Can an Increase to 10% of the GDP on Public Health, Solve Healthcare Crisis?
Public Health The Union of India, with a GDP of $2.651 trillion, has very recently surpassed the United Kingdom to become the fourth-largest economy in the world and is only expected to go up the ranks in the coming years. Now, while this number sounds good, several factors determine the overall development of a nation other than its GDP, one of the most important being healthcare. Ironically, healthcare has been one of those sectors in India, the budgetary allocation for which has been amongst the lowest at 1.3% of the GDP as per the 2021 union budget passed in February. This figure was attained after an increase in the healthcare budget by an enormous 137% from 2020. The amount allocation of 2.23 lakh crore, percentage-wise is much lower than OECD countries which average at 7.6% of GDP, and other BRICS countries which also spend about 3.6% of their GDP on healthcare. The result of this; the Covid-19 pandemic struck the already crumbling public healthcare infrastructure of the country and had the Healthline staff overworking enormous hours in order to isolate and treat an upsurge averaging 75,000 new cases on a daily basis for months. Things would have been different with higher expenditure on healthcare every year, but is that all that India needs to solve the healthcare crisis that has been impending for more years than the country’s independence itself?
India’s healthcare crisis can be broken down into a few major concerns, them being the deteriorating state of primary healthcare, the affordability, and the dependency upon private healthcare infrastructure.
Rural India accounts for 65% of the country, with only 35% of the places being urbanized till 2020, and yet, healthcare is still inaccessible in this region. According to a report by DTE, “Sixty percent of primary health centers (PHCs) in India have only one doctor while about five percent have none, according to the Economic Survey 2018-19, tabled in the Parliament on July 4, 2019.” One of the major reasons for this condition is inadequate compensation and improper infrastructure. While one can argue that these are because of the lack of spending by the government on primary healthcare, government reports show a different picture altogether. The Union Government argues that it has started various schemes on the garb of providing free health insurance to its citizens such as the Ayushman Bharat Scheme, it being the most recent one, but recent events also put forward major financial frauds being carried out in the name of this scheme, as reported by Indian Express. The World Bank estimates that 90% of all health needs can be met at the primary healthcare level. Yet, India has arguably under-invested in this area that should matter the most.
While the public health sector in the country has been fragile, the other major concern has been the country’s dependability and the people’s affordability of private hospitals. 90% of the doctors in the country work in private hospitals. While the number of private hospitals in the country may be adequate in most urban areas, the exorbitant amount of money charged by these hospitals remains a major concern. A recent report by the WHO, as reported by Ward Health highlighted the fact that nearly 70 percent of India’s population spends most of their available income on healthcare. Each year nearly 40 million Indians are thrown into poverty because of out-of-pocket health spending. The two major reasons for these exorbitant costs in private hospitals are quite simple, the first being the monopoly it plays in the healthcare infrastructure in the country, and secondly, the ambiguity in the regulations for these hospitals.
An increase to 10% of the GDP from 1% would mean an increase to the amount of Rs 22,300,000,000,000, an amount which just at the looks of it looks very impressive. Theoretically, it would put India at par with major European countries with their health expenditure, and the amount would be ample to contribute to boosting public health infrastructure majorly, the primary healthcare infrastructure would get a much-needed boost, with enough funds to provide adequate compensation and facilities to qualified doctors and medical staff to work in these areas. The increase in budget would also bring about more competitiveness against the private sector, thus bringing down healthcare costs, making it more affordable for the lower middle class and the other economic sections of the population. The increase in funds could also be used to increase the number of Medical Schools in the country, which is again much needed as India faces a shortage of about 600,000 doctors and more than 2.5 million nurses. Better insurances at much lower prices could be provided and medical research could be strengthened within the country. But, while there may be a lot of initiatives that could be taken just with a dramatic increase in the budget, one should also note that increased budgets don’t always mean an increase in expenditure. A perfect example of this would be the constant underspending of the Education budget over quite a few years. Therefore, the question here arises, is merely increasing the healthcare budget to 10% of the GDP from its current level enough to solve India’s healthcare crisis? Public Health
