New Delhi: Delhi Medical Association (DMA) has expressed its “deep concern” over the reduction in health budget from approximately Rs 37,350 crore to Rs 33,152 crore in the General Budget 2015-16 presented by Finance Minister Arun Jaitley in Parliament on Saturday.
In a press statement, Dr Anil Goyal, president, DMA, said, “We are concerned how the government will initiate universal health insurance scheme, preventive health promotion for communicable and non-communicable diseases and will achieve ‘Health for All’ by 2020 in these meagre resource and reduction in health budget.”
Dr Goyal, however, appreciated the finance minister’s proposal to increase tax-free medical expenses from Rs 15,000 to Rs 25,000 and Rs 30,000 for senior citizens and to establish five AIIMS like institutions in the country. He also said that reducing the corporate tax to 25% from 30% will reduce the cost to patients in the hospital.
Speaking to India Medical Times, Dr K K Aggarwal, honorary secretary general, Indian Medical Association (IMA), said, “Health is not at all a priority for the government. If the healthcare expenditure is low, it is difficult to provide even basic healthcare to poor and conduct public healthcare scheme and programmes like National Health Assurance Mission (NHAM) to provide citizens basic healthcare services.”
Omar Abdullah, former chief minister of J&K, while reacting on the budget proposal to set-up five new AIIMS, including one in J&K, said, “Bricks & mortar don’t make AIIMS & IIMs. In fact quite the opposite, they dilute the brand equity of the original institution.”
Abdullah further tweeted that “If Kashmir is to get the AIIMS rather than a greenfield project, I hope the money is pumped in to SKIMS (Sher-I-Kashmir Institute of Medical Sciences) to raise it to global standards.”
Dr O P Yadava, CEO and chief cardiac surgeon, National Heart Institute, New Delhi, also felt that establishing more AIIMS in different states won’t help better than raising the standards of the already existing centres of AIIMS in cities like Patna and Rishikesh.
“These ideas and proposals look wonderful on paper but implementing them is a tremendous challenge. The amount of nepotism and corruption that exists in the AIIMS centres in different states is rampant; none of them has facilities like that of the Delhi centre. They have virtually become district hospitals. Creating more AIIMS centres has become a centre of gross corruption,” Dr Yadava told IMT.
According to Dr P L Nawalkha, former principal and controller, SMS Medical College, Jaipur, the creation of more AIIMS as centre of excellence is a “laudable step”. However, he also felt that “simultaneous attention to produce competent teachers for AIIMS needs attention”.
Reacting on the move to increase the limit of deduction in health insurance premium, Dr Debraj Shome, founder, MediAngels, told IMT, “Increasing the limits for health insurance exemptions is very good. Health inflation is growing in India by about 7 to 10 per cent every year. Hospitals are getting more expensive and hence by giving exemption limit on the premium of Rs 25,000, one would be able to cover their health.”
Dr Shome said, “I also think the government has stepped on the right path by giving exemption for the treatments like cancer as the treatment for such chronic diseases are so expensive.”
He further said, “I also appreciate that they have tried ‘Make In India’ to be a part of this budget and have reduced the corporate taxes by 5 per cent (from 30% to 25%) for the next four years.”
“Their announcement of opening small banks that will be looking into micro financing SMEs is what is required at the moment because SMEs are the backbone of any economy as people try to become entrepreneurs and provide more jobs than to seek them. This will help to boost healthcare entrepreneurship because doctors are self-employed and small to medium entrepreneurs,” added Dr Shome.
Expressing his disappointment, Dr Neeraj Nagpal, convenor, Chandigarh-based Medicos Legal Action Group, in a statement, said, “Maybe I have not understood the full budget but to me it appears that ‘health’ has been given a go by in this budget.”
“Establishing AIIMS in different states is a faulty way to provide health to the people. For one Govt does not allocate adequate resources to establish a functional AIIMS like institute which alone would require substantial funds and then to provide AIIMS like faculty on salaries given is a quixotic idea. Good faculty remains in AIIMS because of the excellent academic environment, intellectual opportunity and overall lifestyle of the staff. These so called AIIMS become a caricature of the premier institute with no purpose except to fool the public as a political vote gathering tool,” Dr Nagpal opined.
“The only thing I could find was relief provided to ambulance services from the purview of service Tax. If taxing the ambulance services was on the radar of the government then I must thank the finance minister for the “Acche Din” (Good Days) indeed,” he said.
“Yoga has been included in the list of charitable activities and hence can be expected to have tax benefits. There has been mention of “diagnostics” becoming expensive due to increased service tax on some talk shows but I still need to see the concrete details before commenting on this,” said Dr Nagpal.
He further said, “All in all no special mention of any increase in health budget which means no increase in number of Primary Health Centres from current 27000, no increase in rural medical officers and other staff. No tax benefits to small and medium healthcare establishments (SMHCE) means the private entrepreneur is not incentivized.”
“No plan to increase the tax base so professionals like doctors who anyway are taxpayers can expect to be squeezed. Increase in exemption to health insurance will benefit corporate hospitals with increased business more than the SMHCE. The budget is blind to the role the SMHCEs who play a crucial role in healthcare delivery to the nation and their needs have been left unfulfilled,” Dr Nagpal concluded.
Suneeta Reddy, managing director, Apollo Hospitals Enterprise, said, “The government has announced five new AIIMS, which will both increase access to health facilities in those states and also provide a training ground for medical professionals. The visa on arrival for 150 additional countries is also a progressive move. This will go a long way in facilitating medical tourism, which is a growth industry that showcases India’s world class health facilities while contributing foreign exchange to the exchequer.”
by Priyanka V Gupta