VIEW POINT;
HEALTH SECTOR :NOT IN GOOD HEALTH !
The BJP's election manifesto had promised to reduce the out-of-pocket spending on health care with the help of state governments. In addition, the focus on key determinants of health — sanitation and potable water — created an impression of sincerity. A report published in an international medical journal, The Lancet, coinciding with the NDA government's one year in power, however, has a different story to tell. Trouble began in January 2015, when the government unveiled its New Health Policy (NHP), which did not commit to any increase in public spending on health. India spends grossly 1.2 per cent of its GDP on health. 

The annual budget for 2015-16 reinforced the government's new thinking. It slashed the Central Government's health spending by 15 per cent over last year. The justification given was that a greater devolution of tax revenues to states, as recommended by the Fourteenth Finance Commission, should enable states spend more on health. Since the primary and secondary health care system is funded by states, this shift in policy rings trouble for the states with the poorest health indicators. Even if it is assumed that they would earn more in terms of revenue, the poorer states tend to spend on development works rather than public health. This trend cannot reverse in the absence of explicit directions from the Central Government, which so far has not exhibited sufficient concern on this count. 

The National Health Mission, under which the Central Government provides funds to the states for reproductive, maternal, newborn, child, and adolescent health programmes, also received almost a quarter less money for 2015-16 than last year. With the out-of-pocket spending on health, even by poorer Indians, being among the highest in the world and nearly 3.1 million households slipping to levels below the poverty line due to the rising health care expenditure, the deterioration of health indicators is a cause for worry. The government, over-focussed, as it appears, on development, should also worry about the health of its citizens.