When Diagnosis Becomes a Luxury…!

Credit By: ISHFAQ AHMED

• Comments 0
• 17 Apr 2026

For many families in Kashmir, the first shock in a journey of illness is not the name of the disease, but the cost of finding out what it is

The last time a daily wager from downtown Srinagar walked into a private diagnostic lab, he carried two things in his pocket: a crumpled prescription and just enough money, he thought, to pay for a few routine tests. By the time he walked out, the prescription looked less frightening than the bill. To get a simple set of investigations done, he had to borrow from a neighbour, postpone his children’s school fee, and decide that the follow‑up tests the doctor had suggested would have to wait. During that short visit, the high costs of diagnostic services in Kashmir became apparent.

In our public conversation on healthcare, we often speak about medicines, surgeries, or hospital admissions. What we rarely acknowledge is that before any treatment begins, patients must cross another, increasingly expensive bridge: diagnostic tests. From basic blood work to advanced imaging like CT scans and MRIs, diagnosis has become a marketplace where the suffering of ordinary people often collides with the profit motives of a rapidly growing health industry. The result is that for many families in Kashmir, the first shock in a journey of illness is not the name of the disease, but the cost of finding out what it is.

Over the last decade, diagnostic centres, big and small, have mushroomed across our towns and cities. Sleek signboards, digital displays, air‑conditioned waiting rooms, and glossy advertisements promise “world‑class accuracy” and “state‑of‑the‑art technology.” There is nothing wrong with medical advancement; in fact, timely and accurate tests save lives. The problem arises when this progress is built on a model where every test is a product, every patient a consumer, and health a business opportunity. Prices for routine tests have boomeranged, while more sophisticated investigations remain utterly out of reach for a large section of our population.

For a salaried middle‑class family, a sudden request for multiple tests might mean cutting back on monthly expenses, dipping into savings, or delaying some other necessity. But for a labourer, a street vendor, a widow, or an unemployed youth, an MRI worth several thousand rupees is not just a medical test; it is a financial catastrophe. Many people simply do not get it done. They gamble with their health because they cannot afford certainty. This silent choice between debt and diagnosis never appears in official health statistics, but it defines the reality of healthcare access in our society.

The impact of these rising costs is felt in several painful ways. Most of the time, there is a delayed diagnosis. When tests are too expensive, patients wait. They try home remedies, borrow medicine from neighbours, visit pharmacists instead of doctors, or keep hoping that the pain, the cough, the fever, or the fatigue will go away on its own. By the time they finally gather the courage and the cash to walk into a lab, the disease has often advanced. What could have been treated with a short course of medicine becomes a long, complicated, and far more costly illness.

Also, there is under‑diagnosis. Doctors, aware of their patients’ economic condition, often hesitate to order the full panel of tests they would ideally like. They compromise, choosing only the most essential investigations, knowing very well that an incomplete picture can lead to an incomplete treatment. This is not a failure of the doctors alone; it is a system that forces them to treat with one eye closed. We celebrate modern medicine, yet we deny it the basic tools it needs, simply because we have allowed diagnostics to become unaffordable for the very people who need them the most.

Further, there is a heavy psychological burden on families. To fall ill is frightening enough; to fall ill and then be handed a long list of expensive tests is overwhelming. People feel humiliated when they have to borrow money for medical expenses, and even more so when they must explain at every counter, “Please, can you reduce the cost a little?” We speak of dignity as a value in our society, but our healthcare experiences often strip that dignity away. A mother should not have to choose between buying winter clothes for her children and paying for her own diagnostic tests. A father should not have to wonder whether his chest pain is serious enough to justify taking a loan for a CT scan.

The irony is that while diagnostic technology is advancing globally and, in many places, becoming more efficient and affordable, our local experience often feels the opposite. Packages are marketed as “discounted” and “affordable,” yet when you compare them to the average household income, they remain punishingly high. The language of discounts hides the reality that there is no meaningful regulation of prices and no transparent system that tells a patient why a particular test costs what it does.

Government hospitals, in theory, should provide a humane alternative. They do perform many tests at subsidised rates, and for countless families, this is the only lifeline. But the story inside government facilities is complicated. Long queues, frequent machine breakdowns, shortage of reagents, and delays in getting reports mean that time, another critical factor in healthcare, is lost.

A person who has travelled from a remote village, missing a day’s wage, cannot always afford to be told, “Come again next week, the machine is not working,” or “The slot for MRI is after ten days.” For emergencies, such delays can be dangerous. So people are pushed, reluctantly, towards private labs where they pay heavily for speed and convenience.

Behind the rising costs lie multiple layers: expensive imported equipment, high maintenance charges, staff salaries, electricity, rent, and yes, profit margins. Owners of diagnostic centres will argue that without profit, there is no incentive to invest in better machines and services. There is some truth in that. But when medicine becomes too much of a marketplace, it slowly forgets its moral purpose. What we need, therefore, is not the destruction of private diagnostics but a serious, honest regulation of it.

Pricing transparency is almost entirely missing from this sector. A patient usually does not know in advance what a test will cost across different centres, or whether there is any cap on charges. There is no publicly displayed rate list set by the government that is actually enforced. In this vacuum, each centre sets its own prices, often benchmarking itself against the most expensive competitors, not the poorest patients. An ordinary citizen has no bargaining power, no information, and no choice but to accept what is offered.

Insurance, which could have been a shield, rarely covers diagnostics in any meaningful way unless tied to hospitalisation. For the large chunk of our population that is either uninsured or under‑insured, every test will continue to come directly out of pocket. In such a landscape, any rise in diagnostic costs is felt instantly and painfully at the household level. It deepens inequality: the well‑off can access the best tests early and repeatedly; the poor test late, test less, and suffer more.

This situation demands more than quiet acceptance and individual adjustment. It deserves public debate and policy action. Concerned authorities must move beyond occasional inspections and take a hard look at pricing, standardisation, and quality control. Are there reasonable caps that can be introduced on certain commonly prescribed tests? Can the government negotiate bulk rates with private labs for specific categories of patients? Can we build stronger public‑private partnerships where private centres are mandated to reserve a portion of their capacity for low‑income patients at regulated prices?

At the same time, our public facilities need urgent strengthening. A well‑functioning diagnostic wing in a district or sub‑district hospital can dramatically reduce the financial pressure on families. When machines work, reagents are available, and reports are timely, people naturally prefer the public system because it is closer to their means and, often, closer to home. Investment in public diagnostics is not charity; it is one of the smartest economic decisions a government can make. Early and affordable diagnosis reduces the long‑term cost of treating advanced disease, not just for individual families but for the health system as a whole.

There is also a role for civil society, media, and professional bodies. Patient awareness campaigns can help people understand which tests are genuinely necessary and which are being driven by aggressive marketing or defensive medicine. Medical associations can evolve guidelines to discourage unnecessary investigations. Journalists, including those in our own Valley, must continue to ask difficult questions of both the public and private sectors: Who sets these prices? Why are there such wide variations in cost for the same test? Who benefits, and who is being left behind?

Ultimately, the rising cost of diagnostic tests is not just a technical issue about machines and margins. It is a moral question about what kind of society we wish to be. If illness becomes a luxury that only the relatively well‑off can afford to investigate properly, then health ceases to be a right and becomes a privilege. A just society does not wait for its poorest citizens to deteriorate before paying attention. It ensures that the first step in healthcare—the act of knowing what is wrong—is within everyone’s reach.

Adding another invisible tax in the form of unaffordable diagnostics is neither fair nor sustainable. The man walking into the lab with a crumpled prescription should not have to calculate which necessity of life he will sacrifice this month. He should walk in with only one worry: his health. The rest is the responsibility of a system that claims to care for him. If that system fails to make diagnosis affordable, then it is not just his body that is under strain; it is our collective conscience.

(The Author is the Op-Ed Editor of Rising Kashmir and can be reached at: ishu00234@yahoo.com)