By Karthik Shankar:
When Arun Jaitley gave his budget speech in the parliament, he brought a whole lot of cheer to the industry. The government’s budget has a host of positive developments, all of which will no doubt stimulate the economy. The business friendly environment that the NDA has long promised seems closer to being a reality. The centre, however, barely gave any thought to one of our most pressing issues – healthcare.
Despite all the hoopla about Modi’s ambitious plan to offer universal healthcare under the National Health Policy 2015, the idea seems to have disappeared without a squeak. That plan was estimated to cost $26 billion (Rs 160,693 crore). Keeping that in mind, it’s alarming to note that the government’s outlay for The Department of Health and Family Welfare is Rs 29653 crore, almost Rs 6000 crore less than that allocated in last year’s budget. India’s spending on healthcare is already one of the lowest, even in the developing world. It’s spending as a percentage of its GDP lags significantly behind other BRICS countries – just 1.3% of the GDP is spent on healthcare. The second lowest country, China, spends 5.1%. These are horrendous figures, anyway you cut it. So let’s look at what the government has focussed on.
There are plans to set up new AIIMS in several states including Kashmir, Tamil Nadu and Punjab. India might have a shortage of quality doctors, but what we lack even more is matching medical professionals to people who are in dire need of their services. There’s nary a mention of Gramin health centres in the Centre’s budget plan. These are the key venues where most of rural India avails medical care. While there are passing references to setting up medical centres in each village, tangible measures seem to be non-existent.
And there are, rightfully, questions about who the government is fending for. The limit of deduction for health insurance has increased from Rs 15,000-25,000. While it’s a good move, its primary beneficiaries will be middle class families who can afford health insurance. The government seems to be incentivising the middle class to switch over to private healthcare, which is not a bad way of reducing the state’s healthcare burden, but also provides a lower impetus to improve the infrastructure and quality of public hospitals. There’s also the problematic aspect of giving perks to those who can afford healthcare and ignoring the many millions who can’t.
The government also seems to think access to clean drinking water is not a problem. The National Rural Drinking Water Programme has an allocation of Rs 108 crore for a population of 1.3 billion people! Water borne diseases are one of the primary killers in our country, responsible for cholera, diarrhoea and a host of other illnesses. Diarrhoea is the biggest killer of children globally and India alone accounts for over a quarter of deaths .
The centre is also asking states to increase their contribution to schemes such as the National Health Mission. Medical care is the prerogative of the government and to shift the burden to the states will only create even more of a divide in health services between different states.
There’s also the question of how much the government is serious about tackling epidemics like swine flu which have the potential to wreak havoc on the social fabric in our country. A mere Rs 41 crore has been allocated for ‘Matters Relating to Epidemics, Natural Calamities and Development of Tools to Prevent Outbreaks’. Given that so far, more than 19,000 people have been infected with swine flu and over a thousand have died, the outlay is a pittance.
To be fair, the government t has taken some notable measures. Import duties on medical equipment have not been increased. Meanwhile ambulance services are now both tax-free and customs duty exempt. However, what has been proven time and again is that universal healthcare is essential for a country that aims to improve a host of welfare indicators from life expectancy to productivity. It’s the reason why a world superpower like the United States lags behind countries like UK, Germany, Switzerland and Sweden with regards to healthcare. At least with regards to medical care, socialisation need not be a dirty word.