Health and the Union Budget 2016 – IMA’s suggestions
New Delhi, February 28, 2016: “Ensuring its citizens health and well-being is of uttermost importance for a government and we at the Indian Medical Association strongly believe that the time has come to increase the public expenditure on health from the current level of 1.2% GDP to at least 5%. The government must also ensure that a minimum of 55% of health budget is spent on primary, 35 percent on secondary and a maximum of 10 percent on tertiary care services as against the current levels of 49%, 22% and 28% respectively. Separate funds should be allocated for national disease control programs. Presently these programs cover only 15% of disease burden. Lifestyle diseases, re-emerging communicable diseases, health problems of the elderly, mental health, rare diseases, orphan drugs, etc. should receive adequate funds”, said Dr S S Agarwal, National President IMA & Padma Shri Awardee Dr K K Aggarwal, President HCFI and Honorary Secretary General IMA.
Other suggestions shared by IMA include
Government should introduce a health cess (0.5%) as a component of the existing VAT system and the new Goods and the Services Tax (GST) that is proposed.
There should be additional health cess for sweetened beverages/products, tobacco, alcohol and cars.
Water, hygiene and sanitation are the corner stones for effective public health protection. Government should not only increase allocation to these areas, but also ensure that the money is spend properly and time-bound
The present schemes such as JSBY, RSBY, JSY etc. should be converged so that we can evolve a comprehensive social security package
Public and private sectors should not move as parallel systems, but should complement each other. Public private partnership in health should be promoted.
The primary health centres where there is non-availability of doctors should be declared as difficult rural areas and special package of salary, incentive for higher education and allowances for house, vehicle, children’s education should be provided
The population served by each PHC should be restricted to 30,000 and each PHC should have at least 3 Medical officers with MBBS qualification
Central Government Fund should be allotted for periodic recruitment of health workers including doctors at PHC and CHC level
Services of family doctor/single man private clinics should be optimally used on a retainer ship basis, at least in places where government doctors are not available at PHCs, until government is able to recruit and sustain regular doctors.
Government should increase the allocation for health awareness programs. A repository on health information should be created and disseminated using the social media.
Non-communicable diseases and health needs of the elderly need urgent attention. Government should increase the allocation to these areas significantly. National programs for NCD and care of elderly should be introduced in all the districts within the next two years.
Telemedicine should be given importance, with simultaneous investment in increasing the availability of trained and qualified human resources
District hospitals should be converted to medical colleges on a need-basis in states with less number of medical colleges. This will avoid huge investment required to start stand-alone medical colleges.
Keep aside, at least 2% of the health budget for health research. Build systems like online, time-bound clearance mechanisms for all health research proposals
Use of Electronic Health Records (EHR) and enrolment of the entire population at the sub-center level should give a comprehensive picture of burden of disease, which should help to plan and allocate resources as per epidemiological need. Invest in a standard uniform EHR system for both public and private sector.
Invest and promote health equipment manufacturing industry within the country. Health technology should be made a separate department under the Ministry of science and technology
Medical grants commission should be instituted with adequate funding for research and collaboration between institutions and development and maintenance of uniform standards of medical education
Lifesaving equipment should be exempted from all taxes
Aided hospitals concept should be developed to support medium and small health institutions, which cater to 40% of health care needs of our population.
The tax on health care like luxury tax for rooms and ICUs, VAT on drugs, service tax on procedures, import taxes on medical equipment’s should be withdrawn
Electricity and water charges should be subsidized
Various acts and regulations governing hospitals should be brought under single window and single registration should be made the norm. As on today, more than 72 such clearances are required
Tax exemptions for medical start-ups.