No money for health

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Public health expenditure will remain low, even if the needs of rural India are a new focus.

CARE QUOTIENT: The pediatric intensive care unit of the BRD Medical College in Gorakhpur (Photo: Maneesh Agnihotri)

The 2020-21 budget for health care was daunting: 67,484 billion rupees, a modest 5.7 percent increase over the revised estimate of 63,830 billion rupees last year. Given the estimated 10 percent nominal GDP growth, the allocation means a decrease in public health expenditure as a percentage of GDP. Healthcare inflation in India is currently between 14 and 16 percent. Given the slight increase in funding, public health spending is likely to remain below 1.5 percent of GDP – far from the targeted 2.5 percent by 2025. At 1.3 percent. In India, public sector health care spending will lag behind Bhutan's neighbors ( 2.5 percent) and Sri Lanka (1.6 percent). However, sub-strategies within the allocations indicate a stronger focus on rural areas with unmet medical needs.

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), which is billed as the world's largest government-funded program, is expected to be used to create bed infrastructure by increasing the number of hospitals in Tier II cities through the public-private partnership and III to be established (PPP) mode. For this purpose, funding of the profitability gap for the establishment of hospitals in 112 districts without own hospitals is proposed as part of the AB-PMJAY. "This is a commendable step," says Dr. G. S. Rao, Managing Director of Yashoda Hospitals Group, Hyderabad. "However, without adequate equipment and medical personnel to deliver high quality care, these hospitals will only exist as empty hulls. The government must act on the proposed model of increasing the reach of government facilities for the average citizen to restore their care." Confidence in the quality of care in these facilities. "The proceeds of 4,000 rupees from the proposed discontinuation of medical devices will be used to fund these hospitals, while half of last year's allocation of Rs 6,400 crore will go unused for the same scheme.

1.3% – India's health expenditure as a percentage of GDP

"Countries with better health systems and previous experiences with implementing such systems do better," said Sakthivel Selvaraj, director of economics, finance and planning at the Public Health Foundation of India. While this is a step in the direction of the government's vision of universal health insurance, the amount earmarked for this task is insufficient and inevitably leads to significant payment delays and cannot be claimed by any insurance company.

An additional 5 percent health quota when importing medical devices is a damper in a country that imports over 80 percent of its medical devices. In connection with an inch of 7.5 percent, imported devices become very expensive. The healthcare industry advocates that the government should at least consider exemptions for medical devices that are not manufactured in India. "The infrastructure status required by the industry has not been granted," said Vikram Vuppala, CEO of NephroPlus.

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