How Feasible is Congress’s Promise of Doubling Health Budget and Providing Universal Healthcare?

In its election manifesto released on Tuesday, the Congress has promised to enact the Right to Healthcare Act by including free diagnostics, out-patient care, medicines and hospitalisation through public hospitals and enlisted private hospitals.

As per the economic survey 2017-18, in about last six years the health expenditure has varied from 1.1% to 1.5% of the country’s GDP. It spent the least in 2015-16 (1.1%). As per an analysis by News18, both the UPA and NDA governments have spent from 1% to 3% in healthcare, out of the total expenditure budget. This includes spendings in research and Ayush—a ministry that works to promote ayurveda, yoga, naturopathy, unani, siddha and homeopathy.

Through its manifesto, the Congress intends to change that. The party says it will increase the government expenditure year-wise to double the healthcare budget to 3% of the GDP by 2023-24.

The manifesto also discourages the ‘insurance-based model’ in healthcare and promises instead to promote and implement free public hospitals model to provide universal healthcare. The party also promises to introduce ‘well-designed health insurance and pension schemes’ for the senior citizens.

It also commits to expand child healthcare services (pre-natal, post-natal and pediatric). As News18 has analysed earlier, the country is currently burdened with comparatively higher instances of disease affected children than previous years, rising cost of vaccines like pneumococcal, and polio IPV. Also, there is a need to expand a few vaccines nationally like that for rotavirus.

It also promises to implement the Clinical Establishments Act 2010. Passed by the Centre, the act has prescribed minimum standards of facilities and services provided by established clinics. It has not been implemented nationally and is currently only effective in states like Arunachal Pradesh, Himachal Pradesh, Mizoram, Sikkim, Uttar Pradesh, Uttarakhand, Rajasthan, Bihar, Jharkhand, Assam and Haryana, and all Union Territories except Delhi.

The manifesto also pledges to improve the doctor-patient ratio by increasing the capacity of medical colleges and providing scholarships and loans to medical students. It also intends to license pre-qualified institutions in the public and private sector to teach and certify medical professionals. As per the latest National Health Profile 2018, average population served per government allopathic doctor is 11,039, which was 10,189 in the 2017 report.

Last year, the current government had dissolved the Medical Council of India with the board of governors claiming to bring some regulation in the healthcare sector. However, allowing the medical teaching institutions to decide their strength and fees drew much criticism.

The preamble, the directive principles and several articles of the Indian Constitution address public health in different ways and impose the liability on the state and the local governing bodies like the municipalities and panchayats. Acknowledging the same, the party has promised to enable the state governments to revamp and equip the network of primary health centers (PHCs).

It has made a major announcement of filling all the vacancies at all levels of PHCs and public hospitals within a year of coming to power. The party also promises to expand ASHA programme by appointing a second ASHA worker in all villages with a population exceeding 2,500 persons.

Additionally, the manifesto promises to establish a council of ministers for healthcare as the one for GST, introduction of more ambulances in several districts, emergency health care centres at highways for travellers and residents in the surrounding areas, digitisation of medical records with suitable provisions of privacy, etc. – News18