The fifth and last union budget for the present term of the BJP government focuses mainly on agriculture and rural economy. Besides, this budget  is also promoting education and health (1). Healthcare demands a national priority status and requires allocation of more funds to deliver affordable and quality healthcare services to all. Health budget was expected to revamp this year considering the lowest spendings on Indian public health among other countries in the world and an emergency to address this issue to recuperate the healthcare system. In this budget, Health Ministry is expecting a cumulative budget increase to Rs. 52,353 crore this year over Rs 48,853 crore allocated to it last year (2).

Two major initiatives are announced under the Ayushman Bharat Programme in the Union Budget 2018. The first is ‘National Health Protection Scheme’ to cover 100 million poor and vulnerable families. Under the scheme approximately 500 million beneficiaries, approximately 40% of the population of India, will be provided an insurance coverage of upto five lakhs rupees per family for secondary and tertiary care hospitalization every year (1). This is supposed to avoid impoverishment due to wage loss. The Rashtriya Swasthya Suraksha Yojana used to offer insurance of Rs 30,000 to poor families, but this new scheme can definitely be proven as world largest healthcare programme if implemented widely (3).

The second notable initiative is the allocation of Rs. 1,200 crore as a boost for the healthcare sector for preventive healthcare and management of non-communicable diseases, maternal care and child services, providing free essential drugs and diagnosis (4). This include the creation of around 1.5 lakh health and wellness centres, to provide free essential drugs and diagnostic services close to residences (5). As per government there would be at least one medical college under three constituencies. The government plans to set up around 24 new medical colleges and hospitals while upgrading district level ones (1).

This budget has brought a considerable relief for senior citizens and salaried individuals in tax deduction related to healthcare services. The limit to Section 80D of the Income-tax Act relating to deduction of health insurance premium for senior citizens is raised to Rs 50,000 from the earlier Rs. 30,000. Under Section 80DDB, the deduction limit of medical expenditure for certain critical illnesses for all senior citizens increased to Rs 1 lakh which was earlier Rs. 60,000 for senior citizens and Rs. 80,000 for very senior citizens (6). The concessions will cost the government Rs 4,000 crore.

In addition, a standard deduction of Rs. 40,000 in lieu of medical reimbursement and transport allowance is reassured. This involves the government expenditure of Rs 8,000 crore. This deduction seems to be a very nominal benefit for taxpayers as the current tax-free limit for medical expense and transport allowance exemption is Rs. 34,200 per annum together (7). Therefore, these relieves to the taxpayer would encourage them to spend more on healthcare which in return would improve the quality of healthcare services.

As per WHO’s Global TB Report 2017, tuberculosis infection in India is in the most vulnerable condition as India topped the list of seven nations, accounting for 64 % of the 10.4 million new TB cases worldwide in 2016 (8). The deficiency of micronutrients and protein-energy increases the risk of tuberculosis (9). Considering delayed recovery and higher mortality rates in malnourished  patients than well-nourished patients, the Government has allocated Rs. 600 crore for nutritional support to tuberculosis patients under this budget. As per finance minister Rs. 500 per month will be provided to each of the TB patients undergoing treatment in India (8). However, this would not be the adequate step in the direction of reducing the number of new reports on tuberculosis.

The  government has taken many appreciable steps to provide affordable healthcare services, such as, to control medicines cost, stent prices and free dialysis facilities for the poor (1). Regardless, the taxes for the medical devices is fixed at 12% under GST, impacting the final cost of the healthcare sector (10). The government should reconsider this segment to achieve the ultimate goal of affordable healthcare services for all.

The Union Budget has increased the expenditure on AYUSH Ministry by more than 13% to Rs 1,626.37 crore. This Ministry works on  development of education and research in Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homoeopathy. The allocation of the funds has been increased for statutory and regulatory bodies controlling Ayurveda and Homeopathy (11). Hopefully this budget would support the traditional medical systems to develop to world-class level.

References:

  1. Union Budget 2018: National Health Scheme to provide Rs 5 lakh cover to 10 crore families
  2. Union Budget 2018: Why healthcare should be a national priority
  3. Budget 2018: Jaitley’s ‘World’s Largest Health Programme’ Rejigs Flailing Old Ones
  4. Jaitley announces world’s largest government funded healthcare programme in Budget 2018
  5. Budget 2018: Jaitley announces ‘world’s largest healthcare programme
  6. Budget 2018: Heyday for grey days – Senior citizens get triple break
  7. Rs 40,000 tax deduction on transport, medical expenses.
  8. Union Budget 2018: Govt allocates Rs 600 crore for nutritional support to tuberculosis patients
  9. Gupta K.B., Gupta R., Atreja A., Verma M, and Vishvkarma S. (2009) Tuberculosis and nutrition Lung India 26(1), 9–16.
  10. Budget 2018: GST on medical devices should be reduced, give impetus to health insurance
  11. AYUSH Ministry allocation in Budget increased by 13 per cent

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