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An inclusive budget: towards building a healthy and vibrant India

By:
Bhanu Prakash Kalmath S J,
Karan Kakkar
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The government has proposed an inclusive budget prioritizing employment, skilling, MSMEs, and the middle class, with a clear focus on fundamentals such as inclusive growth, women-led development, and digital public infrastructure.

From the public health point of view, the budget focuses on preventive and promotive care with an objective to bring down the cost of curative care and addressing the healthcare needs of the large Indian population over the long term to build a Viksit Bharat.

Announcements to build an additional 3 crore houses in both rural and urban areas and allocating INR 10 lakh crores to address housing needs of 1 crore urban poor and middle class families under the PM Awas Yojana and promoting water supply, sewage treatment and solid waste management projects and services for 100 large cities will improve quality of life, promotes healthy living and better sanitation measures. All these are steps towards prioritizing preventive health.

More than INR 3 lakh crore has been allocated for schemes benefiting women and girls. Additionally, the plan to set up a new medical college in Bihar will further enhance the overall health infrastructure.

Finance Minister also mentioned stepping up digital public infrastructure for health including education and other sectors. The development of Digital Public Infrastructure (DPI) applications at a population scale is expected to lead to productivity gains, business opportunities, and innovation by the private sector. This initiative has the potential to strengthen the interoperability of digital health data, primary healthcare and enhancing accessibility.

In an effort to provide relief to cancer patients, the government has proposed to fully exempt Trastuzumab Deruxtecan, Osimertinib, and Durvalumab from customs duties. This move will reduce the cost of care for patients, as the price for some of these medicines can range from INR 1.5 lakhs to INR 2 lakhs per vial. It’s important to note that one in nine people in India are likely to develop cancer in their lifetime. Among non-communicable diseases, cancer (18.1%) contributes the second most the death rate after cardiovascular disease (63.3%). Further, proposed changes in the Basic Customs Duty (BCD) on x-ray tubes and flat panel detectors for use in medical x-ray machines under the Phased Manufacturing Programme aim to support local manufacturing and innovation in the medical sector.

The announcement to spur private sector-driven research and innovation at a commercial scale with a financial pool of INR 1 lakh crore could lead to advancements in lifesciences and healthcare.  Furthermore, the announcement pertaining to women-led developments and Employment Linked Incentive will benefit the healthcare and life sciences sector. It is important to note that women constitute a large portion of the healthcare workforce. The allocation of INR 15000 crores for Andhra Pradesh to strengthen infrastructure will potentially support the industry as Visakhapatnam is one of the large pharmaceuticals manufacturing hub in India.

The finance minister has commented on the simplification of GST and a comprehensive review of the customs duty rate structure over the next six months. This is a development to watch, as rationalisation of rate structure for input items has been a longstanding demand of the healthcare sector, which would bring down the cost of healthcare.

Further, few relaxations under GST law have been proposed in line with announcements made pursuant to 53rd GST Council meeting. Time limit for availing ITC from FY 2017-18 to FY 2020-21 is proposed to be extended to 30 November 2021. Further, conditional waiver of interest and penalty or both will be provided for demand notices issued under Section 73 for FY 2017-18, 2018-19, and 2019-20, except for cases of erroneous refund, provided full tax is paid before notified date. Such amendments will provide necessary relief to the industry for initial few years under GST regime.

While most of the announcements have been towards ease of doing business however industry was expecting additional allocations towards PLI scheme for pharma sector. Further, a lower rate of GST on health insurance, clinical trials and research activities would have been another step towards affordable healthcare.

In general, the Interim Budget laid a strong foundation for healthcare improvements, particularly in maternal and child health, with a focus on integrating various schemes, the main budget continues this focus on preventive and promotive care aims at reducing the cost and address the healthcare needs of the large Indian population over long term.