In 2011, The Lancet published a special Series on the progress and future of health in India. The central message was a call for universal health coverage by 2020. Despite India’s Prime Minister at the time, Manmohan Singh, being supportive of this goal, the move towards universal health coverage in India has gained little traction. Public health spending remains desperately low at 1·3% of gross domestic product, while more than 40 million Indians are driven into impoverishment from out-of-pocket health expenditure every year.