With the Lok Sabha election in full swing and Prime Minister Narendra Modi battling hard for re-election, let us take a look at what will be his priorities when it comes to healthcare, if he is voted back to power.
The best document to refer to is his party's election manifesto. The party promises to reduce out-of-pocket expenditure on health and talks about health for all, if they retain power.
Ayushman Bharat
The manifesto starts with Modi's flagship programme Ayushman Bharat. It calls this programme "historic" and "world's largest healthcare programme".
Ayushman Bharat also called as the Pradhan Mantri Jan Arogya Yojana (PMJAY), launched in 2018 provides annual health cover of Rs 5 lakh to 10.74 crore poor families. According to PMJAY’s latest update, so far 3.22 crore e-cards have been issued. Around 23.1 lakh hospital admissions worth Rs 3,078 crores have been done, and 64 percent of that is in private hospitals.
Modi is relying on this scheme in states such as Uttar Pradesh, Bihar, Haryana, Madhya Pradesh, Himachal Pradesh, Jammu & Kashmir and Jharkhand, where such healthcare initiative is getting implemented for the first time ever.
The government authorities have been on full throttle to ensure these "greenfield" states get priority in the implementation. UP, Bihar and Madhya Pradesh together constitute over one-fourth of the total Lok Sabha seats.
Primary health
The manifesto mentions about its ambitious programme to set up 1.50 lakh Health and Wellness Centres (HWCs) by 2022.
Till date, the manifesto says 17,150 HWCs have become functional, and talks about scaling up and taking it to next level by providing telemedicine and diagnostic laboratory facilities at these HWCs by 2022 to ensure quality primary medical care to the poor at their doorstep.
Price controls of drugs and medical devices
Well, this may not be of much liking to the industry, but price controls of drugs and medical devices are not going away, if Modi retains power. The party takes credit about controlling prices of medicines.
It also says that it will create an essential devices list and a separate pricing policy for medical devices to ensure their accessibility and affordability to masses.
Healthcare infrastructure
The manifesto claims that its government had successfully reached the stage of ensuring one Medical College for every three parliamentary constituencies. Now, it promises to set up one medical college or post-graduate medical college in every district.
"We will take it forward and set up one Medical College or Post Graduate Medical College in every district, through public or private participation, by 2024. To start with 75 such Medical Institutes will be set up by 2022. This would ensure availability and accessibility of quality secondary and tertiary medical care to the citizens across the diverse landscape of our country," the manifesto says.
The party says that in a span of 5 years, it had increased the number of MBBS seats by 18,000 and that of post-graduate medical seats by 12,000. It also promises to double the number of MBBS and Specialist doctors in the country by 2024, as compared to the work done from 1947 till 2014.
It also talks about accelerating the reforms in para-medical education sector so as to increase the availability of nurses, pharmacists and other paramedical personnel.
Immunization & TB control
The Mission Indradhanush programme has ensured full immunization of 3.39 crore children and 87.18 lakh pregnant mothers.
The party promises full immunization coverage for all the children and pregnant women by 2022.
On Tuberculosis, the party promises to eliminate the disease from India by 2025.
"We will ensure this becomes a success much ahead of the target given in Sustainable Development Goals (SDGs)," the manifesto says.
Silence on healthcare spending
The healthcare spending remains just a little over 1 percent of the Gross Domestic Product (GDP), as opposed to the National Health Policy direction of 2.5 percent. The budgetary allocation on healthcare as percentage share of the total budget remained at 1.98 percent.
The allocations for Ayushman Bharat are taking a large portion of the budget allocation, that has not kept up pace with the rising healthcare requirements. In the recent Interim Budget, the government raised the allocation for Ayushman Bharat scheme by a whopping 167 percent to Rs 6,400 crore for 2019-2020.
Beyond Ayushman Bharat, the allocations for health expenditure remained flat on others heads. For instance the immunisation or vaccination programme was cut 7 percent to Rs 6,758.46 crore.
Through Ayushman Bharat, the government is pushing the demand for healthcare services, but the supply side has not kept pace.
The government was silent on providing incentives for setting up hospitals across the country.
Also the state of public health infrastructure is in a bad shape. Most government hospitals have vacancies for doctors and specialists unfilled for years. The government hospitals in rural and tribal areas suffer from lack of facilities and corruption.
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