The new Health Budget… Healthy in long run
Dr K K Aggarwal
The pro-manufacturing and pro-infrastructure budget focuses on a long-term road map for the economy and health and lays down short-term strategies to achieve them. The budget will ultimately benefit the common folk and generate jobs for the strong and young. Rising transparency levels in governance would ultimately generate more revenues and improve targeted spending. Make in India, Digital India, Housing for all, 24x7 power and water will help health care spending in long run.
Only 33,152 crores have been earmarked for health sector, but there are other avenues. This amount must not lapse and reach every house hold.
Jan Dhan, Aadhar and Mobile will allow transfer of benefits in a leakage-proof, well-targeted and cashless manner. Incentives for card transactions with the aim of making India a cashless society will make healthcare system more transparent.
Jan Dhan Yojana, with over 12.5 crore families brought into the financial mainstream will raise education standards and reach of health care.
Swachh Bharat campaign with its target of 6 crore toilets will promote hygiene and cleanliness; it is a program for preventive health care and reduce communicable diseases; 100% tax deduction for contributions under this, other than by CSR contributions, will make available more money. Swachh Bharat Cess of 2% on all or certain services will finance and promote initiatives towards this campaign.
By 2022, as a part of Amrut Mahotsav (75th year of independence), India will have 6 crore new houses each with 24x7 power supply, clean drinking water, a toilet, road connection and at least one earning member; electrification of remaining 20,000 villages; 1,78,000 connected habitations by all-weather roads; provision for medical services in each village and city; avenues for education and skill development of youth; a senior secondary school within 5 km reach of each child. Increase in overall agricultural productivity and connectivity to all villages will help general economy leading to a healthy society. India will become the manufacturing hub of the world through Skill India and Make in India programs.
Any spending in the rural area will include health spending. Rs 25,000 crore to the corpus of Rural Infrastructure Development Fund set up in NABARD; 15,000 crore for Long Term Rural Credit Fund; 1500 crore in Deen Dayal Upadhyay Gramin Kaushal Yojana, 45,000 crore for Short Term Cooperative Rural Credit Refinance Fund and 15,000 crore for Short Term RRB Refinance Fund will promote rural health; 34,699 crore for MGNREGA will provide employment to the poor. A universal social security system for all, especially the poor and underprivileged, will also help create health security.
For the welfare of SCs, STs and women, 30851, 19,980 and 79258 crores respectively have been earmarked; 3738 crore has been allocated for welfare of minorities.
Pradhan Mantri Suraksha Bima Yojana will cover accidental death risk of 2 lakh for a premium of just 12 per year; Atal Pension Yojana will provide a defined pension with government contributing 50% of beneficiaries’ premium limited to 1,000 each year, for 5 years. Pradhan Mantri Jeevan Jyoti Bima Yojana will cover both natural and accidental death risk of 2 lakhs at a premium of 330 per year for the age group 18-50.
Unclaimed deposits of 3,000 crore in PPF and 6,000 crore in EPF corpus will be converted into Senior Citizen Welfare Fund. A new scheme for the elderly with age-related disabilities will provide Physical Aids and Assisted Living Devices for those living below the poverty line. Life insurance service provided through Varishtha Pension Bima Yojana is exempt from service tax.
In nutrition, 68968 crore for education and mid day meal will cover deficiencies in children. 5,300 crore towards microirrigation, watershed development and Pradhan Mantri Krishi Sinchai Yojana will increase production of health-friendly food. Exemption of service tax in cold storage services and in transportation of food stuff by rail/road will make available healthy food at a cheaper cost.
Rs 10,351 crore has been allocated for women and children with another 1,000 crore towards the Nirbhaya Fund for women safety; 1500 crore has been earmarked for Integrated Child Development Scheme and 500 crore for Child Protection Scheme.
A defence budget of 2,46,727 crore will cover health of all Army personnel and related units.
MUDRA (Micro Units Development Refinance Agency) bank with a corpus of 20,000 crore, and credit guarantee corpus of 3,000 crore can fund small health business houses.
Family gold, under Gold Monetisation Scheme can earn interest. With transparent coal auction, coal bearing States will get additional several lakhs of crore of rupees towards betterment of society.
Infrastructure development will help build safe roads and railways; 22,407 crore for housing, 4,173 crore for water resources, 14031 crore for road development, 10050 for railways and + 70,000 crore towards infrastructure development with provision for tax-free infrastructure bonds will reduce disease burden. Plug-and-play projects in infrastructure projects will aid road safety.
National Investment and Infrastructure Fund will have additional 20,0000 crores. Excise duty on petrol and diesel at 4 per liter into Road Cess will additionally fund 40000 crore investment in roads and other infrastructure.
Five Ultra Mega projects of 4000 MW each to make electricity available across the country will indirectly also help the medical profession.
In insurance, the employee will have the option of choosing either ESI or a Health Insurance product; the employee may opt for EPF or the New Pension Scheme. Increase in the limit of deduction in respect of health insurance premium from 15,000 to 25,000 (for senior citizens 30,000 from existing 20,000; for 80 plus people who are not covered by health insurance, deduction of 30,000 towards expenditure incurred on their treatment; deduction limit of 60,000 towards expenditure on account of specified diseases of serious nature enhanced to 80,000 in 80 plus; additional deduction of 25,000 allowed for differently abled persons under Section 80DD and Section 80U of the Income-tax Act.
Rs 150 crore under Atal Innovation Mission, will promote scientific research in India.
India will have six new AIIMS, three National Institutes of Pharmaceutical Education and Research, two Institutes of Science and Education Research and one University of Disability Studies and Rehabilitation. All ambulance services will be exempt from service tax. Donation made to National Fund for Control of Drug Abuse will be 100% exempt from deduction under 80G. Artificial hearts (left ventricular assist device) and flexible medical video endoscopes will become cheaper with reduction in custom duty.
Visa on arrival for 150 countries will promote Medical tourism.
Rs 750 core allocated towards Faster Adoption and manufacturing of Electric Vehicles will reduce pollution. Renewable energy capacity to 1,75,000 MW will reduce pollution. Clean Energy Cess from 100-200 per metric tons of coal will help clean environment initiatives.
Self-Employment and Talent Utilization with 1000 crore, will promote IT. National Optical Fiber Network Programme of 7.5 lakh km, will help digitize 2.5 lakh villages. Fully IT based Student Financial Aid Authority through Pradhan Mantri Vidya Lakshmi Karyakram will ensure that no student misses out on higher health education for lack of funds.
Reduction in Corporate Tax from 30% to 25% over 4 years may make corporate health services cheaper. Making quoting of PAN mandatory for any billing of over 1 lakh will maintain transparency. Wealth tax has been replaced with an additional surcharge of 2% on the super-rich with a taxable income of over 1 crore. Service tax now will be consolidated rate of 14%. The tax does not involve medical services.
Income Tax Savings will be for every doctor with proper planning. [Deduction u/s 80C `1,50,000/ Deduction u/s 80CCD `50,000/ Deduction on account of interest / On house property loan (Self occupied property) `2,00,000/ Deduction u/s 80D on health insurance premium `25,000/ Exemption of transport allowance `19,200 = Total `4,44,200]. Transport allowance exemption from 800 to 1600 per month will help the middle class to earn money.
National Skills Mission, a skill-building initiative with 31 Sector Skill Councils will help develop skills including health skill manpower.
Income tax rate on royalty and fees for technical services has been reduced from 25% to 10%; increase in excise duty on cigarettes, cigars, cheroots and cigarillos by 15-25% will reduce some smoking related illnesses.
More investments will create Jobs with rationalized conditions for FDI in medical devices sectors.
Inclusion of Yoga within the ambit of charitable purpose under Section 2(15) of the IT will see more Yoga Centers.
The Govt. is envisaging a national database of NGOs, which will promote transparency.
[Dr K K Aggarwal is Padma Shri, National Science Communication and Dr B C Roy National Awardee. He is Honorary Secretary General IMA and President Heart Care Foundation of India]