Union Health Budget 2018: Reactions from Top Industry Leaders

New Delhi: With the Budget 2018 being announced today, Finance Minister Shri Arun Jaitley indeed gave a blockbuster announcement of universal health coverage, a move that will indeed act as a gift of healthcare to the Indian poor who face immediate impoverishment with the onset of diseases.

The minister announced a universal health policy called National Health Protection scheme to cover 10 crores poor and vulnerable families, targeting approximately 50 crore beneficiaries. The scheme will provide upto Rs 5 lakh per family per year for secondary and tertiary care hospitalization.

The minister spoke about strengthening the 1.5 lakh health and wellness centers to provide a comprehensive healthcare including non-communicable disease and maternal and child services adding that these centers will also provide free essential drugs and diagnostic services. For this, the minister committed Rs 1200 crores in this budget.

To enhance the accessibility of quality medical education and healthcare, the government announced that it will be setting up 24 government medical colleges and hospitals by upgrading district hospitals in the country. The minister also allocated Rs 600 crores to provide nutritional support to all TB patients at the rate of Rs 500 per month for the duration of their treatment.

The Budget 2018 for Health, drew mixed reactions from the top industry players, with all welcoming the move of Universal Health Coverage, yet many criticizing the meagre budgetary allocation to health as compared to desired.

Welcoming the budget Dr Prathap Reddy, Chairman, Apollo Hospitals said, “My heartiest congratulations to this government for investing in creating a swasth bharat by launching the Ayushman Bharat programme. Such ambitious out of the box thinking was a burning need of the hour and the government has not disappointed. The initiative to cover 10 crore families with 5 lakh per family/per year WITH INSURANCE COVER FOR SECONDARY AND TERTIARY HEALTHCARE will be a gamechanger.”

Also welcoming the budget, Dr Minnie Bodhanwala, CEO, Wadia Hospital said, "The Healthcare Budget 2018 is groundbreaking and will transform the Healthcare industry thus giving it a further boost. The Government has finally focused on what was most essential for Healthcare. Finance Minister Shree Arun Jaitley has announced positive schemes and steps towards improving healthcare in India. Overall this Healthcare budget has provided good reforms in Healthcare. Rs 600 crore allocated for tuberculosis patients for nutritional support at the rate Rs. 500 per month during the course of their treatment. This is a good initiative to increase the compliance of antibiotic regime by the affected patients. Will help to reduce the disease load of TB."

Mr Arindam Haldar, CEO, SRL Diagnostics, however, pointed out that the minister did not clarify whether the UHC would include Diagnostic Costs, “ The announcement of universal health insurance at Rs 5 lakh medical cover per year for 10 crore(s) poor families across the country, is an appreciable step. It would be a welcome step if out-patient diagnostics costs/coverage is covered in this limit. The absence of coverage for outpatient care and pre-existing diseases is an impediment to a comprehensive and affordable health insurance cover. Also, specific focus on the diagnostics sector would have been of great benefit to supplement primary healthcare machinery. Nevertheless, we welcome the various health initiatives announced by the government in which limelight has been shed on the alarming rise of non-communicable and communicable diseases in India.”

Dr Kaushik Murali, Paediatric Ophthalmologist & President, Sankara Eye Hospital pointed out to the need for strengthening PG Medical Programs,."Healthcare sector has been a clear priority in budget 2018. There has been a good balance on short term respite from out of pocket health costs & building capacity in the long term.The idea to increase the number of doctors is good with the 24 district hospitals being upgraded, however strengthening of the other postgraduate programmes like the DNB course would also need to be done simultaneously. Health can be one of the key job creators. More focus from the Skill India initiative with these announcements should see this sector contribute in this area too. We hope that other announcements like the Pradhan Mantri Research Fellowship & the Research allocation would also spur healthcare research. With 1200 crores to the National Health Policy, we look forward to a continued impetus to the National Programme for Control of Blindness which is one of the most successful Public – Private healthcare programmes. It would be interesting to see how these would be funded, the finance minister indicated a widening of the tax base and an additional 1% cess, we only hope that the 3.5% fiscal deficit does not force a rethink on these allocations later. Also it would be good to expand the ease of doing business to ease of working with insurance & schemes and simplifying the process for health care providers. "

Poonam Muttreja, Executive Director, Population Foundation of India, however, lamented the budgetary allocations, especially to the issue of population control "A mere 11.5 percent increase in budgetary allocations for health from Rs. 47,353 crore from previous year to Rs. 52,800 crores is disappointing and discouraging especially with the announcement of schemes that require large sums of money. The budgetary allocations are clearly mismatched with the stated policies goals despite the political commitment to increase investments in health (National Health Policy 2017), family planning, and achieve better health outcomes (SDG Goals). The continuing trend in lower budgetary allocations for health reinforce the fact that, while there is the intention and attempt to improve the health status in the country, the financial commitment continues to be missing for translating these goals into action.The allocation for family welfare schemes under central sector schemes/projects, which is meant for procurement and distribution of contraceptives have increased only marginally by 2 per cent (Rs. 770 crore) over the budget (Rs. 755 crore) last year. This will be insufficient not only to meet the future demand but will also fall short of the current demand for contraceptives and for improving the much needed quality of services."

"The Ayushman Bharat initiative and the National Health Protection Scheme announced by the Finance Minister is a welcome move for the country’s healthcare development as they intend to significantly reduce the cost of healthcare borne by the households on medicines, diagnostics and hospitalisation. While both these schemes are conceptualised with good intentions, the government has to match up with a strong regulatory framework and clear financial outlays and implementation plans. While universal access to health care services remains a distant dream with the current allocation strategies of the government, resource prioritisation is the key to effectively utilise the available budgets for primary health care. To quote an example, prioritising critical elements of reproductive health care for instance can reduce large expenses incurred on incentives and compensation. Rather, these amounts can be used more productively to improve the quality of care and strengthen health service delivery," she added.

MTaI opposed the bill due to rise in duties on medical devices - "We have just learnt that the custom duties on medical devices have been increased. It is surprising that on one hand, government is giving healthcare relief to the common man on the other it is reducing the extent of this relief by increasing custom duties on a category where 70% of the products are still imported," said Mr. Pavan Choudary, Chairman & DG, MTaI.