Ahead of the sixth Union Budget, experts from the medical fraternity talk about what their expectations and recommendations are from the Government. Pioneer Health reports
Right partnership approach
With Prime Minister Narendra Modi promising that the Government will more than double its public health spending to 2.5 per cent of gross domestic product (GDP) by 2025 from 1.15 per cent at present, all eyes are on the healthcare sector. The last year has been a challenging one for India’s private healthcare providers, with multiple headwinds impacting growth & profitability.
Even the existing players are slowing down their capex plans, given that more than two-thirds of the sector is driven by private operators, the Government has to increase its willingness to partner with the private sector players. The ambitious Pradhan Mantri Jan Arogya Yojana (PMJAY) under Ayushman Bharat mission holds a lot of promise and has the right intent, but the Government authorities need to take the right partnership approach to broad base participation. India’s fast-growing economy has led to a significant increase in demand for modern healthcare facilities, rise in awareness about diseases, health consciousness among people, increase in per capita income, changing lifestyle and most importantly, a transition in disease profile.
Non-communicable diseases like heart disease and diabetes account for as many as 60 per cent of total deaths in the country. An effective PPP model within the wellness outreach where diagnostic test providers can participate effectively will go a long way towards the overall vision of health for all.
The fact that these are preventable needs the focus and investment of the Government, especially in diagnostics. It is only through better partnerships with the private industry experts that the country can achieve the vision health for all by 2022, the 75th anniversary of independence.
— Arindam Haldar, CEO, SRL Diagnostics
Expansion of digital healthcare
The biggest challenge in the Indian Healthcare sector is the delivery model, especially in rural India. We need to start investing in training more primary health providers and put more emphasis on delivering quality healthcare options, and everyday basic medicine to those who do not have access to it due to the lack of infrastructure, medical practitioners and qualified primary healthcare attendants. We must prioritise on improving healthcare outcomes, building primary healthcare infrastructure, lowering costs via technology and addressing accessibility, approach and affordability.
There is also a need in strong support on the implementation of health information technology, which has the potential to save the India billions of dollars in healthcare costs each year. Increased investments, incentives and tax benefits on primary care infrastructure and technology is important for scale in India. Budget should support expansion on digital healthcare, data flow, and invest in new data-driven tools and policies that reward improving the quality and value of care. Doctors, hospitals and entrepreneurs are demonstrating that startups in healthcare can bring smarter, better, more accessible and more proactive care; showcasing the best way to improve quality and control health care costs.
— Nilesh Jain, co-founder, Clinivantage Healthcare Technologies Limited
Invest on preventive treatment
The Government needs to focus on increasing the viability of various preventive and treatment programmes. Preventive health programmes can help in early diagnosis and timely treatment and will result in lowering the burden on secondary and tertiary care facilities. More doctors and healthcare staff at various levels will have to be hired to achieve the mission of universal healthcare.
Despite introduction of health insurance schemes, overall coverage and penetration is still low. Government should focus on expanding insurance to middle class along with the lower strata of society to allow access to super speciality healthcare. We are expecting that medical insurance coverage in the country will be strengthened.
Digital and other advances in technology need to be harnessed through specific budget allocations. High cost of imported medical devices are a challenge and hence, there is need to give incentives to device and medical industry which will not only encourage Government’s Make in India initiative but will also reduce the monetary burden of the patients.
— Dr Manoj Luthra, CEO, Jaypee Hospital, Noida
Heavy taxes on cigarette & others
Ayushman Bharat is a positive step towards universal healthcare in India but it needs to accommodate tertiary care in its scheme of things. Under the scheme currently, tertiary healthcare service providers will be forced to cut cost at every level to cater to an Ayushman patients and the outcome might be affected.
Our per person average healthcare spend is 85$ which is amongst the lowest if compared to other countries. The upcoming budget should reflect a break-up of the benefits Ayushman Bharat extends to private entities as currently there are multiple restrictions to extend quality treatment to an Ayushman patient.
The healthcare sector needs privatization where implementation should be undertaken by private service providers to ensure that uniformity in quality healthcare is maintained. If the Government plays a role of a monitoring agency, we will fare much better to deliver value based healthcare.
Cancer can be defeated only when there is a change in behaviour. Government should levy heavy taxes on components like cigarette and other sources of tobacco consumption and strike a strategy to help farmers with alternate model of beneficial agricultural practices.
— Dr BS Ajaikumar, chairman and CEO, Healthcare Global Enterprises Ltd
Focus on Priority Sector Status
The Government should make health insurance coverage mandatory for all citizens in a phased manner initially covering the organised sector. They should introduce Healthcare Infrastructure Upgradation Fund and sought ‘National Priority’ status for healthcare sector.
In view of very low penetration of health insurance in the country, out-of-pocket spending for healthcare services is very high. For an effective management of population health universal health insurance would act as a powerful catalyst.
While the Government has taken laudable steps to introduce a health insurance scheme for weaker section with PM-JAY, it is requested that the Government could also explore making health insurance coverage mandatory for all citizens. Starting with organised sector, employees could be given the option of either paying their Employee’s State Insurance contribution or purchasing insurance from any Insurance Regulatory and Development Authority regulated insurance company. Scaling up PM-JAY to all citizens including middle and upper middle class needs to be done in the next phase.
Adequate funding in the healthcare is a major concern hence a Priority Sector Status would push financing and funding to the sector. This will help in the process of enabling development of innovative long-term financing structures for healthcare providers apart from creating an attractive environment for domestic production of medical equipment, devices and consumables while also catalysing research and development.
Access to timely credit with priority status and funding by creating a specific fund for healthcare infrastructure and innovation would facilitate access to capital for the sector. These funds would encourage entrepreneurship and newer business models which are the need of the hour for improving access, availability and quality, especially in Tier 2, Tier 3, Tier 4 cities and rural areas. The Government can consider providing the seed capital for such funds.
Other recommendations include incentives to medical value tourism, Zero rating GST on healthcare services and health insurance premiums, incentivising capacity building, promotional policies for private providers, and exemption of custom duty on medical cyclotron among others.
— Siddhartha Bhattacharya, secretary general, NATHEALTH
