Budget '22 and Indian Healthcare: Key Takeaways

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Budget '22 and Indian Healthcare: Key Takeaways

1 Feb, 2:30 PM

[Music] good evening friends thank you for coming in at short notice we set this session up in the evening and we thought while there isn't so much which has happened in the budget especially on healthcare we still thought it would be useful to cover the three or four things which are coming out of it as usual the budget comes in a summary on on this day and then the more uh the fine print comes through in the subsequent weeks and months so we'll look at what we know as of today and this was the fourth budget uh by mississippi and uh you know uh opinions are uh divided depending on where people are thank you so much uh i was just uh about to start we haven't started yet uh what i was saying is that uh i i have a very short like five seven minute summary of what's happened uh what's been announced today uh i'll just run that through uh and then would love to have uh your thoughts on what we need today uh what what we missed and what's coming out uh to give a brief introduction of ritesh to all the friends here he's a doctor he completed his mbbs then ventured on the entrepreneurial path he is the person who set up innovate some of you may have heard of it it was india's first organized co-working space provider they were the wework of india and uh innovate uh scaled beautifully grew very large and it was eventually acquired by uh oyo and uh is a very active angel investor he's as far as i know he's done 70 75 plus investments uh and uh currently he's the trustee and founder of laksha university uh towards the end of the session uh it would be very very lovely to hear a few words uh about your entrepreneurial journey uh but thank you so much uh for making time with ish and and uh if all of you watch tv uh he's a very regular healthcare expert on on most uh good uh top class news channels so thank you so much for making time for us thank you very much super excited for this thank you right so uh the the first uh the first slide we have is on overall highlights and i just run through four or five things these are non-healthcare overall key highlights uh things which you will read in the papers tomorrow so the the most uh interesting news coming out is that uh they have introduced a 30 tax on cryptocurrency and i mean not not using the word cryptocurrency but digital assets uh everybody is looking at this as a sign of uh regularizing cryptocurrency so so nobody is worried about the 30 tax uh everybody's just happy that you know the fact that you're taxing it uh indirectly means that you're legalizing it so i think that's one major news uh there's also going to be a one percent transaction tax unlike uh other taxes and uh this the losses made on cryptocurrency or digital assets cannot be set off uh so that's on uh that the the second interesting related thing is rbi is planning to launch a digital rupee uh which will also be using a blockchain like technology uh more details are awaited but uh it is expected that this may not be like cryptocurrency so this this will actually have be backing real assets uh it is just going to be a digital currency in alternate to printed paper but but more details are awaited so too early to say the exact nature of the digital rupee but the timeline is very short it's expected in 22-23 there's a very tactical thing so there are no changes in income tax labs but just one extra thing that we can now file our updated returns within two years if we made any errors so this option was not there earlier but otherwise no changes in income tax uh mrtharaman said that she didn't want to increase tax burden in a pandemic here uh so that was the additional context to that uh on long-term capital gain this is a slightly tricky one so if you have long-term capital gains you typically pay 10 tax when the capital gain increases above 50 lakhs there's a surcharge which starts getting added so from 50 lakhs to two crores the surcharge is 15 percent then 2 crores to uh onwards it's 25 then it's 37.5 percent what they have done is now they've kept the surcharge at 15 so irrespective of the amount of gain the surcharge is going to be 15 also earlier this facility was only available for listed shares now they have made this available for unlisted shares also so things like startups unlisted equities uh manufacturing bonds etcetera so these are likely to benefit from this this is on the very high scale i mean two crore plus gain is not going to really affect uh most people uh and amongst a couple of policy announcements 5g is expected to be rolled out by 23 and the spectrum auctions will be conducted later this year and they are planning to create e-passports e-passports will not be intangible there will be physical passports but they'll have a chip uh and the chip will have your biometrics encoded in the passport so so these were just some of the things which we expect to hear more details about in coming years now coming to healthcare uh the the the big i mean the big highlight of the healthcare announcement is that thanks to kovad the expenditure as well as the outlays have increased so i mean this is a number heavy conversation but indian healthcare was uh 2.7 lakh crore recovery uh that increased to 4.7 lakh crore porsche covent and and this is including the 35 000 crore allocated to the vaccination program in terms of percent of gdp the uh the 1.3 percent has uh from 2021 has increased to 2.1 percent in 2122 and the government targets to take this to 2.5 percent by 25 on this point a lot of experts are saying that we are aiming too low uh we should be aiming higher uh it's just uh not going to be adequate uh for a country like us and uh the fact that kovid demonstrated how weak the healthcare system was and this was a golden opportunity to actually invest aggressively in healthcare which is something which some experts have said we've missed the the second announcement which is not really a first time announcement this has been announced earlier was on the national digital health system uh an open platform [Music] where there will be different registries for providers uh facilities uh unique health ids for everyone so so that was again mentioned as a focus area and this has been uh talked about for the last more than a year and i think under the hood a lot of work is happening on this front lot of work at the government level a lot of startups are getting into it and building integrations so i think uh this is something we are all fairly excited about of what this can create it is uh it is positioned as the aadhaar moment or the upi moment for healthcare would love to hear dr ritesh's thoughts on this what this exactly means what this can open up and finally on the tele mental health program this was one of the only specific announcements in the budget today uh so setting up of 23 telemental health centers under the guidance of nimhans something which has been welcomed because mental health is put squarely in focus thanks to this and it has long been talked about as a very very important thing and kovit has just helped bring it to the forefront but the counterpoint to this from a lot of experts is that we've missed out on chronic diseases with missed out on preventable diseases and uh only spoken about mental health so so in a nutshell uh these were the things on health care and just some views from experts which we've collected from media i would let i would let everyone read this i don't want to just read out the sentences but i'll just leave this on for 10 20 seconds for everybody to read it on medical devices uh they have said that we missed uh doing something special for them india exports a very large percentage of its imports a very large percentage of its medical devices and uh we should have done something more to encourage local production uh yeah otherwise i think no specific comments so i i think i will uh stop presenting with that and uh uh yeah so so dr ritesh welcome and uh would love to hear your thoughts great uh rohan thank you very much please call me first of all thank you very much super excited to be a part of netflix i've been hearing such amazing feedback and reviews from so many people you must be very proud of what you've built uh so so i'll tell you my candid feedback on the budget uh i i feel uh all the so so a balanced budget is the one on where short-term and long-term measures are equal in this budget it is too level so they should have a clearly first control second which is very important is employment so these are topics which are away from health care but employment i'll just come to health care that is completely disappointing and i'm not a negative person i'm just i'll so i think [Music] [Music] and these two will truly redefine buddha bhutan is one of the happiest nations in the world the reason is health care health care and education have been sorted out unfortunately nothing came and if you want to have equitable health model you need to ensure early medicine infrastructure is phenomenal and usually i'm glad that india if you see a country like india we hardly give under two percent of our gdp to health care whereas over five lakh crore has gone to defense but only and only two percent goes to health care now health and family welfare stands at about 74 75 000 rupees okay now with this amount of of budget we have to take care of the entire and and also mark my words when i say that health care in india for the for the majority of the public is public health care not private health care yeah now they should be developing and giving a lot of incentivized schemes to doctors reduce i cannot emphasize this enough reduce and help doctors to become doctor preneurs build help them create it and i'm sure or the the the upi based s and health care is one area we saw what happened in the second wave and if we say yes we are not prepared for it unfortunately i i don't know whether you know this or not there's a place in india called now now is up this is a city where they created a special economic zone for generic pharmaceutical companies to be there and for 15 years they have given tax rebates that led for india to become a generic drug manufacturer and an exporter in drugs like there are so many drugs from cholesterol management to uh sexual wellness drugs all are being manufactured in indian food for the world the sold reason was was the government incentivized there was was pli schemes around that so i think first of all and you'll be amazed as an entrepreneur i can tell you no one wants to invest in health care infrastructure because it's a very high capital return business full of medical legal and and and hardly and if you see the number of nursing homes in india have reduced from 2010 because smaller nursing homes are getting closed so in my opinion uh and lastly one thing which we were expecting was a country is as good as its health insurance infrastructure as a country our health insurance cover is in shambles we have almost zero health insurance in our country they should remove gst we have told like this is the basic thing that you can do to create they should reduce 18 gst which is a massive friction then another point for dr preneurs who are hospital owners who are clinic owners is we don't get gst from our patients but for buying things the hospital is expected to give an 18 gst that means while the government says that we are helping you out by not giving you gst they are not helping the hospitals we are getting a minus 18 ebitda on day one which no one understands a hotel owner is better he gets 18 gst from the customer it gets outputted as 18 gst right so so these are a couple of things and the only way to get this thing done is they should they should actually spend a lot of time with doctors get to know their challenges uh example uh so so one of the challenges in india india is one of the countries where doctors get beaten up and i'm not talking about tired three cities in india i'm talking about cities like delhi i still remember my dad and the association fought for getting the medicare act that in delhi now in a hospital you cannot touch a doctor this needs to go national just imagine uh no doctor wants his patient to die right no one would do it intentionally there are courts there is counsel go and do a civilized complaint don't beat doctors it's as simple as that every day there is someone or the other getting beaten up so i think so so so coming back this is a this is something which i i feel that healthcare and doctors and and not to ignite anyone but i i just feel um we've not been very well represented in my opinion if you see i was also going through the ratio of engineers in the rajya sabha and lok sabha when you when you compare with the ratio of doctors we hardly have any doctors in the in politics so until and unless is r and that is why our challenges are not being heard of and until political bill is there around that because you see every year we are we get excited that now something will come for health care now something will come for health care in spite of it if it is not coming then it's a serious concern and and i think it's also a laxity on our end because we don't ask doctors we don't have the time to chase is and lobby and we don't have the means and capital uh for this you need a lot of capital for lobbying as well absolutely i think uh if if we couldn't uh do better in the kovid years then once the pandemic is gone and the pain is forgotten there's just i mean you can't hope for much more in the budgets to come in the subsequent years so uh yeah that's what many many people have said it's a missed opportunity and aiming for 2.5 is just aiming too low so yeah u.s is 18.75 exactly so and then i'm not saying u.s is a good health care system but at least that gives a precedence that health care developing nations like brazil mexico they do better than us and our population 136 crore aadhar cards this is this is the registered number of people that we have in india mary in my opinion there are 14 15 crore people were not even registered we were talking about like 1.5 billion people and their healthcare five black people dying just because of just because of that century in india five black india the people health care challenge is not it's it's not a challenge of and it's a diverse challenge it's a challenge where malnourishment obesity infectious diseases we are a country which is a blend of almost every disease still so many people are fighting with tb so i just feel that we need a lot of incentives for doctors at least at least just imagine by by the time a doctor turns 35 he barely starts making making enough money to enjoy his life i was trying to do bizarre and by the time and one of the reasons i'll be very candid here one of the reasons i left the profession was that i realized that by the time i turned 35 i wanted to make a lot of money so and and in our profession making money is frowned upon unfortunately we've seen that in medical college also they always say that only do intellectual stimulatory things which is very good but why is making money frowned upon in our profession it's good to make money it's very good as long as you're paying your taxes it's very good to make money but the challenge is that you people think that doctors should not make money because it's a noble profession if it is a noble profession why are doctors beaten so i i think you've just strung a chord in my heart but i just feel that we need better better representation and i think platforms like metrics can can truly help we should actually write this to the health ministry absolutely uh absolutely ritesh and uh maybe we should uh you know uh with your uh offices and all in for this i mean we can we can get a petition and signed by uh ten twenty thousand doctors on the platform and and at least write that that's the least we can do uh honestly i don't expect much to happen but uh at least we should give it a shot uh but no so uh yeah what you're saying uh is evident from my presentation also so the first slide was uh full of seven eight points and and that was a very short list there were 30 points that we had and the second slide which was on health care had just three points and the first point was just a data point which is two point one percent and then there's something on digital health mission and something on uh national tele uh telemental health uh and and if you think about it we we study so many national health programs in preventive and social medicine so it's not like the programs aren't there uh you have programs on vector-borne diseases on blindness on cancer and it it it defeats us right that they don't even find a mention somewhere in aggregate at least like if nothing not even a single finance minister in the past so many years has ever used the word cataract which is the largest cause of blindness in india so like these are very basic things how will we how will we become um a nation which will be progressive so healthcare is right to health and in healthcare also comes climate change right to the right aqi air in delhi i have lost 15 years of my life i am an asthmatic eqi in delhi in 2021 average was 247. it's it's it's it's bizarre at 247 singapore shuts down all ships everything and at foreign we just had to summarize uh there's nothing much for patients there's nothing much for doctors and there's nothing much for hospitals in fact when you know we were thinking about setting up this session we we had a genuine dilemma whether we should or not uh because there's nothing much to talk about uh but we thought we'll still have the session and talk about the fact that there's nothing much to talk about so uh so which is you know the reason quest which i always have for doctors i have a lot of respect for doctors i don't consider myself to be a doctor because it will be cheating for the profession because i don't see patients uh my lifestyle is way comfortable than all of yours because i i i don't practice seek seeing patient my my wife is a doctor my sister is a doctor my entire family my parents are doctors i i realized that as a doctor our life is very harsh it's a very difficult life when you compare with your colleagues or your batchmates so i just feel that as doctors as we should also conduct a lot of interdisciplinary learning exercises instead of just focusing on uh the course curriculum we should talk about ftcg we should talk about investments we should talk about having a holistic lifestyle i think i think that is which is extremely important the question is why i'm sure out of the 131 people right here i don't know how many people today have a goal that my balance sheet should have 1000 crores in the next 10 years i don't know whether you have it or not when you tell me that i don't have this i just why not because i have i've and and the good part is if you start thinking like that and in health there are a million opportunities is and which can be pursued while while you are a doctor while you are treating patients you don't need to become like me but you have so many opportunities you can invest by investing well and by compounding you can you can you can you can become a billionaire there are so many things so so my only request to all of you is to ensure that you not only become the master of your art of your skill but also devote some time to interdisciplinary skills one of the key things which i see lacking in doctors is the fact that we are very tunneled we we are only limited to our icus we are only limited to our our work life and i think that that is something that needs to change as doctors the question is interesting please don't think that i'm demeaning anyone this is just my heart out because i really want this to change ima as an organization for the past 30 years i am 13 to 32 now so for the past 30 years i i know how im is working doctors used to earn well earlier [Music] a meeting you will rarely see two or three doctors having a luxurious car so and and and this perception needs to change and it's not about buying a car but ensuring that because whenever i talk to my friends that aims and the moment i tell that money is important they feel that they feel very uncomfortable in accepting that and then i realized that the reason why they don't have it is because they feel that what will my batchmates think and as a doctor a lot of the times uh i i just hate it when patients haggle like patients haggling with doctors on their clinic so i just feel that we should be very clear with what we want we should have a lot of financial knowledge my parents i'll be very honest with you my parents have done 10 investments in their lives [Music] i just realized that we don't do enough diligence we don't do so i think investing is an art every doctor and the good part is if you start early why don't we try why don't we try the administrative posts actually why why we are not asking for the indian medical services and for the past five years we have been fighting as a group for indian medical services we can be in administrators and we can change our own systems instead we are getting competition from the bureaucracy and politicians even the 17th uh uh commission didn't tell of you know this uh indian medical services yeah we have to fight for these sort of things and uh we have to get upgraded because you know if we have the administrator we can we can just change all these things i mean as dr malik said financial part will also be improving if we get the administrative uh positions and the higher positions we will be in a this is a best example the covet uh pandemic is the best example where we can take over the administration we should fight for this this is a major first step which we can do and we have to come into i i don't find we entering the politics but at least we should uh secure that ims indian medical services 2017 one of the information provided it said that there were only seven states which uh have answered or replied that uh they were for this ims and uh seven to eight states were not uh in the will of uh this ims actually indian medical services is like indian administrative services and other administrative services where we can take the top uh seat you know yeah and dr malik what do you say about this no no 100 i am i'm completely in agreement we should definitely fight for that and unfortunately the problem medical is and and all these organizations are so bureaucratic they have the in my opinion they have wrong people like we need young blood we don't need they they they try to control the power we need young minds who are who are different and who have the probability of taking ownership changing systems and i think in and and in my opinion if you see the largest change in the startup ecosystem has been bought out by organizations like rohan knows nasscom uh iamai and now adif so so so one of the key things that and other professionals have done very well is build good organizations because see we have we have a large number of professionals as and and we are like extremely skilled professionals are we i think we need a counter body to actually have all the doctors together and then get the right representation and it's not hard to go to the government and ask for all of this i i just feel that it needs to be a channeled effort guys i have a heart stopped up in in one minute no no wonderful uh wonderful having you uh ritesh and i think we we raised a lot of uh pertinent points thank you so much for uh extremely candidly sharing your thoughts um it's not every day that we get people to uh speak so openly and honestly on public platforms uh really appreciate the candle and i think change can happen once we speak our minds so uh thank you so much for joining us uh i'll carry on the conversation with a couple of guests who want to come on stage uh but but we'll have you again to tesh to talk about your journey uh and you mentioned uh finance uh so so this session is in a club called money matters on on metrics the club is called money matters and we do sessions there's a session on investing by dr malpani on 4th web request everyone join in but we'll have you again thank you so much for coming thank you


Financial Minister Nirmala Sitharaman kicked off the much-awaited healthcare budget announcement with an optimistic promise of increasing healthcare spending from 1.5% of GDP to 2.5 % by 2025. Additionally, she touched upon the components of the National Digital Health Ecosystem and how the government is working towards rolling out the National Tele-Mental Health Programme. Curious to know how the budget impacts you? Join us live at 8 PM on Medflix with Dr. Ritesh Malik and Dr. Rohan Desai to unpack the salient features of the healthcare budget.


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