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Will Union Budget 2020 live up to expectations of healthcare fraternity?

Union Budget 2020

Healthcare fraternity has huge expectation from Finance Minister Nirmala Sitharman who is set to present the Union Budget on February 1. As India spends around 1 percent of GDP on healthcare, Industry believes that it should be increased to support various healthcare infra projects, to enable people accessible and affordable care.

In addition, tax exemption on preventive health check-ups, measures to support investment in Research & Development, provision for liberalized FDI regime for investments in health infrastructure, medical innovation fund, import duty relief for lifesaving equipment, conducive government policies for startups, and focus on primary healthcare infrastructure are some of the expectations of the industry players from the Budget.

Let’s check what Industry players pin their hope upon:

Niira Radia, Chairperson, Nayati Healthcare

India is at the cusp of becoming the Economic power house over the next two decades, which would only be possible with the support of a robust healthcare infrastructure that should be available to masses and not limited to metros only.

The creation of healthcare facilities in the non-metros need to be incentivised to enable early diagnosis of growing non-communicable diseases (NCDs), which correspondingly would be easier and economical to treat thereby enhancing the probability of the disease reversibility besides bringing down the cost of treatment. Tax holidays, soft loans, subsidized land would be some of the areas to be worked upon in this direction. Whilst Ayushman is covering a certain section of the society, the access to tertiary care centres still remains a challenge.

While Ayushman is a welcome step and would evolve over time, it is restricted to the 50 million BPL families and does not cover the remaining population – 80% of which does not have any form of access to any form of healthcare coverage. Insurance penetration is less than 5%, that leaves a approx. Close to 50% of the population remains without any health cover. India needs to move towards a universal healthcare policy available for every citizen.

Keeping pace with the advancements in technology would also be imperative and thus the Government should look at measures to support investment in Research & Development with an aim to bolster new product development and techniques which in turn would generate employment and contribute to the development of the Economy.

Import duty on life saving healthcare equipment’s should be exempted and domestic production of such equipments encouraged and incentivized. Make in India in healthcare should be fast tracked and incentivized.

Ishiqa Multani, President, Sagar Group of Hospitals, and Advisor, Dayananda Sagar University

The Indian government’s Ayushman Bharat scheme is not only a saviour of the poor and diseased, but is going to open up several opportunities for healthcare industry as well. It is estimated that Ayushman scheme will create over a million jobs in the coming decade. In addition, government has also taken timely decisions in sanctioning several new medical colleges across different states that will create the much-needed increase of skilled doctors. However, the hospital industry will continue to face an acute shortage of skilled medical staff professionals such as paramedics, nursing, lab technicians etc., which requires an equal attention. We expect policy initiatives towards incentive-based programs to be rolled out by the government. Also, in the upcoming budget government must also consider setting aside a larger portion of the funds towards preventive healthcare, so as to reduce the disease burden.

Furthermore, large amounts of patient data generated from the private and public healthcare services requires a credible connected platform that can foster new and improved healthcare operations and opportunities. Healthcare data can be the driving fuel for new technologies such as computational drug discoveries and digital doctors. Besides, a nationally connected data will also ensure a reduction in fraudulent claims. To support universal healthcare, government can implement tax-exempt policies for all life-saving medical devices, consumables used with devices in the specific life-saving treatment procedure and their spare parts from Customs Duty. Finally, the healthcare sector in India has immense opportunities for disruption and investment, government can create special healthcare start-up tax incentives to further support it.

Nickhil Jakatdar, CEO, GenePath

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.

Chander Shekhar Sibal, Senior Vice President, Fujifilm India

The primary expectation would be to see policies that fulfil the government’s vision of affordable healthcare. Higher spends on healthcare will be essential to provide good quality primary healthcare in rural areas. Major reforms and investments are expected that would improve the quality of healthcare drastically in smaller towns and rural areas and help build a healthier prosperous nation. The healthcare sector has always been one of the key focus areas with initiatives such as the Ayushman Bharat scheme. The scheme has benefited so many people and helped to improve the healthcare infrastructure in the country.

We would like to urge the government to introduce zero-rating GST on healthcare services, provision for liberalized FDI regime for investments in health infrastructure and medical innovation fund and import duty relief for lifesaving equipment. It will help in bringing down the expenses of healthcare significantly.

Another important aspect is Preventive Health check-ups that can eradicate and analyse high prone diseases. We hope that the government will increase medical reimbursement deduction pertaining to the rise in inflation and encourage the need for prevention amongst people. We at Fujifilm are working extensively towards promoting preventive healthcare amongst consumers and understand the importance to offer medical solutions to the community that best cater to their needs and demands.

Meena Ganesh, MD & CEO, Portea Medical

India has one of the lowest spending on healthcare globally. While it was stated that the country is set to increase healthcare spending to 2.5% of the GDP by 2025, it continues to stand at 1%. We hope to see some action around this in the upcoming budget. A major focus must be given to the home healthcare industry which is one of the ways to realize the government’s vision of affordable healthcare for all. However, current taxation policies and regulations do not cover home healthcare and diagnostic tests and other at-home aspects still form a large part of people’s out of pocket expenses.

Home healthcare is not recognized as a mainstream sector and should be brought under the ambit of governmental schemes like the Ayushman Bharat yojna. We also expect to see an increase in the limits on reimbursement of expenses on diagnostics, preventive health check-ups, etc. and for home healthcare to be made a part of this exemption. Critical healthcare equipment such as ventilators, wheelchairs, crutches, and medical equipment spare parts should be exempted from GST. This will help make quality healthcare more accessible.

While it is encouraging that steps have been taken to register services like elder care homes and home care agencies for the provision of care to elderly, the real challenge is in terms of lack of facilities. Add to this is the cost of elder care and complete non-availability of insurance.

Sarvesh Shashi, Founder, SARVA, India’s fastest growing yoga and wellness ecosystem

Data from the World Economic Forum indicates that over 77% of Indians will be under the age of 45 by the next decade. However, despite being one of the youngest countries, we are also the most unfit with estimates suggesting that 1 in every 3 Indians are medically unfit and suffer from preventable lifestyle disorders. In the last five years, the government has exhibited a keen interest in the revival of Yoga.

The hon’ble prime minister has personally taken a lot of interest in positioning Yoga as a universal exercise that can help people stay fit, look good and be healthy. While these have been welcome and have helped encourage players like SARVA who are ensuring that there is a more organized and holistic approach to the concept of yoga, we still have a long way to go. Preventive health and wellness is the need of the hour for each given the high instances of disease and lifestyle-induced illnesses in our country.

In order for holistic health to be made more attractive to consumers, it is important that the tax component on commercially-run Yoga practices and institutes be revisited since yoga can help address chronic medical ailments and fill the gaps in traditional healthcare.

Under section 80D of the Income Tax Act of 1961, taxpayers can claim tax deductions on health checkups and health premiums; preventive wellness, however, is still placed under a high tax bracket.

This year however we hope that the budget goes beyond providing tax deductions to those getting back to good health after falling sick but also supports and incentivize those who take care of their own fitness. This could potentially include fitness services such as memberships to gyms, fitness studios, commercially-run yoga centers, etc.

Amit Choudhary, Founder & CEO, Dawaa Dost

The government had pushed for affordable and accessible healthcare in its last term, and we hope that this year’s budget will also have some concrete action plans to realize this vision. Innovative, tech-based, large-scale and affordable healthcare solutions are the need of the hour in India and our expectations from the budget also revolve around the same.

We hope the government will simplify regulations for pharmacies buying medicines from GST paid channels. There should be 100% input credit for such entities and the working capital must be freed even under circumstances where the manufacturer or authorized distributor have erred on paying the deposit.

The retailer has no recourse to anyone else nor the margins to absorb the entire GST as is the case today. We also hope the government will consider offering income tax breaks to affordable medicine providers like Dawaa Dost as this will make them more accessible to the masses.

There can be specific provisions for the creation of a sunrise industry for providingincome tax subsidies for hiring new talent from a PF contribution standpoint, accelerated depreciation on stores, and subsidy on technology development via grants. There is a huge opportunity in terms of building a new industry and the need of the hour is for government support like the one provided to the IT sector two decades back.

Neha Rastogi, Founder and COO-Agatsa

The start-up ecosystem in India is thriving thanks to some conducive government policies announced in the last budget. Given this, startups in all sectors including those focusing on healthcare and health tech innovation are going to witness rapid growth in the years ahead.

However, the issue that needs to be addressed at the outset is India’s current healthcare infrastructure and allotted budget which are not adequate to ensure universal healthcare services to all. This is where innovations in medical devices and services come into picture and we hope the budget will focus on this aspect.

A growing number of tech-enabled companies like Agatsa are stepping in to provide specialized healthcare monitoring solutions through portable devices using cutting edge technology. The need of the hour therefore is to provide adequate funding and support to fuel further innovations under the Make in India and Digital India campaigns.

While the market for healthcare startups and digital healthcare devices is robust, we also need more support from the government to promote indigenous innovations and provide an impetus to domestic device manufacturers.

We would like to see the government procure more Indian products from the market so that our dependency on foreign imports can be brought down to a minimum. This will not only boost the Indian startup niche but also make healthcare services more affordable for the common people.

Vikas Bagaria, Founder, Pee Safe

The femtech industry has a huge potential and is expected to reach $50 billion globally by 2025, as per estimates by Frost and Sullivan. Though this is a relatively new industry, it aims to address some of the age-old problems women have been facing and is projected to be the next big thing in the women’s health and hygiene market.

It promotes the use of digital health applications such as hygiene products, diagnostics, reproductive health monitoring systems, etc. to help women take control of their health.

Our expectation from the budget 2020 centres around government policy and regulation to enable ease of doing business through centralized policies. This will also attract more foreign investment opportunities in the segment. There is also a need to simplify the taxation process and make early stage funding easier.

While the government has done well in terms of facilitating foreign investments in India, this outlook needs to be maintained going forward to effectively promote more innovations under the Make in India campaign. Even though there is immense potential, the investor confidence in the Indian femtech industry is still considerably low – and we hope the policies to be announced in the budget ahead will be an enabler.

Gaurav Gupta, Co-Founder, Navia Life Care

We would like Government to partner with healthcare startups to implement their projects and help them establish quality care for the people. The budget should aim to create healthcare facilities in small towns and rural areas. Ayushman Bharat is a nice step towards universal healthcare in India but better healthcare facilities need to be implemented.

There are lack of doctors in public centres and are currently not able to serve. Technologies for doctors like video conferencing and diagnostic tools helps the doctors to diagnose the patient and assisting with services across the country. Government needs to allocate appropriate budget for the development of healthcare ecosystem in the country. To provide good quality healthcare in rural India needs to be taken care of like building healthcare infrastructure in rural and remote areas.

The government must help the startups to grow through the implementation of tax benefit to angle investors for investing in startups and to reduce the GST for the new entrepreneurs.

MoHFW came up with the National Digital Health Blueprint in July 2019, we hope that the government would take significant strides in that direction with specifications in the budget towards implementation of digital health in the government hospitals.

Last year, the then Finance Minister announced that the Government of India has envisaged a national program for artificial intelligence (AI) in a bid to leverage the technology and take it to the masses, we believe that there would be bigger contribution in the form of budgetary allowance towards that. We hope that there would be specific guidelines given to government agencies on prioritizing the implementation of AI driven technologies in their organizations and departments.”

Nitiz Murdia, Marketing Director, Indira IVF

Budget 2020 should focus on cost of elder care and complete non-availability of insurance. We need to fix the economic angle and create some institutional solutions with government funding and sponsorship.

The budget should upgrade the medical technologies which should be specifically designed to help Indian healthcare needs. Including IVF treatment in the insurance plan will help to minimize the financial risk to the person who is seeking the help. As of now, both private and *public sectors* are not including the insurance for IVF Treatment but should come up with such covers.

Budget is eagerly awaited by medical devices space as expectations are pegged on shaping the industry to be globally sustaining. Government should continue to focus on healthcare and invest in upgrading the primary and secondary health tiers in the country. All healthcare providers should provide the quality healthcare and help to shape the better healthcare system.

More investment must be there to provide the primary healthcare infrastructure, lower cost via technology and accessibility, approach and affordable treatment. Women must be provided with the assurance that they will receive the full pay during their maternity leave and should not be discriminated for future promotions and also paternity leave for men should be increased .

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