Budget 2023: Why last full budget of Narendra Modi govt should focus on health sector

India’s health infrastructure needs more attention. PTI

Since next year, 2024, the country will hold general elections, it would be a vote-on-account. Hence, 2023 would be the last full Budget of the Narendra Modi government since it was voted to power in 2019.

COVID-19 has made us realise the importance of health for the economy. So, it is time that the nation gives health its due share, which is long overdue.

The budget allocations on health should consider the following:

1)  National Health Policy (NHP-2017) released in 2017 promised to increase the health outlay to 2.5 per cent by 2025. In 2023, this must go up to 1.80 per cent. It must include allocations for public hospitals, diagnostics, pharmaceuticals, and digital health, including R&D and capacity building for healthcare at all levels.

2) Healthcare is a public good. If India wants to become a developed nation by 2047, healthcare must be made tax-free. The poor become poorer due to increasing healthcare costs, and it is shocking to see people avoid treatments due to expensive healthcare in the private sector.

3) Jan Aushadhi and AMRUT stores must have a separate budget to provide free and subsidized medicines on the lines of PDS.

4) Senior citizens are now above 130 million, and cancer cases are rising. We need to build hospice and care homes (with community centres) in every town. We must allocate a budget for the same as a mission-mode programme.

5) India is a young country with an average age below 30 years, so it is time to allocate at least Rs 30,000 crore for a Comprehensive Sexual and Reproductive Health Programme. Otherwise, the burden of unwanted pregnancies, STDs, and associated mental health disorders will become massive.

6) We must implement ‘The Giving back to society program’ mentioned in the NHP-2017. The government must allocate at least Rs 500 crores to implement the same, so the care providers who wish to contribute can serve the needy sections of society.

7) Some cities do not have basic diagnostics and specialty care, and this must be a focus area for the government to strengthen public infrastructure in line with the NHP-2017. We must launch pin-code-wise mapping of services to ensure people do not have to travel beyond the Golden Hour to get any level of care. I see no reason why we should encourage big healthcare chains to enter smaller towns. The providers from these smaller towns should be able to deliver healthcare, and government must ‘ONLY’ give local providers viability gap funding and subsidize their services while ensuring the quality of care is appropriate and outcome-based. The disclosure of outcomes should be made mandatory, and we should incentivize those who achieve the desired outcomes.

8) There is an urgent need to provide hearse van service at all public hospitals and towns. My mother was a class one government employee when she died, the hospital refused an ambulance to carry her body home, and we had to take the body home wrapped in a bedsheet in the boot of the three-wheeler. The same thing is being seen even now and then with the dead being carried on a two-wheeler or a handcart. Healthcare should not rob people of their dignity and, more so, when the system fails to save lives. The government must ensure that every public hospital and every town should have a hearse van service on the lines of the ambulance, which must be a part of the NHM.

9) Women’s health remains the biggest challenge of our times. It should follow the life-cycle approach and not just the reproductive cycle approach and must be holistic. This is the key to achieving ‘Health for All’. The women’s health program must be re-oriented with Integrated Child Development Services (ICDS). Other programs with Women and Child Development Department (WCD) must be brought under the Ministry of Health and Family Welfare (MoHFW), and the budget allocations must be increased.

10) During my stint as advisor to the Union health minister, I initiated the digital dashboard to track beneficiaries for the ‘coverage’ and the ‘usage’ (utilization) of various government schemes. This must be rolled out with a separate IT budget under National Health Mission (NHM) / National Health Authority (NHA).

11) The government must ensure the community-based monitoring mentioned in the NHP-2017 does not remain on paper and has a budget to take inputs from the grassroots. Holding review meetings in five-star hotels during the last quarter to exhaust health budgets should be banned. The review should be held in the community setting, and there should be a budget for monitoring and evaluation.

Health is a Unique Electoral Proposition (UEP), and a government that invests in health will never lose an election. Investing in health will be a compelling proposition for voters, and for the Modi government to win the 2024 election with a massive mandate, focusing on health and education will undoubtedly break the record of 2019.

The writer is the founder of Health Parliament and Digital Health Academy. He tweets @rajendragupta. Views expressed are personal.

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