By Kaushal Kishore
New Delhi: Union Finance Minister Nirmala Sitharaman has allocated ₹90,958.63 crore for the healthcare sector in addition to ₹3,712.49 crore for the AYUSH Ministry in Union Budget 2024-2025. Last year it was ₹80,517.62 crore for the Ministry of Health and Family Welfare, and ₹3,647.50 crore for the AYUSH Ministry. This means a hike of 12.5 per cent for the Ministry of Health and Family Welfare, and 1.7 per cent for the Ministry of AYUSH.
In this year’s Union Budget, healthcare has been allocated 1.5 per cent of the GDP, however, the ruling Bharatiya Janata Party promised to increase it to 2.5 per cent in its manifesto during the elections.
The Union Budget has been all centred around the idea of Viksit Bharat (Developed India) with its nine priorities – agriculture, employment and skilling, inclusive human resource development and social justice, manufacturing and services, urban development, energy security, infrastructure, innovation, research and development, and the next generation reforms.
However, neither health nor senior citizens figure in these nine priority areas.
The Welfare State had initiated a medical insurance scheme intending to help the vulnerable citizens under the Ayushman Bharat. The AB PM JAY refers to the Pradhan Mantri Jan Arogya Yojana within the framework of ‘Modi ki Guarantee’. This scheme is considered to be the largest publicly funded health insurance scheme globally providing the secondary and tertiary care of hospitalisation coverage to approximately 55 crore beneficiaries or 12 crore families belonging to the lower strata of the population. It has offered health coverage of up to ₹5.00 lakh to economically weaker families, however, the senior citizens are one of the most vulnerable people among the voters. But still, they are not covered under the scheme, and there was a plea to include them in the Ayushman Bharat health insurance scheme.
In 2023, the NITI Aayog in its report and the Economic Survey mentioned the importance of addressing the healthcare of the senior citizens along with certain other issues. Consequently, the BJP promised in its manifesto, “We will expand the Ayushman Bharat Yojana to cover senior citizens and provide them access to free and quality healthcare.”
Interestingly, the government announced that senior citizens over 70 years of age will also be eligible for free healthcare under the scheme, but without allocating the funds.
Also read: Care of the elderly: Need to create an impact
The Ayushman Bharat has an allocation of ₹7,300 crore as compared with the previous allocation of ₹6800 crore. In the interim Budget presented by the Union Finance Minister Nirmala Sitharaman in February this year, she had allocated ₹7,500 crore for the Ayushman Bharat PM-JAY. An additional ₹646 crore was earmarked for the Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), aimed at strengthening healthcare facilities and services.
The inclusion of senior citizens needs further allocation of ₹4,000 to ₹500 crore which is yet to be approved by the Union Cabinet. Hence it refers to the critical gap in the budget, leaving many of the elderly people without the promised healthcare coverage.
The senior citizens demanded for withdrawal of 18 per cent GST on the mediclaim services and for the accommodation that the government ignored in the budget 2024-25. Around 15 crore senior citizens had expected the restoration of railway concession, a facility which was withdrawn during the COVID-19 pandemic in 2020. This concession was crucial for the mobility of elderly people. Therefore they have reasons to be unhappy with the lack of travel concessions, and the funding of their health insurance.
Many senior citizens’ groups raised the demand to revise the central contribution to old age pension under the NSAP (National Social Assistance Programme). The NGOs advocate increasing the amount from the current ₹200-500 to ₹1,000 per month for those aged over 60 years and ₹1,500 for those aged over 80 years. With the share of the state contribution, it can be increased to ₹1,500 to ₹3,000 per month.
The national policy on dementia is yet another issue related to senior citizens. The Alzheimer’s & Related Disorders Society of India (ARDSI) has been diligently following up with the government since they submitted the Dementia India Strategy Report to the Union Health Minister in September 2019. The Finance Minister maintained silence on this issue in the budget speech.
To implement these schemes, the National Health Authority (NHA) and other agencies of the government would require an additional annual expenditure of ₹10,000 to ₹15,000 crore. It is time that the government ensures better care for the senior citizens.
*Author of The Holy Ganga (Rupa 2008) and Honourary Secretary, Srishti Sustainable Development Foundation.
