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Does India really not have enough money to spend on healthcare?
  1. Sagarika Kamath1,
  2. Rajesh Kamath2
  1. 1 School of Management, Manipal University, Manipal, India
  2. 2 Department of Public Health, Manipal University, Manipal, India
  1. Correspondence to Dr Rajesh Kamath, Department of Public Health, Manipal University, Manipal, Karnataka 576104, India; rajeshkamath82{at}gmail.com

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It is often asked why the Indian government does not spend more on healthcare. India is at the bottom of the table on almost all human development indices and clearly needs to spend more on the health of its people. A lack of funding is often given as the reason for many unmet healthcare needs, but a careful look at India’s budget suggests the contrary. The media tend to focus on the factors affecting GDP growth. It might be pertinent to ask, growth for whom? This seems to be an important question. Nobel laureate Amartya Sen has argued many times that growth has to lead somewhere, and that ‘somewhere’ should be an inclusive and equitable rise in living standards rather than an end in itself.1 

P Sainath, an eminent Indian journalist, has described how, with each budget, the ‘statement of revenue foregone’ keeps increasing, whereas social spending is cut.2 Social spending is characterised by the increasingly neoliberal media as ‘wasteful spending’. Revenue foregone from the corporate sector for the past financial year stood at 6.11 lakh crore rupees (US$91 billion), whereas ‘wasteful subsidies’ amounted to 2.5 lakh crore rupees (US$37 billion).3 Thus, the subsidy to the rich was almost two and a half times the subsidy to the poor. The Indian budget is just under 20 lakh crore rupees (US$300 billion), which means that a sum equal to almost one-third of the Indian budget is being foregone each year. The Indian government began publishing these data for the financial year 2005–2006.

The budget allocation for the health ministry for 2017–18 is less than 50 000 crore rupees (US$7.5 billion).4 Thus the corporate subsidy of 6.11 lakh crore rupees (US$91 billion) is more than 12 times larger than the health budget. We feel that it would be beneficial if some portion of this revenue foregone was invested in public healthcare. It seems to us that a lack of resources might not be the problem and that neoliberal policies which favour capital to the detriment of the proletariat and lead to a loss in revenue should be changed. Fiscal policy makers need to reconsider whether the current quantum of corporate subsidy is justified.5 We believe it is not. There is also a strong case for increasing corporate taxes.5

Ninety per cent of business loans are disbursed by government-backed public sector banks5 and 90% of bad loans in India are from public sector banks.6 Substantial portions of these bad loans, which are large, are written off and funded by the tax payer. This is an example of private enterprise and profit at public risk.

We wholeheartedly agree with Dr Ashok Mitra, former finance minister of the Indian state of West Bengal, and compiler of the collection of essays: ‘The IMF loan, facts and issues’, when he says: “All economics is a class question now”.5 We believe that this is hurting the health of a nation.

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Footnotes

  • Contributors Both authors have contributed in the conceptualisation, writing, editing and proof-reading of this piece.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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