The Indian Healthcare Manifesto - What Have Our Politicians Promised Us and Will They Deliver?

The central and state governments budget for healthcare expenditure was 2.1% of GDP in 2022, according to a report released by the Parliament. In a country where only half of healthcare expenditure is borne by the government with most of the remaining coming as out of pocket expenditure, the result is a severely underfunded healthcare sector. Similar metrics from other prominent nations show a 5.6% total health spend in China, 12% in UK and 18.8% in USA.

With the elections underway, here are the healthcare related promises being made by the various popular political parties according to their publicly available manifestos:

Aam Aadmi Party (AAP)

Increased spending on education and healthcare.
Expand healthcare infrastructure – 900 new PHCs, 30,000 new hospital beds of which 4,000 maternity beds. Target of 5 beds per 1000 people.
Quality generic drugs at affordable prices.

2. Bharatiya Janata Party (BJP)

Strengthen the network of AIIMS Hospitals and Medical College seats.
Strengthen Ayushman Arogya Mandirs (PHCs, SHCs, UPHCs, AYUSH and UHWCs).
Expand the Jan Aushadi Kendra network for low-cost medicines.
Expand Ayushman Bharat scheme – expanded to cover senior citizens. Health Insurance up to 5 lakh rupees per family per year.
Launching the Emergency and Trauma care mission.
Strengthen disease eradication programmes for TB, Leprosy, Lymphatic filariasis, Measles, Rubella, Trachoma, Kala azar, Foot mouth disease and Brucellosis.
Increase vaccine production.
Increase training facilities for paramedics, health technicians, pharmacists and nurses.
Improve mental healthcare services.
Improve women’s health with a focus on reducing anemia, breast cancer, cervical cancer and osteoporosis. Focused initiative to be launched to eliminate cervical cancer. Making sanitary pads available for 1 rupee.
Mission Indradhanush for maternal and child vaccination.

3. Indian National Congress (Congress)

Universal healthcare: Insurance up to 25 lakh rupees per family.
Upgrade PHCs with diagnostics and ensure they conform to the standards.
Encourage private health insurance and private hospital participation in government schemes.
Maternity leave to be made mandatory from all employers.
Increase health budget yearly to reach 4% of GDP by 2029.
Double allowance and better housing for doctors serving in rural areas.
Double allowance to ASHA workers. Increase to 2 ASHA workers in more populated villages.
Establish 1 government hospital and medical college per district. Mandatory minimum of 75% staffing in all hospitals and medical colleges.
All public health job vacancies to be filled in 3 years.
Review of NMC act and full autonomy to the NMC.
All systems of medicine will be supported by the government.
Strict scrutiny on pharmaceutical manufacturers.
Increased central government dispensaries and availability of generic medicines at these dispensaries.
100% immunization (from 76%) within 5 years.
Expand the mid-day meal scheme up to class 12.
Make violence against doctors illegal.

4. Communist Party of India (Marxist)

Right to free health care.
Public expenditure on health to be raised to 3.5% of GDP in the short term and 5% in the long term.
Maternity leave of 26 weeks.
Minimum wage and social security to ASHA workers.
Implement the provisions of the ‘Rights of persons with disabilities’ act and the ‘Mental health care’ act.
Increase accountability of the public health system. Scrap Ayushman Bharat which is based on the insurance model.
Reverse privatization of health services. Regulate the private healthcare sector. Bring an end to private insurance led healthcare.
Expand the ESI scheme.
Free uninterrupted supply and increased public sector production of medicines. Removal of hazardous formulations. Controlling price of essential drugs by adopting a cost-based pricing formula. Reduction of taxes on medicines. Removal of US-FDA officials from India.
Strict regulation of clinical trials.
Setting up and increased funding of government medical colleges.

5. Shiv Sena (Uddhav Balasaheb Thackeray)

Upgrading district hospitals
Ensuring that every Primary Healthcare Centre is well-staffed.

6. Nationalist Congress Party (NCP) (Ajit Pawar)

Rural development through health and sanitation.

7. Nationalist Congress Party (NCP) (Sharad Pawar)

All-inclusive development with affordable health.

Our country is grappling with a chronically underfunded public healthcare system and the masses are unable to afford private healthcare. A healthy workforce is one of the basic pillars of a strong economy. All developed nations bar none have well-funded (if often inefficient) healthcare solutions. Seeing as we aspire to be one of them, this step is non-negotiable. If some or all of these pre-election promises were to be fulfilled, we could get on the path towards a healthy and prosperous future.