Hike in public health spending key

NEW DELHI: India needs to raise public health expenditure to 2.5-3% of gross domestic product (GDP) as it continues to underperform in comparison to other low and lower middle income (LMIC) countries despite improvements in health care access and quality, the Economic Survey said, citing the Covid-19 pandemic, which has highlighted the importance of the health care sector and its linkages with other sectors.

India currently spends around 1% of its GDP on health. One of the expectations of Union Budget 2021-22 is that it will increase allocations to public health.

“Despite improvements in health care access and quality (health care access and quality scored at 41.2 in 2016, up from 24.7 in 1990), India continues to underperform in comparison to other Low and Lower Middle Income (LMIC) countries. On quality and access of healthcare, India was ranked 145th out of 180 countries (Global Burden of Disease Study 2016). Only few sub-saharan countries, some pacific islands, Nepal and Pakistan were ranked below India,” the survey said.

It added that hospitalisation rates in India are among the lowest in the world , reflecting lower access to and utilisation of health care — one of the reasons behind the high cost of quality health care in the country.

In 2018, the government approved the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PM-JAY) as a step to provide healthcare access to the most vulnerable sections in the country. With the implementation of the scheme, critical, lifesaving procedures like dialysis seem to have not been severely affected during the Covid-19 pandemic. So far, 32 states and UTS have implemented the scheme.

India has one of the highest levels of out-of-pocket (OOP) health expenditure in the world because of low public expenditure on health care. “Hence, there is need for higher public spending on health care to reduce OOP... an increase in public spending to 2.5-3% can substantially reduce OOP from the current level of 60% to 30%,” the survey said.

“Higher investment in health, at both central and state levels, is absolutely essential now to counter public health emergencies but to provide all needed health services efficiently and equitable manner... If we are serious in our commitment to universal health coverage, we must raise the public financing of health to at least 2.5% of GDP in the next 2-3 years...,” said Dr K Srinath Reddy, founder, Public Health Foundation of India.

The survey, however, said India’s policy response to Covid-19 was successful. The stringent lockdown enforced in late March to contain the spread of the Covid-19 pandemic transformed the short-term trade-off between lives and livelihoods into a win-win in the medium to long-term that saved both lives and livelihoods, the survey said.

“The stringent lockdown in India from 25th March to 31st May was necessitated by the need to break the chain of the spread of the pandemic. This was based on the humane principle that while GDP growth will come back, human lives cannot be brought back,” it said.

The lockdown period was used to scale up the necessary medical and paramedical infrastructure for active surveillance, expanded testing, contact tracing, isolation and management of cases, it said.

“The lockdown provided the necessary time to put in place the fundamentals of the ‘5T’ strategy — Test, Track, Trace, Treat, Technology. As the first step towards timely identification, prompt isolation & effective treatment, higher testing was recognized as the effective strategy to limit the spread of infection,” the survey added.

Speaking about the India’s policy response to the pandemic, chief economic advisor (CEA) Krishnamurthy V Subramanian said the strategy helped the country in preventing 3.7 million cases and 100,000 deaths. Thus India could successfully flatten the curve.

In a press briefing, Subramanian said, “The cover captures the V-shaped recovery that has happened in economy. In fact, it mirrors V-shape performance that Indian cricket team delivered in Australia well after being short out for 36 in an hour, they went on to win the series. The resilience of the Indian economy is mirroring the resilience of Indian cricket team as well.”

The Indian economy was hit hard by the Covid-19 pandemic and the 68-day-long hard nationwide lockdown imposed on March 25 to check its spread.

On quality, access of health care, India was ranked 145th out of 180. Some pacific islands, Nepal and Pakistan ranked below India ECONOMIC SURVEY