  I study households' primary health care usage in India, which presents a
paradox. I examine why most households use fee-charging private health care
services even though (1) most providers have no formal medical qualifications
and (2) in markets where qualified doctors offer free care through public
hospitals. I present evidence that this puzzling practice has deep historical
routes. I examine India's coercive forced sterilization policy implemented
between 1976 and 1977. Utilizing the unexpected timing of the policy, multiple
measures of forced sterilization, including at a granular level, and an
instrumental variable approach, I document that places heavily affected by the
policy have lower public health care usage today. I also show that the
instrument I use is unrelated to a battery of demographic, economic, or
political aspects before the forced sterilization period. Finally, I explore
the mechanism and document that supply-side factors do not explain these
differences. Instead, I demonstrate that places with greater exposure to forced
sterilization have higher confidence in private hospitals and doctors to
provide good treatment.
