The union budget recently presented in Parliament by Finance Minister Nirmala Sitharaman has not exactly drawn applause from any section of the healthcare industry in India. This is because there were expectations and due to budgetary constraints those expectations were belied. It is all very well to say in seminars that the budget for the healthcare sector must go up in terms of percentage of the GDP, but when it comes to putting money on the table, constraints crop up. There are other sectors that are accorded more importance and the health sector becomes the soft target of budgetary cuts. In this scenario, the central government's revenues will have to be particularly booming for the health sector to get more funds.
The direct impact of the shortage of budgetary allocation for healthcare is that doctors and healthcare staff is not recruited in the numbers required to run our healthcare services in an orderly manner. If the staff is not there to provide services, what is the use of physical infrastructure? Even if some doctors and paramedics are recruited, this recruitment is done on a 'contract' basis, thus creating two classes of employees, both doing the same work. One class is that of 'permanent' employees, and the other is those hired on 'contract' who may work for a pittance for decades on end. This leads to discontent, protests and strikes, thus impacting health services every now and then.
The inadequate outlay in the budget for the healthcare sector also means that the various diagnostic machines in the hospitals will not be purchased, and that medicines will be in short supply in the dispensaries. When the cash crunch becomes acute, the existing machines will not be repaired and the patients will be turned away.
So, the lack of sufficient budget for healthcare is not an academic question of a few statistics, it is harsh reality for the patients and for all those who are stakeholders in this crucial sector. If we accord less priority to this sector, we will have stunted children, rampant malnourishment, the poor being denied treatment, and the country performing poorly on various health indicators.
The planners in the Finance Ministry must realize that money spent on healthcare is money well spent. It is actually an investment in the human resource of the country and gets multi-fold returns. If money is not spent on health, it is not a saving but an invitation to disaster which will require much more to be spent on a later date on fighting a calamity.
This said, the current economic scenario in the country with various sectors facing uncertain times, does cramp the union finance minister. Resources can be earmarked for the health sector only when these resources are available. When the government is fighting a daily battle to garner resources to keep itself in business, how can the government be blamed?
In this situation, lest the healthcare sector also go the way that the auto sector has gone in the country, it is time to think of and implement out of the box solutions. Fortunately, the healthcare facilities owned by the governments across the country are a huge resource that can well be leveraged to raise resources and make a success of a brilliant scheme like Ayushman Bharat.
The only thing that seems to be keeping Ayushman Bharat from becoming a runaway success is the lack of funds with the government. After all, the empanelled hospitals have to be paid for the services they render to the poor patients. If this money is simply not sufficiently there, the success of Ayushman Bharat scheme can only be limited. It would be great if the real estate that the health ministries are sitting on can be shared with the doctors on the condition that they will take Ayushman Bharat forward. Monetizing existing assets is the way to go when liquidity is in short supply.