Govt Spending on Healthcare FY-2023-24 : UPSC Key Points

Context

According to the 2023-24 Budget document, the total central government budget for health (not including research) will be roughly Rs 86,175 crore ($10 billion) — that is, roughly Rs 615 for every citizen. 

• This is a 2.7 per cent increase from the previous fiscal year and lower than the rate of inflation. 

Probable Question

As India aims to be a healthy nation, the only way to go is by increasing government investment and allocation for health. Elucidate. (150 words, 10 marks).

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Health Expenditure by the Government

• India currently spends about Rs 8 lakh crore ($100 billion) or about 3.2 percent of its GDP on health.
  • This is much lower than the average health spending share of the GDP — at around 5.2 per cent — of the Lower and Middle Income Countries (LMIC).
• Of this, the government (Centre and states put together) spends about Rs 2.8 lakh crore (about $35 billion) — roughly 1.1 per cent of the GDP.
  • Contrast this with the government health expenditure in countries like China (3 percent), Thailand (2.7 per cent), Vietnam (2.7 per cent) and Sri Lanka (1.4 per cent).

Impact of Health Expenditure on the Poor

• According to the WHO, 55 million people fall into poverty or deeper poverty every year due to catastrophic expenditures on health.
• A day of hospitalization at a public hospital is estimated at Rs 2,800. At a private hospital, it is Rs 6,800. 
• Vaccinating a single child against all childhood illnesses costs at least Rs 1,600.
• The poor, elderly and sick are already at a disadvantage and the burden of health expenditure makes this even worse.
• A greater proportion of disposable incomes is taken away from a poor household as compared to a non-poor one, further broadening the gap between the two. 
• Households have to often sell or mortgage their productive assets, such as land and cattle, to cover the treatment costs.

Significance of Budgetary Spending on Health

• The $10 billion spent by the central government may be a small fraction of overall health spending but it is consequential as it pays for immunization, newborn and child health and nutrition, maternal health, infectious disease control, health systems and training. 
• Rupee for rupee, this spending by the government purchases far more health than out-of-pocket or private spending by Indian citizens.

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Areas where greater spending by the central government could help in the immediate term

• Balanced focus for both communicable and non-communicable diseases: The National Health Mission allocates less than 3 per cent (Rs 717 crore) to non-communicable diseases (NCD) flexipool. In comparison, the allocation for communicable diseases is three times more at Rs 2,178 crore and for reproductive and child health services about nine times greater at Rs 6,273 crore.
  • The burden of disease from NCDs accounts for more than half of the total burden of disease and this proportion further increases in both rural as well as urban areas. 
  • Greater focus on communicable diseases is driven by past epidemiological patterns and should be rebalanced now to pay attention to non-communicable diseases.
• Public health and primary health care focus on rural areas: Urban areas have poorly developed infrastructure for primary care even if secondary and tertiary health care services are better.
  • For example, immunization coverage is now lower in urban India than in rural India. 
  • A third of the country now lives in urban areas and greater resources are needed to improve health here
• Focus on Health research: Health research has been neglected for too long. The allocation for the Department of Health Research in this year’s budget is Rs 2,980 crore, flat from last year. Spending Rs 20 per Indian is inconsistent with the need for innovations and technologies in the sector.
  • The bulk of the resources provided to the Indian Council of Medical Research goes towards maintaining a large payroll of scientists and the output is poor.

Way Forward

• India should follow the example of countries where government-funded health research is conducted at academic institutions, and the government’s role is to make grants — not to carry out the majority of research. 
• Competitive funding will encourage the best research and the example of the Wellcome Trust/DBT-India Alliance in promoting the culture of competitive grants can be replicated across the system.

Conclusion

• The health (and education) of Indians is the most important determinant of what the country can achieve during the next 25 years of Amrit Kaal. There is a need to find more money for health, and also more health for the money to ensure that all Indians achieve their true potential.

Frequently Asked Questions (FAQs)

News Source: Indian Express

https://indianexpress.com/article/opinion/columns/on-budget-2023-health-in-amrit-kaal-8422946/

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