The Union Budget for 2020-21 is all set to be presented on Saturday, February 1, 2020.
What is likely to be announced and what not will be answered soon. Nevertheless, the industry is ready with its bag of expectations.
BioSpectrum brings to you the industry expectations from the Union Budget 2020-21-
"Clear central government guidelines to enable Public Private Partnership in the diagnostics segment to realise the vision of quality advanced diagnostics at affordable cost with accountability and better clinical outcomes
Higher allotment for health sector to help schemes like Ayushman Bharat to reach larger section of population with measurable outcome
Investment in Diagnostics Services sector in tier 2 & 3 towns to get similar tax breaks & subsidies like hospitals
To avoid any ambiguities in GST in health sector including diagnostics services segment
Tax free spending limits for annual preventive Health Check to be enhanced to promote preventive medicine and wellness focused health care initiatives"
G. S. K. VELU, Chairman & Managing Director, Neuberg Diagnostics, Chennai
“With about 80% of the medical workforce in 10 cities serving only 28% of the total population, access to quality healthcare is still an aspiration for many. India will double the number of smartphones by 2023. The mHealth market is growing rapidly at a CAGR >42%. Policies and budgets towards adoption of clinically validated mHealth will help address last mile access challenges, improve quality of care and reduce costs.
Combating inflation and currency depreciation, requires exports to be a backbone of the economy. Entire industries and job markets in India come from exports, like the IT sector that draws 75% of its revenues from exports and constitutes 6.7% of India’s exports market. Affordable, clinically validated healthcare IT solutions can drive significant exports as healthcare spends are 8-18% in more developed economies compared to 1.2% in India and clinically validated solutions like digital therapeutics (DTx) are growing at a CAGR of >20% globally. Government benefits and forward thinking policies to this category can help drive exports and help an already ready talent and entrepreneurial base in India help boost the economy”.
Abhishek Shah, Cofounder Wellthy Therapeutics, Mumbai
"This year’s Budget comes at a time when we head into a new decade and there are high expectations for a certain paradigm shift in healthcare services across the country. It is important to strengthen the infrastructure, capacity and financing for the healthcare sector while envisaging a complete overhaul of the sector in a way that will expand its scope and scale.
India has one of the lowest spending on healthcare globally. So, it is more important than ever now to revitalise the public health system to ensure access, outcome, quality and affordability. The focus must be on finding solutions, which are affordable, scalable and yet high quality.
A main focus in Budget 2020 must be given to transforming the home healthcare industry. Non-communicable diseases (NCDs) — or chronic diseases — are presently a challenge for India’s health sector since they are increasing at an alarming rate. These are diseases of long duration and generally slow in progression. Unlike the largely short-term effects of communicable diseases, the dual health and economic impacts of non-communicable diseases on individuals, families and households are both devastating and long-lasting. The ratio of hospital beds to the number of patients is low. Focus is required on developing home healthcare which can address the gap in hospital beds and patients by offering care for terminally ill patients at home in a hospital-like setting.
Home healthcare is also currently not recognized as a mainstream sector. If this sector is brought under government schemes like the Ayushman Bharat Yojana, there can be an increase in the limits on reimbursement of expenses on diagnostics, preventive health check-ups, etc.
The government needs to promise comprehensive primary care that has continuity with higher levels, improved access and affordability of services through a combination of public hospitals and strategic purchasing of services from the private health sector. The most crucial element for the implementation of the budget is a strong public health infrastructure. While there was a commitment to increase the healthcare spending to 2.5% of the GDP by 2025, as of now it still remains at 1%. This requires some attention in Budget 2020.
The preventive health check-up segment also requires some attention. Currently, preventive health check-ups account for less than 10% of the total market and this segment is witnessing a CAGR of 20%. The government needs to increase the tax exemption on preventive health check-up from the current Rs. 5,000 per person to Rs. 20,000 under section 80-D of Income Tax Act 1961. This will encourage more people to go for health check-ups.
As technology is making great inroads in all sectors including healthcare, this year’s Budget will have to bring a mindset shift by identifying healthcare as an important pillar in improving both quality of life and economic prosperity of the nation."
Dr. Rohinton Dastur, Director Medical-Bhatia Hospital, Mumbai
"The Indian Budget should focus on increasing public spending on healthcare, considering India’s demographics, growing population and increasing disease burden. The Budget of 2019-20 saw Rs62, 398 crore outlay for the healthcare sector which was just 1% of GDP. This should be increased to 2.5% or around Rs150,000 crore to drive the health sector fast forward. Along with the private spend of 1.5% the total GDP percent shall go to an acceptable 4%. In developed countries it is 10% and in the USA it is 18% of the GDP. This will help in making healthcare accessible to marginalized populations.
There is a requirement for a viability gap funding by the government for smaller hospitals in Tier 2 and 3 cities by the government to increase the provider base for Ayushman Bharat. There is also a requirement for increasing the package rates of Ayushman Bharat for more hospitals to take this up and make the program a success.
Focus on increasing the number of healthcare professionals as the doctor: patient ratio is 1: 1,445 against the WHO recommended 1: 1,000. Government should ease the rules and regulations for establishing more medical teaching and training institutions to produce more medical professionals to fill the gap. The recent decision to allow medical colleges by joint venture between trusts and companies is a welcome step with the PPP model attached to government hospitals. The establishment of National Medical Commission (NMC) aims to address the skill gaps but more clarity on increasing UG and PG seats should be brought in.
The government should give a boost to digital healthcare to increase accessibility. Although the National Digital Health Blueprint (NDHB) is a step in the right direction, there needs to be further action and investment for developing infrastructure for electronic health records, for data portability, privacy and security. Telemedicine connectivity between the Primary Health Centers, Taluk Hospitals, District Hospitals and Medical Colleges must be increased to provide expert opinion in the peripheral centers.
Compulsory rural service for two years after MBBS and PG doctors and other para medical graduates with higher pay scales supported by government should be rolled out to get more doctors to the rural areas."
Dr. Azad Moopen, Founder Chairman & Managing Director, Aster DM Healthcare, UAE
“The cost of hospitalisation is increasing and medical treatments are becoming more expensive . With the upcoming Budget 2020, we expect the government to focus on increasing its overall allocation on the health sector. Unfortunately, in India, the awareness about insurance is very low which is one of the major reasons for low-level of insurance penetration. Before Ayushman Bharat Yojana was introduced, very few people had any kind of health insurance, thus the government should also consider on introducing measures to increase health insurance penetration . The industry expects tax deduction cap for medical insurance under Sec. 80D to be increased further from Rs.25,000 to Rs.50,000 for self, and from Rs.50,000 to Rs.75,000 for elderly and dependent parents. This could be a huge relief for those who are apprehensive about the rising healthcare costs. The government should also consider reducing GST slab for health insurance premiums paid, tax benefits for health checks ups and should also focus on primary care and prevention as these could be driving factors for customers to invest in health insurance. To sum it all, these measures would help in increasing health insurance penetration in India as well as bolster a culture of preventive healthcare in India.”
Mayank Bathwal, CEO, Aditya Birla Health Insurance, Mumbai
“In the upcoming budget, we expect the government to focus on bringing more people under the ambit of Life Insurance, promote long-term savings and encourage capital formation. In a country with inadequate social security, protection offered by life insurance is inevitable; however, lack of its penetration is plaguing the industry. Introducing separate deduction of Rs 50,000 for first time life insurance buyers and an additional capping of Rs 50,000 for someone purchasing a pure protection (term) plan will put life insurance on fast track. Another important move would be to encourage women to insure their lives and savings. Extra tax benefit for women policyholders will be a significant step. Moreover, relaxation of section 10(10)(D), where minimum sum assured is required to be 10 times of annual premium will be a desirable move. The budget should also bring about measures to bring parity between pension products offered by life insurers and NPS. Lowering rate of GST at 12% (with input tax credit benefit) will be beneficial for both policyholders and companies. These measures will pave the growth path for the LI sector, besides increasing the security net of the nation’s people at a very low cost.”
Kamlesh Rao, MD & CEO, Aditya Birla Sun Life Insurance, Mumbai
"The economy is going through a phase of low GDP growth, Finance Minister should adopt softer interest rates to encourage new investment and expedite Capex cycle aiming at generating more employment opportunities and roll out tax benefits for individual taxpayers so consumption can also get a boost.
Enhancement of weighted tax deduction on R&D from 150% to 200% will enable new discovery and innovation. If the government gives proper financial support to SMEs from technology upgradation fund for Pharma SMEs, then the pharma SMEs in India can graduate to the next level and can become exporters.
Indian Pharma industry is facing challenges such as increased scrutiny from drug regulators, stalled new product approvals and price control in the home as well as developed markets affecting the growth. With the government’s initiative, not only can the industry support the government in providing affordable and efficacious medicines it will also help to mark its presence in the global markets."
Mahendra Patel, Managing Director, Lincoln Pharmaceuticals, Ahmedabad
“Over the last few years, the government has taken some major steps to improve Healthcare in India. But there is a lot more to be done, so the government should continue to invest in medical education and the healthcare infrastructure. The government should invest in best of breed digital tools that supplement the new competency based curriculum, thus enabling the students to learn better, being on par with their counterparts in other countries. We must also ensure that medical colleges and hospitals have access to world class evidence based content and technology solutions, that accelerate learning and readiness to practice. These investments will go a long way towards reducing medical errors and improving healthcare outcomes".
Shireesh Sahai, CEO – Wolters Kluwer India, Gurugram
"Molecular diagnostics and genetic testing for preventive screening of cervical, breast and ovarian as well as prostate cancer is known to be significantly more accurate than regular tests and are routinely used in the developed world. However the higher costs of these tests dissuade doctors in India from prescribing them to the lay man, while the lack of scale inhibits R&D activity to come up with lower cost and South Asian genome relevant tests. If the tax exemption on preventive health check-ups is raises from the current Rs. 5,000 to Rs. 20,000 under section 80D of the Income Tax Act, it will significantly accelerate the adoption of a better level of healthcare in the country.”
Nickhil Jakatdar, CEO, GenePath, Pune
“Over the last few years, healthcare sector hasn’t received adequate attention in the Union Budgets. This year, we anticipate that the Government will introduce measures to improve the quality of healthcare and make it more affordable to common citizens. Over the past decade, healthcare is in a state of constant transformation, as a new revolution in the sector is setting in to transform the sector – mainly driven by mobile technology, artificial intelligence (AI), Big Data analytics and other emerging technologies. The Government should earmark budgetary allocations to deploy newer technologies for enabling access to better healthcare to the farthest corners of the country. Special emphasis needs to be on improving the state of rural healthcare as majority of our population still continues to dwell in villages and smaller towns”.
Dr Somesh Mittal, MD & CEO Vikram Hospital, Bengaluru
This article was originally published on BioSpectrum