Avoid dichotomy

Healthcare, which most budgets generally treat lightly, has received a fair share of prominence in this budget. Treatment and maintenance costs for chronic ailments, which keep rising each year, are not easily affordable to an average Indian citizen. Healthcare costs keep rising for all, and, as of now, (only) the affordable gets it. Every segment of society should ideally get covered. Extending the tax sops u/s 10 (23G) of IT Act to private hospitals with 100 beds or more will no doubt make it easier for healthcare players to access funds from financial institutions. How much of this will go into promoting India as a global health destination rather than enhancing national health or make it easier for most citizens to access health facilities remains to be seen. In that connection, encourging the public sector insurance companies to design community-based universal health insurance plans at a Rupee a day for the marginalised citizens is a good augury. It will still be the government hospitals that will be patronised and private hospitals will not be easy to access. The finance minister’s hunch (or hint?) that state hospitals may now start charging for services rather than give free treatments is another thing that needs to be seen. If it happens, it is true that some revenues generated by state governments as receipts from Insurance companies will definitely help states in providing better healthcare within the existing system.

On the one hand, the FM has addressed the health insurance needs of the poor and at the same time given out doles to the rich (private players). On paper, the ministry cannot be faulted for being partisan. One needs to remember that the poor are alone and not strong, and they will need all help and guidance. With the voluntary nature of the scheme, one can only wonder how this can happen and benefit this segment of people. Question is, will it be workable? There are a lot of details and (operational) nitty gritties that are not clear and have to be looked into. If the government is serious, it would do better to convert the voluntary nature of the scheme to a mandatory one where all employers from organized to unorganized sectors are obliged to contribute, however small, in addition to the employee’s contribution. Extend it to farm and agriculture sector and you cover majority of the nation’s work population. With the government’s slant towards privatisation of healthcare, let there be no dichotomy. Let there be different hospitals, all affordable through health insurance, for different sections of the people. The urban areas are no problem for the operational part, but allow local NGOs to monitor and run the process and keep out bureaucratic and political interference in non-urban areas. All this because the marginalised worker is alone, uneducated and is probably unaware of the benefits of group/community insurance. Make it implementable. The volumes will make insurance companies pro-active players. Otherwise, tax sops for private players will be like a dollop of icing in addition to other concessions, excise and customs duty reductions and depreciation benefits etc, widening the chasm in society. A social divide in a developing economy is inevitable, but it should be seen to be kept at a minimum.

nvramamurthy@expressindia.indexp.co.in