Public Money, Public Trust, and the 4% Question
Public Money, Public Trust, and the 4% Question
India has never spent more on health. So why do we still pay twice — and where does Ayurveda actually fit?
Ayurveda Unfiltered
A note before you read. What follows are my personal reflections — not the official position of any institution I serve, and not an attack on any individual or body. This piece grew out of a simple, growing curiosity. As an ordinary citizen living through the same economic pressures as everyone else — rising costs, the steady weight of healthcare and education bills — I found myself wanting to understand where our public money actually goes, and where my own field sits within that larger picture. Everything here rests on published data and budget documents already in the public domain; I have tried to point at facts, not personalities. So please read this not as a critique thrown from the outside, but as introspection from within — a vaidya asking hard questions of the system he belongs to, in the belief that honest self-examination is the first step toward doing better.
India has never collected more tax. It has never budgeted more for health. And it has never talked more loudly about Ayurveda’s “civilizational potential.”
And yet a salaried family in Hubli, Pune or Patna will tell you something the GDP charts won’t: they pay the state, and then they pay again — at the hospital counter, the diagnostics lab, the chemist, the coaching class. The growth story is real. So is the bill that lands on the kitchen table.
This is not a complaint about taxes. It is a question about return on trust. A country of roughly 146 crore people cannot be made healthy by hospitals alone — and this is precisely the gap Ayurveda claims to fill. Prevention. Lifestyle. Constitution-based care. The catch is uncomfortable for those of us inside the system: Ayurveda asks for a larger seat at the public-health table while taking less than 4% of the central health budget — and has not yet built the evidence to demand the rest.
Let me make the case with numbers, not adjectives.
Part 1 — Who actually pays for India?
Begin with a paradox. India has nearly 100 crore working-age citizens, but the direct-tax base is astonishingly narrow.
Barely 6% of the population files a return at all. Of those who do file, close to two-thirds owe nothing once rebates and deductions are applied. So perhaps 2% of Indians meaningfully fund the income-tax system — while almost every Indian, rich or poor, pays GST, fuel levies and embedded taxes on daily consumption.
| The tax base, in plain numbers | Approximate figure |
|---|---|
| Total population | ~146 crore |
| Working-age citizens | ~100 crore |
| Income-tax return filers (FY 2024–25) | ~9 crore (~6%) |
| Filers with zero tax liability | ~63% of individuals |
| Citizens paying meaningful income tax | ~2–3 crore (~2%) |
| Citizens paying indirect tax (GST etc.) | Almost the entire population |
| Annual GST collection | ~₹20 lakh crore |
The political consequence is a squeezed, anxious formal middle class that feels it carries the state on its shoulders — and a vast informal majority (80–90% of the workforce) that, though outside the income-tax net, still feels every rupee of indirect tax in the cost of living.
Part 2 — The “double payment” trap
Here is the engine of middle-class frustration, in one diagram.
You pay your taxes. The public system, stretched thin across 146 crore people, cannot fully deliver. So you pay again — for the private hospital, the private school, the coaching centre. Families increasingly finance the second payment by depleting savings, selling assets, and taking gold and personal loans. Medical inflation has outrun general inflation for years. A single hospitalisation can undo a decade of savings.
This is no longer only a medical problem. It is a problem of trust in the social contract.
Part 3 — Healthcare: the fault line
To be fair to the record: life expectancy is up, maternal and infant mortality are down, vaccination has widened, AIIMS and medical colleges have multiplied, and COVID-19 proved the system could mobilise at scale. None of that is small.
But look at how the money is shaped. For FY 2026–27, the Ministry of Health & Family Welfare received about ₹1.06 lakh crore. The Ministry of AYUSH — Ayurveda, Yoga, Naturopathy, Unani, Siddha, Homoeopathy combined — received about ₹4,409 crore.
| Central health spending (FY 2026–27) | Approximate allocation |
|---|---|
| Ministry of Health & Family Welfare | ~₹1.06 lakh crore |
| Ministry of AYUSH | ~₹4,409 crore |
| AYUSH share of the combined pool | ~4% |
| Standing committee’s recommendation | 5% → 10% (unmet) |
| New All India Institutes of Ayurveda announced | 3 |
Now, the honest reading of this chart cuts two ways — and Ayurveda Unfiltered has never been in the business of cutting only one.
Part 4 — The 4% question, asked properly
First edge — against the state. A parliamentary standing committee has, more than once, asked for AYUSH to receive 5% and eventually 10% of the health budget. Instead, the share has drifted downward since 2023–24, even as the mainstream health budget grows. If the government genuinely believes its own rhetoric about traditional medicine, the budget does not show it. Three new institutes and a press-release flourish do not make a public-health strategy. Tokenism is not patronage.
Second edge — against ourselves. Here is the part my colleagues dislike. A larger share must be earned, and on the metrics that justify public money — outcome data, clinical evidence, primary-care integration, measurable reduction in disease burden — Ayurveda has under-delivered relative to its claims. We cannot demand 10% of the budget on the strength of philosophy while resisting the very evidence standards that would warrant it. The 4% is partly an injustice. It is also, partly, a mirror.
Both things are true at once. Pretending otherwise is how a profession loses credibility.
Part 5 — Follow the money: where does the ₹3,993 crore actually go?
Even the 4% deserves a harder look. A budget is a statement of priorities, so take FY 2025–26 — when the Ministry of AYUSH received ₹3,992.90 crore — and ask the unfiltered question: did that money go to delivering health to people, or to maintaining the apparatus that talks about health?
The answer is uncomfortable.
Two facts dominate this chart.
First, nearly half the ministry’s money — ₹1,965.80 crore — went to autonomous bodies: the research councils, national institutes and universities. The four research councils alone command roughly ₹907 crore (CCRAS ₹457 cr, Unani ₹214.50 cr, Homoeopathy ₹165 cr, Siddha ₹70 cr), with another ₹251 crore for the All India Institute of Ayurveda in Delhi.
Second, the National AYUSH Mission — the one scheme that actually puts AYUSH on the ground (integrated hospitals, rural dispensaries, contractual AYUSH doctors) — received about ₹1,275 crore, and grew by a mere 6.25%.
| Where the ₹3,992.90 crore went (FY 2025–26 BE) | Allocation | Share |
|---|---|---|
| Autonomous bodies (research councils, institutes, universities) | ~₹1,965.80 cr | ~49% |
| — Research councils (Ayurveda, Unani, Homoeopathy, Siddha) | ~₹907 cr | ~23% |
| — All India Institute of Ayurveda, Delhi | ~₹251 cr | ~6% |
| National AYUSH Mission (grassroots delivery) | ~₹1,275 cr | ~32% |
| Secretariat, central-sector schemes, regulators, other | ~₹712 cr | ~18% |
| Medicinal Plants Board + drug standardisation (PCIM&H) | ~₹41 cr | ~1% |
Now read it as a critical insider should.
The research apparatus is not undeserving of funds — but ₹907 crore for research councils invites a blunt question: what has India received back in published, replicable, outcome-grade evidence proportional to a decade of such budgets? If the honest answer is “less than the spend implies,” then the evidence deficit I keep writing about is not merely a cultural failure. It is a budgeting failure — we have been paying for research and harvesting press releases.
Meanwhile the vehicle that could actually reduce disease burden — grassroots AYUSH primary care — gets the smaller, slower-growing share. We fund the institutes that study prevention more generously than the mission that delivers it. And the workforce meant to staff that delivery is thinning: registered non-institutional AYUSH practitioners reportedly fell from about 2.12 lakh in 2018 to 1.15 lakh in 2022.
And note the final indignity in that chart: a system whose entire therapeutic identity rests on herbal medicine spends roughly 1% of its budget on the medicinal-plant supply chain and drug standardisation combined — the very things that would make Ayurvedic pharmacy safe, reproducible and credible.
So the 4% problem has a second layer. It is not only that Ayurveda receives a thin slice of the national health budget. It is that we spend our own thin slice in a way that privileges the apparatus of knowledge over the delivery of care — and then wonder why the public-health dividend never arrives.
That is not a funding problem the government can fix for us. It is a priorities problem we must fix ourselves.
Part 6 — With the money in hand, is Ayurveda doing enough to belong?
Set aside, for a moment, what the government gives or withholds. Ask the harder question of ourselves: with the funds, the institutes, the councils and the deep cultural goodwill we already possess, is Ayurveda actually doing the work required to be accepted as a serious public-health system?
Looking honestly around, the answer is troubling. What I see growing fastest is not evidence, not primary-care integration, not community prevention. It is dilution, commercialization and exploitation:
- “Wellness” branding that sells lifestyle as luxury rather than offering health as a public good.
- A flood of social-media promotion in which clinical claims are made with the confidence of marketing and the evidence of none.
- A 3,000-year epistemology compressed into fifteen-second reels, miracle cures and before-and-after testimonials.
Let me be fair, because fairness is the point of introspection. In the present day, a social-media presence is, to a degree, a necessary evil. A young vaidya building a practice, a clinic trying to reach patients, a teacher trying to correct misinformation — none of them can simply abstain from the platforms where the public actually lives. To have no presence at all is to hand the entire conversation to the loudest and least scrupulous voices in the room.
But there is a line, and we cross it constantly. The line is this: are you using the platform to serve the system, or using the system to serve yourself?
When practitioners think only within the narrow bracket of personal reach — the followers, the funnels, the franchise, the personal brand — they forget something obvious. The credibility they are spending is not theirs. It belongs to Ayurveda. Every inflated claim, every commercialized shortcut, every “ancient secret” repackaged as a supplement quietly draws down a reservoir of public trust that took centuries to fill and that none of us, individually, created. We are spending the system’s capital to build our own — and calling it growth.
And here is the question that genuinely worries me: how many in our own profession are even aware that this is happening? Not as a vague discomfort, but as a measurable erosion. How many faculty, practitioners and administrators can clearly tell the difference between promoting Ayurveda and protecting it?
More pointedly still — do we have a single institutional mechanism that is actually thinking in this direction? A body whose task is not to issue circulars or count colleges, but to ask the only question that ultimately matters: is the public’s trust in this system rising or falling, and what are our own actions doing to it? Regulators count seats and inspect buildings. Councils fund research. Marketers chase reach. But who is guarding the reputation of the system itself — the one asset no budget line can ever buy back once it is gone?
If the honest answer is “no one,” then that — far more than any shortfall in the 4% — is the real crisis. A system can survive being underfunded. It cannot survive being hollowed out from within while each of us is too busy promoting ourselves to notice.
Part 7 — The strength we keep wasting: prevention
The world’s health systems are drowning in lifestyle disease — diabetes, hypertension, obesity, metabolic syndrome, sleep and stress disorders, autoimmune conditions, mental-health crises. These are not surgical problems. They are problems of how people live, eat, sleep and move.
This is the one domain where Ayurveda’s classical architecture is not borrowed and not derivative:
- Dinacharya — daily regimen
- Ritucharya — seasonal adaptation
- Ahara — disciplined diet
- Nidra — sleep regulation
- Vyayama — appropriate exercise
- Sadvritta — ethical and mental discipline
If even a fraction of this were operationalised — in schools, in workplaces, in geriatric and community care — it could blunt the chronic-disease wave before it reaches the expensive tertiary ward. That is not “alternative medicine.” That is public health.
But potential is not performance. To convert one into the other, four shifts are non-negotiable:
| The reform agenda | What it actually demands |
|---|---|
| Evidence | Real clinical trials, outcome studies, epidemiology, transparent documentation — not testimonials |
| Primary & preventive care | Chronic-disease management, rehabilitation, geriatric and community health — not OPD-only models |
| Education | Curricula that build critical thinking and research literacy, not rote defence of tradition |
| Integrity | An end to exaggerated claims and commercial wellness branding that corrode credibility |
Part 8 — The larger national question
Strip away the line items and one question remains: what is development for?
If record tax collections and record budgets do not translate into healthier citizens, lower financial distress, better schools and institutions worth trusting, then dissatisfaction will persist no matter how impressive the GDP figure. India’s harder challenge is not growth. It is the moral and institutional work of converting public money into public well-being.
| India’s two simultaneous realities | |
|---|---|
| The growth story | The lived story |
| Record tax collections | Rising household debt |
| Expanding infrastructure | Hospital bills that destabilise families |
| Booming digital economy | 80–90% informal employment |
| Fast wealth creation (top 1% holds ~40%) | Bottom half holds a sliver |
| Strong markets | Everyday financial insecurity |
A healthy nation is not built only from hospitals, highways and budgets. It is built from prevention, accountability, community responsibility — and a healthcare philosophy that puts human well-being at the centre of national life.
In that vision, Ayurveda still holds real, unrealised potential. But let us be clear-eyed about the bargain: the seat at the table will not be granted by reverence, and it should not be. It has to be earned — with evidence, with reform, and with the honesty to admit that 4% is, for now, partly a verdict and not only an injustice.
That is a conversation worth having unfiltered.
Sources for the figures cited: Union Budget 2026–27 documents and reporting (MoHFW and AYUSH allocations); AYUSH Ministry head-wise allocations for FY 2025–26 (autonomous bodies, research councils, National AYUSH Mission); CBDT / Ministry of Finance data on ITR filers and zero-liability filers; Parliamentary Standing Committee reports on AYUSH allocation; World Inequality Lab estimates on wealth concentration. Figures are approximate and intended to convey scale.
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