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The new budget sends mixed signals on health with promotion of social determinants and ignorance of

Contact Counsellor

The new budget sends mixed signals on health with promotion of social determinants and ignorance of

  • The clear signal that emerged from the Budget is that COVID-19 is no longer perceived to be a major threat though the Finance Minister referred to the Omicron variant of COVID-19 and the need to maintain caution
  • She also mentioned that the post-COVID-19 phase of development must focus on capital-intensive infrastructure projects under PM Gati Shakti scheme
  • The commitment to primary healthcare that was strongly articulated in the Budget of 2021 was much more muted this year

Definition of Health

  • The FM expanded the conventional definition of health in the Budget of 2021, while including water, sanitation, nutrition and air pollution control in it

Expenditure on Health sector

  • Expenditure on health reached 2.1% of GDP with an annual increment of 0.4% in the last two years according to the Economic survey 2022
  • This increase of expenditure in the sector represent both the redefined accounting categories and the COVID-19-related attention to augmented health services

Announcements regarding Social determinants of Health

  • Supply of tap water to 38 million more homes
  • Provision of housing under the Pradhan Mantri Awas Yojana
  • Initiatives for pollution control which include expansion of zero emission public transport services, incentives to reduce crop stubble burning and battery-swapping policy
  • Expansion of digital classroom support to schools across the country

Healthcare schemes: allocations, analysis and suggestions

  • There has been less than anticipated increase for the health programmes

  • National Health Mission: it received a 7.4% increase over the money expended last year.

  • Analysis: It is less as compared to the large need to strengthen both rural and urban primary care

  • Suggestions: There is a need to galvanise the Urban Health Mission which has moved slowly thus far. A number of rural and urban Health and Wellness Centres need to be established and activated with staff, equipment and supplies. There is also a requirement of higher investment in trained human resources

  • Pradhan Mantri Jan Arogya Yojana (PMJAY) : allocation to it stays unchanged at ₹6,412 crore.

  • Analysis: the scheme fell short of utilising its allocated budget for the past two years because of reduction in non-COVID-19 care under its payments and also because of the limited number of accredited hospitals in Tier-2 and Tier-3 urban locations and rural areas.

  • It does not also cover the cost of outpatient care and medicines outside a hospital setting.

  • Health Infrastructure Mission: it has got an allocation of ₹5,156 crore.

  • Analysis: Since the mission has projected an expenditure of ₹64,120 crore over six years, the allocation seems to fall short of ambition.

  • Pradhan Mantri Swasthya Suraksha Yojana: it has been allocated a 35.1% increase

  • AIIMS will be established in every State and several medical college hospitals will be upgraded under it

  • Department of Health Research: It has been given 3.92 percent increase from Rs 2,663 crore to Rs 3,200 crore.

  • Analysis: This is insufficient for setting up laboratories for COVID-19 research and development of new vaccines.

  • Suggestions: There is a need for health systems and implementation research to support effective delivery of national health programmes that span communicable diseases, maternal and child health, nutrition, non-communicable diseases and mental health.

  • Development and evaluation of appropriate and affordable health technologies too would be in keeping with the spirit of Atma Nirbhar.

  • Digital Health Mission: it has been allocated ₹200 crore and 23 Telehealth centres to provide support for mental health services to be established across the country.

  • Analysis: the allocation appears sub-optimal given the potential and promised services under that mission

  • Mental health impacts over 6-8 percent of our population and is a major unaddressed epidemic, estimated to cost the economy $1.03 trillion and accounting for 2,443 disability-adjusted life years per 1 lakh population

  • Addressing this requires the implementation of the Mental Health Act through an infusion of substantial money, ideas and imagination.

  • COVID-19 vaccines: it received an allocation of ₹5,000 crore as against ₹39,000 crore the previous year.

  • Analysis: This suggests that the government believes that all the eligible persons who need to be vaccinated through public funding will receive the vaccines in the current financial year and that there would be no major threat which would call for large-scale investments in new vaccine procurement.

  • Tax relief: The Budget provides tax relief to differently abled persons, whose parents or guardians have crossed the age of 60 years.

  • Analysis: This takes into account the fact that employment and the earning capacity of the person who provides such support usually diminishes at that age.

Conclusion

  • India needs a massive building up of its economy to ensure a minimum quality of life for all its people. But we also need to envision a transformative change by attacking inequality, disease and ignorance by investing in health, education, nutrition and employment to ensure equal opportunities.

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