sarwesh

In Union Budget 2008-2009, the health sector received significant attention, and was mentioned as one of the pillars of social reform. This article evaluates the effectiveness of the government's health improvement initiatives in Union budget 2008-2009.

Increased Healthcare Budget Outlay by the Government

Overall, the healthcare budget increased by 15.0 percent - from Rs. 15,291 crores in 2007-2008 to Rs. 16,534 crores in 2008-2009. However, the government failed to keep its promise of increasing the health sector outlay from 1.0 percent to 2.0 to 3.0 percent of the Gross Domestic Product (GDP). The health expenditure has remained static - at around 0.99 percent of the GDP since 2005-2006. Additionally, of the total health expenditure, that is 0.99 percent of the GDP, the Central Government's contribution is only 0.34 percent, while the rest is borne by the state. To meet the rising healthcare needs and its promise, the Central Government's contribution should have risen to 1.0 percent of the GDP in 2008.

Flagship Program to Uplift Rural Healthcare

The National Rural Health Mission (NRHM), which aims to improve the healthcare of the rural population, was allocated Rs.12, 050 crores, an increase of 15.0 percent over the last year. The goal of the mission is to establish a fully functional, community-owned, decentralized health delivery system. However, this scheme covers only selected geographical areas, but it is likely to be extended to other areas in the upcoming budget plans.

Most of the additional funds promised in the current budget would go to the NRHM mission. Hence, the healthcare budget is rural biased. However, since there is an urgent need to reduce the disparity between the rural and the urban healthcare systems, this move of the Finance Minister is debatably justified.

Disease Control Programs to Continue to Focus in the Right Direction

The budget allocated Rs. 993 crores for the National Acquired Immune Deficiency Syndrome (AIDS) Control Organization (NACO) - for the National Aids Control Program. Efforts to control AIDS have been effective, and the prevalence rate of Human Immunodeficiency Virus (HIV)/AIDS has come down to 0.9 percent from 0.36 percent. This achievement is encouraging and has attracted further funds in the budget. Additionally, polio eradication continues to get focus in the healthcare budget, with allocation of Rs. 1,042 crores in 2008-2009, with a revised strategy. The focus of the program would be on the high-risk districts of Uttar Pradesh and Bihar. In 2007, India recorded 864 polio cases as against the 676 cases of 2006. In 2008, the country has already recorded 82 cases, more than the number of cases reported in the entire 2005. Despite the increase in the incidence of polio, the budget outlay for the same reduced by Rs. 247 crores in 2008-2009, over the previous fiscal year, highlighting the insufficiency of funds with the government. However, what is satisfying is that even the limited funds are being directed to the right areas.

Union Health Budget - a Pro-Poor Budget

The proposed Rashtriya Swasthya Bima Yojana is to be launched in 2008-2009, and will provide a health coverage of Rs. 30,000 to every worker and his/her family in the unorganized sector, falling under the below poverty line (BPL) category. Most of the states have agreed to join the Yojana, particularly Delhi, Haryana, and Rajasthan. The government provided Rs. 205 crores as the Center's share of the premium in 2008-2009. Additionally, the budget provided Rs. 10 billion for the Aam Admi Bima Yojana that provides insurance coverage to poor households. This is expected to cover 10 million poor households by September 3, 2008. However, the effective implementation of these schemes is doubtful, as they cover uneducated people. Hence, the government needs to adopt a more effective strategy to impart this information to the target people.

Vision for the Future - National Program for the Elderly

Another major budget intervention was the National Program for the Elderly, for which the government outlaid a plan to provide Rs. 400 crores in 2008-2009. In the Eleventh Five-Year Plan, two National Institutes of Aging, eight regional centers, and a Department for Geriatric Medical Care in one medical college/tertiary-level hospital in each state will be established. India is currently in need of such schemes because of its fast aging population. This initiative would improve the healthcare system for the elder population, and help ease the challenge.

Remedial Measures for the Pharmaceutical Industry

The Union Budget introduced certain initiatives that are expected to have a positive impact on the pharmaceuticals industry, such as the reduction of excise duty from 16.0 to 8.0 percent for all pharmaceutical companies, reduction of customs duty on certain life-saving drugs and bulk drugs used to manufacture them from 10 percent to 5 percent, and excise duty exemption on all anti-AIDS drug. The budget also announced a weighted deduction of 125 percent on payments made for outsourcing research services. These initiatives will give a boost to the industry and encourage pharmaceutical R&D in India.

Conclusion - Health Sector in Need of Greater Attention

The healthcare sector received a positive response in Union Budget 2008-2009. The government's effort to enhance health coverage among the poor and the elderly, and increase their drug accessibility by making drugs cheaper, is praiseworthy. However, the allocated funds and the newly initiated schemes do not balance the rising healthcare needs in India. Additionally, given the fact that the country's position on health parameters is unsatisfactory when compared to some of its neighbors, the budgetary outlay for the healthcare sector still seems insufficient. There is no doubt that India has improved over the years - with respect to health conditions - however, the country is still in need of more funds and health improvement programs.

praveen

This reforms will not see immediate result .. it will take a lot of time .
but this is the right move..