Finance panel report to devote a chapter to health financing

For the first time, the Fifteenth Finance Commission (FFC) will devote an entire chapter on health financing in its final report, its Chairman NKSingh has said.

He also said that the high-level committee on the health sector constituted by the FFC and the World Bank will dove-tail their study and analysis to come up with suitable recommendations for the sector.

The Government of India’s spending on health through Centrally sponsored schemes will also be studied in detail by the Commission before it gives its recommendations to the Union Government, Singh said during a meeting with representatives of the World Bank, NITI Aayog and member of the FFC’s high-level group on the health sector.

The World Bank was represented by Junaid Ahmad, Country Director; Muhammad Ali Pate, Global Director; and other senior officials. Randeep Guleria, Director, AIIMS; Indu Bhushan, CEO, Ayushmann Bharat; and VK Paul, Member, NITI Aayog, also took part in he meeting.

Junaid Ahmad said that health was not just a social expenditure but also important for economic growth and development of the country. In this regard, he felt that the Finance Commission may like to look at health in three different ways: grants to enhance per capita spending, block grant for capacity building and a performance incentive for certain health outcomes. Similarly, in the context of health, a pivotal role may be played by the local bodies. Also, more than 60 per cent of health demand in India is supplied by the private sector. Leveraging private clinics along with direct benefit transfer (DBT) may increase engagement with the private sector. The importance of non-communicable disease can’t be undermined. Another area that needs focus is infectious disease programmes like tuberculosis, he said.

Role of World Bank

Ahmad also stressed the importance of engagement. He cited the example wherein World Bank had engaged with five States for the implementation of Samgra Shiksha Abhiyan. Similarly, in the health sector, institutions like district hospitals, primary health centres and municipalities and the social sector could be leveraged. The World Bank, he suggested, could play a role in designing and implementing such programmes while working closely with such institutions.

The World Bank also made a presentation during the meeting. It was highlighted that the adverse economic impact is likely to be proportionately larger than the direct impact of the coronavirus on morbidity and mortality.

Paul emphasised the importance of local bodies in delivery of health care services. He also said that 65 per cent of public spending on health comes from State governments while 35 per cent comes from the Union Government. There is an enhanced need to increase the overall expenditure on health sector, he said.

Guleria, Director, AIIMS, emphasised that public–private partnership in health sector should be encouraged. He also asked for enhanced focus on investigative infrastructure of health.

Indu Bhushan stressed the need to cover the ‘Missing Middle’ population in PM-JAY. He also stated that private hospitals need help as they are stressed with falling revenues and rising cost. He emphasised that health should be a concurrent subject.

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