“Today, India’s health care system is routinely ranked as one of the worst in the world,” Patel said. “A few get expensive, world-class care, while a large part of the population doesn’t even get basic quality care.”

Where the current commission differs from prior efforts is that it is based on a consultative effort to seek input from an array of stakeholders, including representatives of the private health care sector, providers of traditional medicine, physicians, community health workers, and citizens from diverse communities across the country.

“It genuinely is a cross-section of society,” said Khanna, HBS’ Jorge Paulo Lemann Professor. “That makes consultation more complex, but the potential for achievement is large.”

The eventual report will focus on the “architecture” of a new system, according to an article by the initiative’s co-chairs and commissioners in The Lancet in December. It will include ways to provide preventive care for physical and mental health, offer financial protection for all health care costs, not just hospitalization, and ensure access to the same quality of care for all.

“We aspire for a health care system in which most people do not pay out-of-pocket for most health care needs,” Patel said. “The last thing a sick person needs is to have their care calibrated by how much they can afford to pay or to be impoverished by their medical bills.”

Resources are always a key issue in consideration of universal health care and India — whose proportion of GDP spent on health care is low compared with other middle-income countries — will likely have to spend more, Khanna said. But he also said that significant low-cost steps probably could be taken early in the process.

“I think we can improve outcomes with existing resources being better managed,” Khanna said. “We can get some victories in the next two to three years through optimization of existing structures.”