The ambitious PMJAY scheme (Ayushman Bharat) holds a lot of promise and has the right intent, but I do hope the government authorities take the right partnership approach to a more inclusive participation
The main expectation from this year’s budget is that the healthcare industry must be made attractive from investment point of view. We have seen private healthcare players have slowed down their expansion plans. Keeping in mind the role played by the private healthcare sector, the government has to increase its intent to collaborate with private sector. The ambitious PMJAY scheme (Ayushman Bharat) holds a lot of promise and has the right intent, but I do hope the government authorities take the right partnership approach to a more inclusive participation.
Government spending money on healthcare stays put at around 1 per cent of the GDP. The healthcare sector can only get affordable if the government revises this upwards. The government must extend sops to the sector especially with respect to power and utilities which is long overdue. Cost of medical equipment’s is another pain point, which requires thrust and making the medical devises and equipments a part of the Made in India , shall go onto benefit this sector.
Introduction of Artificial Intelligence facilitating and predictive analytics for patient monitoring will add to significant financial savings and will increase the reach of healthcare in the country. Let 2019 be a year of healthcare digitisation in the larger interest making healthcare more accessible, more affordable and patient friendly.
The vision of GS1 India is to significantly enhance patient safety through elimination of medication errors, track and trace, product recalls, counterfeit detection and authentication of medicines and medical devices
The pharma sector could be incentivised in the budget for adopting global practices and standards which enable counterfeit detection and authentication. The vision of GS1 India is to significantly enhance patient safety through elimination of medication errors, track and trace, product recalls, counterfeit detection and authentication of medicines and medical devices.
PPP models would not only ensure a business boost for the private sector including startups but will also contribute to nation’s growth
For healthcare industry, I believe there are three areas that need immediate attention in this budget.
First of it being the public private partnerships – Ayushman Bharat was a great initiative by the Government of India that was a requirement for the country. But in order to realise its full potential and maximise the benefits, there is a need of enhanced fund allocation and introduction of PPP models for larger participation from private players, as 80 per cent of the healthcare services in the country are provided by the private sector. PPP models would not only ensure a business boost for the private sector including startups but will also contribute to nation’s growth.
Second key area would be the GST benefits which also need to be extended to the startups and other p
layers in the healthcare sector, beyond the core healthcare service providers. Due to its absence, we are not able to capitalise on the pass-through benefits. While we pay GST when we procure anything for our business we are GST free when sell the services to customer. Resulting in a cost burden for us. In industries like IT, there is input and output GST which provides a balance.
Third important aspect is the ‘Angel Tax’ – government needs to take solid steps to reduce this burden for startups. Getting an investment in the current economic scenario is not easy. Angel Tax deduction from the difficultly brought in investment greatly hurts the startups.
Overall, healthcare as an industry touches each and every citizen of the country and people have been seeking positive reforms for the sector. We expect the government to take it as a priority area this budget, allocate more funds, announce steps that encourage private sector and startups to do business and provide quality services to every section of the society.
With more people adopting technology for various needs, it will be most appropriate if the government’s health policy will accelerate the adoption of technology to address the unmet medical needs for millions
Over the last few years, the Indian healthcare sector has witnessed a major overhaul in order to attain the Prime Minister’s goal of ‘Healthcare for all’. This year, we are looking forward to some measures from the government that incentivise HealthTech companies to improve the accessibility and affordability of quality healthcare. With more people adopting technology for various needs, it will be most appropriate if the government’s health policy will accelerate the adoption of technology to address the unmet medical needs for millions. In this budget we are hoping to have clearer policies around different segments of heath-tech including e-pharmacy, remote monitoring of patients, digital prescriptions and video consultations. We are excited to see a positive turn out from the government to encourage startups across all domains, particularly in healthcare.
I expect the NDA government to bite the bullet and at least triple the healthcare budget over the next two years from the current 1.2 per cent
Current healthcare system is in the spotlight from social as well as political needs and requires more funds and attention. Pre-polls announcement of Ayushman Bharat now requires allocation of funds and implementatio
n on both inpatient as well as outpatient commitments. Honouring this commitment is important but will not be easy for the government to significantly reallocate the budget from other areas to health.
I expect the NDA government to bite the bullet and at least triple the healthcare budget over the next two years from the current 1.2 per cent.
There are many countries with high costs and inefficient healthcare operating systems. For this reason, apart from allocating appropriate budgets, its important for government to initiate appropriate building blocks, take right decisions and good implementation in this sector to further develop the healthcare ecosystem in India.”
The need of the hour is the primary care system should be strengthened in such a way that they are capable of doing the initial assessment, diagnosis and basic management and appropriate referral if need be
“With the introduction of central government’s Ayushman Bharat National Health Protection scheme, the burden on healthcare scheme is only expected to rise. As it covers 50 crore households or 500 million people, healthcar
e isn’t only getting more accessible but also becoming more efficient in diagnosing and treating patients with a strong primary care system in place. The need of the hour is the primary care system should be strengthened in such a way that they are capable of doing the initial assessment, diagnosis and basic management and appropriate referral if need be. A thorough assessment and investigation at the primary care or secondary care can lead to a significant saving of resources in the territory level. The government should facilitate more Continuous Medical Education (CMEs) to upgrade their skills which can solve the problem of shortage of trained doctors.”
We hope that the government will increase the budgetary allocation this year, and lay out a roadmap to better integrate the use of naturopathy and yoga as these two systems can be developed with minimum cost into our primary healthcare systems
“Disease patterns have undergone a significant shift over the last two decades, and the disease burden for non-communicable diseases has gone up. With over 60 per cent of the deaths caused by NCDs, we are in the midst of a growing epidemic. These diseases require regular visits to the hospital and put a dent in patients’ wallets and there is a growing need to educate people on the benefits of holistic preventive care systems such as yoga and naturopa
thy. Last year, the Union Government increased the allocation for the AYUSH Ministry by 1630 crore to promote education and research in indigenous systems of medicine. When Shripad Naik assumed office as Minister of State in the AYUSH
Ministry on May 30, he stressed on the need to increase the infrastructure required for the dissemination of indigenous healthcare treatments. We hope that the government will increase the budgetary allocation this year, and lay out a roadmap to better integrate the use of naturopathy and yoga as these two systems can be developed with minimum cost into our primary healthcare systems. This will help us reduce the burden of NCDs in the long term and bring down the economic burden of health for patients with limited financial resources. ”
A specific budget has to be allocated to set up an execution body with a timeframe to deliver respectful milestones for PMJAY
Amongst one of the SDGs (Sustainable Development Goals) accepted by India, “Zero Hunger” needs to work out in terms of infant nutrition and women’s health. Hence there should be a specific budget allocation for eradicating malnutrition.
As Pradhan Mantri Jan Arogya Yojana (PMJAY) has been announced in the past, its execution till the primary h
ealthcare (PHCs) levels needs to be monitored for its success. A specific budget has to be allocated to set up an execution body with a timeframe to deliver respectful milestones for PMJAY.
Pharma and medical devices industry aims towards reducing the disease burden which our country is carrying and needs special attention and speed of response. Our appeal is to keep this industry separate with an exclusive Ministry for Pharmaceuticals and Medical Devices. Department of Pharmaceuticals (DOP) has been already established, but this industry having more than Rs 200,000 crore revenue deserves a separate ministry.
With regard to taxation, we believe health services should be zero rated under the GST instead of a complete exemption so that cost of inputs can be reduced by claiming refunds of the taxes paid on these inputs
“Our foremost request to the government is to accord due recognition to the emergency medical services (EMS) industry and recognise it as an independent sector within the healthcare industry. 90 per cent of the EMS space is controlled by the government and we believe, the sector is in urgent need of impetus in the form of budgetary allocation of funds so that even the remotest parts of the country has access to timely quality medical care. There is a sever
e demand supply gap when it comes to the availability of ambulances in India with the ratio of ambulances per capita pegged at 1:146249. We need to move to a ratio of 1:60000, and this can only happen if the government incentivises the industry in the form of subsidies. The government should also invest in setting up skill centres for training paramedics and emergency medical technicians. While the government is already taking steps to improve road connectivity, we believe the government should look at increasing the accessibility of emergency medical services through station ambulance services on national highways and medical units on trains. With regard to taxation, we believe health services should be zero rated under the GST instead of a complete exemption so that cost of inputs can be reduced by claiming refunds of the taxes paid on these inputs.”
Health spending needs to go up from 1.15 per cent to 2.5 per cent of the GDP by 2025 if we are to get closer to meeting the UN’s sustainable development goals and achieve universal health coverage
A lot rides on the allocation for the healthcare sector in the upcoming Union Budget, especially considering the fact that the interim budget left a lot to be desired in terms of a concrete future roadmap to improve healthcare delivery systems. Health spending needs to go up from 1.15 per cent to 2.5 per cent of the GDP by 2025 if we are to get closer t
o meeting the UN’s sustainable development goals and achieve universal health coverage. Although the healthcare sector attracts a lot of investments from private players, most of them go to secondary and tertiary centres while the bedrock of the health industry, primary healthcare, is in shambles with just one primary healthcare centre for every 51,000 people. The proposal to set up 1.5 lakh health and wellness centres in rural areas by 2022 is ambitious, but the government needs to leverage public-private partnerships to make it a reality. We also hope that the Union Minster allocates resources to roll out more programmes that focus on promoting preventive care practices to reduce the disease burden of non-communicable diseases, which are currently responsible for 61 per cent of all deaths in the country, a number that is only set to go up due to rapid urbanisation and lifestyle changes.
With Ayushman Bharat as a focus area, the government should do everything in its power to enable an ecosystem where this scheme can get large scale acceptance in the health industry
The budget should be dedicated to healthcare this year and a significant increase in its GDP allocation is wished for. Economic evidence confirms that a 10 per cent improvement in life expectancy at birth is associated with a rise in the economic growth of some 0.3-0.4 percentage points a year. With Ayushman Bharat as a focus area, the government should do everything in its power to enable an ecosystem where this scheme can get large scale acceptance in the health industry. This can surely be achieved by introducing schemes to fund the working capital for private medic
al establishments especially in tier 2, 3 cities, and rural areas which will boost growth to meet the rising demand of Ayushman Bharat scheme. Additionally, with regards to Ayushman Bharat, the government should work towards adequately and promptly reimbursing member hospitals which will encourage other hospitals to join the programme benefiting poor at large. Increased expenditure on R&D of medical devices coupled with quick approvals for new medical device innovations and increase in medical seats will boost cure and care experience for professionals and patients. Also, a more favourable GST for the entire healthcare ecosystem will go a long way towards helping make healthcare more affordable.
There needs to be a more focussed approach to preventive health, which is still lacking in terms of policy
India has come under scrutiny in the global context due to its relatively small health budget as compared to other nations. India spends about 2 per cent of overall expenditure on health. This needs to increase substantially.
A closer look at the components of the expenditure on health indicates that there has been a drop-in funding to the National Health Mission, maternal and child health and communicable diseases. Reduction in funding in these areas should be reversed and in fact increased. These particular areas in India have not attained high levels of efficiency, the outcomes are still not where they should be and the required infrastructure to achieve this is not yet in place. Continuing to meet the demand of high input costs in these areas will result in robust systems being established which, over time will make these systems more effective and thus more efficient.
There needs to be a more focussed approach to preventive health, which is still lacking in terms of policy. Awareness programmes and the push for non-medical interventions in this area needs to be emphasised at every stage of health care in rural and urban settings. Resources for this needs to be allocated. Out of the box thinking like the provision of safe cycle tracks, encouraging walking, reducing commute time for students and workers need to be come from policies on health. Provision of waivers for preventive health check-ups need to be increased to reflect inflationary changes in the cost of such investigations. Checks and balances like Aadhaar verification and prevention of unnecessary testing can be enforced to prevent abuse.
Much like some other indigenous systems of medicine, India is now the world leader in the field of homeopathy. The international medical community is looking towards India to lead the way. The Indian population is a voracious consumer of homeopathic medicine and services.
Ayushman Bharat and the central government health schemes need a substantial injection of funds for the provision of homeopathic health services in the centres covered by them. Thousands of homeopaths need to be employed and posted at these centres to meet the increasing demand for these services. Reliable supply and ready availability of homeopathic medicines can only be ensured by increasing funding for homeopathic services. Homeopathy plays an important role in preventive health and in tertiary care. Palliative treatment, in terminally ill patients, for example, can be cost effectively provided by homeopathy. This can greatly reduce the burden on existing health infrastructure. Recurrent infections, allergic conditions, a large number of skin conditions are just some areas where homeopathy is able to provide a far more cost effective, and permanent solution to the patient.
There is an urgent need to establish centres of excellence for education and research in homeopathy. The National Institute of Homeopathy in Kolkata needs a drastic revamp. Centres modelled on the All India Institutes of Medicine, need to be established in different regions – All India Institutes of Homeopathy in major cities in different regions of the country are urgently required to serve as referral centres and also to accelerate clinical research in homeopathy.