Not highlighted in budget speech, Ayushman Bharat, FSSAI get major chunk of funds

While the healthcare allocation had already been covered in the Interim Budget earlier in February, no new commitment was made in the area on the budget day. The flagship health scheme of Modi government unveiled in 2018 called ‘Ayushman Bharat’ rests on two pillars, namely the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PM-JAY)—providing health insurance and upcoming 1.5 lacs Health & Wellness Centres.

While ministry of health and family welfare this year witnessed around 18.67% increase in the total outlay with ₹62,659.12 crore allocation compared to ₹52,800 Crore (Budget Estimates) in 2018-19, , the AB- PMJAY has got a whopping 154.87% increase.

AB-PMJAY-- a typical health insurance scheme –that seeks to cover about 500 million poor and vulnerable people with a benefit cover upto Rs. 5 lakhs. Touted to be the largest health insurance scheme globally, the scheme envisages providing hospitalization benefits involving over 1400 medical interventions and conditions whose premium is paid by the government. For beneficiaries this means cashless and free treatment that can be availed from the empanelled government or private hospitals of their choice.

“Against the revised estimate of ₹2,400 crore for the year 2018-19, the budget estimate for PMJAY stands at ₹6,400 crore, almost double the amount. But a careful assessment reveal that the amount to be spent on PMJAY for 2018-19 was meant to be half the year while during the next year, this would mean similar amount if entire year is to be accounted for," said Shaktivel Selvaraj, Director, Health Economics, Financing and Policy, Public Health Foundation of India (PHFI). Therefore, on an average, PMJAY’s allocation works out to be a paltry Rs. 128 per person per annum for the world’s largest health insurance scheme," he said.

With Prime Minister Modi promising since he came into power that his government will increase the public health spending to 2.5% of Gross Domestic Product (GDP) by 2025 from 1.15% at present, all eyes have been on the healthcare sector.

“The ambitious AB-PMJAY scheme holds a lot of promise and has the right intent, but requires much larger budgetary allocations, a new collaborative approach and a conducive eco system to ensure viability and long term stability," said Rajit Mehta, Chief Executive Officer & Managing Director, Max Healthcare.

The BJP manifesto talked about various other healthcare strengthening initiatives that were missing in the budget speech. “We will create an essential devices list and a separate pricing policy for medical devices to ensure their accessibility and affordability to masses. We will also accelerate the reforms in paramedical education sector so as to increase the availability of nurses, pharmacists and other paramedical personnel," the BJP manifesto said.

However, as promised in the manifesto, some allocations have been made for strengthening health infrastructure in the country to tackle the increasing patient burden. “As part of strengthening of the healthcare institutions, which form an integral pillar of health systems network in the country, the provision for Infrastructure Maintenance has been increased by 11.42%, whereas for Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), an additional 4.58% has been allocated in Budget Estimates 2019-20 over the previous financial year," said Harsh Vardhan, union health minister.

“In addition, ₹3,000 crore will be raised through Higher Education Financing Agency (HEFA) for PMSSY Projects during 2019-20. Also, the proposed National Research Foundation (NRF) shall provide a direction for consolidation and expansion of research, technology development and technology led innovations," he added.

Also, there has been an increase of 154.24% for Food Safety and Standards Authority of India (FSSAI) for strengthening of food testing system in the country including provision of Mobile Food Testing Labs. In addition, the basic excise duty been imposed on Tobacco and Tobacco products, which will help tobacco control efforts.