Further, the IMA said deficit funding is the most important cause behind the lack of penetration of the AB-PMJAY. If the funding has to be raised to at least the CGHS (Central Government Health Scheme) level, then the amount required is around ₹1.6 lakh crore, the doctors' body said. The money being provided now is around ₹12,000 crore, it said, adding that it is not possible to deficit finance to this level. Insufficient fund allotment is the root cause of the unrealistically low package rates, the IMA said.

In its proposal to the government, the IMA also recommended creating a special welfare fund for doctors in general and for the "Covid-19 martyrs" in particular.

The doctors' body said the government should conceive a zero-rate Goods and Services Tax (GST) on healthcare services, allowing the service providers to claim the input tax credit.

As the GST is not payable on healthcare services, the service providers are not eligible for the input tax credit.

Enabling this would ensure that input taxes are not added to the cost of the services and provide some relief to patients, the IMA said.

"The healthcare industry is the only industry that does not get input credit because of exemption. Actually, the GST paid by the institutions becomes expenditure and indirectly adds to the cost of treatment. Either some percentage of the total GST paid by healthcare providers be treated as advance tax or MAT (Minimum Alternative Tax) or the GST paid by them on equipment or otherwise should be reduced to 5%," it suggested.

"The country lost more than 2,000 doctors during the (Covid) pandemic. Unfortunately, the majority of the families of the deceased doctors did not receive any help other than whatever little the IMA could marshal.

"A special welfare fund for doctors in general and for Covid martyrs, in particular, has to be set up. The nation owes at least this gesture to the medical community," it said.

The IMA has also sought a hike in healthcare expenditure from the current 1.1% of the Gross Domestic Product (GDP) to 2.5%, as envisaged in the National Health Policy, 2017.

"The health policy 2017 promised GDP in healthcare of 2.5% by 2025. But the increase for healthcare has been negligible and still hovers around 1.1% of GDP," it said.

Of the healthcare expenditure of ₹89,000 crore for last year, a major chunk of ₹83,000 crore was revenue expenditure. Capital expenditure was only ₹5,630 crore.

A substantial increase in the capital expenditure is required in the budget to make a meaningful change, IMA added.

It also said doctors and healthcare organisations be given access to working capital and preferential funding to ensure that the overall cost of operations is reduced.

Benefits should be given to manufacturers of healthcare equipment and consumables under the "Make in India" campaign, the IMA said.

It also demanded the revival of the Indian Medical Services, which was abolished in 1947.

"There is an acute need for a drastic but holistic change in the health administration of the country by creating a specialised cadre of health administrators who would be holding the administrative responsibilities," the doctors' body said.