Health is a state subject in India – the Central government accounted for only 30 percent of total government health expenditure in 2014-15 – there are measures which the Union Ministry of Finance can take to keep the nation healthy not only through higher allocations, but also targeted tax exemptions, given that our out-of-pocket health expenditure is one of the highest in the world. We need more money in our pockets to spend on our health. This, however, does not absolve states and UTs of their primary responsibility vis-à-vis the health of their citizens, and all of them need to do much more than they are currently doing – even health-advanced states like Kerala and Tamil Nadu spent less on health than the miniscule national average as percent of their GSDP.

Policy recommendations that the Union Ministry of Finance could consider :

1) Income brackets: A stratified approach could be developed to make provisions for health care instruments. For example, households without an earning member or those with annual income of 5 lakhs should be provided comprehensive health insurance coverage with the total premium shared between Centre and state / UT governments on a 25:75 basis. Likewise, for those annual income between 5 and 10 lakhs should bear 25 percent of the premium on their own, with the remaining shared between Centre and state as per the same ratio. Similarly, the co-payment of premium can keep increasing according to defined income brackets, with households having an annual income of 30 lakhs and above paying the entire premium themselves.

2) Tax benefits: The limits of medical reimbursement and exemption under Section 80D should be raised from the present 15,000 each to, at least, 1 lakh each per household. There should be provisions for further tax exemptions based on the household burden of disease and disability. We know too well, for instance, how cancer treatments drain out entire family resources, even in developed countries. Where is that money going to come in our pockets? A government in need is a government indeed! Preventive health instruments beyond simple check-ups should also be part of reimbursements and exemptions.

Although health is a state subject in India – the Central government accounted for only 30 percent of total government health expenditure in 2014-15 – there are measures which the Union Ministry of Finance can take to keep the nation healthy not only through higher allocations, but also targeted tax exemptions, given that our out-of-pocket health expenditure is one of the highest in the world. We need more money in our pockets to spend on our health. This, however, does not absolve states and UTs of their primary responsibility vis-à-vis the health of their citizens, and all of them need to do much more than they are currently doing – even health-advanced states like Kerala and Tamil Nadu spent less on health than the miniscule national average as percent of their GSDP (2012-13).

Here are some policy recommendations that the Union Ministry of Finance could consider:

1) Income brackets: A stratified approach could be developed to make provisions for health care instruments.