The Union Budget comes with a marginal increase in allocation to health, compared to last year. It does not fully restore the reduction that caused dismay in the last budget nor does it reflect the larger governmental resource pool available from the growing GDP and falling petroleum prices. One would have thought that the more comfortable fiscal space would permit a higher priority to health, as advocated by the Economic Survey.
The initiative on Jan Aushadi stores is welcome, as it should improve access to low priced, quality assured generic drugs. Will it replace the previously proposed free provision of essential drugs at all public facilities? Or is that something the states have to pursue on their own?
The proposed scheme to provide Rs 1 lakh of health insurance cover to each family appears to be an expansion of the Rashtriya Swasthya Bima Yojana. Will it also restrict its coverage to hospitalised care? While useful in reducing some of the financial shocks of hospitalisation, it will not reduce the high level of expenditure on recurrent out patient care or chronic drug therapy. More details are needed on how this scheme will function. The proposal to fund dialysis centres is again welcome but limited in impact, if primary care is not efficient in preventing high blood pressure or diabetes progressing to kidney failure.
The increase tobacco taxes is a case of ‘willing to strike but afraid to wound’. Bidis have again been left out of the tax net, even though they are the most frequently consumed form of tobacco. The finance minister’s gentle wave is not enough to disperse the dense cloud of tobacco smoke that envelopes public health today.
(The author is the president, Public Health Foundation of India. The views expressed are his personal)