Budget 2018: Finance minister Arun Jaitley Budget speech underscored the government’s intent to improve healthcare access, but the Budget provision may fall somewhat short of delivering. Jaitley announced the launch of the National Health Protection Scheme (NHPS) that will provide `5-lakh annual cover against secondary and tertiary healthcare costs to 10 crore vulnerable households, or roughly 50 crore individuals. For perspective, out-of-pocket expenditure on healthcare in India stands at a staggering 65-69% of total Current Healthcare Expenditure. There are currently 3.63 crore BPL households enrolled under the Rashtriya Swasthya Bima Yojana (RSBY). But RSBY offers only a Rs 30,000 annual cover for hospitalisation on a family floater basis, which is far from adequate. While Jaitley termed NHPS the world’s largest healthcare programme—covering 37% of the country’s population—with just Rs 2,000 crore as “token amount” from the Centre for 2018-19 (before any future supplementary grants), NHPS is has a wide congenital budgetary gap. More money will be made available later, as the scheme’s particulars are firmed up, expenditure secretary AN Jha said in a post-Budget interaction with the media. While Apollo Hospitals chairman Prathap C Reddy called the initiative a “game-changer”, Nilaya Varma of KPMG India advocated a strong gate-keeping system, saying this “will ensure equity by a judicious referral system”.
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The FM allocated Rs 1,200 crore for 1.5 lakh health and wellness centres in the country that offer comprehensive healthcare services, including for non-communicable diseases (NCDs). Given India’s rising NCD burden—55% of the total disease burden in 2016, up from 30% in 1990—strengthening the first front of public health is essential. Jaitley invited India Inc to participate in this via CSR and corporate philanthropy. The finance minister also spoke of the government’s push to improve access to medical education in the country—24 district hospitals in the country will be upgraded to government medical colleges and hospitals. Dr K Srinath Reddy of Public Health Foundation of India welcomed the move, but cautioned that this must be first done for the most under-served regions of the country.
The National Health Mission gets Rs 30,129 crore while the demand under the “medical and public health” overhead is `40,048 crore.