Healthcare must be priority for budget 2021-22; substantial increase in investment required in new fiscal

Health sector has been in focus right from the beginning of the financial year 2020-21, since India was locked down on March 24 last year due to outbreak of coronavirus pandemic. Our healthcare facilities were overwhelmed at a time when the government had actually lowered the allocation, which was just about one per cent of the GDP, while it was 1.5 per cent in 2018-19, and the government had promised to raise it to 2.5 per cent by 2025. The pandemic enforced urgent spending, both public and private, financially breaking most of us, and it is in this context people are waiting for the budget 2021-22 in general and the health sector in particular.

The fear of the pandemic and the biological risks that we may run into do not permit the government to further ignore the hitherto most fund starved health sector. There is no escape but to increase substantially the public spending on healthcare. Even Niti Aayog believes the present health spending of the country is “low” as one of its member V K Paul has said it, adding that the situation must be corrected. Hopes are therefore high and it is most likely that allocation for the health sector will see a substantial swelling in the budget 2021-22

Everybody in the government responsible for making the budget seem to be in favour of increasing allocation for the sector, but there are great financial limitations to it, since all the sectors of the severely contracted economy need increased amount of allocation to revive the economy, which was completely at halt, and has just started moving again, albeit at a very slow pace. Revival of the economy is expected soon, and the economy will bounce back in the financial year 2021-21, as economists generally agree.

This makes the budget making task a little easy, because a buoyance in revenues is expected in the coming year, which will give enough elbow room to strengthen India’s public healthcare budget which is presently lowest in the world. According to international estimates, India needs to increase public spending on healthcare system upto at least 10 per cent of the GDP, and according to some about 14 per cent against average of 1.26 per cent for the last three years. United States spends over 16 per cent, and many other countries like Japan, Canada, France, Germany, Switzerland, Australia etc are already spending about 9-10 per cent of their GDP.

It is shame for India that the government does not want to spend more on this sector while even neighbouring countries like Bangladesh and Pakistan are spending over 3 per cent of their GDP. One should also note that emergency spending, such as every country needed to spend this year on this sector, is not included in the level of spending that has previously mentioned.

Modi government intends to increase health expenditure of the country to only 2.5 per cent and that too by 2025. It indicates the unwillingness of the ruling establishment to spend more at the moment and also its capacity limitation due to lack of revenue, which has dwindled to a new low in 2020-21.

The first major task of the government is to strengthen health infrastructure of the country which was overwhelmed during the coronavirus pandemic. We had to make makeshift arrangements by converting public buildings such as schools and stadiums into hospitals. The government has already planned establishment of hospitals to deal especially in virus infections in every district of the country by 2022 by financial support of the World Bank. However, it will not be sufficient because there are heavy shortages of hospitals for other diseases, at all levels right from the villages to the cities, even in those cities which are now housing several big hospitals such as our national capital Delhi.

Apart from increasing the number of hospital infrastructure, upgradation of the existing ones are badly required. Many of our public hospitals are in very bad shape. There are lack of space, beds, equipment, or even stretchers for patients for treatment and examinations in case of emergencies. It is important because most of the people in our country have no option but to go to public hospitals due to lack of financial resources. Public healthcare thus must be the priority in the budget 2021-22.

The pandemic has also exposed the lack of sufficient number of medical professional and healthcare workers in the country. Large number of people are required to be trained in this profession to enable the country to deal with the present as well as future emergencies. For this we need to open more medical and nursing colleges in the country. Sanitation, hygiene and preventive healthcare training centres are also required. There must have special provisions for this in this very budges, for the country has no time to wait for a very long time to come.

Since, we don’t have sufficient funds to do all that, the budges must try to attract huge private investment in our healthcare system by way of giving financial support and other incentives. The government should also do something to stop exploitation of patients by private hospitals that has been reportedly on the increase. Since, private hospitals also run with government help, such as through land allotment, access to public money through banks etc, it must be ensured that these hospitals are also accessible, equitable, and affordable for the common people. Public healthcare systems also need such measures to ease the burden and heavy load and to make it transparent.

At present, people are not left with sufficient money in their hand, the budget needs to have some other provisions too, such as making medicines available to the common people at affordable prices. The medicine delivery networks should be strengthened. Free delivery of medicines and medical equipment should be made available to those who cannot afford them, and fair priced medicine and medical equipment shops should be opened in large numbers. All the existing programmes need to be strengthened. These require substantial increase in budget allocations, but unfortunately as it is reported, government is likely to increase it only by about 40 per cent. It would be only a drop in the ocean compared to the massive challenges in the health system.

(IPA Service)