Budget 2018: The last full Budget of the present Narendra Modi government played big on its flagship healthcare coverage, which was later dubbed as ‘ModiCare’. Arun Jaitley said that the National Health Protection Scheme (NHPS) providing health insurance coverage of Rs 5 lakh per family per annum to 10 crore poor and vulnerable families “will be the world’s largest government-funded health care programme” and the government is “steadily but surely progressing towards the goal of Universal Health Coverage”.
Miniscule budgetary increase
The decision was largely welcomed, but the welcome came its own share of uncertainty and criticism as the hike in Budgetary allocation to the Health Ministry was less than half this year as compared to 2017. Last month Reuters reported that Union Health Minister J P Nadda had wanted a 33% hike in Budgetary allocation for expanding vaccination programme and free drug distribution and to control the growing threat of diseases like cancer and diabetes. However, the Budgetary allocation was increased just by 11.5%.
When in 2017, the Budgetary allocation to the health sector was raised 28%, the country hailed the move. It was the first time when health was given the much-needed attention. India health budget has not changed much since 2009 and remained merely between 0.98% and 1.18% of the GDP, one of the lowest in the world. Though the Narendra Modi government did reveal its plan of increasing the healthcare spending by 2.5% by 2025, the lower increase this year skids from the roadmap laid last year.
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Universal health coverage – a possibility
On universal health coverage, experts have their doubts. Sunita Narain, CSE DG told PTI, “The experience with previous insurance schemes tells us that most such measures tend to end as damp squibs in the absence of effective implementation and monitoring.” However, the policy lays the possibility of ensuring healthcare accessible to the poorest of the poor, provided it reaches them.
The World Bank has earlier debunked the theory that universal health coverage is too ambitious. In a recent report, it said that many countries including Nepal, Afghanistan and Thailand are on right track of achieving it. In the absence of much details on the plan on how the healthcare coverage will be funded, concerns over delayed payment by the government and hospitals and insurance companies opting out loom large.
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A research done by Public Library of Science concluded that “publicly financed health insurance schemes are likely to stay” but for it to succeed, it is important the “basic health care infrastructure for delivery of primary health services is strong”. This brings to the first argument: Higher budgetary allocation to the health sector for research and development and building infrastructure.
A war on tuberculosis
In 2017, the government announced the elimination of tuberculosis (TB) by 2025. This year, too, the government continued with the war on tuberculosis and dedicated allocated additional Rs 600 crore to provide nutritional support to all TB patients at the rate of Rs 500 per month for the duration of their treatment.