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Given the crucial importance of the healthcare system, the allocations for the health sector in Budget 2013-14 are abysmally low. The sector was allocated Rs 37,330 crore in Budget estimates, a meagre hike of 8.24 per cent from 2012-13. Budget 2012-13 allocated 0.34 per cent of the total budgetary expenditure for health and family welfare.
In rupee terms, the current increase from the previous year is only Rs 7,000 crore. This marginal increase in health sector budget, after adjusting for inflation, amounts to a decline in real terms. Under-funding in healthcare system will not deliver desired outcomes. Certainly the Finance Minister has done little to walk the talk on government’s promises for the health sector.
To cater to the healthcare needs of the population, a minimum allocation of 5 per cent of GDP is necessary. The Government’s spending on the health sector is the lowest amongst the BRICS (Brazil, Russia, India, China, South Africa) nations. Marginal increases in the budgetary allocation are inadequate to make any significant strides in the provision of healthcare.
No shot in the arm
The government’s ambitious plan for Universal Health Care (UHC) and providing free medicines at all government hospitals will face a financial crunch. Of the total health sector allocation of Rs 37,330 crore, the allocation for National Health Mission (NHM), the programme launched by combining the already existing National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM) is Rs 21,239 crore. Though the healthcare industry welcomes this, the allocation under NHM is not at all sufficient. Last year, the NRHM itself was allocated Rs 20,862 crore.
If the public health facilities are not strengthened by budgetary support, there will be increased demand for services from private providers. Many poor and lower-middle class patients cannot afford private healthcare services.
Positive for R&D
However, there is an increased budgetary allocation for medical education and research. Importance is also given to the expansion of medical care facilities for women, the differently abled and the elderly. The department of AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy) under the Ministry of Health and Family Welfare is allocated Rs 1,069 crore. This indicates the priorities of the government to promote alternative systems of medicine.
The absence of funds for the Reproductive and Child Health Project, Pulse Polio Immunisation and routine immunisation, National TB Control programme and National Disease Control Programme raises concern. Crucial health issues such as infectious diseases, trauma care and primary healthcare are not even mentioned in the Budget.
The private sector, which provides 75 per cent of the diagnostics requirements, and the private pharmaceutical industry are not happy with the Budget. There is nothing for them by way of tax incentives and other fiscal relief. The Budget should have offered incentives to private players to make healthcare affordable. Budget 2013-14, like earlier Budgets, does not offer much to revive the health sector.
(The author is professor of health economics at Christ University, Bangalore.)
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