Despite repeated claim of allotting at least 10 % of budget expenditure towards public health, it continues to be much lower at just around 2%. The FM has proposed to allocate Rs 86,175 crore to the department of health and family welfare for the financial year 2023-24, on the face of it, meant an increase of 3.82% compared to the previous budget. But in real terms, there is a decline. Inflation in December 2022 was 5.5%. If adjusted with inflation, this slide would be more. If that is factored into, the dip would surface more clearly. Moreover, it is not clear whether only the health budget has been included in making this calculation or schemes which apparently improve health but that of other departments have also been taken into consideration. For instance, in her budget speech of 21-22, the FM had claimed that the ‘‘health and wellness budget’’ had been increased by 137% —when she had included the funds allocated to the departments of health, health research as well as drinking water and sanitation. Is the situation same this year also? The budget for the National Health Mission (NHM) – a combined programme of the National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM). also came down from Rs 37,159 crore previous year to Rs 36,785 crore this year.
Furthermore, the budget documents also revealed in the last financial year, the government failed to allocate to the department of health what it had proposed. Against the budget estimates of Rs 83,000 crore, the revised estimates stood at only Rs 76,370 crore for the financial year 2022-23. The FM announced launch of a special mission to ‘‘eliminate’’ sickle cell anaemia by 2047. However, there is no specific head in the budget documents to say how much would be spent this year on tackling sickle cell anaemia.
Pradhan Mantri Jan Arogya Yojana (PM-JAY) which provides cashless health insurance of up to Rs 5 lakh per family has been allocated Rs 7,200 crore in FY 23-24, higher than last year’s Rs 6,412 crore. However, utilization of funds under the scheme has been low with only Rs 3,115 crore being used in FY 21-22. On the other hand, premium paid to the insurance companies for crop insurance was round Rs 29, 263 crores in 21-22. But the claim settlement figure was Rs 14, 716 crore proving that insurance companies have merrily pocketed more than half of the insurance amount whereas many of the bona fide claimants of insurance money were left abegging.
It is, therefore, evident despite the rickety face of healthcare in this country having been unmasked during the pandemic, the government is in no mood to improve the health infrastructure under its aegis. Instead, it is clear that the preference of the government is to allow more and more private players to make inroads into the health system and thereby help them sell healthcare as a profitable commodity at a steep price. In other words, common people would continue to be deprived of rudimentary medical treatment while the rich and affluent would be able to buy modern healthcare with money. What a pro-people health policy in ‘‘Amrit kal’’!