A budget that addresses the ‘medical poverty trap’ is the need of the hour

12:00 pm Health Care, Heart Care Foundation of India, Medicine

Government should introduce limit of 8 lakh for EWS for insurance cover

New Delhi, 31 January 2019: Statistics indicate that about 55 million Indians were pushed into poverty in a single year because of having to fund their own healthcare. Another 38 million of them fell below the poverty line due to spending on medicines alone, as per a study published in the British Medical Journal. Health expenditure is considered catastrophic if it constitutes more than 10% of overall household consumption or income.

There is an urgent need to reduce health inequity in India. This has been addressed in the National Health Policy 2017 as a key policy principle, which states Reducing inequity would mean affirmative action to reach the poorest. It would mean minimizing disparity on account of gender, poverty, caste, disability, other forms of social exclusion and geographical barriers. It would imply greater investments and financial protection for the poor who suffer the largest burden of disease.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “With the Union Budget 2019 to be announced in just a short while from now, all attention will be on what policies have been put in place to ensure universal, accessible, and affordable healthcare. It is not just medical care but also social factors that play an important role in determining a person’s health status. These factors are also responsible for the gaps in health among various strata of people. Lack of availability and accessibility to resources that improve health among the socially disadvantaged groups are major factors contributing to health inequity in the country. Though there has been progress in the efforts to make healthcare accessible to the poor, there still exist inequities. Many people are pushed below poverty line on account of the high medical expenses in what has been termed as ‘the medical poverty trap’.”

Among the 10 social determinants of health, social gradient has been deemed to be the strongest predictor of health and wellbeing. It is measured by variables such as income, education, occupation or housing. The lower the socioeconomic position, the higher the risk of poor health.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “The Ayushman Bharat scheme, which provides up to Rs 5 lakh cover, is one step towards ensuring the Right to Health and access to healthcare. This year, the constitutional amendment bill providing for 10% reservation to the economically weaker sections of the General Category was notified. These are in a bracket of less than 8 lakh annual income. Only by reducing the health inequity, can the goal of universal health coverage be realized. In the budget to be announced, the government must bring this limit of 8 lakh to the definition of EWS for the purpose of ESI, health subsidy, and Ayushman Bharat subsidy. Those above this bracket should be able to buy their insurance on their own.”

A common budget allocated for various health programmes will ensure more intersectoral cooperation and knowledge sharing. This will also avoid any overlap in programmes in these ministries to a large extent and result in saving of financial outflow. All in all, we look forward to a budget that focuses on overall health and wellness thereby contributing to better productivity. Positive policies that will make healthcare more simple, affordable and accessible to common people are the need of the hour.

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