The Union Budget 2024-25 presented by the Indian government had a notable double-digit increase in healthcare allocation, demonstrating a positive step towards bolstering the sector. However, it falls short of addressing several critical needs. Despite this increase, India's ongoing struggle to meet the National Health Policy 2017's goal of allocating at least 2.5 cent of GDP to healthcare remains unaddressed, highlighting a persistent gap in the nation's commitment to improving its healthcare system.
The Growing Concern of Out-of-Pocket Expenditures
According to the Economic Survey 2023-24, India still has one of the highest out-of-pocket healthcare expenditures globally, with individuals covering 50 per cent of their medical expenses. This financial burden disproportionately affects poorer households, often pushing them below the poverty line. The absence of targeted measures in the recent budget to mitigate these expenditures further exacerbates the vulnerability of these populations. The lack of comprehensive policies to address this issue underscores a significant area of neglect that could have long-term repercussions on public health and economic stability.
The Health Insurance Gap
A staggering number of nearly 400 million individuals in India have no access to health insurance. This statistic is not just alarming; it is indicative of a systemic failure to provide basic healthcare security to a large segment of the population. Health insurance is a critical component of a robust healthcare system, acting as a financial buffer that can prevent families from plunging into debt due to medical expenses. The current budget's lack of reforms in this sector suggests a missed opportunity to create a more inclusive health insurance framework that could protect millions of vulnerable individuals.
The Need for Healthcare Reforms
To address these critical issues, the Indian government must prioritise healthcare reforms that can provide substantial benefits to the entire healthcare industry. Key areas of focus should include:
Expanding Health Insurance Coverage: The government should introduce policies aimed at increasing health insurance penetration, especially among the lower-income groups. Subsidised insurance schemes or public-private partnerships could be effective strategies to widen coverage.
Reducing Out-of-Pocket Expenditures: Initiatives such as capping the costs of essential medicines and treatments, along with improving the availability of affordable healthcare services, can help reduce the financial burden on households.
Strengthening Public Healthcare Infrastructure: Investing in the public healthcare infrastructure, particularly in rural and underserved areas, is essential to ensure that quality healthcare services are accessible to all citizens.
The Importance of Care-Coordinated Health Management
Another critical aspect that has been overlooked in the latest budget is the need for improved care coordinated health management services. The burden of hospitalisations and repeat hospitalisations, not only impacts the physical health of individuals but also their psychological well-being. Effective care coordination can significantly reduce avoidable hospitalisations and improve patient outcomes by ensuring continuity of care and better management of chronic conditions.
Opportunities for Enhancing Care Coordination
The government should consider the following measures to enhance care coordination and management services:
Integrated Healthcare Systems: Developing integrated healthcare systems that facilitate seamless communication and coordination among various healthcare providers can improve the quality of care and patient satisfaction.
Rigorous Transparency: Implementing rigorous transparency in the healthcare insurance system ensures patients are fully informed about their coverage, including pre-existing conditions and limitations. Clear communication between patients, hospitals, and insurers allows for better healthcare decisions and prevents patients from facing unexpected financial liabilities.
Customised Information and Improved Engagement: Integrating Gen AI optimises healthcare operations by automating content generation, customising information for patients, and enhancing engagement. It clearly outlines what is included and excluded in claims forms and tailors insurance plans to individual needs, reducing the burden of manual contract management.
Telehealth Services: Expanding telehealth services can play a crucial role in health management, particularly in remote and rural areas where access to healthcare facilities is limited. Telehealth can provide timely medical advice and follow-up care, reducing the need for hospital visits.
Training and Education: Investing in the training and education of healthcare professionals in health management practices can enhance their ability to provide coordinated and comprehensive care to patients.
The Union Budget 2024-25 has missed a vital opportunity to address the critical needs of India's healthcare sector. By failing to introduce specific measures to expand health insurance coverage and improve care coordination, the government has overlooked essential aspects that could significantly enhance the healthcare system's effectiveness. Moving forward, policymakers must recognise and address these unmet needs to ensure a healthier and more resilient population. The integration of comprehensive healthcare reforms and improved health management services will be crucial in achieving this goal.
The author is CEO of Heaps.ai
, Dr Shaiwal Khandelwal, Associate Director, Thoracic Surgery, Max Super Speciality Hospital, Saket-2_20240918203538_original_image_41.webp)
