Union budget 2018: Finance Minister Arun Jaitley fails to address key healthcare fundamentals

Apart from the Union budget's highlight - the National Flagship healthcare protection scheme with approximately 50 crore beneficiaries and a cover of upto Rs 5 lakh per family - the Finance Minister Arun Jaitley has not addressed some of the fundamental issues in India's healthcare sector, feel experts.

Though the insurance scheme is envisaged as one of the largest ever government-funded healthcare programmes in the world, the programme only caters to secondary and tertiary care hospitalisation and can fail if those fundamental issues are not addressed, they note.

In the past three years, there have been considerable efforts by the government towards building the health facilities infrastructure upto the HSC level. However, the health delivery system continues to face severe challenges due to lack of appropriate and enough human resources deployed on the ground.

"The budget has announced concentrated efforts towards enabling an increase in the number of medical colleges. However, addressing the HR/ talent gap through appropriate and incentivised deployment across multiple levels in healthcare service delivery will be one of the biggest challenges for the government, especially in the context of National Flagship healthcare protection scheme." says Suparna Diwakar, Co-founder, The Indian School of Development Management (ISDM), Mumbai.

They also note that the overall budget allocations to health, education and social sector has seen an increase of only Rs 16,000 crore in this years budget. While social sector and healthcare experts were demanding a minimum 2-3 percent of GDP spend on heathcare, the allocation accounts to only Rs1.38 lakh crore and is less than 1 percent of the total GDP of India in 2016.

"The newly announced "Health Protection Scheme" seems like a bold move and a big step towards Universal Health Coverage.  However, as with previous schemes, the key remains successful execution and minimisation of leakages", says Dr. Vishal Beri, Hinduja Healthcare Surgical. He says that the Government's idea to set up 24 new medical colleges and hospitals, by upgrading district level ones, will help address the shortage of skilled medical professionals, albeit only over the medium term.

Welcoming the health insurance initiative, Dr. Sujit Chatterjee, CEO of L H Hiranandani Hospital notes that the only challenge here from an infrastructure perspective is to build the essential point of care network to deliver these benefits to the patients.

"The finance minister has taken a positive step in building/enlarging the base for health and wellness by upgrading the existing district hospitals in the country to 24 new Government Medical Colleges and Hospitals. Further, using the 1.5 lakh Health and Wellness Centres already setup last year, it would now provide comprehensive healthcare, free essential drugs and diagnostic services with expected support from private sector and philanthropic institutions", says  Hitesh Sharma, Tax Partner and National Leader - Lifesciences, EY.

Another announcement in the budget was to have at least one medical college for every 3 parliamentary constituencies and at least one government medical college in each state of the country.            

"The increased focus on healthcare augurs well for citizens of the country, it is a moderate budget and continues to lay emphasis on overall infrastructure development and strengthening of the rural economy", said Glenn Saldanha, Chairman and Managing Director, Glenmark Pharmaceuticals.

The three facets of the healthcare budget this year have been enhancing the quality of medical education, covering all poor households under the Jeevan Bima Yojana, and promotion of preventive healthcare, note Dr K. K. Aggarwal, President of Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA).

"The cess increase from 3% to 4% as tax revenues - is slated to be around 11,000 crore. We welcome this and are looking forward to seeing how the government intends to utilize and distribute the revenues collected from this cess increase", said Mustafa Daginawalla - CFO, Saifee Hospital.