A lost opportunity

The healthcare sector had great expectations from the Union Budget 2015-16 but reality did not live up to the hype

201503ehm02The healthcare sector had great expectations from the Union Budget 2015-16 but reality did not live up to the hype. Prime Minister Narendra Modi’s often stated goal of universal health coverage had built up expectations that the budget would increase allocation to the central health ministry but with an increase of a mere two per cent, it fell far short of requirements.

The five new AIIMS in Jammu & Kashmir, Punjab, Tamil Nadu, Himachal Pradesh and Assam plus an AIIMS-like institute in Bihar are steps in the right direction. These will go a long way towards filling the gaps in the public healthcare infrastructure and making health services more accessible in these states. In spite of the direct link between the Swachch Bharat Mission and healthy practices, there was no direct push for preventive and curative care at the primary level which could have had an immediate impact on healthcare outcomes.

Similarly, the Finance Minister’s decision to add more countries to the visa-on-arrival list from 43 to 150 countries will be music to the ears of private healthcare players as it will expand the medical tourism industry in India.

The fact that the government has not indicated too much increase in the percentage of GDP spend on healthcare leads us to believe that the government is encouraging patients to pay from pocket and hence the increase in tax incentives on health insurance.

Perhaps, the best take away is the devolution of a larger part of central taxes to the states as recommended by the Fourteenth Finance Commission (FFC). Now the states will have more funds at their disposal and hopefully they will be able to design health schemes more in tune with each state’s needs, rather than having to follow the centre’s diktat.

But here too, the recommendations have stopped short of providing direction. The intent is good, but implementation remains hazy though Health and Family Welfare Minister J P Nadda has assured us that adequate funds have been provided to ensure that all flagship healthcare programmes will continue.

Similarly, it’s good that health insurance premium exemption has been increased to about Rs 25,000 with Rs 5,000 set aside for preventive health checkup but more clarity will be required on the breakup pf this Rs 5000 across various heads.

Analysts have pointed out that the budget has expressed the intent to promote more PPP projects wherein private investments are catalysed by public investments. A reduction of corporate tax (from 30 to 25 per cent over next four years) could also increase private investments in the healthcare sector. The extension of service tax exemption to all ambulance services provided to patients is also a welcome move.

In summary, the union budget 2015-16 will probably be remembered as a lost opportunity to push for change. Prioritisation on primary and preventive healthcare, using the same zeal as the pulse polio programme, could have seen the eradication of many more such public health concerns like tuberculosis, etc. Will the achhe din chant change into kachhe vaade? Or is it too soon to judge this administration?

It is left to visionaries from the private sector, like Dr Devi Shetty, Founder Chairman of Narayana Health to step in to fill the gaps. Dubbed as the ‘Henry Ford of cardiac surgeries’, he has both compassionate care and economics close to his heart. Do read our cover story (‘Breaking ground on the way to success’, pages 29-33) for a detailed analysis of how he is breaking new ground in productivity, profitablity and affordability.

In our Women’s Day special, (‘Waking up to women’s health’, pages 34-50) we focus on issues that are not only detrimental to women’s health and well-being but also deter the progress of our nation. After all, a healthy woman is the building block for not just a healthy family, but the nation.

Viveka Roychowdhury


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