BENGALURU: As Karnataka looks towards its 2026-27 Budget, public health experts say the State must move beyond incremental announcements and address gaps in its healthcare system, from underfunding and workforce shortages to over-reliance on private players.
Experts point to a long-standing demand for increase in public health spending. “The National Health Policy suggested that states must commit at least 8% of their total budgetary expenditure to health. It is around 4% now,” said Prasanna Saligram, public health researcher with Sarvatrika Arogya Andolana Karnataka (SAAK).
He added that beyond routine allocations, the government must look at a universal health system and consider enacting a Right to Health Act. “If we claim to be a top-ranking state economically, we should move towards guaranteeing health as a right,” he said.
On the ground, practitioners say chronic disinvestment has weakened the public system. “The public healthcare system is suffering from decades of underinvestment,” said Dr Akshay S Dinesh, public health doctor and co-founder of Action for Equity. “Free care exists largely on paper. Patients are often asked to purchase medicines, surgical materials, or drugs for chronic diseases from outside.” He says the government must go back to the basics -- fill vacancies, ensure free medicines, and restore dignity in public hospitals.
Workforce shortage remains a critical concern, particularly in rural areas. Dr Swathi SB, public health practitioner and member of SAAK, points to high vacancy rates among frontline workers.
“Vacancies in primary healthcare posts are severely affecting access, especially in rural and remote areas,” she said, adding that shortage of Auxiliary Nurse Midwife (ANM), medical officers in PHCs and community health officers at Health and Wellness Centres force patients to travel long distances for care. She also flagged delays in implementing the promised increased honorarium for ASHA workers.
Instead, the government attempting to increase the population covered by each worker will negatively impact community health. Experts also emphasised the need to reduce out-of-pocket expenditure, much of which goes toward medicines. “Uninterrupted free medicine supply can reduce financial burden on families,” Swathi added.
The budget must take a broader view of health, say some experts. Upendra Bhojani, Senior Fellow and Head, Centre for Commercial Determinants of Health, Institute of Public Health Bengaluru, said fiscal policy should also discourage health-harming commodities. “If we reduce consumption of tobacco, alcohol and other harmful products, we will reduce healthcare spend,” he said, urging the state to consider taxation and regulatory measures.