Ensure free medicines and easy admission into hospitals; debar drug companies from gifting doctors… the suggestions pour in from citizens as they engage with the local AAP candidate on Twitter.

In fact, health has pride of place on the Congress manifesto as well, where “Right to Health” is endorsed and a promise is made to increase healthcare spends to 3 per cent of GDP. The CPI(M) seeks to better that, promising healthcare spends at 5 per cent of GDP.

Health, it seems, has finally crept into campaign speeches and indeed the agenda of political parties. But scratch a bit and the reality is vastly different. Much of the announcements are rebottled old wine and political parties of all hues still have many health promises to keep.

Increased healthcare spending is a long pending promise of the UPA government. And the rollout of free medicine for the urban poor was a commitment from no less than Prime Minister Manmohan Singh in 2012. It remains a non-starter.

The Common Minimum Programme (2004) had outlined increased healthcare spending to 3 per cent of GDP, says Ravi Duggal, a health researcher with the non-profit International Budget Partnership. The Left had also supported the programme.

Ten years later, the Government’s health spend hovers at a little over 1 per cent of GDP, raising questions on its commitment to the issue.

Even the promise of universal coverage is not universal, as it targets only economically weaker sections, says Duggal. Citing the example of the Brihanmumbai Municipal Corporation (BMC), he explains why a narrow healthcare delivery model will not work.

In the 1980s, about 25 per cent of BMC’s budget was for healthcare and people from all economic classes visited its hospitals. The allocations have since reduced to about 12 per cent, the quality has fallen and people have moved to expensive private hospitals, he observes.

Sakthivel Selvaraj, senior health economist with the Public Health Foundation of India, points out that despite allocation figures showing considerable increase in actual terms, budgets are cut later on to adjust for a fiscal situation.

Commitment towards health in the 12th Plan saw allocations of over ₹300,000 crores for the five-year period, says Selvaraj. The actual plan allocations remain much below that, he adds.

Further, he says, if you compare the nominal increase between the budget estimate of 2013-14 and 2014-15, the growth rate is 6.4 per cent. “If we net out inflation of 8 per cent, this actually means a reduction in real allocation.”

“Poison” medicine The BJP too has its share of unpleasant healthcare stories — it criticised the free medicine scheme of Ashok Ghelot, Rajasthan’s former Congress CM. In the run-up to the State’s Assembly elections, BJP’s Vasundhara Raje slammed the scheme for giving “poison” in the garb of free medicine. Following an outcry from health workers, the Raje government has now said it will re-look the scheme.

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