Union Budget 2022- Pre-Budget: Healthcare Expectation

Dr.Minnie Bodhan Wala

CEO, Wadia Group Hospitals, Mumbai

 

Quote for budget 2022

 

The healthcare Budget last year did get a boost of 137% as compared to previous year on impact of COVID 19, however the total healthcare spending of India is still one of the lowest in the world and lagging behind the GDP growth spending as compared to the budgets of other nations like USA, Canada, New Zealand, Australia etc. who spend more then 17%. The basic expectation from this budget will be to see an increased spending on the healthcare sector, in order to make available the basic healthcare infrastructure and affordable healthcare for all. There is a huge unmet need for healthcare infrastructure and professionals in the nation that needs to be addressed by providing right quality healthcare with trained professionals to improve the Healthcare indicators. The trends in diseases are changing as well, more and more deaths in India are happening because of non-communicable or lifestyle associated diseases, provisions and policies to spread awareness on the importance of prevention and how to mitigate these diseases should be considered.

 

Where most of the renowned Doctors in various other countries are of Indian Origin, India is not considered to be a leading hub for Healthcare, efforts need to be focused in making India a Hub of excellence for Healthcare services by increasing spending on technology and Infrastructure. Increase in tax incentives for research in Healthcare could help achieve the same and further support the made in India Initiative of Government of India as well.

 

Initiatives to encourage improvement of healthcare availability in under-served areas would also help bridge the rural-urban disparity. The government can look into providing more incentives to individuals and organizations that strive hard to improve rural health.

 

Tax incentives should be given for setting up new hospitals. Incentives for domestic manufacturing of medical devices and consumables should also be considered in the budget this year. The progress on improving the condition of women and children is really slow, the under 5 mortality and maternal mortality rates are still on higher side, increased spending’s on nutrition, drinking water coverage, sanitation, female secondary school enrolment should be undertaken.

 

Incentives for emerging sectors like Health insurance and Medical tourism can benefit the industry.

 

As it is rightly said investing in healthcare is investing in the growth of the nation, given the current situation and the lack of healthcare facility for the masses, the Government clearly needs to invest more for Public Health infrastructure and research. There is a need to revisit our public health policy and come up with better solutions to ensure that there is efficient utilization of financial resources as well. There is still a huge gap between the private and public sector healthcare facilities, which needs to be addressed. Poverty alleviation schemes in the metros and cities are also much needed as the cluster of slums becomes a huge hurdle in public health of the nation. Our human resources both medical and paramedical for public health are inadequate as well, there is a strong need to invest more in the training centers and better incentives for the public healthcare workforce.

 

In the current situation of Covid 19 we have learned a lot about the strengths and weakness of our system in addressing public health concerns, these learning’s should be utilized to amend our public health policies and plan the budgets accordingly. One such weakness, which has come forward in the current situation, is our surveillance capacity for natural disasters. The Government definitely needs to increase the investment in surveillance capacity for communicable diseases and other natural disasters as well, to lower the burden on healthcare services during such situations. This is not the first and the last pandemic our country has seen, we need more focus and vigor in the healthcare sector collectively across all the sectors with special attention for the women and children, the elderly and disabled.

 

On the technology front, the need of the hour is to manufacture all healthcare needs, especially biomedical equipment in India. The Made in India campaign needs to be further strengthened for healthcare. This will help in making healthcare affordable for all, and increase job opportunities in India.

 

High taxes that are paid on consumables, equipment, etc., could be reduced to make healthcare more affordable for the masses. Additional subsidies to healthcare providers for utilities like power, etc., will also help to make care more affordable for the masses.

 

Increasing the expenditure on healthcare, and its utilization by implementing schemes efficiently, will help in increasing the health of population at large and reviving and strengthening our economy even further. On policy interventions in the healthcare sector the state policies need to align with the healthcare objectives at large at the national level

 

 Inputs by Dr. Azad Moopen, Founder Chairman and Managing Director, Aster DM Healthcare ~

The budget should incentivise the private sector to improve medical facilities in Tier 2 & 3 cities and rural areas to bridge the healthcare urban-rural divide.

While the last Union Budget saw 137% increase in healthcare spending which accounted for 1.8% of the GDP spends, it would help to increase the allocation to least 3% to ensure many of the initiatives. Technological innovations and government initiatives are transforming the healthcare industry in India.

Government should roll out programs to train new and up-skill the existing manpower to address the shortage of skilled manpower in the healthcare sector.

The Government should also consider “zero-rating” of GST on healthcare services and the lowest rate of GST on drugs, medical devices, and health insurance premiums to improve affordability. Rationalizing the import duty on healthcare equipment is also required.

The government should provide tax incentives for investment in research & development for genetic research and genome mapping which can go a long way in supporting the National Digital Health Mission in early identification of genetic traits and intervention in the prevention of major NCDs.

Last but not the least, the government should increase budgetary allocation for the promotion of digital healthcare to improve access in rural and remote areas. This will not only reduce the burden on our limited healthcare facilities, but also the cost burden on the patients.

Dr. Shravan Subramanyam,

President & CEO of GE Healthcare – India & South Asia region, and Managing Director of Wipro GE Healthcare 

The pandemic has significantly shifted the dynamics of the healthcare sector, bringing to the fore the impending need for developing the medical infrastructure in India for improved access and operations. Recognizing the gaps in the sector, the government has already launched several short-term and longer-term measures for the health system including the PLI scheme for boosting domestic manufacturing of medical devices under the Atmanirbhar Bharat initiative. The launch of the National Digital Health Mission (NDHM) and National Digital Health Blueprint (NDHB) also underlined the value that the government ascribes to digitisation in healthcare.

We firmly believe that an integrated, digital-first healthcare system will be pivotal to India’s overall healthcare industry in the forthcoming years to achieve a holistic care continuum and to ensure that quality, affordable, and personalised healthcare is accessible to all. However, to achieve this, we are looking forward to a larger emphasis from the government on R&D and innovation in healthcare tech, which will further provide impetus to the Make in India initiative. We are expecting the 2022-23 Union Budget to also focus on investments in digital tools to support patient care and hospital workflow. To provide a fillip to the MedTech sector in 2022, waiving off the duty & CESS, and releasing sectoral payment dues will free-up the working capital for investments in inventory of critical spare and lifesaving equipment.

Encouraging and supporting local manufacturing of healthcare equipment and devices will be critical in 2022 to achieve the target of increasing healthcare spending to 3% of the country’s GDP.

Additionally, disruption in the global supply chain has now provided opportunities for large-scale manufacturing in India. We believe that continued focus on innovation and R&D, local manufacturing and digital technologies will enable India to become self-reliant.

As we aim to move towards Universal Healthcare Coverage, ecosystem collaboration for both public and private sectors, will be essential. Supporting and utilizing public-private partnerships efficiently will help drive access to care for non-communicable diseases, including appropriate funds for women’s healthcare, oncology, and cardiovascular research and care. We hope the endeavor to enhance the competitiveness of the industry would remain on the economic agenda

GANDHARV ROY, COO, MEDICA SUPERSPECIALTY HOSPITAL

A nation needs a healthy population to prosper.  The obliteration of nearly 5 lakhs in less than two years owing to pandemic has brought the healthcare sector to the forefront in terms of making healthcare for all.

The last two years have surely been an eyeopener for healthcare professionals globally, with respect to the overnight revamping  of the existing healthcare system. Budget 2022-23 is expected to address to the ground realties of the healthcare and the key components that we are looking forward to such addressal are: research & innovation, digitization, public – private partnerships, tax reforms and research.

Budget 2022-23 needs to address the low per capita spend ($3) on indigenous medical devices since there is a significant dearth in indigenous manufacturing, and imports constitute over a significant percentage of the high-end medical device market. India is a fertile ground for MedTech innovation, and the industry yearns for single window clearances for startups to thrive in the ecosystem. If the government could set up a system to facilitate early validation of MedTech devices and services, it could exponentially accelerate the development and deployment of various technologies in healthcare. Tax break for 10 years for setting up facilities in upcoming economic zones, MedTech Parks & MedTech Manufacturing facilities is one of the primary needs.

Government should also look at increase in customs duty of finished medical equipment / devices and subsequent reduction in customs duty for components and SKD imports to promote ‘Make in India’. Reintroducing tax holidays for rural hospitals with a flexibility to select beneficial years and viability gap funding by the government will incentivize private healthcare infrastructure creation in Tier 3 & 4 towns. GST must be reduced significantly across all products and services, to spur consumer spending.

We expect the government to look at increasing the healthcare expenditure above 2.5 per cent of the GDP. We are expecting an announcement of 10-12 % rise in healthcare expenditure which will enable the much-needed attention that healthcare requires now.

Healthcare services must be brought under GST regime with 1% levy so that they are able to avail the input credit available. If this is done, the overall cost of healthcare services will come down benefitting a larger section of the people. Government needs to bring more life-saving drugs at the lowest rate of GST, “zero-rating” of GST for health care services, this will help achieve the twin objectives of keeping the credit chain intact and will ensure that the tax is not loaded on to the cost of healthcare services making way for more affordable healthcare.

The ongoing pandemic has necessitated immediate need for integration of technology into the healthcare sector. Merging existing technologies and systems and evolving them to match future exigencies is the need of the hour. The focus on innovation and cutting-edge digital health innovations is of supreme importance like never before. Such synergies shall build up faster service delivery, rapid scalability of diagnostics, tele consultations and telemedicine for all.

 

Intellectual capital must be retained & sustained.  Considering the shortage of medical manpower in the country emphasis must be towards skill development to achieve the aim of WHO recommended doctor patient ratio of 1:1000 by 2024. And should that not be possible, it is vital that the country build a solid line of paramedics who can deliver the care most required, on the ground, at the right time

Mr Vishal Bali, Executive Chairperson, Asia Healthcare Holdings

“ The multiple waves of the pandemic are exposing India’s demand – supply gap in healthcare across infrastructure, people, technology. Budget 2022 must remain focused on increased allocation to the healthcare sector and fast track the bridging of the gap. Public healthcare spending on healthcare needs needs urgent reform and a clear allocation of 2.5% of GDP in real terms and not under a consolidation of allocations to various schemes and depts related to health and sanitation. Strengthing Primary Healthcare both at urban and rural level with allocation and execution should be a key priority to develop the tiered healthcare system of the country. The Govt’s push for financing healthcare infrastructure development can also be aided through the issuance of GOI backed healthcare bonds. Indigenisation of medical technology needs more steps under the Make in India program both for local and international players to make India a manufacturing hub for medical technologies. In addition to this, reinstatement of the weighted deduction for R&D expenditure to encourage innovation of new products and technologies, particularly in the pharmaceutical and healthcare industry should become the need of the hour for the country. Technology enablement has the power to redefine healthcare access in India, last mile connectivity acceleration can create a new power of disease surveillance, population healthcare data management and enablement of healthcare services and products. The Government should also look at accelerating rural internet connectivity to support education and healthcare services. The pandemic has shown that the need for health insurance for the citizens is imperative, to accelerate the penetration of health insurance further the Union Budget 2022 should also introduce a higher provision for tax deduction under section 80D. Budget 2022 should continue the path of transformation of healthcare for India and ensure that it continues to be a national priority “ 

 

Dr. Alok Khullar, CEO, Gleneagles Global Health City, Chennai:

“The outbreak of Covid-19 has taught the healthcare sector some important lessons. The healthcare sector has and will continue to play a crucial role in saving lives, treating other ailments while tackling the pandemic. With the disruption caused to the healthcare sector during this period, we urge the government to give adequate importance to the healthcare sector in the upcoming Union Budget 2022 by considering –

• Special schemes that should be provided for formal training of doctors and nurses to enhance skills and bandwidth to offer care to a larger population which will help strengthen the quality of healthcare resources in the longer run
• Building capacity for Intensive Care by enhancing skills of nurses and by providing better equipment and infrastructure
• Significance to be given to Appropriate Screening for Non-Communicable Diseases to ensure timely diagnosis and treatment which will help in reduction of hospitalisation in the last minute
• Upgrading infrastructure at Primary Health Care level for early Outpatient treatment thus reducing Hospitalization time and cost
• Benefits to be given to manufacturers of Healthcare equipment & consumables under the ‘Make in India’ campaign for high quality products and healthcare equipment to be manufactured at reasonable costs
• Healthcare organisations must be given access to working capital and preferential funding to ensure that the overall cost of operations is reduced

Healthcare sector needs to be considered as a priority and an essential service. Various subsidies and benefits should be given on land rates and other necessities such as electricity, as it will pave for accessible and affordable healthcare with better infrastructure and high quality treatment improving access to care and better patient outcomes.”

Pre-Budget quote regarding Healthcare Ecosystem

 Gerald Jaideep, CEO, Medvarsity Online

 Healthcare has been a priority area for the Government. This is evident from the fact that Government health expenditure rose by over 40% in 2017-2018 from 26% in 2013-2014. Furthermore, the Government has launched several mega-health initiatives in recent years which have reaped dividends on the ground. Despite the unprecedented pandemic impact, the Government’s commitment remains undeterred which is visible in India’s vaccination drive that has covered over 64% of adult population. Recently in an event in West Bengal, Hon’ble Prime Minister highlighted that over 60,000 medical seats have been added in last 7 years. He also vowed to make high quality medical services accessible to the poor and added more doctors to the workforce in the next decade.[2] It is therefore expected of the Government to make stronger allocation to the health space with the upcoming budget. While the efforts are really admirable, one of the major gap areas that have resurfaced prominently due to the pandemic is the continuous education and training of the healthcare workforce. Access to quality educational material and avenues of learning are few and remote for the majority of healthcare professionals in the country. This gap can be filled by leveraging online education technologies specially designed for the healthcare industry. While the Government has launched the National Digital Health Mission, it would be a boost to entire healthcare ecosystem if healthcare ed-tech segment gets integrated with the mission. Furthermore, the sector hopes that Hon’ble Finance Minister Smt Nirmala Sitharaman will make focused budgetary allocation for the healthcare ed-tech industry or incentivise the sector through innovative fiscal policies. We also hope that the Government would create an across the board collaboration opportunity for healthcare and Ed-Tech partners to create rich course curricula and learning material for healthcare professionals while incentivising them to pursue the programs.

Mr.Satish Kannan, Co-founder & CEO, MediBuddy.

“With the insistent surge in COVID-19 cases, it is extremely imperative that the budget focuses on strengthening the medical infrastructure uniformly. It should allocate some funds on developing the telemedicine industry to strategically bridge the disparity and to ensure that accessibility of quality healthcare services increases. Persistent problems that have been a hiccup for several years in the industry could be solved with the help of telemedicine, which holds the potential to solve them with ease. There should also be an emphasis on research and development in various medical fields to strengthen the current standing. Overall, we are expecting to see a rise in fund allocation of 2.5% to 3% of the GDP with regards to the healthcare sector.”