This Indian state along the southwest coast, a tropical region, is popular with tourists and home to 18 million residents. It's shown that people with even little money can enjoy good health, and infant mortality rates and life expectancy are all higher than the rest of the country. Here at this hospital, 6,500 babies were born last year and not a single died. This is a no-frills hospital: there are no pain medications and patients often lie on mats on the floor, but the care is good and it's much safer than having a baby at home. This model health system is showing signs of strain. This analyst points to the rate of childhood vaccination and says it has gone down by 5% here and other regions have gone down drastically. He has seen repeated strains of infectious diseases recently including typhoid and at the same time there has been a rise in diabetes and heart disease, as a result of Indians becoming more prosperous, less active, and fatter. This analyst says these so-called life style ailments require different treatments and approaches. But experts say there's a broader problem: India's growing affluence has caused a broader divide between rich and poor and undermines support for public hospitals. In the past, public officials knew they had to deliver on good health care for all or find a new job, but the burgeoning middle class now relies on private hospitals so public health systems are fraying. Indeed many doctors are leaving public hospitals for better pay in private hospitals and the result is that the average person is losing confidence in public hospitals. Increasingly, the Indian state on the coast now has a two-tier system: a good system for those with money and inferior care for the rest. This health care expert says the state could foreshadow problems that the rest of the country may soon face. He notes that China is also experiencing a greater divide between rich and poor in terms of health care, and he says the U.S. also faces a similar situation with lots of private health care with a growing divide. The lesson is that even as a country on the whole grows richer, more of its citizens face lesser health care. And this is a lesson India can also heed.

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