Union Budget 2016-17: Dr Kenneth Thorpe, Chairman, Partnership to Fight Chronic Disease

‘Union Budget 2016 addresses health insurance schemes, dialysis programmes, leaves out overall public health spend’

India’s Finance Minister Arun Jaitley in the 2016-17 General Budget has proposed a health protection scheme with a cover of Rs 1 lakh for citizens, with an additional top-up of Rs 30,000 for senior citizens. A National Dialysis Programme has been devised given the increasing numbers of patients affected by renal diseases. As many as 2,000 new centres are expected to be set up across the country, across districts. This will cut treatment costs for the rural people who need to travel to metro cities for treatment. The government has also proposed to set up 3,000 Jan Aushadhi stores for the purchase of generic medicines with a focus on the rural population, which are most affected by the shortage of drugs.

These are some of the incremental but positive steps announced by the Finance Minister in the area of public health. However, in the broader framework, these measures are not adequate enough to help address the larger issue of access to healthcare, particularly when it comes to addressing the growing burden of non-communicable diseases (NCDs).

The government has not touched the public health spend, which still stands at a meagre 1.2 per cent of GDP. Global evidence on health spending shows that unless a country spends at least 5-6 per cent of its GDP on health and the major part of it is from government expenditure, basic healthcare needs are seldom met.

NCDs are fast surpassing the traditional enemies such as infectious diseases and malnutrition, as the leading causes of disability and premature death in India. According to the WHO India Profile 2014, NCDs account for 53 per cent of disease burden and 60 per cent of the total deaths in the country. It is a crucial time for India to address NCDs which are hampering not only health, but also the productivity and work output.

Due to increased medical costs and dipping government spending on healthcare, almost 60 per cent of the total health expenditure is out-of-pocket. Under-utilisation of allocated health funds by the states is another big area of concern. According to a recent statement by Union Health Minister JP Nadda in the Parliament, the government released Rs 282.68 crores in 2015-16 against the total allocation of Rs 527.36 crores for the NCD programmes. However, only Rs 187.54 crores was utilised by the states under the National Health Mission (NHM).

It is important for the government both at the center and the state levels to understand that investment in the healthcare sector is a big opportunity for the country. With adequate allocation of the budget towards healthcare spend and at the same time devising policies to keep its productive workforce of as many as 12 million healthy, India may be in a better position to lead its way to more efficient and effective delivery of healthcare services as well as become the power capital of the world.”

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