Health in Interim Budget

The Interim Union Budget 2019–20 reflects a definite push for an insurance-based model of healthcare, which comes at huge and disastrous costs of the public provisioning of health. In a country like India, where a large section of the population is poor, vulnerable and dependent on the public provisioning of healthcare, the consequences of the current budget are catastrophic. They also demonstrate the continuing lack of serious commitment of this government to health for all. The scrutiny of the allocation of priorities in the interim budget clearly indicates what the government seeks to achieve.

Under this government, the National Health Mission (NHM) has been continuously neglected in every budget and its share in the total allocation on health has gone down from 61% in 2014–15 to less than half (49%) in the 2019–20 interim budget. The allocation under the NHM has increased only marginally by about 2% over 2018–19 revised estimate (RE) if one excludes the health and wellness centres (HWCs) component. The HWCs, another key component under the Ayushman Bharat Yojana or Pradhan Mantri Jan Arogya Yojana (PMJAY), meant to expand primary care for non-communicable diseases, have received an allocation of ₹ 1,600 crore. This is a mere fraction of what is needed to achieve the goal announced by the government last year: to convert 1.5 lakh sub-centres into HWCs. Further, including HWCs as a new scheme under the NHM without making additional budgetary provisions for it would mean that this money allocated to HWCs would come at the cost of existing interventions under the NHM.