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Budget 2023: Hospitals urge govt to focus on reducing GST, comprehensive insurance cover & public-private partnerships

Union Budget 2023: Ahead of the budget, experts from the hospital segment have expectations like comprehensive treatment coverage, prioritisation of the rural healthcare system, enhancing medical education infrastructure among others.

Union Budget 2023:

Finance Minister Nirmala Sitharaman will announce the upcoming Budget 2023-24 on 1 February 2023. Over the years, India has become one of the most preferred countries for medical tourism and healthcare services. Every year, the number of people coming to India from across the globe for getting various kinds of treatment is increasing.

Ahead of the budget, experts from the hospital segment have expectations like comprehensive treatment coverage, prioritisation of the rural healthcare system, enhancing medical education infrastructure among others.

Reduction in Custom Duties and GST for cancer care

According to Raj Gore, CEO, Healthcare Global enterprises Limited, to encourage investment in cancer hospitals and reduce the cost of treatment for patients, the government must reduce customs duties and GST on critical capital-intensive equipment, reagents/consumables used for cancer diagnostics, and anti-cancer drugs.

?Allocation of resources specifically towards scaling up HCW's and equipping them with trained staff and cancer screening tools will enable early detection and accurate staging of cancer. Furthermore, the inclusion of key diagnostic options (PET scans, biopsies, genomics) and emerging treatment options (targeted therapy, immunotherapy) under all government schemes will offer all cancer patients the best chance of comprehensive treatment and better outcomes,? Gore told Financial Express.com.

Gore also emphasised that the government has been playing a significant role in making healthcare affordable by increasing population coverage under the government schemes from 3 percent to 32 percent in the last 15 years.

?The upcoming budget is expected to prioritize health deserving for an aspiring nation like India. The government has been playing a significant role in making healthcare affordable by increasing population coverage under the government schemes from 3 percent to 32 percent in the last 15 years. Initiatives like ?Heal in India? and ?Heal by India? are encouraging signs of realization of the healthcare sector's global potential and the government's willingness to support the private players,? he added.

He also told Financial Express.com that the upcoming budget should shift the discourse about healthcare to value, standard protocols and comprehensive treatment coverage.

Dr. H Sudarshan Ballal, Chairman, Manipal Health Enterprises Private Limited (MHEPL) told Financial Express. com there has been a long-standing demand for increased government health expenditure, and now there should be a focus on increasing public spending on healthcare, which should contribute at least 3% of the total GDP, making healthcare a priority.

Gautam Khanna, CEO, P.D. Hinduja Hospital & Medical Research Centre, Mumbai told Financial Express.com that allowing medical reimbursement exemption for salaried employees to the tune of Rs. 100,000 per annum will be a welcome move aimed at prioritizing preventive healthcare in India

Focus on Private Healthcare sector

Dr.A K Gadpayle, Medical Superintendent, Sharda Hospital told Financial Express.com that Rural health care system in india is not very much because 80 percent healthcare is provided by the private sector.

?? and the private sector is less prevalent in the rural area. To overcome this gap of primary care, insurance and emergency services in the rural areas need to be facilitated,? Dr. Gadpayle said.

He emphasised that the participation of private sector in healthcare is important.

?Health education is equally important. Shortage of infrastructer,transportation issues, health literacy and social health stigma are hurdles for this. Public pvt partnership, health budget allocation GDP to increase, increase facility to health education for doctors,nurses, paramedicals, to be improved. Participation of local leaders and community to be involved. Health insurance to be implemented. Pradhan mantri health insurance is already introduced. PMJAY is being implemented. In all affordable health care expansion in rural area need to be implemented along with insurance coverage in Rural area,? he said.

According to Dr. Gadpayle, other than improving Telehealth in rural area by improving broadband access, preventive health care services need to be separately introduced.

Dr. Aashish Chaudhry, Managing Director, Aakash Healthcare told Financial Express.com that Public Private Partnerships (PPP) in healthcare have not been giving desired results as compared to Infrastructure and Other sectors.

?The government needs to revisit it with focused reforms and incentives,? he added.

According to Dr. Ballal, to bridge the gap in healthcare workers in India, it is important that we find and encourage doctors, nurses, and other technical employees who are willing to work in Tier 2 and Tier 3 cities and look into unconventional ways to quadruple the number of doctors.

Training more Healthcare Professionals for Robotic Surgeries

Dr. Jagadish Hiremath, Chairman at Aasra Hospitals told Financial Express.com that with increasing penetration of surgical robotics across the country, India has a massive potential to become the world's capital for robotic surgeries.

??It is important at this point in time that the government makes policies and budget allocations to boost up medical value tourism for robotic surgeries and training in robotic surgeries,? Dr. Hiremath told Financial Express.com.

According to Dr. Hiremath, it is indeed laudable that the government has prioritised medical value tourism and has made significant budget allocations to boost this sector in India.

?India is now a popular medical tourism destination for various surgical procedures with people from countries including Europe, USA, Bangladesh and many more opting for surgeries in Indian hospitals,? he added.

Dr. Hiremath pointed out that there is a need for proper educational infrastructures to train doctors for robotic surgeries.

?India's potential in becoming a hub for training in robotic surgeries is huge if proper educational infrastructures are given necessary push. South Korea, a South East Asian country has been a popular hub for Observership programmes for Robotic Surgeries.

Indian surgeons who aspire to gain expertise in robotic surgeries opt for various programmes despite its high cost. For India to become a hub for training in robotic surgeries the existing medical workforce is to be provided with proper support for upgrading their skills in their respective specialities,? he said.

Streamlining Rules for Fertility Clinics

Dr. Somesh Mittal, CEO, of ART Fertility Clinics, India told Financial Express.com that the FY23 budget should include encouraging policies, streamlined rules, and GST laws that can promote the growth of fertility clinics.

?Such measures could include tax breaks for people and companies who invest in fertility clinics, reduced laws that make it simpler for fertility clinics to operate, and government financing for infertility and reproductive health research. Patients will find our services to be more reasonably priced if there are GST exemptions. In order to make fertility treatments more accessible to a larger spectrum of people, the budget should also include subsidies for low-income people seeking reproductive treatments,? Dr. Mittal told Financial Express.com.

He claimed that if such measures are taken, the Indian pharmaceutical industry will likewise see ?unheard-of growth.?

?This necessitates enhancing the pharmaceutical industry's manufacturing and research capacities with a focus on active pharmaceutical ingredients (API) self-sufficiency and value generation through cutting-edge R&D. Government financing for infertility research, reproductive health research, and pharmaceutical sector research could all result in new technologies and treatments that improve patient outcomes,? Dr. Mittal told Financial Express.com.

Dr Kshitiz Murdia ? CEO & Co-Founder of Indira IVF told Financial Express.com that the IVF procedures should come within the realms of health insurance because such treatments are costly for the majority of people and it is going to become a necessity for the upcoming generation.

?It must also be noted that a normal pregnancy is duly covered under insurance, so we recommend an assisted process or treatment for pregnancy, which must also be financially secured. If the insurance company pays for infertility treatments, there will be more standardization and transparency in the system. This will also reduce the financial risks associated with anyone seeking reproductive assistance,? Dr, Murdia said.

Increase depreciation rates of life-saving equipment from 40 percent to 60 percent

R. Udayan Lahiry, Managing Director, Medica Group of Hospitals told Financial Express.com that the government should consider providing tax incentives for Healthcare Skill Development initiatives.

??extending the provision of a weighted deduction of 150% of expenses incurred on skill development projects under Section 35CCD of the Income Tax Act to healthcare organisations (hospitals and diagnostic centres) for apprentice training. Additionally, the government could also extend the Section 80JJAA deduction to healthcare businesses to allow a 100% deduction on stipends to professionals doing DNB and short-term PG Certificate Courses at private institutions,? Lahiry told Financial Express.com.

He also said that GST with respect to healthcare needs to be looked into thoroughly.

?Healthcare industry hasn't yet got all the benefits of GST transition as in other industries. In the case of GST, the recent announcement states that Room rent (other than ICU) has been made taxable @5%, has increased the burden of patients. It is suggested that Healthcare services should be made ?Zero Rated? or should be taxed at a concessional rate of 5% with an input tax credit benefit so that the Healthcare industry can claim the benefit of the Input credit of GST, it is currently paying,? he told Financial Express.com.

Such GST which the industry is paying on the inputs is getting added to the cost of providing healthcare services and is ultimately borne by patients, in terms of higher rates, he added.

Lahiry also suggested that there should be an inncrease in public health spending to 2.5-3.5 percent. Moreover, ealthcare organisations must be given access to working capital and preferential funding, he said.

Vipul Jain, Chief Business Officer, CK Birla Hospital(R) told Financial Express.com that they forward to medical insurance being incentivized by tax breaks or by other mechanisms like reducing cost of medical insurance.

?Currently the tax break on medical insurance is limited to INR 25k under section 80D and we look forward to the budget enhancing this limit and instead of only tax breaks it should also offer tax incentives,? Jain told Financial Express.com.

Nursing and Allied Healthcare Staff Education & Training

Dr. Alok Khullar, CEO, Gleneagles Global Health City, Chennai told Financial Express.com that the nursing workforce in India has one of the highest attrition rates in the country as they go overseas for better financial remuneration and quality of life.

?There must be sustained investments into improving the quality of Nursing Education and hands-on training in the existing Nursing colleges to have a job-ready workforce to replace the exodus of trained nurses from India. A similar focus is needed in Allied & Paramedical Staff education & training,? Dr. Khullar told Financial Express.com.

According to Dr. Khullar, as COVID-19 has exposed the vulnerabilities in our healthcare delivery system and overall Healthcare Industry, there has to be a multi-pronged approach to strengthen healthcare delivery and outcomes.

He also said that the government should also focus on healthcare financing considering the rising cost of healthcare, it is essential to have health insurance for every family.

?The government should provide better financial incentives for people to buy health insurance and make it mandatory for people above the poverty line to reduce the financial burden on household savings because of illness. Further impetus is needed for the development of the health insurance industry,? Dr. Khullar told Financial Express.com.