When our finance minister, promised to deliver “nothing as seen before budget”, she had all eyes set onto her ‘Bahi Khata’ with healthcare sector looking most forward towards it. An exceptionally extraordinary figure suggesting an increase in budget outlay of about 137% in healthcare sector – stunned the minds of common man who can only hope to imagine that this amount was big enough to answer all his health concerns.
Before presenting the sketchy side of the budget 2021 in the context of healthcare sector, i would like to equip my reader with proper knowledge about the health and well being sector. Basically, health and well being expenditure of 2021 could be divided into five main components which includes D/o health and Family Welfare, D/o Health Research, M/o AYUSH, D/o Drinking water and Sanitation and CoVID related special provisions.
The data for 2019-20 from Annexure 1 of Union Budget 21-22 speech, Ministry of Finance shows that out of Rs. 86,259 crores the expenditure on nutrition, water and sanitation was Rs. 18,624 crores and on family welfare was Rs.62,397 crores with hardly any significant expenditure on nutrition and health research.
It is important to note that the National Health Programme,2017 targeted an increase in healthcare spending from 1% to 2.5% of the total GDP. However, the current picture presents a very grim situation where the total expenditure has just increased to 0.34% from 0.31%(last year) of the total GDP.
In order to meet the said targeted level, union budget was required to spend 0.68% of total GDP hence once again leaving one more pothole neglected. Out of 2,23,846 crores, 60,030 crores is reserved for water and sanitation sector whereas 35,000 crores is to be spend on CoVID-19 vaccines.
Undoubtedly, the water and sanitation sector is as important as the other categories but it is clearly not a part of mainstream health expenditure. Likewise, expenditure on Vaccines is also a one-time disbursement and is not going to contribute towards regular health issues. According to Global Hunger Index, 2020, India ranks 94th out of 107 countries and here, we are spending just a fragment of total expenditure on it.
Let’s shift our focus on recently launched PM Atmanirbhar Swasth Bharat Yojana, which concentrates on developing capacity in healthcare at primary, secondary and tertiary levels. This scheme seems like a good deal at first impression, perhaps it’s allocation is too late and perfunctory.
Rs 64,180 crore is to be spend over six years and no mention of budget line in the demand statement of the Department of Health and Family welfare on this new scheme makes it further doubtful about its proper implementation. Further, the issues regarding exorbitant prices charged by private medical institutions were not even talked about.
Now after a very detailed observation this 137% increase seems to be as delusional as it sounds! Doesn’t it ? The title of one of the chapters in Economic Survey 2020-21 was “Health Care Takes Centre Stage, Finally” but sadly the budget documents babble a different tale. It was sin qua non for the Union Budget to increase its spending in this very significant sector and this massive gap needs to be filled and addressed immediately!