Health for all, but Karnataka budget misses pandemic control

BENGALURU: At the outset, Chief Minister B S Yediyurappa must be congratulated for pulling off a tight budget, given the economic despair created by the Covid-19 pandemic. The state stepped up by spending Rs 5,372 crore on managing Covid-19 and testing 1.9 crore people. Continuing with substantial investments in critical care, it is heartening to see these facilities being converted into ICUs at the 
district level.

The focus on strengthening curative services is justified — the lion’s share is devoted to these services — though it is not sufficient to address aspirations for a healthy Karnataka. The government has retained 4% allocation of the total budget for the health sector at Rs 11,908 crore, up from its earlier share of Rs 10,122 crore. The critical question, however, is how will these funds get spent?

Traditionally, apart from salaries and recurrent costs, most budget funds were spent on curative services. In the past few years, the budget for health insurance is increasing. This is not a bad thing because it is essential to protect people suffering from acute illnesses and save them from impoverishment due to catastrophic medical expenses. However, a progressive state should learn from other failed examples. The United States of America spends 17% of GDP on health, and yet, a significant proportion of people does not have access to primary healthcare services. 

It is proposed that primary health centres (PHCs) with more work pressure will be upgraded to model PHCs. The basic problem in urban health is lack of primary healthcare services, and poor and migrant workers suffer the most due to unaffordable private hospitals. Instead of ensuring that primary healthcare is strengthened, I am surprised that another new multi-speciality hospital will be started in North Bengaluru, especially for migrant workers. There should be a moratorium on new buildings till such time that existing ones are used well.

Despite Covid-19 impacting every walk of life, there is no additional focus on disease surveillance; preventing and controlling future pandemics is only possible from an all-inclusive human, animal and environmental perspective.The health department’s logo, ‘Health for everyone, everywhere’ seems to reflect in the budget, but ‘All focus on health’ is missing.

Dr Giridhara R Babu
Professor and head-Lifecourse epidemiology at Indian Institute  of Public Health, Bengaluru, Public Health Foundation of India