Indian Medical Association strongly feels that the policy directions and budgetary provisions including promoting private health insurance are strongly biased in favour of the rich; and the poor still is left with not much choice for health care. Making primary health care completely free is the only way to improve the health situation in the country, said National President of IMA Prof Dr A Marthanda Pillai and General Secretary Dr.K.K.Aggarwal.
Indian Medical Association complimented the Central Government for the proposal for giving University status for National Institute of Speech and Hearing and initiating 6 AIIMS like institutions. IMA noted that there is better allocation for indirect health related issues particularly like sanitation, water supply, education, housing and setting up of six crores of sanitary toilets, mid-day meal scheme etc. IMA views with satisfaction the increased allocation for women and child welfare. Increase in taxation on cigarettes as well as a gutka and other tobacco products is a welcome move
At the same time, IMA is dissatisfied that there has been a dip of 5.7% in budgetary allocation for health, said Dr Pillai at Thiruvananthapuram. The draft health policy itself has suggested increasing health spending to 2.5% of GDP, while IMA has demanded a 5% allocation- he reminded.
It is believed that an important factor contributing to India’s poor health status is it’s low level of public spending on health. According to WHO statistics, India rank 166th among 191 countries as far as public health spending is concerned. Public spending as percentage of GDP in India has stagnated in the past two decades varying from 0.9% to 1.2% of GDP.
A robust and efficient public health delivery system should be in place to reduce the out of pocket expenditure on health, which is about 70%. The prohibitive cost of health care is pushing 4% of our population below the poverty line every year. The policy of too much dependency on health insurance emulating the American model can be catastrophic, making health care less and less affordable and accessible. Increasing allocation of more funds by government is the only way to make public health delivery more efficient, affordable and accessible.
Dr A Marthanda Pillai pointed out that the existing national disease control programs cover only 15% diseases. IMA demands that life style diseases, mental health, health problems of the elderly, cancer and trauma related health issues should all be included under the central government funded programs and expanded across the country
Small and medium private hospitals do play a significant role in making health accessible and affordable even in remote rural areas. To sustain these institutions, a concept of ‘aided hospitals’ just like aided schools should be envisaged and funds should be earmarked for this.
Family doctor system and three-tier health delivery system has to be reinforced and sustained. Services of Doctors working in rural areas in the private sector should be utilized to man the primary health centres where chronically there is absence of Doctors on a retainership basis. Funds should be earmarked for this.
75% of health expense is on account of drugs. There is no provision in the budget to make drugs cheaper. Quality drugs should be distributed through a public distribution system and 0.5% of GDP should be set apart for this. No fund has been set part for ensuring quality of drugs. Number of quality control institutions should be increased.
IMA welcomes the concept of Make in India, but this should be extended to the health sector by setting apart 20% of budgetary provision for production of biomedical equipment and devices and set-up medical research parks across the country in the line with the technoparks.
Dr A Marthanda Pillai Dr KK Aggarwal
National President Honorary Secretary General