On Budget 2023: Health in Amrit Kaal

Source– The post is based on the article “On Budget 2023: Health in Amrit Kaal” published in The Indian Express on 4th February 2023.

Syllabus: GS2- Issues related to development and management of health

Relevance– Health spending

News– Recently, the central government presented the budget for this year.

The total central government budget for health will be roughly Rs 86,175 crore. It is roughly Rs 615 for every citizen.This is a 2.7% increase from the previous fiscal year.

In real terms, the central government’s health spending has declined.

What are issues with health spending in India?

A day of hospitalisation at a public hospital is estimated at Rs 2,800. At a private hospital, it is Rs 6,800. The Ministry of Health is expected to provide health services at a low budget . Therefore, the system fails the most vulnerable and they are forced to turn to the expensive private sector.

The poor, elderly and sick are already at a disadvantage. A greater proportion of disposable incomes is taken away from a poor household as compared to a non-poor one. It further broadens the gap between the two.

If a working member of the household falls sick, he must often withdraw from active employment. Their main source of income dries.

Households have to often sell or mortgage their productive assets to cover the treatment costs. This further reduces their capacity to bounce back.

According to the WHO, 55 million people fall into poverty or deeper poverty every year due to expenditures on health.

India currently spends about 3.2% of its GDP on health. This is much lower than the average health spending of the Lower and Middle Income Countries. It is around 5.2% for these countries.

The government spends about Rs 2.8 lakh crore roughly 1.1% of the GDP. In contrast, China spends 3%, Thailand 2.7%.

What is the way forward for health funding in India?

First, the National Health Mission allocates less than 3% for non-communicable diseases. In comparison, the allocation for communicable diseases is three times more and for reproductive and child health services about nine times greater.

The burden of disease from NCDs accounts for more than half of the total burden of disease. Greater focus on communicable diseases should be rebalanced now to pay attention to non-communicable diseases.

Second, public health and primary health care focus on rural areas. Urban areas have poorly developed infrastructure for primary care. Greater resources are needed to improve health here.

Third, health research has been neglected for too long. Spending Rs 20 per Indian is inconsistent with the need for innovations and technologies in the sector.

The bulk of the resources provided to the ICMR goes towards maintaining the large pool of scientists and the output is poor.

India should follow the example of countries where government-funded health research is conducted at academic institutions.

The government’s role is to make grants and not to carry out the majority of research. Competitive funding will encourage the best research.

We must find ways to both find more money for health, and also more health for the money to ensure that all Indians achieve their true potential.