More healthcare facilities are needed in rural India and their needs must be covered by the budget

Jan 31,2024

India has made giant strides in the healthcare sector. Today we have world class healthcare facilities, staffed with some of best para clinical staff in the world. We also leverage state of the are robotic surgeries for better clinical outcomes. All this has been possible because of the skill and the capabilities of the medical institutions who have produced some world class doctors. The government has played its part in providing the basic infrastructure like medical institutors and some large welfare programs like Ayushman Bharat Digital Mission, which have helped in reducing the out-of-pocket expenses for Indian patients.

Today we can invest further in the healthcare sector with a focus on the rural part of the country. Only 38% of the doctors in India serve in the rural areas and they cover almost 68% of the population. This means most patients in rural India must either travel to the cities for treatment or risk going to quacks or Registered Medical Practitioners (RMPs). Almost 80% of the rural health centers are lacking basic medical professionals like surgeons, gynecologists, and pediatricians. Now this divide is something that the budget can address by incentivizing private institutions to set up facilities in rural centers. Today basic tax incentives are available to the sector, but this has to be increased. Financial incentives under the National Digital Health Mission including the INR 4 Cr incentive to implement EMR and HIS needs to be enhanced further. A tax holiday for those private players setting up facilities in rural areas will go a long way.

The budget allocation for healthcare must increase. As per the last budget it was around INR 86,000 Cr. Not that number is not going to help when the country is battling infectious diseases as well as lifestyle diseases. When we look at the distribution of this money over the population, we hardly have INR 600-700 per citizen that is spent yearly. Hence the allocation of the budget must increase, and this can be done in the form of more direct tax collections in terms of cess or indirect tax collections from other products and services.

The budget should also factor in subsidies for healthcare facilities in rural areas. This could be in the form of cheaper land, electricity or in term of grants for buying equipment. For example, today 18% GST is applied on medical beds or on dental chairs. Now this exception can be given if this is supplied to a medical facility in a rural area. These subsidies will go a long way in not only getting good equipment but also attracting the right human capital in terms of doctors and nurses to rural settings.

While the government has provided more than 1 lakh 55 thousand rural health centers, it does not have the right infrastructure to detect diseases in advance to reduce hospitalization. Here is where public-private partnership at scale can be achieved by leveraging the private sector to run these centers with a strong governance mechanism. Then preventive health can be achieved at scale. To make this work we will need a strong digital infrastructure, today the government has already invested in the India Health Stack, but further budgetary incentives to more organisations to use the stack would lead to building a digital health ecosystem at scale. Similarly leveraging tele medicine beyond just consultations and using the expertise in the cities to conduct remote sessions both for consultations as well as monitoring would go a long way in ensuring the quality of care is available at rural areas. Again, there is an opportunity to provide incentives to telemedicine platforms as well as concepts like Software as a medical device (SAMD)

In conclusion, while we have a long way, a lot more needs to be done. With his budget the expectation is that India makes the right moves to provide tax and financial incentives to invest more in rural areas, on the back of strong technology and leveraging the expertise of our doctors and nurses.

Source: Healthworld