Kerala has garnered global attention for its remarkable achievements in the health sector and its success is mainly attributed to the large public expenditure by the government. The study done by CPPR examines the contribution of small private medical institutions during the 1970s, 1980s and the 1990s when Kerala encountered a fiscal crisis and yet made remarkable developments in its health sector. It looks at the question of whether a state like Kerala, needs stringent regulations to ensure minimum standards and states that excessive regulation will disproportionately affect the operations of small private medical institutions, which adversely affect the health care system in Kerala.

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