jsa-logoThe Jan Swasthya Abhiyan (JSA) has described as disappointing RajasthanÃ¢ÂÂs budgetary allocations for health sector in the State Budget for 2016-17 presented last week. The Budget has few things to be happy about and more things to be worried about. The CM in her opening statement about health budget stated “”Healthcare to all at affordable rates”” and if this is true then it is highly problematic and diametrically opposite to what the Union Finance Minister said, the health activists have said.
The Union Finance Minister talked of “”Health Protection”” which is completely missing from the budget speech of the CM Rajasthan. It is the sovereign duty of the government to provide health protection to all the citizens through several measures including free health care services as a measure to reduce out of pocket expenditure on health care, therefore, an emphasis on Ã¢ÂÂhealth care at affordable ratesÃ¢ÂÂ means that the government does not intend to provide health protection to people and patients would be forced to shell out money and continue to be trapped into poverty, a statement issued by the Jan Swasthya Abhiyan said.
“”The Chief Minister laid good deal of emphasis on Bhamashah Swasthya Bima Yojana and thereÃ¢ÂÂs a whopping amount of fund which has been allotted to the scheme this year, almost double as compared to last year. Such great emphasis on health insurance is a clear sign that the government is only going to upscale its strategy of insurance/PPP in health care by bringing about more and more private hospitals at StateÃ¢ÂÂs expenses. This is quite unfortunate that the funds which could have been used to strengthen the public healthÃ system, are being diverted to strengthen private public health institutions. It should be noted that already 60% of the inpatients and 80% of the outpatients are seeking care from the private health facilities and these schemes would further enhance this trend much to the discomfort of the majority of the citizens. There is also an issue of the capacity of the private health system which has very haphazard growth. In reality, private health system does not exist in areas where it is required most which are remote and difficult areas,”” Chayya Pachauli of JSA said.
The very crucial free medicines and free diagnostics schemes already operational in the state hardly had any mention in the budget speech. While the budget for free medicines scheme remains almost the same as last year (Budget estimate 2015-16 – 367 Crores, 2016-17 – 360 crores), thereÃ¢ÂÂs a slight reduction noted in budget allotted for free diagnostics scheme (Budget estimate 2015-16- 117 crores, 2016-17 – 105 crores). But, it seems the focus of the government is to push health insurance as a vehicle of health care delivery which has been an issue under intense debate among public health experts and the government.
The budget of the National Rural Health Mission (NRHM) has also been marginally slashed this year (from an budget estimation of 1810 crores in 2015-16 to 1598 crores for 2016-17). This essentially means that all the community based health processes including strengthening of Village Health Sanitation and Nutrition Committees (VHSNC), Village Health and Nutrition Days (VHNDs) etc are going to be affected. Overall there is hardly any increase in health budget this year as compared to last year (from a budget estimate of 9416 crores in 2015-16 to 9537 crores for 2016-17). The per capita expenditure on health care remains the same and reduced in real terms after adjusting for inflation, the statement further said. Increasing reliance of the government on private health care sector and health insurance model as saviours of public health system is a dangerous sign. In a nutshell, an analysis of the health budget clearly indicates that the health care in the state would continue to function with the same dearth of resources and an increasing dependency on private providers to meet all the health care needs of the 7 crore population.”