Let the 2020 Union Budget and the decade ahead turn out to be in the larger interest of healthcare, making it more accessible to all, affordable and patient-friendly
The growing disease burden should compel the country’s policymakers to allocate a fair chunk of funds for public healthcare infrastructure. The recent news on infant deaths in Muzaffarpur district of Bihar due to Acute Encephalitis Syndrome and in Kota district of Rajasthan due to hypothermia are glaring examples of existing fault lines within the primary healthcare system in India. Such incidents send a grave reminder that affordable and accessible, good quality healthcare still remains the biggest challenge in the rural hinterlands of our country.
The Centre’s ambitious flagship health insurance scheme, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) has immense potential to correct the healthcare basics in the country. It holds a lot of promise and has the right intent, but one can just hope the Government and healthcare authorities take the right partnership approach to a more inclusive participation.
In the last Union Budget, the budgetary allocation for the healthcare sector stood at Rs 60,908.22 crore, with Rs 6,400 crore earmarked for the AB-PMJAY.
The scheme aims at providing annual health cover of up to Rs 5 lakh per family for secondary and tertiary care hospitalisation to over 10.74 crore vulnerable families (approximately 50 crore beneficiaries). Rationalisation of treatment packages and speeding up the recovery process are essential elements that will encourage more private hospitals to empanel under this scheme.
Let us focus on the basics: The healthcare sector is one of the biggest contributors to the Indian economy and accounts for six per cent of the country’s Gross Domestic Product (GDP). The hospital industry in India, accounting for 80 per cent of the total healthcare market, is witnessing a huge demand from global as well as domestic investors. It is expected to reach $132 billion by 2023 from $61.8 billion in 2017; growing at a CAGR of 16-17 per cent. The country’s medical tourism market is expected to grow from its current size of $3 billion to $7-8 billion by the end of 2020.
Yet, the country’s spending on public healthcare is estimated only at 1.3 per cent of the GDP. Besides having a poor infrastructure within public health facilities, there is also a lack of adequate resources. When over two-thirds of the sector is driven by private players, the Government should be more willing to get into a partnership-based approach with them to achieve Universal Health Coverage in line with the United Nation’s Sustainable Development Goals (SDGs).
A multi-pronged approach: We require a multi-pronged approach from the Government to strengthen and reform the health sector. On the one hand, it involves improving the state of public healthcare by increasing budgetary allocation, establishing more medical colleges and improving primary healthcare facilities. On the other hand, it involves measures to enable the private sector to spread its presence beyond the urban landscape. This will help in improving accessibility for secondary and tertiary care in tier-II and tier-III towns, besides rural areas.
For the latter to happen, the Government must offer major incentives and tax breaks to private healthcare organisations setting shop in non-urban areas.
The incentives can include income tax breaks for the first few years of operations, help in procuring land, making medical equipment Goods and Services Tax (GST)-free for such hospitals and relaxation on service tax on hospital inputs. Similarly, establishing a mechanism to offer fund support or subsidisation in treatment costs to private hospitals in smaller towns and rural areas can go a long way in bridging the prevalent accessibility gap.
The cost of medical equipment is another pain point, which requires thrust and making the medical devices and equipment a part of the ‘Made in India’ initiative shall benefit this sector.
Impetus to innovation: There is also a need to provide an impetus to innovation within the medical technology sector. For that, special funds for start-ups that manufacture medical devices would specifically address the needs of the Indian populations, serving as a big boost to the sector.
The introduction of Artificial Intelligence (AI) and predictive analytics for patient monitoring will add to significant financial savings and will increase the reach of healthcare in the country.
The need of the hour is that the primary care system should be strengthened in such a way that it is capable of doing the initial assessment, diagnosis and basic management and appropriate referral if need be. A thorough assessment and investigation at primary care or secondary care level can lead to a significant saving of resources at the territory level. The Government should facilitate more Continuous Medical Education to help professinals upgrade their skills which can solve the problem of shortage of trained doctors.
That Government must also consider oral health as an integral part of healthcare and give it the importance it deserves. The Narendra Modi Government should provide an enabling environment for the healthcare sector to grow. This is where the forthcoming Union Budget can show some vision and leadership.
This being the first Budget of the new decade, it will not only be a marker of the Government’s assessment but also a vision for the economy over the next 10 years.
Let 2020 and the decade turn out to be in the larger interest of healthcare, making it more accessible, more affordable and patient-friendly.
(The writer is founder and CEO of a dental healthcare chain)
