The National Medical Commission Bill, 2019, if passed in its present form, could be a bonanza for private medical colleges as it gives the proposed commission the power to fix fees for only 50% of seats in private institutions. Currently, in most states, a fee regulatory committee stipulates fee ceilings for all seats in private colleges.Ignoring the concerns raised by state governments and other stakeholders about the fee fixation clause leading to malpractices and auctioning of seats, the Centre has chosen to continue with the bill. The parliamentary standing committee to which the NMC Bill, 2017 was referred, after hearing various stakeholders, had recommended in March 2018 that the existing fee regulatory mechanism by states for private colleges should not be diluted.As for colleges currently not under fee regulation - deemed universities and deemed-to-be universities - the committee had recommended that the fee "should be regulated for at least 50% of the seats".However, in the NMC bill introduced in the Lok Sabha, the section on the powers and functions of the commission includes the "power to frame guidelines for determination of fees and all other charges in respect of 50% of seats in private institutions and deemed universities". This is an improvement over the 2017 version, in which the commission was to regulate fees for "seats not exceeding 40%" in private medical educational institutions, but a dilution of the parliamentary committee's recommendations.Speaking in the Rajya Sabha earlier this month, Jairam Ramesh, a member of the standing committee, pointed out that "the cost of medical education in this country is prohibitive and we have to reduce the cost of medical education. Every state government has a committee which fixes fees under a retired high court judge."Several states argued along the same lines. Odisha pointed out that under the Orissa Professional Educational Institutions Act, 2007, a fee structure committee headed by a retired judge regulates the fee charged for all seats in private colleges - 85% as state quota and 15% as NRI quota with the fee at four times what is charged for a state quota seat. Similarly, fees are fixed for 100% of seats in Himachal Pradesh, Haryana, Rajasthan and Punjab. Maharashtra, too, pointed out that its fee regulatory authority decided fees for all seats. Uttar Pradesh and West Bengal also objected to this clause.The AIIMS director told the committee that the fee structure suggested in the bill "would result in a decline in merit and creation of an economic reservation wherein the medical seats would be given to those who can pay a higher amount of fee instead of those who deserve them based on merit".The justification given by the government for restricting regulation to half the seats was that capping all fees would discourage entry of private colleges, thereby undermining the objective of rapid expansion of medical education.