A new health protection scheme on the road to universal coverage, a national dialysis programme and a 13-per cent hike in Budget allocation — it was relative windfall for the health sector that has stagnated since the beginning of the current five-year plan, and for a couple of years before that. The government stopped short of implementing a health cess on tobacco products, although it did increase the excise duty on cigarettes by 10-15 per cent. The continued exemption for beedis would be a dampener.
The Budget allocation for the health ministry went up from Rs 33,765 crore in 2015-16 to Rs 38,892 crore, slightly less than the Rs 40,000 crore the ministry had demanded. The RE for the current financial year is Rs 35,534 crore. This is apart from Rs 1,326.20 crore for AYUSH that brought the total sectoral allocation to Rs 38,892.
Watch video: The Big Picture Of Arun Jaitley’s Budget 2016
The break-up, thus: is Rs 19,037 crore for National Health Mission, Rs 16,555 crore for health, Rs 1,500 crore for Rashtriya Swasthya Bima Yojana (RSBY), and Rs 1,800 crore for health research. However, the announcement of a health protection scheme was clearly the highlight for the sector — a scheme that has been in the works since 2012 when the report of the high-level expert group of the erstwhile Planning Commission on Universal Healthcare Coverage was unveiled.
“Catastrophic health events are the single most important cause of unforeseen out-of-pocket expenditure which pushes lakhs of households below the poverty line every year….In order to help such families, the government will launch a new health protection scheme which will provide health cover up to Rs 1 lakh per family. For senior citizens…an additional top-up package up to Rs 30,000 will be provided,” finance minister Arun Jaitley said in his Budget speech.
It was in preparation for the roll-out of a nationwide health insurance scheme that the RSBY was transferred from the labour ministry to the health ministry in April 2015. Jaitley said the health insurance scheme will provide coverage to a third of India’s population — about 40 crore people.
The Indian Express had first reported that a health protection scheme was in the offing.
Jaitley also unveiled a dialysis service programme, an important measure for a country with a very high load of diabetes and hypertension, both, in the long term, known to affect kidneys. According to figures Jaitley presented, there are nearly 2.2 lakh new patients of End-Stage Renal Disease in India every year, resulting in additional demand for 3.4 crore dialysis sessions. At present, there are about 4,950 dialysis centres in the country, mostly in the private sector and in urban areas.
“Every dialysis session costs about Rs 2,000 — an annual expenditure of more than Rs 3 lakh,” Jaitley said. “Besides, most families have to undertake frequent trips, often over long distances, to access dialysis services, incurring heavy travel costs and loss of wages. To address this, I propose to start a ‘National Dialysis Services Programme’. Funds will be made available through PPP mode under the National Health Mission, to provide dialysis services in all district hospitals. To reduce the cost, I propose to exempt certain parts of dialysis equipment from basic customs duty, excise/CVD and SAD.”
Experts have welcomed the move. Dr Vivekananda Jha, professor of nephrology at PGIMER, Chandigarh, said: “Provision of dialysis has long been a benchmark for willingness of governments around the world to provide healthcare to its populations. The devil will be in the details, for it is easy to spend a lot of money on dialysis for a relatively small proportion of the population. Lessons learnt from implementation in other countries should be used to develop replicable schemes for delivery of good quality dialysis in an ethical manner.”
Specifying that there is a “danger of market ethics drowning quality”, Dr Jha said, “This should be supported by a quality assurance system to be developed in consultation with professional societies and national and international organisations. Quality should not be sacrificed at the altar of cost.”
Jaitley also announced renaming of the Jan Ausadhi scheme for generic drugs as the Prime Minister’s Jan Ausadhi Yojana, under which 3,000 new stores will be opened in the coming financial year.