Hits And Misses Of Health Budget 2024-25

Manorama Bakshi

National health priorities include strengthening primary health care, enhancing disease surveillance, expanding health insurance coverage, and ensuring equitable access to health services across all demographics. The ministry comprises two departments: the Department of Health and Family Welfare and the Department of Health Research. Out of the ₹90,958.63 crore allocated to the Health Ministry, ₹87,656.90 crore has been allocated to the Department of Health and Family Welfare, and ₹3,301.73 crore to the Department of Health Research. With a 12.93% increase over the previous year, the critical question remains: does this allocation sufficiently address health as a critical pillar of viksit bharat.

The article is going to analyze how the budgetary allocation sufficiently addresses health as a critical pillar of Viksit Bharat. The relation between the allocations and policy directives laid out in the 2024-25 budget and the national health priorities, will be dealt with in this article. Additionally, investments in medical devices and medical value travel and one health will be discussed .

Constructive Steps Towards a Healthy India:

The 2024-25 budget emphasizes on measures to reduce treatment costs and promote preventive care. Cancer cases have been on a rise in India, according to ICMR’s National Cancer Registry Program, 1,496,972 cases were recorded in 2023, compared to 1,461,427 in 2022. On the backdrop of the hike, exemption of three additional cancer drugs from custom duties by the Ministry of Finance, to improve the affordability of cancer treatment, is a welcome step. Additionally, the introduction of a vaccination program for girls aged 9-14 to prevent cervical cancer is a proactive measure towards early intervention and reducing mortality linked to this disease.

The intersection of health with other sectors, such as technology and innovation has been an important component of the health budget. In the budget, the government has announced customs duty exemptions on X-ray tubes and flat-panel detectors for use in medical X-ray machines to promote domestic manufacturing of these machines.As India aims to emerge as the hub of medical technology devices, emphasizing the need for innovations in medical technology and meeting the demands of the medical device industry to advance healthcare delivery is an essential approach reflected in the budget.

The increase in budgetary expenditure for the National Health Mission of 4,000 crore, from ₹31,550 crore to ₹36,000 crore that addresses all the four major components of healthcare including rural, urban, tertiary care and human resource for health and medical education, is an effort towards making health care services inclusive. Higher allocation for the National Health Mission, an umbrella fund will ensure an uniform advancement in all health sectors. Extending outpatient care and free medicine services to OPD patients is also a commendable step towards inclusive healthcare services.

To increase the reach of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) to cover more people and move towards a single-payer system, the budget extended the Ayushman Bharat PMJAY to ASHA workers, Anganwadi workers, and community mobilizers. Extending the benefits of Ayushman Bharat PMJAY to the three important pillars of the primary healthcare system will ensure enhancing universal health coverage by linking proper financial outlays with primary health and AB-PMJAY.

Gaps in the Health Budget:

Even though the budget has made some strides, in cancer care and reproductive and child health care components, there are significant areas that require further attention and investment. The anticipated extension of ABPMJAY to elderly individuals has not yet materialized, which remains a critical area of concern since the elderly population is expected to rise to 347 million by 2050 according to United Nations Population Fund (UNFPA). Therefore, addressing the healthcare needs of our elderly citizens remains a critical area for further development.

Insufficient allocation compared to other sectors has been a major concern of the health budget 2024-25. The health budget, when compared to allocations for defense and other sectors, remains significantly less. This disparity underscores the need for a more balanced approach to national spending, prioritizing social sectors like health to ensure comprehensive development. National Health Policy 2017, published by the Ministry of Health and Family Welfare, advocated for an increase in health expenditure to 2.5 percent of GDP by 2025. Meager 0.4% hike in the current health budget, as compared to the allocations made in 2023-24, does not correspond to the aspirations of the National Health Policy.

The budget also falls short in enhancing funding for health research. Continuous investment in health research is crucial for innovation and addressing emerging health challenges. The absence of substantial increase in this area is a missed opportunity. Furthermore, the need for substantial development in healthcare infrastructure remains unmet. Investments in building and upgrading healthcare facilities are essential to handle the increasing demand and to provide quality healthcare services to every citizen.

Universal Health Coverage (UHC) Goals Not Fully Addressed. The budget does not sufficiently address the goals of Universal Health Coverage. For UHC to be a reality, there needs to be a more comprehensive approach that includes expanding health insurance coverage, ensuring equitable access to health services, and integrating primary healthcare with other health initiatives.

Areas that Need Attention:

Health sector policies for sustainable health outcomes for all citizens includes promotion and adoption of the principle of ‘One Health’, interconnecting human, animal and environmental health. With climatic catastrophes being on a risse due to climate change and environmental pollution, increasing incidences of disease outbreak has become inevitable. Therefore, it is important to reframe climate change as a public health issue. Spread of zoonotic diseases is also spiraling up due to constant environmental degradation. Prioritising public health in adaptation policies and supporting them through necessary investments is a potential way forward in dealing with this polycrisis.

Leveraging India’s potential in medical value tourism to attract international patients seeking affordable and high-quality medical care can be a breakthrough in increasing health investment for India. Over the years, India has developed to become an attractive destination for medical value travel. The world-class global hospital and medical care services at lower cost along with expansion of alternative and traditional medical services has made India a favored destination for medical value tourism. To leverage the medical value of tourism, organizing facilitators would be a crucial step along with covering traditional systems of medicine under insurance policies at the international level.

Ensuring that universal health coverage is advanced further, with financial strategies to unify and support all insurance programs effectively needs to be undertaken. Special attention is required for diseases such as diabetes and hypertension. Non-communicable disease deaths have risen from 37.9% in 1990 to 61.8% in 2016, according to the study report “India: Health of the Nation’s States” by ICMR.

The budget lacks a robust plan for strengthening the overall healthcare system. This includes improving healthcare infrastructure and increasing healthcare coverage to ensure that quality care is accessible to all. Initiatives like extending the Ayushman Bharat PM-JAY to include more groups such as elderly citizens and ensuring outpatient care and free medicines for OPD patients are critical areas that need more focus and funding.

Conclusion:

However, together, a path towards a more resilient and equitable health system can be forged. The expansion and effective implementation of the National Health Mission (NHM) remains a priority, alongside efforts to combat communicable diseases and promote the principles of One Health. Innovations in medical technology and meeting the demands of the medical device industry are essential for advancing healthcare delivery in India. It is therefore evident that while the budget represents progress in addressing key healthcare challenges, there are critical areas that demand continued attention.

Dr Manorama Bakshi, Director and Head Healthcare Consocia advisory and Visiting Senior Fellow, IMPRI

Disclaimer: All views expressed in the article belong solely to the author and not necessarily to the organisation.

Acknowledgment: This article was posted by Reetwika Mallick, a Visiting Researcher and Assistant Editor at IMPRI.