Syllabus
GS Paper 3 – Government Budgeting.
Context
The goal of having every Indian protected by universal health coverage cannot be realised if budget allocation is meagre.
Source
The Hindu| Editorial dated 25th July 2024
A Budget that places health on the margins
The Union Budget has transitioned its focus from the immediate health concerns of the COVID-19 pandemic to broader economic growth drivers like infrastructure and employment. Despite this shift, it was anticipated that the importance of population health as a key investment for sustainable economic growth would continue to be recognized, with investments to strengthen health systems.
Health Sector Issues in India
Infrastructure and Accessibility
- Urban-Rural Disparity: Significant differences in healthcare infrastructure and services between urban and rural areas.
- Insufficient Facilities: Shortage of hospitals, clinics, and medical equipment, particularly in rural regions.
- Primary Healthcare: Weak primary healthcare system leading to overburdened tertiary care facilities.
Workforce Shortage
- Doctor-Patient Ratio: Low ratio of doctors to patients, with an acute shortage of specialists.
- Training and Retention: Insufficient training programs and retention issues for healthcare workers, especially in rural areas.
- Multi-Skilled Workforce: Lack of a multi-layered, multi-skilled workforce to handle diverse health needs.
Financial Constraints
- Out-of-Pocket Expenditure: High out-of-pocket expenses for healthcare, leading to financial burden on families.
- Insurance Coverage: Limited reach and effectiveness of health insurance schemes like PMJAY.
- Funding Gaps: Inadequate funding for national health programmes and infrastructure development.
Disease Burden
- Communicable Diseases: High prevalence of diseases like tuberculosis and malaria, with inadequate control measures.
- Non-Communicable Diseases: Rising incidence of lifestyle-related diseases such as diabetes and cardiovascular conditions.
- Child and Maternal Health: Persisting challenges in reducing maternal and infant mortality rates.
Budget Allocation for Health Sector
- Overall Increase: Only a 1.98% increase in the overall Health Ministry budget from BE 2023-24 to BE 2024-25.
- The Union Budget for the health sector has seen a modest increase in overall allocations.
- This increase is primarily focused on enhancing primary healthcare infrastructure and expanding insurance schemes.
- However, the growth in budgetary allocation is relatively small when compared to the rising healthcare needs and challenges faced by the country.
- Flagship Programmes: Specific flagship health programmes like the National Health Mission (NHM) and the Pradhan Mantri Jan Arogya Yojana (PMJAY) have received incremental increases in their budget allocations.
- National Health Mission (NHM)
- Increase of 1.16%: The NHM, which plays a vital role in improving healthcare delivery, particularly in rural areas, has seen a budget allocation increase of 1.16%.
- This is relatively minor given the NHM’s extensive mandate, which includes strengthening primary healthcare, addressing communicable and non-communicable diseases, and improving maternal and child health services.
- Pradhan Mantri Jan Arogya Yojana (PMJAY)
- Increase of 1.4%: PMJAY, a flagship health insurance scheme aimed at providing financial protection to vulnerable families for secondary and tertiary care hospitalisation, has received a budget increase of 1.4%.
- Medical Colleges: Investment in new medical colleges is mentioned, but there is no significant budgetary backing to ensure their establishment and operation
- Specific Programmes
- HPV Vaccination : Encouraged in the Interim Budget but not detailed in the main Budget.
- U-WIN Programme: Announced for improving immunisation coverage but lacks detailed budgetary allocation.
- ASHA and Anganwadi Workers: Inclusion in PMJAY not reflected in explicit budgetary terms.
Way Forward
- Strengthening Infrastructure
- Invest in Healthcare Facilities: Increase the number and quality of hospitals, clinics, and health centres, particularly in underserved areas.
- Modernize Equipment: Ensure availability of advanced medical equipment and technology.
- Enhancing Human Resources
- Training and Recruitment: Expand training programs and recruit more healthcare professionals.
- Skill Development: Focus on multi-layered, multi-skilled workforce development.
- Improving Accessibility and Affordability
- Expand Insurance Coverage: Strengthen and widen the reach of health insurance schemes like PMJAY.
- Reduce Financial Barriers: Implement policies to reduce out-of-pocket expenses for medical treatments.
- Addressing Disease Burden
- Comprehensive Care for NCDs: Develop robust strategies for prevention, early detection, and management of non-communicable diseases.
- Strengthen Maternal and Child Health: Enhance programs to lower maternal and infant mortality rates.
- Enhancing Health Governance
- Efficient Fund Utilization: Ensure allocated funds are used efficiently and transparently.
- Policy Implementation: Strengthen mechanisms for effective implementation of health policies and programs.
- Inter-Governmental Coordination: Improve coordination between central, state, and local health agencies for cohesive action.
- Focused Interventions
- Preventive Healthcare: Invest in preventive healthcare measures, including vaccination and awareness campaigns.
- Public-Private Partnerships: Leverage partnerships with the private sector to enhance healthcare delivery and innovation.
Conclusion
The Union Budget’s modest increases in health allocations and missed opportunities for investment in key areas such as workforce development and drug pricing mechanisms reflect a gap between the health sector’s needs and the government’s commitments. While economic growth drivers are crucial, strengthening the health system remains imperative for achieving universal health coverage and tackling emerging health challenge.
Related PYQ
One of the intended objectives of Union Budget 2017-18 is to ‘transform, energise and clean India’. Analyse the measures proposed in the Budget 2017-18 to achieve the objective. [ UPSC Civil Services Exam – Mains 2017]
Practice Question
Critically analyze the Union Budget’s allocations towards the health sector in light of the post-COVID-19 economic recovery. [250 words]