Is India’s healthcare system keeping pace with India’s rate of economic growth? Opinions vary, but the general consensus is that India’s health system, while not falling behind, has to accelerate its reach, depth, and quality to avoid becoming an anchor on continued economic growth. There is, of course, a parallel question: To what extent can access to quality care be available to citizens of all socioeconomic levels? These universal and perennial questions are not unique to India but have a special urgency in the rapidly developing nation because progress in healthcare availability and health equity – or the lack thereof – will accelerate or deter growth as well as determine the future of political leaders.1 This chapter seeks to lay the groundwork for this book by elucidating the broad spectrum of challenges to the Indian healthcare system, and in turn their impact on society and the economy. The underlying purpose of the chapter, however, is to explore some of the creative approaches to addressing these challenges and to stimulate further innovative thinking into each of the challenges confronting India.