Experts put their views forward on Interim Budget 2019
Shanthini Arunthavanathan, CFO, Westminster Healthcare, Chennai
The 2019-20 Union Budget comes as a cheer to many due to the government’s attempt of creating a mass -budget this year with special focus on rural health. Ayushman Bharat Scheme that was launched last year for providing medical treatment to around 50 crore people have so far treated 10 lakh people who could save nearly ₹ 3,000 crore. This is a great achievement by the country’s healthcare and roping in private hospitals to the scheme as proposed by the government last year will certainly provide more teeth to it. However, more allocation of fund for appropriate execution of the scheme was a necessity and was expected. Apart from announcing about 14 new AIIMS since 2014, the announcement regarding setting up of 22nd All India Institute of Medical Sciences (AIIMS) in Haryana is a welcome move towards enhancing advanced medical research in India, producing a greater number of qualified medical professionals and expanding opportunities for the aspiring medical students of the country.
The government’s vision towards having a distress free healthcare and a functional, comprehensive healthcare system by 2030 are praiseworthy. Availability of drugs at a subsidised price at Jan Aushadhi Kendras and implementation of a price cap on drugs have made medicine affordable for all. With five lakh villages being declared open-defecation free along with achievement of over 98 per cent rural sanitation coverage, there will be a certain improvement in both rural and urban health condition.
Dr Prathap C Reddy, Chairman, Apollo Hospitals Group
A forward-thinking budget with a definitive vision to accelerate much greater progress and enhance well being of Indians, the allocation of ₹ 6400 crores for Ayushman Bharat is very welcome. Now it is paramount, that India ramps up its efforts to arrest the upsurge of non-communicable diseases (NCDs), which are increasing like an epidemic.
The morbidity and mortality due to diabetes and increasing prevalence of cancers are very concerning. Nine out of 10 deaths due to NCDs can be prevented by awareness and early screening. I commend the government for the budget recommendation. The endeavours and efforts that the Government of India has embarked upon will make our nation healthier and a model for the world to emulate.
Saurabh Arora, Founder & CEO, Lybrate
It is laudable that the Finance Minister has outlined the government’s vision of a healthy India with ‘distress-free and comprehensive wellness system’. The government launched Ayushman Bharat scheme last year that aims to provide medical care coverage to about 50 crore Indians. Envisioning a healthy India and taking a step towards it will have a far-reaching positive effect in the years to come on the country’s healthcare delivery system. Accessible and affordable quality healthcare is the need of the hour and therefore, the announcement of the 22nd AIIMS in Haryana is also a good measure in the direction of universal health coverage.
Another noteworthy policy that will enable the reach of healthcare to several of the most backward districts of India is the Aspirational Districts Programme. While we were looking forward to some conducive polices for healthcare and healthtech startups alike, the announcement to establish a National Centre on Artificial Intelligence will boost the usage of AI in the field of healthcare and the step is a push for healthtech startups like Lybrate, which are already using AI to make healthcare accessible and affordable.
Meena Ganesh, MD & CEO, Portea Medical
The Interim budget this year is in favour of two sections: the common man seeking access to quality and affordable healthcare; and the organisations providing this. Given the rising cost of healthcare, the reduction in prices of essential medicines, stents, and knee implants will come as a boon. The budget is also in favour of startups using technology to make breakthroughs and deliver healthcare innovatively. The National Centre for Artificial Intelligence will be an enabler in using technology to make diagnosis, treatment, and tertiary care more accessible and better. We would have been happy to see some policies in the area of home healthcare. Overall, it has been a budget inclined towards addressing the concerns of the masses.
Krishna Ulagaratchagan, Co-Founder & CEO, healthi.in
The government has launched three key initiatives that will, together, have a significant bearing on the health of the country. First, it is encouraging to see that the government is establishing a National Centre for Artificial Intelligence to direct efforts in the area of using technology. Our hope is that the government will consider healthcare as one of its nine core focus areas. This will help India become a leader in innovative healthcare solutions and improve the efficacy of the treatments delivered across the country. Second, the government intends to build 1 lakh digital villages with an internet connection and digital devices in the next few years. And third, the government is making healthcare more affordable and accessible by providing access to medical care for about 50 crore Indians, and perhaps more going forward.
Together, Ayushman Bharat, AI for healthcare and digital villages, will extend the reach and access of such digital health solutions to the parts of the country that are currently underserved by quality healthcare. We would love to see preventive healthcare also be factored in this grand vision for a healthier, digital India.
Antony Jacob, CEO, Apollo Munich Health Insurance
The Budget has maintained a pragmatic balance between the country’s economic development and holistic growth. While the Vision 2030 is a commendable move taken towards building a distress-free and comprehensive wellness system for all, it will act as an impetus in making India health confident. Also, the full rebate on income up to ₹ 5 lakh will leave more money with people to buy health insurance and other investment avenues, which will ensure their financial security against unforeseen situations.
Neerja Birla, Founder and Chairperson, Mpower
With the new Budget comes an indication that we will be taking on a more comprehensive approach to healthcare and wellness, and I think that it is definitely aimed in the right direction. However, I hope that this holistic vision will mean a more focussed approach to mental health as well, especially in terms of creating the required infrastructure and encouraging more mental healthcare professionals. According to the plans outlined, there should be around 1.5 lakh Health and Wellness Centres by 2022, and I do hope that the promise of affordable treatment extends to mental health as well.
While we are taking positive steps to provide health insurance and reduce the burden of medical expenses on lower income families, I think it would not be as effective in the long run if it does not offer the same for mental health concerns as well. One in five Indians suffer from a mental health concern, and if left unaddressed, we could be seeing its negative impact on our economy to the tune of trillions by 2030.
Rahul Paith, Chief Operating Officer, DocOnline.com
This Union Budget has further showcased the government’s intent to provide an equal opportunity to small and medium businesses. Its initiatives like increasing the sourcing to 25 per cent from SMEs by government enterprises, doubling the exemption from GST from Rs 20 to ₹ 40 lakhs and two per cent interest rebate on incremental loan of ₹ 1 crore to GST-registered SME units will continue to benefit this business segment.
The thrust on Digital India and massive penetration of mobile Internet is propelling the consumers to not only visit the e-commerce platforms thereby increasing the top lines of consumer product companies but also in enhancing the awareness about the product innovation which could meet their needs.
Lesser income tax burden is one of the most important announcements impacting the large strata of the country thereby making higher available money on consumer products.
Amit Mookim, MD, South Asia, IQVIA
The interim Union Budget 2019 was presented in the backdrop of ever-evolving healthcare and pharmaceutical industry. Over the last couple of years, the industry has witnessed some significant developments in an effort to make healthcare affordable and accessible to all. This year too, the government has made ‘Healthy India’ as one of the top 10 priorities for its Vision 2030. The existing initiatives such as Health and Wellness centers and Ayushman Bharat –Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY) will contribute to make the vision successful along with other initiatives. Plans to focus on comprehensive care will put individuals in end-to-end care continuum and improve the overall health status.
The newly announced AIIMS in Haryana will cater to the population of 25.4 millon for specialised care. These institutions will further provide scope of paramedical training which will contribute in Nation Skill Development Mission of India. Additionally, it would imply greater institutional opportunities for pharma and medical device players. Companies will have to beef up their overall institutional channel strategy to tap the opportunity.
Dr BS Ajaikumar, Chairman and CEO, Healthcare Global Enterprises
While it is good that they were able to find funds for the defense sector, there was nothing pathbreaking for the healthcare. In fact, the gap between the rich and the poor only seems to be getting wider. In fact, not just for healthcare, there should have been more resources for dealing with rising unemployment, quality of education and rural poor. All the three — health, education and unemployment — are linked, but instead of creating new opportunities that generate employment, the focus seems to have been on doling out freebies such as those for farmers and on LPG connections.
Dr RB Smarta, CMD, Interlink
In case of healthcare, out of 17 SDGs India has prioritised 3 SDGs. Although with an excellent intention to march towards 2030 by taking actions on child welfare along with Pradhanmantri Ayushman Yojana, this budget will have a lot of challenges for its execution right from primary healthcare centres.
The government is also trying to make comprehensive wellness system and also look forward to invest in digitalisation which will overtime be beneficial for pharma and Healthcare industry.
Silver lining in this budget is development of a national programme on Artificial Intelligence, which will initiate a lot of activities in the pharma sector right from R&D to consumption of medicines.
Varun Gera, Founder & CEO, HealthAssure
The expectation from this years budget was more on allocations and implementation of the grand dream which was sold. Unfortunately, this year’s budget has relegated that vision to back seat and its come to be a populist pre-election Budget.
The increase in healthcare allocation is only 16 per cent over the last year which is in no way planning to achieve the grand health insurance of ₹ 5 lakhs for 500 million citizens.
Additionally, the Mental Health Act budget which should have seen a dramatic increase has dropped from an already low budget of ₹ 50 crores to ₹ 40 crores. There also does not seem to have been a thought on providing incentives for setting up hospitals across the country. This was a base need if we need to cover ground on starting to build health infrastructure.
However, there is an increased focus on National Rural Health Mission for setting up primary care wellness centres with a budgetary allocation of ₹ 1350 crores which will help rural India get better access to basic healthcare.
It seems like 2019 was a lost year in our nation’s progress for better healthcare for its citizens and we will have to wait for another year to hopefully resume the journey.
Gautam Khanna, CEO, PD Hinduja Hospital and MRC
Overall, the budget is growth oriented and pro-farmer and pro-middle class. On the healthcare front, Ayushman Bharat scheme has been launched in a short time, which is creditable. Effective implementation of the scheme and ensuring a win-win situation for both the healthcare providers and patients will be critical for its success in the future. Setting up of 22nd AIIMS at Haryana is a much-needed step to augment the public sector healthcare facility in the country. The government focus on Swach Bharat, Safe drinking water and food-for-all are good preventive healthcare measures, which are likely to improve the overall health and well-being being of people. The decision to extend the tax rebate on an annual income of Rs 5 lakhs will definitely help citizens better manage their healthcare needs. The Pradhan Mantri Jan Aushadhi Kendras has also reduced the prices of essential medicines, cardiac stents and knee implants, enabling access to various income groups.
We will work towards aligning our efforts with a positive impact of the national health schemes and the government’s vision towards providing a distress free healthcare and a comprehensive wellness system for all by 2030.
Dr Partap Chauhan, Director, Jiva Ayurveda
We welcome the Central Government’s announcement to open the 22nd All India Institute of Medical Sciences (AIIMS) in Haryana. A world-class medical facility like AIIMS in Haryana will further the cause of providing comprehensive healthcare to all in the state. In November 2018, it was announced that Ayurveda departments will be opened in all the new 19 AIIMS. Such initiative will further the government’s mission of ‘Ayurveda for Public Health’. A few months ago, the Ministry of AYUSH took the pioneering step of publishing the guidelines for insurance coverage to Ayurvedic treatment and settlement of claims on the basis of benchmark rates for various interventions. Following this, the Insurance Regulatory Development Authority (IRDA) issued clarifications to general and health insurance companies and Third Party Administrators (TPAs) to provide coverage to Ayurveda and other systems of medicines under AYUSH. We hope in coming years Ayurvedic treatment will also be covered under Ayushman Bharat, the world’s largest healthcare programme.
Nilesh Jain, Founding partner, Clinivantage Healthcare Technologies
The central government’s role in the healthcare sector of the country has increased drastically with Budget 2019, and so will the pressure on the transparency of care and the financing of the same. The thought of accessible and affordable medical healthcare treatment is taking a centre stage, along with this it will be very critical to upgrade the technology infrastructure and adapt new technologies to scale reach and make this programme a huge success. Adoption of new technology, AI and transparency controls via deployment of unified cloud system will help speed the success story of Ayushman Bharat.
Dr Alok Roy, Chairman, Medica Hospitals
Now that the Interim Budget has been announced, people of the country will look forward to how best the policies are implemented. In terms of healthcare, the citizens of India, will look forward to even better facilities and more infrastructural developments in deeper pockets and hinterlands. Upgrading the national health mechanism should always be a primary agenda for any government to come. We can see significant measures to help poor and marginal population of our country in this interim budget.
Dr Vikram Shah, CMD, Shalby Hospitals, Ahmedabad
This is a commendable Budget with all the right intentions. It has several announcements that can be a game changer for the Indian economy and society in the years ahead. Three major provisions have been announced – direct income support to 12 crore farmers, pension scheme for poor workers in the unorganised sector, and full income tax rebate till an income of Rs 5 lakhs. These, along with the prevailing low inflation rate, will increase liquidity with the middle and poorer sections of the society in both rural and urban areas. It will leave people with more money to spend on basic necessities of life such as food and healthcare.
The ongoing Swachh Bharat Mission, 98 per cent sanitation coverage in rural areas, and schemes like Ayushman Bharat and free LPG connections are positively impacting healthcare parameters of the society. It is heartening that the government has declared a ‘Healthy India’ as part of its future vision for the country. Its stated goal of working towards a distress-free healthcare system and a functional and comprehensive wellness system for all Indians is welcome.
I, however, feel that the government should have taken some positive steps towards increasing the public healthcare expenditure as percentage of GDP from beyond a mere 1 per cent, and announced some incentives to enable the spread of modern healthcare system and hospitals beyond the cities to smaller towns and villages. The government should have also reduced import duty on implants to make joint replacements affordable to the masses.
Dr Rana Mehta, Partner and Leader Healthcare, PwC
The allocation to Ayushman Bharat has been tripled which reinforces the commitment towards Universal Healthcare for all citizens and the vision for a healthy India by 2030. However, to spurn demand from the middle classes increased deduction towards medical insurance premium under section 80D could have been considered. Zero rating of GST for the sector would also have helped catalyse investment in the delivery space.
Dr Shravan Subramanyam, MD, India and Neighbouring Markets, Roche Diagnostics India
The Union Budget 2019 speech clearly spelled out the Central Government’s scale-up in healthcare initiatives over the past few years. This is encouraging as this focus helps augment and strengthen health access across India.
While establishing access through healthcare infrastructures like hospitals and medical colleges is great, focussed and planned expenditure on improving participation from the public in preventive healthcare at these hospitals through awareness programmes is important.
With the announcement of ambitious projects like Ayushman Bharat last year, expectations were high for the 2019 budgetary recommendations on healthcare. Some inclusions on outpatient care and diagnostics would have been great. We would have liked to see in this budget a roadmap for healthcare development programmes announced last year to be implemented seamlessly across the country.
Dr Sujit Paul, Managing Director, StayHappi Pharmacy
We have not seen any major positive push in healthcare to the truest sense. One large healthcare facility in a specific state is surely not the solution, more tertiary centres should have been planned then. Moreover, more reach and penetration strategy towards affordable medicine should have been planned for.
Saurabh Agarwal, CFO, Medlife
Ayushman Bharat, one of the world’s largest healthcare scheme was introduced with the aim of making healthcare affordable and accessible to all and has till date benefitted nearly 10 lakh patients. While, the Finance Minister did speak about the Digital India revolution, we hope to see more emphasis on digital healthcare given the positive impact it has created in improving access. However, we are confident that digital healthcare will find more prominence in the upcoming budget sessions. We will continue with our efforts to improve the healthcare ecosystem and align our efforts with the government’s vision to create distress free healthcare and a comprehensive wellness system for all.
Pavan Choudary, DG, MTaI
By bringing health and artificial intelligence together on the agenda, the government has set a very progressive human resource tone. The national programme on AI should be unfolded by co-opting knowledgable stakeholders from the nine domains that are being targeted.
The AIIMS announced in Haryana is a welcome move. All the AIIMS in the making, including this one, should be monitored for speedy commissioning.
The commitment to pursue progress in medical devices as almost a mission, is heartening and is reflective of this government’s understanding that this sector is of key importance.
Ashish Gupta, CEO, Docprime.com
The interim budget presents some encouraging possibilities for the social and healthcare sector. While the details are still to be studied, it is reassuring to see the official recognition of artificial intelligence (AI) with the announcement of the National Artificial Intelligence Centre and National AI Portal. AI is critical for the healthcare sector to mitigate unfavourable doctor-patient ratio in India, which is further compounded by the rich-poor and urban-rural divide.
This combined with 2030 vision of 1 lakh digital villages could help transform the way healthcare is delivered in the country. We do hope these initiatives will be rolled out effectively and fuel a spurt of healthcare innovation in the country.
Daljit Singh, President, NATHEALTH
As India aspires to become $10 trillion country by 2030, inclusion of ‘Healthy India’ in the government’s 10 key priorities under ‘Vision 2030’ is one of the key takeaways from today’s Budget and emphasis on health assurance with necessary infrastructure, sanitation, pollution control for comprehensive wellness of people would go long way to achieve the goal of sustainable and inclusive development, according to NATHEALTH.
Creating a robust health delivery system for comprehensive wellness of the people would be game changer. India’s NCDs burden is rising alarmingly and it is estimated to cost $6 trillion by 2030. We need to declare war on NCDs and address the critical need for strengthening the primary care framework focussed on prevention. The Vision 2030 announced would be a critical step to stem the tide now. Proactive steps by a forward-thinking government can help enablers in healthcare to win the war against the disease burden in our country.
Siddhartha Bhattacharya, Secretary General, NATHEALTH
NATHEALTH welcomes the scaling up plans for the Ayushman Bharat Mission and the government’s focus on universal health coverage that improves India’s march towards a Swasthya Bharat. However, we believe it has to be done collaboratively through value based scientific costing driving sustainable pricing supported by improved ecosystem efficiency gains. This is only way to improve quality and health outcomes over the longer term towards our goals of a healthy India.
According to NATHEALTH, the Interim Budget 2019 appears to be a comprehensive, wide ranging and balanced, with many positives for the health sector, however, the government needs to revisit unfinished agenda such as ‘Priority Sector’ status to Healthcare for smooth credit flow, mandatory universal health insurance, tax incentives for capacity building, creation of a dedicated infrastructure and innovation fund, while presenting Union Budget 2019-20 couple of months later.
Manish Sacheti, CFO, Ziqitza Healthcare
We applaud the government’s announcement directed towards the lesser privileged and middle class population. The budget this year has indeed addressed a lot of issues that will help the economy to prosper. The allocation of ₹ 19,000 crores for the development of the roads in the rural areas is a great initiative. Being an emergency medical provider, this will help us reach out to the remotest corners of the country which has connectivity constraints. The success of the Ayushman Bharat Scheme is commendable and we are glad that the healthcare sector of the country is undergoing a significant transformation.
We hope that the Skill India programme will include training of youths to become dedicated paramedics to help efficient and quality ambulance services. One avenue that should have been looked at is making healthcare services ‘zero-rated’ under GST provisions, instead of being exempted, as the cost of inputs throughout the industry could further be reduced by claiming refunds of taxes paid on these inputs. This would help to enable these specialised services to reach out to the masses.
Siraj Dhanani and A Vijayarajan, Founders, InnAccel Technologies
Creating a healthy India with distress-free and comprehensive wellness system for all is a laudable aim, which can be achieved by the widespread adoption of indigenously developed medical technologies that solve problems faced by Bharat and India both. Artificial intelligence has the potential to disrupt healthcare delivery in the country. With the focus on Digital India in the last few years and integrated with this new AI initiative will help us to meet some of the challenges in the healthcare industry.
Siddharth Angrish, Founder, Jiyyo.com
The government’s focus on Ayushman Bharat is giving results. However, a lot more can be achieved. Local players in online healthcare can be roped in for increasing outreach and awareness about such government initiatives. For example, it should be really easy for any patient to find out the hospitals and services covered under the scheme. Being able to show pricing details to patients will also increase their confidence. Such data can be shared with startups so they apply their creativity and create more value-added services.