Context: 

Recently, in the 2023-24 Union Budget speech, the finance minister announced that the total central government budget for health will roughly be Rs 615 for every citizen.

Concern:

• This is a 2.7 percent increase from the previous fiscal year and lower than the rate of inflation.
  • In real terms, the central government’s health spending has declined. 

Significance of budgetary spending on health:

• The small fraction of overall health spending has consequential effects on issues like immunization, newborn and child health and nutrition, maternal health, infectious disease control, health systems and training. 
• This spending by the government purchases far more health than out-of-pocket or private spending by Indian citizens.

Burden of healthcare in India:

• Vaccinating a single child against all childhood illnesses costs at least Rs 1,600.
• A day of hospitalization at a public hospital is estimated at Rs 2,800. At a private hospital, it is Rs 6,800. 
• Add to these the expenses for supporting women through deliveries, control of infectious disease, primary healthcare, and much more.
• 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 and the burden of health expenditure makes this even worse.

Increasing poor and non-poor gap:

• A greater proportion of disposable incomes is taken away from a poor household as compared to a non-poor one, further broadening the gap between the two. 
• According to the WHO, 55 million people fall into poverty or deeper poverty every year due to catastrophic expenditures on health.
• India’s spending is even lesser than the Lower and Middle-Income Countries. India currently spends 3.2 percent of its GDP on health. 
• This is much lower than the average health spending share of the GDP — at around 5.2 percent of the Lower and Middle Income Countries (LMIC).

Steps need to be taken:

• Rationalizing NHM spendings: The National Health Mission allocates less than 3 percent to non-communicable diseases. In comparison, the allocation for communicable diseases is three times more.
• Balancing Urban and poor health care: Public health and primary health care focus on rural areas. Urban areas have poorly developed infrastructure for primary care even if secondary and tertiary health care services are better. 
• A third of the country now lives in urban areas and greater resources are needed to improve health here.
• Focussing on Health research: Health research has been neglected for too long.
• The bulk of the resources provided to the Indian Council of Medical Research goes towards maintaining a large payroll of scientists and the output is poor.
• India should follow the example of countries where government-funded health research is conducted at academic institutions, and the government’s role is to make grants and not to carry out the majority of research. 

Conclusion:

• Health is the most important determinant of what the country can achieve during the next 25 years of Amrit Kaal. 
• We must find ways to both find more money for health, and also more health for the money to ensure that all citizens achieve their true potential. 

News Source: The Indian Express        

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