A Letter to the Finance Minister

Dear Madam Finance Minister,

I must start by acknowledging the very difficult task that you have in front of you. Preparing the Union Budget this year, in times of such economic turmoil, is far from easy. Ordinary people of the country have huge expectations from the budget and I know, it is almost impossible to meet everyone’s aspirations. I am also sure economists and self-styled pundits of all hues must be offering you gratuitous advise on how to aim for greater growth, generate employment, rein in the burgeoning deficit and balance the budget. I am no expert in these matters and hence will refrain from adding to the chorus. My sole purpose in writing to you is to draw your attention to the healthcare sector and the urgent support it needs from the government.

As you might be aware, the National Health Policy of the Government of India itself has committed government spending on healthcare at 2.5% of our GDP. Currently, the government spends a measly 1% of the GDP on healthcare. This isn’t getting us anywhere at all. The health of the citizens of the country and their access to good quality healthcare you would accept is of paramount importance. Even a small increase in the allocation for healthcare can go a long way in improving public healthcare infrastructure particularly in the far flung regions of our country and in the area of primary healthcare.

The government had announced the world’s largest healthcare insurance scheme called Ayushman Bharat a couple of years ago. The scheme was envisaged to provide an insurance cover of INR 500000 to over 500 mn poor people. The scheme is indeed ambitious in its scope but does suffer from lack of funding. The insurance companies (mostly government owned) have been arm-twisted to accept extremely low premiums and private hospitals are being asked to support the scheme even though it is almost impossible for them to provide good quality healthcare at the government mandated price-points. Ayushman Bharat, which is designed to provide access to healthcare to the poorest of our poor needs proper funding and government support. I trust, this will be right on the top of your agenda, while looking at competing demands for funds from other government welfare schemes.

The private sector provides the bulk of healthcare to the citizens of our country. In the last couple of years the private healthcare players have had a tough time with respect to the regulatory environment mandating price capping for medical devices like stents, joints and life-saving cancer drugs. While, this has helped the common man in making healthcare more affordable, the hospitals have seen their slim margins shrink further. It would greatly help if the government was to include healthcare sector in the ambit of infrastructure sector. This will allow private sector hospitals to raise funds at low costs, which will go a long way in shoring up their sagging profits, which in turn will kick-off fresh investments in new capacity, technology and new jobs.

To attract private sector healthcare investments in smaller cities and towns in India, you must consider offering incentives and subsidies to private healthcare players. They will be able to partner with the government in setting up ”low cost” hospitals, readily accessible to most of our citizens at attractive price points. This will lead to investments and job creation, locally something that the government will be delighted with.

Healthcare insurance penetration in India is abysmally low. Most people are either uninsured or under-insured. This makes quality healthcare completely inaccessible to a very large number of our citizens. It would be very useful if the government was to consider making healthcare insurance mandatory for all private sector employees with the responsibility of providing a suitable cover with the employer. This should be mandated for all Small and Medium sector organisations as well thus dramatically increasing the number of people covered under healthcare insurance. While, we are at this, may I also point out that the Central Government Health Scheme (CGHS), which covers millions of serving and retired government employees is in dire financial straits and owes millions of dollars to private healthcare providers, who are now increasingly constrained to refuse services to CGHS beneficiaries by opting out from the CGHS panel. You must consider funding CGHS and other similar government schemes adequately so that their beneficiaries continue to receive adequate healthcare.

The export of healthcare services from India popularly called Medical Value Travel (MVT) has the potential to earn billions of dollars of foreign exchange for the country. Indian healthcare service providers have tremendous advantages. They deliver quality healthcare at very low costs. We have the potential of attracting people from all across the world to India for medical care. Last year, at Max Healthcare, where I work, saw patients from over 110 countries. The opportunity is immense. However, we do need some help from the government in marketing India as world-class destination for inexpensive healthcare. The previous government had set up a board to promote wellness and medical value travel to India. For the last few years, it is lying defunct. It would be very useful to revive this board with adequate funding, infrastructure and a clarity of vision to help promote India and its healthcare prowess across the globe. Tax breaks and incentives to private healthcare players investing in MVT will also go a long way in attracting foreign patients.

Finally, I must draw your attention to technology, which is changing the landscape of healthcare delivery across geographies. India has an excellent penetration of mobile telephony and we can deliver and address a lot of healthcare concerns of our citizens using technology. A mobile phone can be used to capture healthcare data remotely, images can be sent and analysed, AI applications can be used to report and diagnose smartly. The world is increasingly moving in this direction. My request to you would be to set aside a small sum of money and create a mechanism, which encourages entrepreneurs to invest in these technologies helping deliver healthcare to our people living in far-flung areas of the country with limited access to healthcare.

Madam, the health of its citizens has to be a major priority for any forward looking government. I am sure, you will be addressing some of these concerns in you budget proposals. We are eagerly waiting to hear from you.

The views expressed are personal

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