The Union Budget 2018 evokes mixed reviews from the healthcare industry
The 2018 Union budget looks positive for the healthcare sector. With this health protection scheme, most of the health needs of the low-income group will be taken care of.
In my opinion, the budget should have given some preference to health screening as well so that a culture of prevention could have been created. Government is focussing more on NCDs, which mostly show symptoms at the end stages, hence treatment becomes difficult and expensive. The setting up of 1.5 lakh new health and wellness centres is also a good decision, however, strengthening the preventive healthcare sector would have lowered the NCDs burden and treatment cost. This would also help in reducing health expenses of the country as a whole. Even if a small budget was allocated to preventive health checkups, the NCDs would receive cure at the initial stage and the treatment cost would lessen. Addressing prevention at a larger level like the curative measures would lower the out-of-pocket-cost for the population that isn’t covered under the scheme.
– Amol Naikawadi, Joint Managing Director, Indus Health Plus
“The budget rightly provides a focus on Agriculture, Healthcare & Education. The big move towards the path of Universal Healthcare Coverage under the flagship National Health Protection scheme which will bring 50 crore citizens with Rs 5 lac/ family for secondary and tertiary care hospitalisation is transformational for the country. The question to answer is how will the scheme be funded and executed given the fact that health is also a state subject. This move coupled with the announcement of 24 additional govt medical colleges and hospitals gives healthcare the centre stage in this budget. In addition the increase in tax exemption for senior citizens on health insurance premium and medical expenditure is a good move. This was also the opportune time for the FM to give infrastructure status to the healthcare sector and provide the much needed acceleration to capacity creation in the sector.The reduction in corporate tax for SME businesses with revenues up to Rs 250cr is a step in the right direction to push the agenda of their growth and the Rs 10k cr outlay for the telecom infrastructure under Govt projects including the support for establishment of indigenous 5G centres with IIT Chennai is an excellent move.”
– Vishal Bali, Co-Founder & Chairman, Medwell Ventures
“Budget has definitely boosted the spirits of the healthcare sector. The announcement around the National Health Protection Scheme, which will provide Rs. 5 lakhs medical reimbursement for the poor will be beneficial to nearly 50 crore people . The lack of clarity in processes was also witnessed with the Ayushman Bharat programme as the tertiary healthcare sector was not touched upon. The government also took a massive stride in making medical education more accessible, by setting up 24 government colleges and hospitals. The effort would see more traction by joining hands with the private sector to implement colleges that can provide aspiring doctors with quality learning. We hope that in the coming months, this ambiguity is resolved to make quality healthcare available to the masses, in a clear and structured way.”
– BS Ajaikumar, Chairman & CEO, HealthCare Global Enterprises
Emphasis on improving and extending the healthcare schemes to the grassroot level was the need of the hour. The ambitious plan that the government has announced in this sector is a welcome move. Initiatives like the National Health Policy of 2017 which commits Rs 12000 crore for development of health centres and the National Health Protection Scheme which will help 10 crore poor families by providing them with upto Rs 5 Lakh cover per family per year for secondary and tertiary care will be gamechangers in the healthcare industry. These initiatives show that the government is taking steps to improve the quality of life in the country and create awareness regarding the importance of health. I believe that the government’s emphasis on health insurance is a positive sign. Overall, we welcome the move by the government towards the healthcare industry.
– Vishal Gondal, CEO and Founder, GOQii
“Nearly four time increase in allocation for health insurance through National Health Protection Scheme is one of the biggest highlights of the budget. Most of the social sector schemes have seen a marginal increase in allocation keeping with trend of actual expenditure. There is no major surprises or radical policy changes in the announcements made.”
– Ashok Varma, Partner and Leader – Social Sector, PwC India
Launch of National Health Protection Scheme which will benefit 50 crore population & 1200 crores has allocated for wellness center where they will provide essential drugs & diagnostic services is one of the best highlight of this 2018-19 union budget.
Last budget AIIMS story is still incomplete and there is no provision for improvement in present govt hospitals and so there is no point of announcement of another 24 medical colleges.Private healthcare provides around 75 to 80 per cent of healthcare in the country so we are expecting some private & public partnership deal in this budget which will automatically improve better healthcare access in rural India but there is no such announcement in this budget. Unfortunately Healthcare & Job creation has not been considered in this 2018-19 union budget.
– Pavan Kumar, Senior Cardiac Surgeon, Cardiothoracic and Vascular Surgeon from Lilavati Hospital, Mumbai
There were two key highlights this year. The first was the proposed launch of the flagship National Health Protection Scheme which would cover 10 crore poor and vulnerable families and provide up to Rs 5 lakh per family per year for hospitalisation in secondary and tertiary care institutions. With 50 crore beneficiaries, this would be one of the largest benefits program of its kind in the world. Not only is this scheme a step towards the universal health coverage proposed by the National Health Policy 2017, but the inclusion of secondary and tertiary care hospitals indicates that the government is going beyond its focus on primary healthcare. This scheme, thus, will not only make quality and critical care more affordable for the masses, but it would provide the boost to secondary and tertiary care hospitals for expansion into smaller cities and villages, thus improving accessibility.
The proposal to open up 1.5 Lakh healthcare centres to provide free essential drugs and diagnostics is also equally laudable and reflects the government’s concern for the common man’s health.
Both the schemes are focus of this year’s budget. It is vital that they are implemented and monitored effectively and efficiently so that they enable providing high quality patient care and that they truly benefit the citizens.
In addition to this, the government increased the health and education cess to 4 per cent. This 1 per cent increase will bring in an additional amount of Rs 11,000 crore which can be used for the government-funded programs in healthcare and education.
Announcement of setting up 24 new medical colleges, one in each state, is a welcome step, which will not only help to reduce the shortage of doctors, but will also help in even distribution of medical facilities and doctors across the states in the long term. However more needs to be done in this area. Medical education is expensive and time consuming and today’s youth have choice of several other professional streams, with shorter lead times. Allied health services professionals and nurses are equally in short supply and facilities to promote education facilities in these areas should also be introduced.
The rise of tuberculosis is a growing concern in India and the government’s aid of Rs 600 crore for nutritional supplement for all TB patients at Rs 500 per month for the treatment duration, will provide relief. This also poses opportunities for public private partnerships for effective and efficient execution. We also hope the government continues its efforts to tackle other communicable diseases like malaria, HIV.
Besides the health insurance plan, the government has also introduced favourable changes for medical expenditure: (a) Standard deduction of Rs 40,000 introduced in lieu of transport and medical reimbursements for salaried employees, (b) benefit of a deduction of Rs 50,000 for medical insurance for senior citizens, and (c) deduction limit of Rs 1,00,000 for critical illnesses.
As senior citizens will take a large portion of our total population in the coming years, favourable insurance for them would increase affordability and hence boost the entire ecosystem (patients, insurers, care providers) of healthcare specifically targeted for senior citizens.
Besides policies for the health sector, there were other plans announced this year, which would indirectly impact the health sector. Chief among them was the focus on pollution control and sanitation (plan to open 2 crores additional toilets). These would definitely impact public health by reducing infectious and pollution-related diseases, thus reducing the burden on health systems by some degrees.
While there’s a lot in the budget for the healthcare sector, some items in our wish list remain. These include an increase in public spending on healthcare, universal health coverage, public private partnerships, implementation of GST to lower the cost of running of hospitals, digital healthcare and incentivizing healthcare innovation, research and technology.
On the whole1-Feb-18, this budget marks the importance of social sectors and the government’s focus on healthcare for the common man is a step in the right direction for India’s health.
– Gautam Khanna, CEO at PD Hinduja Hospital & MRC
“We are witnessing the public- private partnership model emerge as an effective way of accelerating improvement in health outcomes. These partnerships allow the public and private sectors to do what they do best and complement each other’s efforts as a way to reach out to more people, expand what works and create a stronger impact. The National Health Protection Plan is a much needed scheme and has the potential to improve access to quality healthcare for the vulnerable population. There is a need to develop innovative strategies to improve the quality of care a woman receives regardless of where that care takes place, the public or the private facility. We also need to ensure that the right incentives for quality are entrenched in the system. Health financing and quality assurance efforts must work in tandem to ensure that services are adequate and affordable.”
– Pompy Sridhar, India Director, MSD for Mothers
“The proposed national health protection scheme is an important step towards making healthcare accessible for a large section of the population and is a very welcome initiative. While the details of the scheme are not yet known, if implemented thoughtfully, it has the potential to significantly change the health indices of the country. Also, the proposals aimed at growing the rural economy and income levels, when implemented, would in turn enhance the affordability of quality healthcare services.”
– Dilip Jose, MD & CEO, Manipal Hospitals
“The announcement of the Ayushman Bharat Programme is a bold and ambitious move in the right direction. Once rolled out, it will hasten India’s progress towards achieving universal health coverage for all. Fresh investment in healthcare delivery infrastructure and medical education are also welcome developments, given that healthcare education and delivery need to be efficient for insurance outlays to be used optimally. The increase in medical colleges will hopefully change our presently skewed doctor-patient ratio.
India must now consider the use of adaptive learning and mobile-based learning technologies in medical education, which will help our medical practitioners make the most of the latest developments in medicine and use global best practices to improve healthcare delivery in India. Countries that score high on healthcare metrics have made significant investment in healthcare technology that enable healthcare practitioners to make evidence based clinical decisions, which in turn lowers mortality and healthcare costs. Insurance companies that would be the implementation channels for the National Health Protection Scheme will benefit from the technologies that enable clinical effectiveness because they minimize risk and improve efficiencies. We look forward to partnering with the government in implementing these transformative programmes in India.”
– Shireesh Sahai, CEO, Wolters Kluwer India
A mere 11.5 per cent increase in budgetary allocations for health from Rs. 47,353 crore from previous year to Rs 52,800 crores is disappointing and discouraging especially with the announcement of schemes that require large sums of money. The budgetary allocations are clearly mismatched with the stated policies goals despite the political commitment to increase investments in health (National Health Policy 2017), family planning, and achieve better health outcomes (SDG Goals). The continuing trend in lower budgetary allocations for health reinforce the fact that, while there is the intention and attempt to improve the health status in the country, the financial commitment continues to be missing for translating these goals into action.
The allocation for family welfare schemes under central sector schemes/ projects, which is meant for procurement and distribution of contraceptives have increased only marginally by two per cent (Rs 770 crore) over the budget (Rs 755 crore) last year. This will be insufficient not only to meet the future demand but will also fall short of the current demand for contraceptives and for improving the much needed quality of services.
The Ayushman Bharat initiative and the National Health Protection Scheme announced by the Finance Minister is a welcome move for the country’s healthcare development as they intend to significantly reduce the cost of healthcare borne by the households on medicines, diagnostics and hospitalisation. While both these schemes are conceptualised with good intentions, the government has to match up with a strong regulatory framework and clear financial outlays and implementation plans.
While universal access to health care services remains a distant dream with the current allocation strategies of the government, resource prioritisation is the key to effectively utilise the available budgets for primary health care. To quote an example, prioritising critical elements of reproductive health care for instance can reduce large expenses incurred on incentives and compensation. Rather, these amounts can be used more productively to improve the quality of care and strengthen health service delivery.
– Poonam Muttreja, Executive Director, Population Foundation of India
“This year Healthcare gets a boost with National Health Protection Scheme. Under NHPS, people will get medical treatment in secondary and tertiary hospitals. This will benefit middle class and poor public at large. The announcement of National Health Protection Scheme will take healthcare protection to new level. It’s also very commendable about the plans of coming up with 24 new Medical colleges and at least one medical college every three constituencies.India is moving aggressively towards a progressive developing economy” shared.
– Rekha Dubey, CEO, Aditya Birla Memorial Hospital
“I congratulate the government for focusing on common man of India in this budget by announcing various schemes across sectors. The announcement of universal health insurance at Rs 5 lakh medical cover per year for 10 crore(s) poor families across the country, is an appreciable step. Also, the allocation of Rs 1,200 crore(s) for health and wellness centres clearly indicates that health sector has received utmost priority in this budget.
It would be a welcome step if out-patient diagnostics costs/coverage is covered in this limit. The absence of coverage for outpatient care and pre-existing diseases is an impediment to a comprehensive and affordable health insurance cover.
Also, specific focus on the diagnostics sector would have been of great benefit to supplement primary healthcare machinery. Nevertheless, we welcome the various health initiatives announced by the government in which limelight has been shed on the alarming rise of non-communicable and communicable diseases in India.”
– Arindam Haldar, CEO, SRL Diagnostics
Overall, this has been a pro-people and a pro-poor budget. For the first time, Universal Health Care has got the impetus it needs. I am quite happy with the government’s plan to introduce 24 new medical colleges. That is the only way to address the glaring lack of talent in the industry. The 1.5 lakh centres which will provide free essential drugs and diagnosis is a welcome move and a step towards boosting the government’s National Health Policy. The flagship national healthcare protection scheme which will cover 10 crore, underprivileged families, is a highly commendable initiative. Through the budget, the government has definitely shown its interest in making healthcare more accessible and affordable through the Ayushman Bharat programme.
Another highlight of the budget has been the focus on fighting the ever-growing hazards of pollution from crop burning, promotion of gas connection in houses using wood fire for cooking, among others. By not just talking about healthcare, but its indicators as well, the government is definitely on the right track towards improving the sector across the country.
We truly hope that going forward, the government also has plans for utilisation management, financial monitoring, audit mechanisms and accountability.
– Ameera Shah, Promoter and MD, Metropolis Healthcare
“Budget 2018 has definitely added significant impetus to the healthcare sector with emphasis on the elderly and underprivileged. The biggest declaration by the Finance Minister was the health protection scheme where 10 crore poor families – for secondary and tertiary treatment – will get Rs 5 lakhs per family. This announcement could be the first steps towards Universal Healthcare in India.
The minister announced that 24 new government medical colleges will be set-up and this could be a big incentive for medical education in the country. The allocation of Rs 1200 crore towards health and wellness centres and Rs 600 crore towards nutrition for patients suffering from tuberculosis are positive steps.
We were pleased to hear in the budget that the government has allowed senior citizens to claims benefits of Rs 50,000 as part of medical insurance – earlier this was Rs 30,000. However, the government’s discontinuing of Rs 15,000 per annum for medical benefits to salaried employees – as per today’s budget announcement, is unfortunate.
– Mustafa Daginawalla, CFO, Saifee Hospital
Increase in tax allowances for health insurance will increase the opportunity on healthcare services delivery. This is an indirect fillip for not only insurance service providers but also healthcare services providers. The FM highlighted the availability of low cost medicines and the like. The glorifying tenor should lead to a reasonable presumption that there will be further action on the price control front going forward. The National Health Protection Scheme will be an interesting initiative – private players, if allowed to participate in the scheme, will have an additional opportunity to service more patients.
– Sameer Sah, Associate Partner, Khaitan & Co
We applaud the announcements made by the Government in the Union Budget 2018 which has indeed addressed a lot of issues that will help the economy to prosper. It aims in creating the largest healthcare blanket for the biggest democracy of the world. The government’s initiative of setting up 1.5 lakh health facilities across the country will help bring healthcare closer to homes of the people and will enable them to receive medical help within the golden hour hence improving the chances of survival.
Granting 50 crore beneficiaries and 10 crore families, Rs 5 lakh per year cover for secondary and tertiary hospital expenses is a breakthrough move and the world’s largest government-funded healthcare programme. This will allow the poor to access world class healthcare facilities which was not affordable or available earlier. Also, the announcement of setting up one medical college for every three parliamentary constituencies is a good move as this will help in training the emergency medical technicians which will, in turn revolutionise the quality of care of the emergency medical response services in the country.
– Naresh Jain, CEO, Ziqitza Healthcare
Fuelled by the Rs 1200 crore allocation for healthcare, what is exciting is the 1.5 lakh new healthcare centres that are going to be initiated. For a country that presents the highest number of patients in area of breast cancer and Head and Neck (Oral) cancer cases in the world, these centres need to be equipped with primary onco scanning and treatment options. An early detection and treatment option would reduce healthcare cost burden on the Indian exchequer by several thousand crores in terms of disability adjusted life years (DALY)
– Debayan Ghosh, Founder & President, Epygen Biotech
The Union Budget 2018 has taken a huge step in making healthcare affordable and accessible by launching the world’s largest healthcare scheme. It is indeed heartening that 40 per cent of India’s population will be covered under an insurance scheme. The payor problem demanded urgent attention and the government has paid heed. If the Flagship National Health Protection Scheme to cover 10 crore poor and vulnerable families with upto 5 lakh per family per year for secondary and tertiary care hospitalisation is properly implemented and monitored, we would have taken an important step in creating a Swasth Bharat. Effectively, this initiative which amounts to $800 billion tops even the US’ Medicaid programme which amounts to $ 550 billion.
– Suneeta Reddy, MD, Apollo Hospitals
It is really encouraging to see that the government has laid strong emphasis on Healthcare by announcing the world’s largest health protection plan. We are confident that progressively, similar importance will be given to Home Healthcare which is fast becoming an important element in the health Management value chain.
– Rajiv Mathur, Founder, Critical care Unified (CCU)
The provision of Rs 5 lakh per family per year for medical reimbursement, under National Health Protection Scheme – ‘Aayushman Bharat’ will go a long way to achieve the goals of Universal Health Coverage, according to NATHEALTH.
Reacting to Union Budget announcements, the Healthcare Federation of India (NATHEALTH) has termed the overall Union Budget 2018-19 including healthcare part as progressive along with some populist measures.
NATHEALH had recommended making health insurance mandatory and National Health Protection Scheme partly covers the insurance needs of the country. However, there are other critical needs which remain unmet – eg. according National Priority Sector Status to healthcare.
NATHEALTH applauded the government’s focus on health protection scheme which would be the largest healthcare programme in the world.
The government has announced an unprecedented Rs 5 lakh medical insurance cover per year for 10 crore families or 50 crore beneficiaries across the country.
Announcement of 24 new medical colleges should also have positive impact on health education. With corpus of Rs 1,200 crore, setting up 1.5 lakh healthcare centres should bring good health closer to every household. These centres will provide free essential drugs and diagnosis.
– Anjan Bose, Secretary General, NATHEALTH
The government has reiterated its commitment to ‘Universal Healthcare’ and has announced flagship schemes to provide better healthcare to people at the bottom of the pyramid – National Health Policy and Rashtriya Swasthya Bima Yojana. These schemes will expand the reach of basic healthcare facilities in the country. While access to basic healthcare is an important determinant of Universal Healthcare, another critical factor is quality of healthcare. The latter requires access to advance healthcare technology for best health management of patients. The government should have looked at incentivising import of advance medical devices into the country by bringing down the customs duty.
There is also a need to undo the unnuanced price control imposed by NPPA as the move is leading to unintended consequences on the healthcare ecosystem without any significant reduction in the cost of patient. The current price control regime has also lead to a drastic fall in foreign direct investment in healthcare sector from $417 million in April-September 2017 against $173 million in the same period in 2016, a reduction of 59 per cent.
Under the current ecosystem where more than 70 per cent of medical devices have to be imported from abroad, a balance approach to reduce cost to patient is trade margin rationalisation for distributors, gradation in pricing thereby allowing a higher price bracket for superior medical devices, and lower customs duty. These measures will reduce the cost to patient without dis-incentivising technical innovation by medical device manufacturers.
– Pavan Choudary, Chairman & DG, Medical Technology Association of India (MTaI)
India has taken a long stride towards Universal Health Coverage as envisioned in the NHP 2017, by announcing the launch of a flagship National Health Protection Scheme (NHPC) initiative with nearly 50 crore beneficiaries which will provide up to Rs 5 lakh to a family per year, for secondary and tertiary care hospitalisation. We need to learn from experiences from other parts of the world. A robust technology, integrated ground level operations and governance system will ensure success of NHPS and avoid delays in its implementation. Primary and wellness care is high on the government’s agenda. PPP, telemedicine and technology adoption will be key to enable for the proposed 1.5 lakh new healthcare centres for primary and wellness care. Free essential drugs and diagnosis will be instrumental in addressing growing non communicable diseases. Leveraging PPP for creating the announcement of 24 new medical colleges is necessary for this to be successful.
– Nilaya Varma, Partner and Head, Government and Healthcare, KPMG in India
My heartiest congratulations to this government for investing in creating a swasth bharat by launching the Ayushman Bharat programme. Such ambitious out of the box thinking was a burning need of the hour and the government has not disappointed. The initiative to cover 10 crore families with 5 lakh per family/per year with insurance cover for secondary and tertiary healthcare will be a gamechanger.
– Dr Prathap Reddy, Chairman, Apollo Hospitals
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