Budget 2016: Health sector must be accorded the status of infrastructure. This could make healthcare the biggest job-generating sector and raise contribution to GDP.
Budget 2016: By 2050, India is expected to become the world’s third-biggest economy, predicts the Economist Intelligence Unit. But that’s only possible if healthcare is given its due importance, recognition and an ecosystem to flourish. The loss in productive years is enormous in India today, and we need to address this by bringing necessary reforms on board at the earliest.
The larger Indian healthcare delivery system can be split into two—public and private. The public or government system provides basic healthcare facilities via primary healthcare centres, mostly in rural India, with a limited focus on secondary and tertiary care institutions in key cities. It’s the private sector that provides the majority of secondary and tertiary care institutions with a major concentration in metros, tier-1 and tier-2 cities.
What it means is that the government is ultimately responsible for providing healthcare for a vast majority of Indians. But with a minuscule 1.3% of GDP being allocated for public expenditure on healthcare (much lower than the global average of 5%), that’s a tough proposition. While this is a huge problem, we prefer to call it a huge opportunity that—if supported by the government—can be developed to provide healthcare across the country.
The government should provide incentives to encourage the use of technology such as telemedicine, electronic health records, mobile health, etc. Such initiatives can help increase the penetration of healthcare services to tier-2, tier-3 cities and rural areas, and improve operational efficiency. We at Apollo Hospitals, for example, use telemedicine to manage around 60,000 common service centres and provide healthcare to remote areas.
We are well-positioned to expand this reach to everyone who owns a smartphone. Currently, mobile penetration in the country is 80%, and of those, 87% use smartphones. We can address not only the idea of preventing the occurrence of diseases, but also manage emergency situations.
Another problem area is infrastructure. India needs at least 5 lakh beds to get to WHO standards—an investment of $50 billion. The government must incentivise investment in healthcare to help close the gap. A good example to learn from is IT services sector. The government provided the IT sector with tax advantages and free land as incentives. The healthcare sector needs something similar. A welcome move towards that was the introduction of the provision Sec 35AD in the Income-tax Act, which allows 100% depreciation for building and operating a hospital with at least 100 beds, anywhere in the country. This should be encouraged.
There is a long-standing promise—and demand—to accord the sector the status of infrastructure. This could make healthcare the biggest job-generating sector, raise contribution to GDP and help the nation effectively cope with the challenge non-communicable diseases. We also have to ease conducting business in healthcare. A hospital needs 74 licences to be operationalised. While these licences are important, obtaining them has to be made simpler.
We have to focus on medical tourism. Medical travel is valued at $97 billion, but India gets less than 1% of this, despite the fact that we have world-class healthcare at a tenth of the cost in the US, a fifth of that in Singapore and a third of the cost in Thailand. India can become a healthcare destination, but for that to happen all stakeholders have to come together.
A task-force under PMO to drive medical value travel;
Special branding initiatives to promote medical tourism in all Indian embassies;
Option of visa-on-arrival for all countries;
Option of online visa;
A policy where we can issue medical visa within one week of applying with the embassy;
Lower the conversion time from tourist visa.
Medical tourism will contribute to GDP, and create an ecosystem of excellence for every Indian by providing healthcare of the highest standards.
Finally, we need skilled manpower. The announcement of five new AIIMS was a great first step, but it’s a drop in the ocean considering the sort of scale that India needs. The government should set out a clear strategy to increase availability of skilled manpower in the sector, by offering tax breaks and land at concessional rates to set up medical colleges and training services.
The author is executive director, Apollo Hospitals