Quick comments

 Some quick comments on the health budget as below

1. The bureaucrats and members of parliament continue to assure for themselves a very robust share of the health budget for their own privilege. This Rs 6066.24 crores for the 42.38 lakh beneficiaries amounts to Rs 14314 crore per beneficiary contribution by the Union budget in sharp contrast to Rs 86737 crores (92803 crores - 6066 crores) which woks out to a mere Rs  620 per capita. And even if we add the state health budgets which would add up to is about Rs 340,000 crores then the per capita expenditure works out to Rs 2460 per capita and this being 5.8 times less than our honourable bureaucrats and MPs ge ( Its time JSA made this issue of inequality between the electors and the elected and public servants a major highlight ) .
2. Overall too little is allocated to healthcare. The policy mandate is 2.5% of GDP for healthcare (ofcourse excluding water and sanitation which the Eco Survey made us believe that we are spending 2.2% of GDP on health) which is todayRs 680000 crores. Of this the NHP says the Centre should contribute 40%. Accordingly the Centre's health budget should be Rs 270000 crores. This means that the allocation deficit by the Centre is to the tune of Rs 178000 crores. So health clearly not a priority in the budget despite benchmarking from their own health policy
3. The budget structure is becoming increasingly less transparent. The 2021-22 budget information includes much more details than the subsequent years. Thus NHM is now a single entry in the budget in contrast to 2021-22 when NHM was disaggregated by various programs. Earlier years provided even more disaggregated information for example by each disease program, family welfare activities, breakdown of primary healthcare and hospital expenditures etc..
4. We see significant increases in budgets of technology driven and infrastructure related allocations - NDHM, PMABHIM etc as well as PMJAY probably because these promote private sector partnerships or privatization
5. The NHM allocations in the Expenditure statement dont seem to be complete. As per the schemewise table in Expenditure profile docum,ent NHM was Rs 37800 in 2022-23 and in 2023 -24 is down to an allocation of Rs 6785 crores
6. PMJAY is a problematic budget item. It receives a huge allocation but spending is usually half of that each year. For instance in 2021-22 the budget was Rs 7500 crores but actual spending was only Rs 3116 crores. And we know from NITI Aayog data that 78% of the PMJAY funds flow into private hospitals.