Draft policy throws up some fresh solutions
The National Health Policy 2015 Draft, now in the public domain for consideration, reaffirms the Union Government's commitment to find funds for the health sector, even as the Modi administration grapples with a high fiscal deficit arising, among other things, out of high public spending and low revenue collection. The policy proposes to raise a health tax to pay for the Government's ambitious health programmes and also suggests effective mobilisation of funds raised through special commodity taxes, such as taxes on tobacco and alcohol, and special taxes on “extractive industries and development projects”, which adversely impact public health and even natural habitats.
Although there is no clarity on how these plans will materialise, the moot point is that the Government seems sold to the cause and is taking concrete steps on the ground. last year, Prime Minister Narendra Modi had promised in his election manifesto that he would provide universal healthcare, and towards that end, had also announced the National Health Assurance Mission. later, the Union Ministry of Health and Family Welfare had proposed a free healthcare package that includes some basic medicines, diagnostic services and consultations at Government hospitals and clinics across the country.
But, while all these plans sound good on paper, the fact of the matter remains that, howsoever sincere the Government is about sharing the country's hospital and medicine bills, it simply does not have the kind of money needed to achieve the purpose. Already, it is spending more than it earns and is under pressure to bridge the fiscal deficit. This is why, late last year, the Government had to cut back its health allocation by 20 per cent — about Rs6,000 crore was shaved off the Rs35,163 crore total allocation for the financial year 2014-2015. Expectedly, the international media and some sections of the national media played up the story as yet another example of the Modi Government going back on its commitments, turning its back on the poor and not paying attention to the social sector.
Few cared to point out that the cut was, in fact, a routine accounting process, and that past Governments had done the same. For example, the Congress-led UPA Government's initial health outlay for the financial year 2013-2014 was Rs33,278 crore. However, its final allocation was shrunk by Rs5,747 crore to only Rs27,531 crore. The previous year too, there was a difference of about Rs5,500 crore between the amount that had been promised in the annual Budget and what was finally released. But negative news reports notwithstanding, there is no denying that the Government, irrespective of which party is at the helm, faces a severe cash crunch and often has to take difficult decisions — which may include trimming an already small health budget. It is against this backdrop that the Modi Government's efforts to find new financial solutions must be viewed.