It is a growth-oriented budget with a major focus on boosting economic development through structural changes and reforms. However, the social sector did not get as much attention as was expected from the first full-fledged budget of the Modi Government. Healthcare was conspicuous by its absence and revolutionary announcements that were required did not materialise.
There was a continuation of the business-as-usual approach of the last few years, with no major changes in the quantum or pattern of healthcare allocations. The need of the hour, instead, is to increase the outlay exponentially year on year until it reaches at least 3 percent of the GDP. This would necessitate a much more radical approach to healthcare than what was exhibited in the Budget.
For the first time, the Economic Survey talks about reorienting family planning towards reproductive health and rights, paying greater attention to quality and spacing methods, doing away with targets and incentives for sterilisation as well as sterilisation camps. This is an extremely significant move by the Government. However, it is not clear how the conservative changes in allocations to health in the Budget will move not just the family planning agenda but also the entire health assurance agenda including the five new AIIMS, forward – and take us closer to universal health coverage.
While the focus on social determinants like sanitation (Swachch Bharat mission) is welcome, the behavioral change that would make this a success is a challenging and long-term process. In the meantime, we need a far stronger emphasis on preventive and curative care at the primary level to have an immediate impact on healthcare parameters. The abysmal quality of care delivered by public health systems is a big challenge. The situation demands a much stronger emphasis on upgrading infrastructure, skill development and procurement efficiency. This is something that the budget did not address adequately.