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Healthcare: Allocation Is Positive but Not Enough

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Ameera Shah, MD & CEO, Metropolis Healthcare
Although the increase in allocation for healthcare is a positive move, but is certainly not enough. As I had mentioned earlier, for the sector to make significant strides a minimum allocation of 4 to 5 per cent of GDP is necessary.  Although an increase in spending has been promised, a more sound allocation of resources is crucial for India to enjoy its benefits. Need of accountability on money spent is crucial to effective implementation of healthcare programmes, including the flagship National Health Mission.

Diagnostics ignored yet again: A lot of importance is accorded to treatment, but the basic question is; can one prescribe a drug without diagnosing the disease? Despite of diagnostics being the first step towards effective treatment, none of our vertical programmes have given adequate importance to it, and the Union Budget also fell short of this. The diagnostic industry did not get any relief in tax exemptions for life saving reagents on pathology tests. We need to understand that such taxes get transferred to patients. This is particularly more important for an Indian healthcare consumer, who is paying for healthcare and particularly diagnostics out of his/her pocket. A whopping 1.2 billion Indians pay for healthcare out of their pockets. In a limited health insurance environment, these taxes are directly affecting these 1.2 billion Indians.

Direct benefactors for healthcare: 24 per cent increase over the allocation to National Health Mission is certainly a positive note for the sector. There is a lot of hope from the National Urban Health Mission, and one could contemplate that diseases which were out of focus hitherto would garner more attention. Chronic diseases and mental illnesses should gather pace with the National Urban Health Mission. The demographic transition which India is likely to witness in future, allocation for geriatric care is a step towards preparing India to face the burden of healthcare costs from ageing population. Countries like Japan are already facing such a burden. This should subsequently be extended so as to effectively control healthcare costs. Allocation of Rs 4,727 crore and making six more AIIMS like institutions functional this year should increase the medical capacity, but is too small to affect the Doctor : population ratio significantly. Nothing has been spoken on ensuring a fair distribution of medical capacity across the country. Incentivising Doctors and paramedics is the only promising way to ensure an equitable distribution of medical capacity.

Indirect benefactors for healthcare: Apart from direct allocation, healthcare would benefit from other sector allocations. Prominent among such allocations is the mid-day meal programme and Integrated Child Development Programme (ICDS). Since these do not fall under the ambit of healthcare, measuring their impact on reducing child-malnutrition is difficult. This year’s budget focus on women is a strong enabler towards making them financially independent which improves their access to healthcare services.

Amit Mookim - Partner, National Industry Head - Healthcare, KPMG in India
The budget has announced a few key initiatives in healthcare.  Some of the notable ones are around a mainstreaming of Ayush practitioners that if implemented effectively will partly address the need gap for doctors and healthcare professionals in the country. Additionally, the investment in both teaching hospitals and medical colleges will enable bridging the capacity gap in the sector. Initiatives around infrastructure investment and sops thereof would enhance both domestic and foreign investment in infrastructure creation in the sector.

Rana Mehta, Leader Healthcare, PwC India
Despite the hike in the healthcare allocation the government spend is the lowest amongst BRIC nations. It may be insufficient to achieve the goals of universal healthcare set out the next five year plan. A renewed focus on Medical education and creating skill sets in the sector will help reduce the human resource shortage which is currently a roadblock in building the healthcare delivery infrastructure.
Antony Jacob, CEO, Apollo Munich Health Insurance
Including banks to distribute insurance would ensure greater penetration of insurance in areas where people require this essential financial product, but have had no means of obtaining it so far.
Also, an extension of RSBY to other categories of families, such as rickshaw, auto-rickshaw and taxi drivers, sanitation workers, rag pickers and mine workers, should go a long way in ensuring insurance coverage for those who need it, but cannot afford large healthcare expenses.
Some respite through enhanced deduction under Section 80D of the Income Tax Act would have been a welcome change however we are hopeful to see the changes in due course.