Budgeting for a Healthier India: Can the Upcoming Budget Heal the System's Woes?

As the Union Budget 2024-25 approaches, the healthcare industry awaits significant pronouncements that will define its trajectory for the coming years. At Atrius Cardiac Care, a leading provider of cardiac care, we believe this budget presents an opportunity to strengthen India's healthcare infrastructure and make quality care more accessible.

The Challenge of Geographical Imbalance:

A significant challenge in Indian healthcare is the uneven distribution of resources. Studies show that a staggering 69% of hospital beds are concentrated in urban areas. This disparity forces many in rural areas, who often lack access to specialists and advanced facilities, to undertake medical travel to metros. This migration for treatment not only disrupts lives but also inflates costs due to factors like temporary accommodation and additional travel expenses.

Addressing the Needs of the "Missing Middle":

The budgetary focus should extend beyond just increasing bed capacity. We must bridge the gap for the estimated 30% (approximately 40 crore people) of the population who fall under the "missing middle." These individuals lack coverage under either government schemes or private health insurance. This gap can be even wider due to overlaps and limitations in existing schemes.

Here's where strengthening existing health insurance initiatives like Ayushman Bharat becomes crucial. Streamlining claim processes and ensuring wider coverage will incentivize more people to participate, reducing their dependence on out-of-pocket expenditure.

Out-of-Pocket Expenses:

The Indian healthcare landscape is tilted towards the private sector. Nearly 70% of hospital beds and a significant portion (almost 60%) of hospitalization and OPD treatment are provided by private hospitals. While this offers choice to patients, it also contributes to the high Out-of-Pocket Expenditure (OOPE) burden in India.

A 2024 analysis based on NSSO surveys highlights a grim reality: over 7% of the population is pushed into poverty every year due to healthcare costs. This statistic underscores the urgency of addressing affordability challenges.

Way to accessible Healthcare:

• Investigating the Rise of Chronic Diseases: A concerning trend has emerged in recent years – the rise of specific, potentially life-threatening chronic diseases. To effectively address this public health challenge, a multifaceted approach is required. One crucial aspect is investigating the potential sources of these illnesses. This may involve evaluating the role of food processing practices and agricultural methods. A critical review of relevant policies in these sectors may be necessary. Furthermore, promoting public health awareness campaigns that encourage healthy lifestyles has a significant impact. By empowering individuals to make informed choices about their well-being, we can foster a culture of preventative healthcare.

• Making Healthcare Affordable: Measures like reducing GST on essential consumables (used for life saving surgeries and/or procedures) drugs and medical devices, along with reviewing the current GST levied on hospital room rent, can make treatment more affordable. Additionally, promoting Public-Private Partnerships (PPPs) for cardiac care facilities can leverage private sector expertise to improve affordability and service delivery.
• Strengthening the PPP Model: The current PPP model for healthcare requires an overhaul to attract participation from startups and new enterprises. Aligning policies with industry needs will encourage a wider range of providers to join the initiative.
• Increased Research and Development Budget: A significant increase in the R&D budget is crucial to prioritize internal research for developing cost-effective solutions for diseases and stricter food quality control measures.
• Disease Mapping During Census: The upcoming census should include data on pre-diagnosed diseases within families for better planning of future healthcare infrastructure.
• Single Window Approval System for New Hospitals: A streamlined system would make it easier for individual doctors to establish their own healthcare facilities.
• Industry Regulator and Standardization: A dedicated regulator can address industry concerns and ensure standardization across healthcare providers.

Investing in a robust healthcare system isn't just about financial resources; it's an investment in the well-being of a nation. The Integrated Health Information Platform (IHIP) under the IDSP is already partially functional across several states. The experience in few states has demonstrated its potential to detect epidemics, issue early warning signals, capture outbreak investigation and respond appropriately. There is potential for this platform to be rapidly scaled up across the country, to expand on the number and type of disease conditions captured and to include data from the private sector. By addressing the challenges outlined above, the government can build a more accessible, equitable, and sustainable healthcare system. This, in turn, fosters a healthier and more productive workforce, contributing to India's overall growth and prosperity.