest fees.
The annual cost of an MBBS course in a private college in Maharashtra ranges from Rs 4.75 lakh at NKP Salve to Rs 1.68 lakh at ACPM, Dhule, with the bulk of the colleges ó most of them run by politicians ó charging in the range of Rs 2.5-3 lakh.
The main reason for this state of affairs is that the government committee responsible for regulating fees in the state has been approving hikes proposed by the managements of these colleges every year.
Take for instance the only private college within Mumbai, K.J. Somaiya. Between 2003 and 2006, its annual fees went up from Rs 1.89 lakh to a whopping Rs 3.72 lakh.
Kamal Kishore Kadam, president of a state association of unaided private medical and dental colleges, claims that the medical colleges cannot be run on fees of Rs 2-3 lakh and that managements everywhere are under "great financial strain".
However, Rajesh Jain of the Parents Association of Medical Students points out that managements inflate costs despite inadequate facilities.
And ultimately cost is passed on to the general public. When the government does not opt for starting its own medical colleges, the private sector jumps in with glee. Only the poor have to pay for all the greed and folly of policy makers, observers note.