New Delhi: Finance Minister Nirmala Sitharaman didn’t mention the government’s Ayushman Bharat health insurance scheme during her budget speech today. Piyush Goyal did not mention it in the interim budget he presented before the general elections either. Nevertheless, India’s health spending has received a considerable boost in the first budget of the Narendra Modi government’s second term.
Although conventionally this health spending would be assessed only in terms of how much the union health ministry is getting in its budget allocation, the Modi government’s spending should be assessed also in terms of what it is pumping into programmes like Swachh Bharat.
As The Wire has earlier noted, schemes like Swachh Bharat, Ujwalla and Jan Aushadhi also impact health care, and many programmes from the Ministry of Women and Child Development are also related to health care. None of these are funded or administered by the union health ministry.
Health ministry’s budget goes up by 15-18%
The budget estimate for the union health ministry for 2019-2020, announced today, is Rs 64,559 crore. Rs 64,559 crore for the whole ministry, is an increase from last budget’s revised estimate which was Rs 56,044 crore. This is an increase of Rs 8,515 crore or 15%. When compared with last year’s budget estimate, it is an increase of Rs 9,950 crore or 18%.
When compared with actual expenditure from just two years ago in 2017-2018, it’s shows a more impressive jump of Rs 11,447 crore or 21.5%.
The two core pillars of India’s health policy – the National Health Mission for urban and rural areas – are allotted Rs 27,039 crore and Rs 950 crore.
This brings the total to Rs 27,989 crore or 43% of the health ministry’s budget. The ministry is comprised of the department of health and family welfare, and the department of health research.
Seen separately, the department of health and family welfare’s budget estimate for 2019-2020 is Rs 62,659 crore. Their actual spending in 2017-2018 was Rs 51,381 crore. The budget estimate for it, in 2018-2019, was only slightly more, at Rs 52,809 crore.
The revised estimate for the same year was also slightly more, at Rs 54,302 crore. The move to allocate Rs 62,659 crore is thus an increase of Rs 8,357 crore or 15% over last year’s revised estimate.
The department of health research, which runs bodies like the Indian Council of Medical Research, has been budgeted Rs 1,900 crore this year. It was budgeted Rs 1,800 crore in the previous budget, which was revised to Rs 1,742.
Ayushman Bharat gets a big boost of Rs 7,998 crore, 12% of the health ministry budget
Ayushman Bharat, which the government announced in 2018 as the “world’s largest healthcare programme”, has been given a budget allocation of Rs 7,998 crore. This means the programme is being given 12% of the health ministry’s entire budget of Rs 64,559 crore.
This is a big jump from last year’s allocation of Rs 2,000 crore, and the same amount was already announced in the interim budget by Jaitley, before the elections. The programme has two components – the health insurance component of Rs 5 lakh coverage for 50 crore people, and the upgrading of health sub-centres.
The insurance component has taken the lion’s share, at Rs 6,400 crore. The upgraded health and wellness centres are being given Rs 1,349 crore in rural areas and Rs 249 crore in urban areas.
A lot of this Rs 6,400 crore could go towards funding private players in building these hospitals for the health insurance, as reported earlier by The Wire.
The Wire reported last week that so far, and in the last year, the government has seen Rs 3,077 crore of claims made on Ayushman Bharat health insurance. This is about half of the total budget that has actually been allotted for the insurance for 2019-2020.
Substantial allocations to Swachh Bharat
The Economic Survey released yesterday made some nuanced points on how the Swachh Bharat mission should be seen in the light of its impact on improving healthcare. But this scheme is not administered by the union health ministry.
The mission aims to make India free of open defecation by constructing toilets, getting people to use it, and also moving towards safe and healthy disposal of faecal waste. So far the government claims to have undertaken major improvements on, at least, the construction of toilets.
The mission is administered by the Jal Shakti ministry for rural areas, and the Ministry of Housing and Urban Affairs, for urban areas. This budget has allocated Rs 12,644 crore for the Swach Bharat Mission in total, with Rs 9,994 crore for rural areas and Rs 2,650 for urban areas.
The National Rural Drinking Water Mission, also under the Jal Shakti ministry, has been allotted Rs 10,000 crore.
AYUSH, women and child development also see small change
The AYUSH ministry which looks into the promotion of traditional medical practices of Ayurveda, Yoga, naturopathy, Unani, Sidha and homeopathy has not been allotted a lot, at Rs 1,939 crore. It is a small increase from the last budget’s revised estimates of Rs 1,692 crore.
The women and child development ministry handles programmes related to the advancement and safety of women and children but also handles issues related to maternal and child health. Overall, this ministry’s budget allocation is Rs 29,164 crore, up from last year’s revised estimate of Rs 24,758 crore.
The Integrated Child Development Scheme, which is specifically concerned with the nutrition status of children, has been allotted the bulk of the ministry’s budget at Rs 27,584 crore, up from last year’s revised estimate of Rs 23,356 crore.