Want Ameera Shah MD and CEO of Metropolis Healthcare Ltd
The Indian healthcare industry is growing at rapidly but 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 still lag behind in meeting the international standards. Currently, India is amongst those countries which 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 even among poor countries of GDP to 2.5%. Today 70% of the healthcare services are provided by the private sector for the country. 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 the key focus areas for the government. The challenge is immense as nearly 73% of the country’s population lives in rural areas. Modalities like subsidies, tax exemptions, robust national health insurance schemes and innovations in healthcare is must for a country like ours where the healthcare system is marred by limited financial accessibility to healthcare. In India over 1.4 million children die before the age of 5. Mothers and children need neonatal care. 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 centres across the country have questionable quality.
Distribution of Funds: Allocation of funds in healthcare and the effective use of these funds are two big crises 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 disease like drug resistant TB and anti-biotic infections continue to loom over, 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 PM, Mr.Modi 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 paucityis 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. For a matter of fact an overall monitoring and evaluation mechanism is totally off the budget picture.
Finally, I would like to conclude that the budget should not only simply allot bigger numbers to healthcare spending, but should also ensure a more regulated spending. Ear-marked 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 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 stricter regulatory environment, because at the end the central principle of medicine is – First do no harm!