New Delhi, July 30 -- I have spent a large part of my life in intensive care units where families arrive frightened and exhausted. Nobody negotiates in that state. When a doctor hands you a slip and points you to a counter, you do not wonder whether that medicine costs less somewhere else. You pay, because your child or parent is all you are thinking about.

That asymmetry between an institution that knows everything and a family that knows almost nothing could be the backdrop to the Maharashtra Food and Drug Administration's order last month telling hospitals and their affiliated pharmacies to stop forcing patients to buy medicines from in-house counters.

Prescriptions must be handed to patients, and every hospital must display a sign i...