'Govt should make fiscal roadmap for affordable healthcare'

In order to realise the vision of affordable healthcare for all, the Centre should frame a solid fiscal roadmap to raise the expenditure on health to 2.5 percent from the current 1.2 per cent of the GDP, a Parliamentary Committee said in its report today.
The Committee said that low expenditure on health leads to high out-of-pocket payments by individuals households on healthcare which not only forms a barrier to accessing care, but also leads to households incurring catastrophic expenditure due to health costs which in turn push them into indebtedness and poverty.
"The Committee observes that despite rapid economic growth over the past two decades, successive Union governments have not made the requisite level of financial investments in health and the growth in the Union Health budgets have been lower than needed to achieve the 2.5 percent goal.

"Acceleration in economic growth by itself will not translate into higher public spending on health. The government will also have to demonstrate its commitment to ensure that adequate financial resources for providing essential healthcare to all indeed gets allocated and spent," the Committee on Health and Family Welfare observed.
According to the National Health Policy 2015, over 63 million people are pushed below the poverty threshold every year due to healthcare costs alone, it said.
As per the NASSO survey-71st round (January-June 2014), the out-of-pocket expenditure accounts for 58 percent of total health expenditure which is one of the highest even among the low income countries, it added.

The Committee was distressed on the reasons spelt out by the Department of Health regarding the problem areas in implementation of the National Health Mission (NHM) such as public health being a state subject, implementation of approved plan under NHM depending upon state and UTs and implementation capacity of many states being slow particularly in respect of civil construction, procurement of drugs and equipment among others.

It recommended the Department to take measures and make short, medium and long term plans to overcome the shortcomings and delays in implementation capacity of states.
The Committee also asked the Department to avoid large variations in the budget estimates, revised estimates and actuals to ensure that the budgeted funds are not locked up and surrendered later.

"The Committee would like to impress upon the Department that non-utilisation should be a rare exception instead of being a recurring feature as has been witnessed year after year," the Committee said while recommending that definite yardsticks be devised for the purpose of projecting realistic budgetary assumptions and balanced utilisation.