Budget 2023: IMA says deficit funding is the most important cause behind the lack of penetration of the AB-PMJAY
In its proposal to the government for consideration in the upcoming Union Budget, the Indian Medical Association (IMA) has suggested that the funds for the Ayushman Bharat Pradhan Mantri Jan Arogya Yojna (AB-PMJAY) should be used exclusively for the private sector for strategic purchase and creating a retainer system and not for critical gaps in the funding of government hospitals.
The IMA has said deficit funding is the most important cause behind the lack of penetration of the AB-PMJAY.
If the funding has to be raised to at least the CGHS (Central Government Health Scheme) level, then the amount required is around Rs.1.6 lakh crore, the doctors’ body said. The money being provided now is around Rs.12,000 crore, it said, adding that it is not possible to deficit finance to this level. Insufficient fund allotment is the root cause of the unrealistically low package rates, the IMA said. “AB-PMJAY should remove the unjust exclusion criteria for procedures imposed on private hospitals,” it added.
It also said doctors and healthcare organizations be given access to the working capital and preferential funding to ensure that the overall cost of operations is reduced. Benefits should be given to manufacturers of healthcare equipment and consumables under the “Make in India” campaign, the IMA said. It also demanded the revival of the Indian Medical Services, which was abolished in 1947.
The IMA also recommended creating a special welfare fund for doctors in general and for the “COVID-19 martyrs” in particular. The doctors’ body said the government should conceive a zero-rate Goods and Services Tax (GST) on healthcare services, allowing the service providers to claim the input tax credit. As the GST is not payable on healthcare services, the service providers are not eligible for the input tax credit. Enabling this would ensure that input taxes are not added to the cost of the services and provide some relief to patients, the IMA said.
“The healthcare industry is the only industry that does not get input credit because of exemption. Actually, the GST paid by the institutions becomes expenditure and indirectly adds to the cost of treatment. “Either some percentage of the total GST paid by healthcare providers be treated as advance tax or MAT (Minimum Alternative Tax) or the GST paid by them on equipment or otherwise should be reduced to 5 percent,” it suggested. “The country lost more than 2,000 doctors during the (Covid) pandemic.
Unfortunately, the majority of the families of the deceased doctors did not receive any help other than whatever little the IMA could marshal. “A special welfare fund for doctors in general and for Covid martyrs, in particular, has to be set up. The nation owes at least this gesture to the medical community,” it said. The IMA has also sought a hike in healthcare expenditure from the current 1.1 percent of the Gross Domestic Product (GDP) to 2.5 percent, as envisaged in the National Health Policy, 2017.
“The health policy 2017 promised GDP in healthcare of 2.5 percent by 2025. But the increase for healthcare has been negligible and still hovers around 1.1 percent of GDP,” it said. Of the healthcare expenditure of Rs.89,000 crore for last year, a major chunk of Rs 83,000 crore was revenue expenditure. Capital expenditure was only Rs.5,630 crore. A substantial increase in the capital expenditure is required in the budget to make a meaningful change, the doctors’ body said.
“There is an acute need for a drastic but holistic change in the health administration of the country by creating a specialized cadre of health administrators who would be holding the administrative responsibilities,” the doctors’ body said. The structure of the Indian Medical Services would be in the form of a cadre specialized in character for the dispensation of healthcare services, including those in the domain of public health and excluding the domain of medical education in its entirety, like the All India Civil Services emanating out of the All India Services Act, 1951, the IMA said.
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1) All these recommendations are beyond understanding for being policy matters, who & what benefits common man will get is lost in this policy news.
2) Make mandatory for all people to sit in sunlight daily for 30 minutes. Creates spaces in city for people to sit joyfully through some act (walking or sitting or chatting spaces)
3) Encourage pure veg restaurants & give them GST concessions. Serving only veg food. Term it healthy food
4) Non-veg restaurants to be taxed higher, even if they serve veg food, they should be charged at same non-veg GST. Term it unhealthy food.
5) Increase insurance cost for those having drinking habits of hard drinks
6) Encourage ayurvedic medicines & aggressive research & promotion of ayurveda