Modi govt has its finger on the voters’ pulse

The BJP’s canny acknowledgement of healthcare as a major political slogan — Prime Minister Narendra Modi highlighted his decision to cap prices of medical devices during the recent Gujarat Assembly polls — is unlikely to substantially boost the overall central expenditure under that head.

Top sources in the BJP revealed that the Centre’s focus is more towards “helping the States increase their capacity to absorb and spend”, rather than effect a substantial increase in budgetary allocations.

While the National Health Policy 2017, makes a commitment towards spending 2.5 per cent of the GDP on health, it remains a futuristic pledge, to be fulfilled by 2025. This is an extension of the earlier 12th Five Year Plan targets, which envisaged an expenditure increase of up to 2.5 per cent of the GDP by 2017. Those in the know in the BJP asserted that it is more important that the funds are absorbed, rather than focusing solely on increasing the percentage of GDP spent on that count.

“We have been gradually increasing funds for health. Last year, the increase was 27.7 per cent. But what should be understood is that the problem is not a dearth of funds; there is no shortage of funds for health under Prime Minister Modi. The issue is whether the States have the capacity to absorb the funds. What we have achieved in the last three years is that our real expenditure is higher than the estimated expenditure. We have institutionalised the process of consultations with the States for better absorption and expenditure,” said a top BJP leader.

Public health expenditure in India is abysmally low: it stands at about 1.4 per cent of the GDP compared to a world average of about 6 per cent. China spends 3.1 per cent of its GDP on health while fellow BRICS country Brazil’s figure is 3.8 per cent.

The low expenditure on public health is accompanied by high proliferation of private healthcare facilities. According to the National Family Health Survey (NFHS-3), the primary source of healthcare for 69.5 per cent urban households and 62.5 rural households, was private. The total out-of-pocket expenditure on health in India is a staggering ₹3-lakh crore.

The BJP has understood the political volatility of this issue much better than previous governments. Given that 42 per cent of the out-of-pocket expenditure goes into buying medicines, the Centre has brought 732 drugs under price control in the National List of Essential Medicines since April 2016.

Much like the Swachh Bharat Abhiyan that popularises cleanliness and hygiene, the ruling dispensation has stepped up popularising moves like capping the prices of coronary stents and medicine along with ramped up screening of non-communicable diseases, decline in Total Fertility Ratio (TFR) et al.

However, this does not necessarily mean the ruling party will put its money where its mouth is. “We believe the State should be the main provider of universal healthcare. However, the reality in India is very complex. What we intend to do is to make strategic partnerships with the private sector and use the PPP model to reach where we do not have our own facilities,” said a BJP leader.

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