Prime Minister Narendra Modi’s government has its work cut out if it wants to transform the country’s health system and provide a universal health insurance programme.

India has just 0.7 doctors per 1,000 people, and 80 percent of this workforce is in urban areas serving 30 percent of the population, according to industry lobby group NATHEALTH.

Less than 25 percent of the population has access to any form of health insurance. And India’s public and private expenditure on health is around 4 percent of its GDP, the lowest among BRICS countries.

India is seeing a rise in lifestyle diseases and is on its way to become the world’s diabetes capital with more than 60 million diabetics, a number that the Research Society for the Study of Diabetes in India (RSSDI) estimates will cross 85 million in 2030, or nearly 8 percent of the population today.

India Insight spoke to stakeholders in the healthcare sector about their wishlist for the budget. Edited excerpts:

Dr. Jitendra B. Patel, President, Indian Medical Association

“Impetus has to be given to preventive aspect of treatment. Safe drinking water and sanitation are the t wo important things which are to be addressed immediately. Primary care should be given more budget than secondary care. For a developing country like India, corporate culture is not going to help the people. We have to serve the poor people.

“Also, the ratio of doctors must increase. For that, more and more medical colleges are the need of the hour.”

Anjan Bose, Secretary General, NATHEALTH

“Additional detailed clarification from the infrastructure status granted to healthcare. Form a working group and explore the possibility of a healthcare fund and a medical innovation fund.

Healthcare should be exempted from GST. Withdraw the service tax on health insurance premiums, and limit of [tax] exemption for premiums under health cover should be raised to 25,000 rupees [$415] from 15,000 rupees [$250].”

Dr. S.V.Madhu, President Elect, Research Society for the Study of Diabetes in India

“I would strongly pitch for a significantly higher allocation for health in the budget. Of this, a significant allocation should be for non-communicable diseases, focused on diabetes.”

Dr. Vikram Singh, Chief Executive – Healthcare, Jaypee Hospital (the first foray into healthcare by business conglomerate Jaypee Group)

“The government needs to look at taxation fees on high-end equipment that hospitals import. Organisations setting up hospitals in adverse regions like hilly terrains or low population zone need to be incentivized through means where they are given support in the form of electricity in subsidized rates. There has to be support to institutions, which provide human skill related to health sector. Government needs to come up with budgets which are more towards upgrading the existing facilities in the government sector.”

Dr. Bindeshwar Pathak, founder, Sulabh International (NGO working in the field of sanitation)

“The prime minister has said they [government] want to pay tribute to Mahatma Gandhi in 2019 [Gandhi’s 150th birth anniversary] and they want to stop open defecation by then.

“A little more than 110 million houses have no toilets. So they have to be provided. Money will have to come either from subsidy of the government or bank loan, or both. And the requirement would be about 3.5 lakh crore rupees [$58.5 billion]. And it has to be divided into five years. So every year, they will have to construct about 25 million toilets.”

Dr. Shashank R. Joshi, President, Association of Physicians of India

“More economical medication, and friendliness to get newer compounds to India. In diabetes sector, we want the import duties on life-saving medicines like insulin to be removed. Overall allocation of budget on health is very poor, so it has to go up substantially. It is one of the lowest in the world. And they should focus on non-communicable diseases, which kill far more people than diseases like HIV.”

(Editing by Tony Tharakan; follow David on Twitter at @davidlms25 and Tony @TonyTharakan. This article is website-exclusive and cannot be reproduced without permission)