Health and health care development has not been a priority of the Indian state. This is reflected in two significant facts. One, the low level of investment and allocation of resources to the health sector over the years – about one percent of GDP with clear declining trends over the last decade. And second the uncontrolled very rapid development of an unregulated private health sector, especially in the last two decades. Yes, we have a health policy document but it took 35 years after Independence for the government to make a health policy statement in 1982-83. And it is no coincidence that such a policy statement came only after the 1978 Alma Ata Declaration of the World Health Assembly – Health For All by 2000 AD. But this does not mean that there was no health policy all these years. There was a distinct policy and strategy for the health sector, albeit an unwritten one. This was reflected through the Five Year Plans. This, despite the fact that health is a state subject. At the state government level there is no evidence of any policy initiatives in the health sector. The Central government through the Council of Health and Family Welfare and various Committee recommendations has shaped health policy and planning in India. It has directed this through the Five Year Plans through which it executes its decisions. The entire approach has been program based. The Centre designs national programs and the states have to just accept them. The Centre assures this through the fiscal control it has in distribution of resources. So, essentially what is a state subject the Centre takes major decisions. However it is important to note that this Central control is largely over preventive and promotive programs like the Disease Control programs and Family Planning, which together account for between two-thirds and three-fourths of state budgets. Curative care, that is hospital and dispensaries, has not been an area of Central influence and in this domain investments have come mostly from the state’s own resources.