Healthcare Industry: Budgetery Wants And Needs

23/02/2015 5:45 PM IST | Updated 15/07/2016 8:25 AM IST
Indians cover their faces with masks as preventive measure against swine flu at the Gandhi Hospital in Hyderabad, in the southern Indian state of Telangana, Friday, Feb. 20, 2015. Health authorities were working to ensure remote hospitals in India had adequate medical supplies for a flu outbreak that has claimed more than 700 lives in 10 weeks. More than 11,000 cases have been reported since mid-December with most of the cases being reported from Rajasthan, Gujarat, Maharashtra, Telangana and Madhya Pradesh states. Although it was being referred to as swine flu, doctors say it is a variant of the H1N1 pandemic influenza. (AP Photo/Mahesh Kumar A.)

The Indian healthcare industry is growing rapidly yet the sector is in shambles. The sector, therefore, has high expectations from the Union Budget, both for reforms and expenditure. We cannot deny that India lags behind in meeting with international standards. Currently, India is amongst those countries that spend the lowest on healthcare in the world - 171 out of 175 countries in terms of public health spend.

The government is hoping to increase the spending on healthcare from 1.04%, which is among the lowest in the world to 2.5%. Today, 70% of the healthcare services are provided by the private sector. Increase in fund allocation for healthcare is highly appreciable and underlines the fact that health is indeed moving up the priority list in our central policies.

Accessible Healthcare: Making healthcare affordable and accessible for all its citizens should be a key focus area for the government. The challenge is immense as around 70% of the country's population lives in rural areas. Modalities like subsidies, tax exemptions, robust national health insurance schemes and innovations in healthcare are a must for a country like ours where the healthcare system is marred by limited financial accessibility to healthcare. India witnessed an appalling 779,000 of the three million global neonatal deaths in 2012. Needless to say that the primary healthcare system needs to be overhauled and neonatal care should be made free in the rural sector. With limited powers given to central regulatory or governing bodies like NABL, many pathology centers across the country have questionable quality.

Distribution of Funds: Allocation of funds in healthcare and the effective use of these funds are two big issues the government has been facing over the decades. The recent 20% cut in the budget only adds to the woes. With the limited finance-based health safety net, our citizens fall prey to petty price competition thronging across the diagnostic market. We need to build a system with enough checks to ensure that funds are used in the most appropriate manner.

Preventive Healthcare: While communicable diseases like drug resistant TB and antibiotic infections continue to loom, the increasing incidence of non-communicable diseases and deaths due to it, paints a far scarier picture. There is only one way to control the burden of non-communicable disease: to increase the focus on preventive healthcare. The budget should have a more futuristic perspective while allocating resource to healthcare, by which I mean designated and targeted resources for preventive healthcare services and chronic diseases. Today prevention is the most understated and under-resourced section of healthcare. Spending on ensuring healthy behaviour, information, education and communication about health is simply an extended arm of vertical healthcare programmes. It is promising to note that the Prime Minister stresses on the need for preventive healthcare in India. More awareness and early screening can greatly reduce the disease and cost burden.

Ensuring accountable and equitable health system spending: India is a data impoverished country when it comes to healthcare. This data paucity is a big hurdle in understanding the progress, distribution and penetration of healthcare services. Good data and data systems, which enable a robust, centralized monitoring of healthcare resources, is missing. Ensuring distribution and accountability in healthcare spending is therefore next to impossible. With National Health Mission and Healthcare IT, it seems possible to overcome this challenge. But the healthcare budget spoke nothing on healthcare IT as a measure to ensure accountability across the national health system. In fact, an overall monitoring and evaluation mechanism is totally off the picture in this budget.

Finally, I would like to conclude that the budget should not only allot bigger numbers to healthcare spending, but should also ensure a more regulated spending. Earmarked expenditure in shaping and consolidating fragmented healthcare markets like diagnostics is extremely crucial for ensuring better access to quality; especially in light of the fact that major part of the service supply comes from the private sector. It is important the leaders from this industry are heard in the policy-making process where they can join hands with the government to spearhead more planned and regulated funds for health and healthcare. It is time that we too ensure a stricter regulatory environment, because at the end the central principle of medicine is: Do no harm!

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