INSUBCONTINENT EXCLUSIVE:
NEW DELHI: The health budget is good news for the private health sector as there has been a substantial increase in allocation for health
insurance schemes such as the Central Government Health Scheme (CGHS), treatment for CGHS pensioners and the Ayushman Bharat scheme
jump in allocation in the 2023-24 budget.In contrast, the allocation for schemes aimed at improvement in public health infrastructure has
declined when adjusted for inflation
These include the National Health Mission (NHM), Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PMABHIM), human resources for
health and medical education and Pradhan Mantri Swasthya Suraksha Yojana (PMSSY).The overall allocation for health after rising during
Covid, has come down in real terms though it seems like an increase in nominal terms from Rs 83,000 in the budget estimates (BE) for the
current year to Rs 86, 175 crore in BE 2023-24.The revised estimates (RE) for the current year indicate a 9% decline from the BE to Rs
The allocation for insurance schemes, however increased substantially in RE 2022-23; more than 75% hike in allocation for CGHS pensioners
from Rs 2,645 crore to Rs 4,640 crore and for the first time since the launch of Ayushman Bharat scheme, the RE is the same as the BE at Rs
In the past, only about half the budgeted amount for Ayushman was getting spent
However, the allocation for all the public infrastructure schemes put together has been slashed by 16% in the RE for the current year.In
comparison to the Rs 13,266 crore allocated for insurance schemes, which cover only a section of the population, about Rs 30,000 crore has
been allocated for the National Health Mission and a separate Rs 6,500 crore for human resources for health and medical education, which was
earlier part of the NHM budget.Most of the allocation for the insurance schemes usually ends up in the coffers of the private sector
Despite private hospitals accounting for only 46% of empanelled hospitals under Ayushman Bharat, for instance, they accounted for 54% of
hospitals admissions and since private healthcare is more expensive, that could account for a much higher proportion of the money spent
Most CGHS beneficiaries too go to private hospitals as noted by Dr Rakesh Sarwal, who was advisor health in Niti Aayog, in a study of the
Dr Sarwal stated that CGHS had a higher cost of service because of its greater reliance on private facilities.Incidentally, though the
finance minister announced a mission to eliminate sickle cell anaemia, there is no separate budget line for it
Thus even the money for a totally new scheme might have to come from within the NHM budget, further eating into the allocation
The tertiary care programme, which provides for transfer to states for implementing national programmes on control of blindness, tobacco
control, capacity building for trauma centres and for prevention and control of non-communicable diseases such as cancer, diabetes,
cardiovascular diseases and stroke, has had its allocation slashed to just Rs 290 crore, less than the actual spending of Rs 300 crore in
2020-21, and 42% less than the allocation of Rs 500 in the last budget.The budget for the establishment and strengthening of the branches of
the National Centre for Disease Control and for preparation and control of zoonotic and other neglected tropical diseases and for diseases
surveillance, which had gone up during Covid, has been slashed from Rs 71.6 crore to just Rs 55.6 crore, despite the WHO asking countries to
prepare for future pandemics by strengthening surveillance
Even the budget for the Indian Council for Medical Research, which played a crucial role during Covid, has been slashed along with a cut in
the overall allocation for health research.
