“We’re not a schizophrenic organization,” says Thulsi. “We don’t reserve a certain quality of care for our paying patients and offer another thing altogether for our free patients.” The conventional paradigm operates on the premise that you get what you pay for. But Aravind’s founders called for a different framework, where high quality is a given across paid, free, or subsidized care. They also went a step further, making a choice not to brand the services separately, and to house free and paid services under the same roof.1 “If you set up separate institutions for pure paying or pure free, then you split the culture. Doctors might want to work only in one place or the other. If we had distinctly separate hospitals, ...

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