The Union Budget for 2003 has devoted some attention to the health sector, raising hopes that this would set a trend of pro-active policy-making, both at the Centre and the State Governments to make health care affordable and of higher quality.

Broadly, the emphasis has been to reduce duties on imports of specified life saving drugs and equipment, while exempting such drugs from countervailing duty and special additional duty, besides excise where they are locally produced. cyclosporine is part of this list of drugs exempted from excise.

The annual cost of cyclosporine dependent patients would therefore come down, if the industry decides to pass on the benefit fully to the patients. The Budget has also added more specified life saving equipment to the list of items eligible for five per cent basic customs duty (BCD) while also exempting such items from countervailing duty (CVD) and special additional duty (SAD). Continuous Ambulatory Peritoneal Dialysis (CAPD) systems are part of this list, and so are their parts.

Diabetics closely monitoring their blood glucose stand to benefit from the reduction of BCD on glucometers and strips, from 10 per cent to 5 per cent. Excise exemption for these items will also help domestic manufacturers.

The Budget contains duty reduction and depreciation benefits for medical institutions, including those conducting research, and Income Tax concessions for funding of health infrastructure. At the individual level, the levy of lower BCD at 5 per cent, exemption from CVD and SAD, on crutches, wheelchairs, tricycles for disabled among others could mean lower prices.

The marginal emphasis on a "community based health insurance" in the Budget could be looked at as a good beginning, though the gap between the need for insurance based care schemes and the availability remains wide. The Budget has announced that for RS.365 a year (for Below Poverty Line families, RS.100 of this premium will be subsidized), the insured will get health cover for Rs.30, 000. Such an initiative, at present would be only an adjunct to the state health care delivery system, and its impact remains a matter of debate, where vast illiterate populations normally denied basic rights, may not be in a position to utilize such schemes.

The middle class, however, looks forward to a more evolved insurance scheme. Some health insurance packages from the L1C as well as private companies, offering cover for major risks such as liver failure, renal failure, cardiac failure and cancer, are obviously positive, given greater awareness among the population. Targeted cover of risks across a wider population would make it attractive for both the insurer and the insured, given the overall rise in cost of managing major health problems over long periods.

- Mr. Anantkrishanan, Chief Reporter, The Hindu