“Do you have term insurance?” the doctor asked him.
He said yes.
“Good. Let them know they’ll be taken care of. You don’t have much time left.”
No softening. No “let’s hope for the best.” Just a checklist question, asked the way you’d ask about next of kin, because that’s essentially what it was.
I’ve told his fuller story elsewhere: the ICU during the second wave, the twenty-two hours a day on his stomach, and the years of trying and discarding other plans before Dehradun actually worked. If you want the complete account, I wrote it up in how he quit a high-paying job for peace. I don’t want to retell it here, because it isn’t the part I want to focus on in this essay about healthcare in tier 2 cities. I want to focus on what happened after, which I’ve never fully written about until now.
Here’s the part worth naming plainly. He didn’t just leave a stressful job for a quieter one. Somewhere in that recovery, he understood something most people in his position never articulated clearly enough to act on: that going back to the exact environment that had helped put him in that ICU bed (the pollution, the pace, the low-grade stress of a satellite city built around commute and deadline) would likely keep working against a body that had just barely survived. The move wasn’t only about wanting something gentler. It was, in part, a deliberate bet that removing that environment would help a damaged body finish healing, rather than simply stop getting worse.
Three years later, if you sat across from him the way I did, over coffee, in Dehradun, you might not believe his backstory is real. He does long morning walks. He’s fully recovered: no lingering effects, lungs fully functional, and none of the lasting complications people who went through what he went through often carry afterward. The specific thing he moved here to achieve, not just surviving but actually recovering, in a way his old environment was quietly working against, he has achieved.
Healthcare is the question I get asked most often about moving to a smaller city, and I understand exactly why. Underneath the practical version of the question (will the hospitals be good enough) is usually a quieter, more honest one about healthcare in tier 2 cities specifically. Most people asking me this aren’t currently sick. They’re afraid of what happens if they become sick, and the right care isn’t there when it matters most.
I want to answer that fear directly, with real people, rather than with reassurance alone.
What Healthcare in Tier 2 Cities Actually Looks Like, in Two Real Stories
He told me about the years after the move without any of the drama the ICU part of his story carries. This, more than anything, is what healthcare in tier 2 cities has looked like for him in practice rather than in theory. No ailments. No lingering effects from covid. Lungs fully functional. By any ordinary measure he is as healthy as anyone you’d meet on the street, which sits strangely against the man in that hospital bed.
The long morning walks are part of his day now, and so is a slower pace, one he has been able to give his wife and son as well. I want to be careful about what I can and can’t claim here. I can’t tell you which part of that slower life did the healing. What I can tell you is what he was betting on when he moved: that taking a recovering body out of the environment that had helped put it in the ICU would give it room to finish healing.
In that hospital bed he had realised he couldn’t remember the last time he’d actually watched his son do anything. A life with more room in it is, at the very least, one where that stops happening. And chronic stress is not a small thing to take off a body that has come that close.
He is, by any honest measure, as healthy now as anyone I know, and I think that points to the part of the healthcare question that gets missed most often. People ask whether tier 2 cities can match the emergency-care infrastructure of a metro, which is a fair and legitimate question. Almost nobody asks whether the conditions of daily life in a smaller city (less stress, better air, a slower pace) might reduce how often that emergency infrastructure is needed at all.
The second story is one I’ve told before, briefly, in a LinkedIn post. It deserves the fuller version here, because a few lines never captured how much uncertainty sat underneath the tidy-sounding outcome.
A friend of mine had a wife who needed hospital care every week. A real, ongoing medical need, not a hypothetical one, the kind that reorganises a family’s whole calendar around a single recurring appointment. “Even if I really want to,” he told me, “I won’t be able to settle in the hills.” Delhi had the doctors. He didn’t think Dehradun could match that, and given what was at stake,
I don’t think the hesitation was unreasonable in the slightest. When your wife needs a hospital every week, “let’s try it and see” is not a casual sentence. He wasn’t being cautious for its own sake. He was doing the arithmetic anyone would do with a wife’s health on the other side of the equation.
It wasn’t an easy decision. I won’t dress up what it felt like from the inside, because I wasn’t inside it. What I know is what they did. They rented a place here anyway. Not a purchase, not a leap with the door locked behind them. A rented flat is a way of testing an answer before you commit to it.
Eighteen months later, two things had happened. First, the medical care here had matched what they’d had in Delhi. Second, and this is the part nobody expects, his wife needed it less. The visits went from once a week to once a month to once every two months.
I can’t tell you with certainty why her condition improved, and I want to be honest that correlation isn’t the same as proof. But the pattern itself is one I’ve now seen in two families: arriving worried specifically about access to care and finding both that the care was there and that the need for it quietly decreased. Two families is not a study. It is enough to make me stop assuming the opposite.
I want to be honest that the two stories above aren’t the whole picture nationally. Industry estimates put it at nearly 65% of India’s population living in tier 2 and tier 3 cities and rural regions, and access to advanced specialist care still remains disproportionately concentrated in the largest metros. That’s a real, structural gap, not something either of these two stories erases. What’s changing is the direction of investment: the same industry release notes that healthcare providers are already expanding beyond the traditional metropolitan markets.
There’s a related, more specific fear worth naming directly, because it comes up almost as often as the general question does: what happens as parents or in-laws age and need a kind of ongoing care that goes beyond an occasional hospital visit. This is a legitimate, different question from acute emergency care, and I don’t think it has the same easy answer the two stories above provide.
What I can say is that dedicated senior living and assisted-care facilities, once something you’d have had to find specifically in a handful of metro cities, now exist in most tier 2 cities as well. I’m not going to recommend a specific one here, because that’s not the essay’s job, but the category itself, professional dedicated elder care outside the largest cities, is real and growing in a way it genuinely wasn’t a decade ago.
The ICU survivor’s story stays with me because it contains an irony worth sitting with about healthcare in tier 2 cities. He went to Dehradun with a body that had nearly given out on him, to a city most people would consider a step down in healthcare infrastructure from where he’d been living.
What he found, alongside medical care that is there if he needs it, was a version of daily life that seems to have done more for his health than proximity to more hospitals ever did. I don’t think that makes the move a prescription. I think it makes it a reasonable, considered bet on removing a harmful environment, one that happened to pay off the way he’d hoped.
How to Check Healthcare in Tier 2 Cities Before You Move
If healthcare is the thing holding your decision back, this is the research I’d want you to do before trusting any essay, including this one.
– Name the specific care you’d need. Not “good hospitals,” but the actual condition or specialist: a paediatric cardiologist, a nephrologist, a high-risk obstetrician. Find out who practises that speciality in the town you’re weighing and how far the nearest hospital with that department really is.
– Ask what “nearest” means in an emergency. The question isn’t the closest hospital. It’s the closest one that can handle your particular emergency and how long that drive takes at night.
– Check your insurance on the ground. Look at which hospitals in the new city are on your insurer’s cashless network and whether your cover works there the way it does in the city you’re leaving.
– Talk to your current doctor before you decide, not after. Ask what continuity would look like: which records to carry, whether follow-ups with your existing specialist can happen by video, and what they’d want you to have in place first.
– Rent first. The friend in the second story rented before he committed to anything. A few months on the ground will tell you things no brochure or essay can.
Even done well, that research has a limit, and I want to be honest about it, because an essay that pretends to fully resolve this question for you would be doing you a disservice. These are two real stories, and I believe both of them completely. They are not and cannot be your specific answer. I don’t know what care your parent’s particular condition would actually require, or whether the specialist your child sees twice a year has an equivalent within a reasonable drive of the town you’re considering.
I don’t know whether the hospital fifteen minutes from where you’re weighing a move has the exact equipment your situation would need in an emergency, or whether that answer changes depending on which of three or four towns you’re comparing. Nobody can honestly answer those questions in general terms, in an essay, for a reader they’ve never met. Anyone who tells you otherwise is offering reassurance, not research.
That gap is exactly what a Nishchay session is built to close. It’s a 45-minute conversation. Not a general discussion about healthcare in tier 2 cities in the abstract, but a real, specific look at your own situation: your family’s actual medical needs, the actual towns you’re weighing, what genuinely exists there and what doesn’t, before you make a decision this significant based on a feeling rather than an answer. You can book a Nishchay session directly.
I don’t think the honest response to the healthcare question is “Don’t worry, it’s fine everywhere.” I think the honest response is narrower, and it’s one I can only take so far in a piece like this. Ask the specific question that actually matters for your situation.
Not “is healthcare in tier 2 cities as good as a metro?” in the abstract, but “Does the specific care I or my family might need exist in the specific place I’m considering, and what would the life I’m moving toward likely do to how often I need it in the first place?” Those two questions are worth real, individual research before a decision this size, not a general anxiety standing in for either of them.
Next in this series: not a question about your own health, but about theirs: what actually happens to a child’s schooling and the specific kind of pressure that follows a family from a bigger city into a smaller one.