Union Finance Minister Arun Jaitley’s announcement of new AIIMS-like institutions, tax sops for those who buy health insurance, and Rs. 33,150 crore allocation has given the health sector little to cheer.
Though the draft of the government’s new national health policy wants public health expenditure to increase to 2.5 per cent of the GDP, the allocation seems insufficient to meet the government’s ambitious universal health assurance mission that includes free diagnostics and drugs up to a certain quantum, besides improved services.
The medical community feels that opening of new All India Institutes of Medical Sciences in Jammu and Kashmir, Punjab, Tamil Nadu, Himachal Pradesh and Assam in itself holds little meaning, till the government provides quality doctors. “If we go on a spree [of setting up new AIIMS], we are diluting the quality of the brand. A building with machines and no talent will not fill the gaps in health care. The key is to improve on the existing infrastructure,” an official of the Health Ministry said, not wishing to be named.
Mr. Jaitley’s push to health insurance has also received a mixed response. India has a sizeable population without insurance, and this means high out-of-pocket expenses. The Minister himself admitted: “A large proportion of India’s population is without insurance of any kind — health, accidental or life.”
The move is seen as an attempt to encourage private insurance. “By encouraging insurance, we are accelerating [the process of] pushing the middle class towards private health care. This will also lead to a dual structure, in which there will be tax breaks for those who can afford insurance and poorly resourced public provisions for those who can’t pay,” said Amit Sengupta of the Jan Swasthya Abhiyan, an NGO.
The plan to run a scheme for giving physical aids and assisted living devices to senior citizens, living below the poverty line, has met with public approval, though there are wide gaps in geriatric care in the country, even as the population of senior citizens is now approximately 10.5 crore, including over one crore aged above 80.
“Senior citizens are always an ignored part of the budget, but this one seems to have addressed it partially through the reduction of health insurance premium. But what about senior citizens who do not have health insurance cover? Also while we talk of aids and assisted living schemes, we should have provisions for making them affordable. For instance, a pack of 10 adult diapers costs Rs. 540, which means close to Rs. 3,000 just for diapers,” said Bhavani Giddu, CEO of Footprint Global Communications, whose 79-year-old mother is bed-ridden and needs assistance for every activity.
The decision not to increase import duty on medical devices and to bring down service tax on ambulance has also been welcomed.
Sushobhan Dasgupta, president of NATHEALTH, a healthcare federation, said: “It is encouraging that the government has not increased the import duty… 100 per cent automatic FDI route will continue, and this is a very positive signal for investment in the medical device industry. Making the ‘Buy India’ policy mandatory without ensuring the preparedness of the industry for local innovation and manufacturing could have been a serious issue for the health care sector and patients. We are happy that this has not happened.”
Ambulance services have been exempted from tax, and basic custom duty, and artificial hearts have been taken off countervailing duty, a move that will help patients.
Union Minister for Health and Family Welfare J.P. Nadda, however, said the budget would lead to all-round social and economic development, inclusive and outcome-oriented. “I welcome the move towards the Universal Social Security System backed by accident insurance and the Bima Yojana,” he said.
