Union Health Budget 2024-25 : What's in it for Senior Citizens and what's missing?

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 the budget for 2024-2025. The 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.

It means the hike of 12.5 per cent for the Ministry of Health and Family Welfare, and 1.7 per cent for the Ministry of AYUSH. The health research department has been allocated ₹3,301.73 crore and ₹87,656.90 crore for health and family welfare department.

The union budget estimated to spend ₹48,20,512 crore in this financial year with the increase of 8.5 per cent over the actual expenditure of the last year. The total collection is expected to be around ₹32.07 lakh crore, and the net tax receipt will be around ₹25.83 lakh crore, with the fiscal deficit worth 4.9 per cent of the GDP. The healthcare has been allocated 1.5 per cent of the GDP, however, the ruling 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 that includes the productivity and resilience in 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. Sadly health is out of these nine pillar points, and so are the senior citizens.

The welfare state had initiated medical insurance scheme with a view 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 the economically weaker families, however, the senior citizens are one of the most vulnerable people among the voters. But still they were 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 of 2024 duly mentioned about 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.” The government announced that senior citizens over 70 years of age will also be eligible for free healthcare under the scheme without allocating the funds.

The Ayushman Bharat has got 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 Rs 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 need further allocation of ₹4,000 to ₹500 crore that 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 budget. Around 15 crore senior citizens had expected to restore railway concession, a facility which was withdrawn during the COVID-19 pandemic in 2020, when the government began to take care of every citizen. This concession was crucial for the mobility of the elderly people. Thus, they are unhappy with the lack of travel concession, and the funding of their health insurance.

The senior citizen groups raised the demand to revise the central contribution to old age pension under the NSAP (National Social Assistance Program). The NGOs advocate increasing the amount from 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 the senior citizens. The Alzheimer’s & Related Disorders Society of India (ARDSI) has been diligently following up with the government since they have 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.

The National Health Authority (NHA) and other agencies of the government implementing these schemes would necessitate an additional annual expenditure of ₹10,000 to ₹15,000 crore for the exchequer. The traditional Indian family is the best place for timely care of the children and elderly people. In this age of fragmented families, the government needs to promote and support families in order to ensure better care of the senior citizens.