Monday, 3 February 2025

Indranil Mukhopadhyay

 ndranil 

The budget that misses out on health of the people 
Thaugh there is a nominal rise in allocation ,in real terms the hike is paltry. Schemes that aid the poor  have been neglected 

 The government continues to neglect the health sector.
    In nominal terms there is some increase in the total allocation of Ministry of Health and Ayush taken together compared to the previous budget. Allocation has increased from Rs. 94671 crore (2024..25BE) to 10,3851 crore 2025..26 Budget Estimate). Thaugh this looks a significant increase of Rs 9180 crores in nominal terms, if we adjust for  the effect of inflation in real means an increase of 3.04% in real terms .
       Moreover in real terms there is  4.7% less than what was actually spent in 2020..21. This means the care that could be provided into 2020..21 cannot be ensured  now, given that allocation have declined while prices have sky rocked.
         This also means that as percentage of GDP the government location to health has declined from 0.37% to 0.29 percent between 2020..21 Actual Expenditure and 2025.. 26 BE. It means priority  accorded to the health sector in the budget has also declined over this period with  its  share declining from 2.26% to 2.05% in this period .
   Skewed Priorities 
        Schemes which contributed to strengthening the public system and  protecting the health of most vulnerable sections of the society , like the National Health mission, Pradhanmantri Swasthya Suraksha Yojana(PMSSY), Schemes on nutrition , health research received severe cuts despite doing good work during hard times. In contrast schemes to promote commercial interests... like the Pradhan Mantri Jan Arogya Yojana(PMJAY),
the Digital Health Mission, are being rewarded with higher l
allocation despite failures.  
        National Health mission is the key program through which the government intervenes in improving primary and secondary on maternal and child Health disease control program and non communicable diseases. Much of these services have suffered during the lockdown. However since 2019 ..20, NHM allocations had been declining  in real terms. This means that essential services  like safe deliveries , vaccination  for children , treatment of TB provided earlier  cannot be provided  any more with current limited resources.
        NHM money also goes in to paying remunerations for frontline health workers like ASHAs, mostly women  , who received global recognition for their stellar role during the pandemic. Cuts in NHM budget means reduced budget for paying these workers ,who have been demanding  minimum wages for a long time. We need expand net work of  the  Health and Wellness Centres to  ensure quality comprehensive primary care. HWC  are part of  NHM budget. In the context of NHM the plight of HWCs also remains unclear.
    PMJAY seems like the blue eyed boy of the government  even thaugh it fails to deliver 
continuously , known to largely benefit the private sector and exclude the most marginalised, it is rewarded with higher allocation . 
    In the 2023..24 budget Rs 7200 crore was allocated and only Rs 6670 crore  could be spent . Allocation has been further increased by 24 percent compared to previous year to Rs 9406 crore.  PMJAY eating up larger share of budget remains a cause of concern while it fails to deliver.
       Blind obsession to promote  commercial interest needed in serious introspection. A large part of  the Dalits, Shedule Tribes and other marginalised section hardly recieve care from the private sector  under Government  Funded Insurance Schemes like PMJAY.
     Exemption of custom duty on imported medicines is well indeed but nothing more than a mere bandage. Custom duties form only a small part of the price of these patented medicines and the likely impact remain miniscule if at all the benefits are  passed on the customers . What is needed is issuing compulsory  license to Indian  firms so that cheap generic  alternative could be provided.
Indranil Mukhopadhyay

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