Ahead of the budget, experts from the healthcare sector have emphasized the need for increased government spending, improved infrastructure, and enhanced innovation to build a robust healthcare system in India. Apart from that, the Indian healthcare industry holds greater expectations from the budget, right from affordability and accessibility to quality enhancements and more research and development.

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Expressing his views, Dr Girdhar Gyani, director general of Association of Healthcare Providers - India (AHPI), said, "Increased government spending is necessary to address emerging health threats and achieve universal health coverage." He said the government should prioritize a comprehensive approach to building a 'Healthy India,' focusing on sanitation, clean drinking water, and nutrition.

"Public health institutes should be professionalised under autonomous state boards, and the Ayushman Bharat Yojana needs restructuring to include all SECC-2011 beneficiaries. Encouraging the private sector to establish tertiary care hospitals in tier-III towns and opening exclusive PG colleges will address infrastructure shortages. Additionally, promoting the indigenization of high-tech medical equipment and advancing the National Digital Health Mission is also crucial," he stated.

Suneeta Reddy, managing director of Apollo Hospitals Group, said it is crucial to acknowledge the vital connection between our nation's economic health and its healthcare infrastructure as India approaches another Union Budget.

The pandemic exposed our healthcare system's vulnerabilities, highlighting the urgent need for significant investments. To achieve the 5 trillion dollar economy goal, a robust healthcare sector must be central to our strategy, Reddy said.

"Granting the healthcare sector 'national priority' status, similar to the IT sector in the 1990s, can spur this transformation. Boosting domestic manufacturing of medical devices through tax incentives and regulatory support will reduce dependency on imports, enhancing affordability and accessibility," she said.

Probal Ghosal, chairman and director of Ujala Cygnus Group of Hospitals, urged the government to increase healthcare spending to 2.5 per cent of GDP, focusing on rural areas.

"Rationalizing the GST framework and prioritizing capacity building and training for healthcare professionals is vital. Enhancing healthcare infrastructure in Tier 2 and Tier 3 cities and encouraging private investment in medical colleges and healthcare facilities are essential.

Encouraging private investment in medical colleges through land allotments, subsidies, and loan moratoriums, along with mandating doctor rotations and incentivizing specialists in smaller cities, will ensure equitable expertise distribution. Additionally, increasing budgetary allocations for primary care and expanding primary health centres (PHCs) through public-private partnerships (PPPs) is essential," Ghoshal said.

IMA president Dr R V Asokan pointed out that the "the allocation varying from 1.1 to 1.6 per cent GDP together by the various governments is one of the lowest in the world".

Moreover, the expenditure incurred on health determinants like drinking water, sanitation should be provided for separately.

"Thus, the minimum allocation for health alone should be around 2.5 per cent of the GDP. Despite numerous policy pronouncements prioritizing health, the governments in India at the Centre and state levels have historically underfunded the public health sector, resulting in poor health outcomes and rising inequity in access to health care," he said.

India's overall health spending (public and private) is currently estimated to be 3.8 per cent of its GDP, lower than the LMIC average of health spending share of GDP of around 5.2 per cent. India's health system is overwhelmingly financed by out-of-pocket (OOP) expenditures incurred by households," he said.

The IMA has also written a letter to the Union finance minister flagging its demands ahead of the budget.

Dr Ashutosh Raghuvanshi, CEO and MD of Fortis Healthcare, echoed silimar demands of prioritizing healthcare infrastructure by increasing GDP spending to 2.5 per cent.

"We urge the government to designate healthcare as a national priority and implement transformative measures to establish India as a global healthcare powerhouse. The sector currently faces challenges such as a shortage of skilled workforce, indirect taxation issues, and unused Minimum Alternate Tax (MAT) credit," he said.

To ensure sustained and accelerated growth, policies conducive to private sector investment must be focused upon, Dr Raghuvanshi said.

The government should strengthen public-private partnerships by introducing new models and policies to boost the adoption of digital healthcare services and promote medical value travel.
"This can be achieved by facilitating international insurance recognition for Indian healthcare providers to attract more international patients," he said.

Vikram Thaploo, CEO-Telehealth at Apollo Hospitals Enterprises Limited, said, "We anticipate a budget that fortifies the healthcare foundation of our country, as a strong and resilient healthcare ecosystem is a critical driver of India's economic growth." 

He added: "The Union Budget for 2023-24 allocated INR 89,155 crore to the Ministry of Health, a nearly 3.4 percent increase from Rs 86,200 crore in FY 2022-23. A strategy combining Public-Private Partnerships (PPP), Research and Development (R&D), and enhanced funding for rural healthcare infrastructure is crucial. Allocating a significant portion of the budget to research and development in healthcare and increasing funding for rural facilities will ensure equitable access."