Out-of-pocket health spending dips from 62.6% to 47.1% in 5 years, India ranks 67th among 189 countries

The government health expenditure as a share of total health expenditure has increased from 29 percent to 41.4 percent between 2014-15 and 2019-20 while government health expenditure's share in country's total GDP has increased from 1.13 percent in this period.

New Delhi: There is a consistent decline in the out-of-pocket spending in total health expenditure from 62.6 percent (in 2014-15) to 47.1 percent (in 2019-20), reveals the National Health Accounts (NHA) estimates for 2019-20 factsheet released today. Significantly, India ranks 67th in the list of 189 countries in the out-of-pocket expenditure comparative estimate.

NHA estimates state that government health expenditure's share in country's total GDP has increased from 1.13 percent (2014-15) to 1.35 percent (2019-20) while share of government health expenditure in total health expenditure has risen from 29 per cent to 41.1 percent during this period. This apart, the per capital government spending on healthcare has doubled, it stated.

Stating that increase in Government’s Health Sector spending is in the right direction, the factsheet pointed out that the Government’s health expenditure on primary care is 55.9 percent while that on both primary and secondary care is around 86 percent. “With the launch of Ayushman Bharat – Health and Wellness Centre, the expenditure on Primary care has increased and will increase further in coming years,” the estimate read.

For the year 2019-20, Total Health Expenditure (THE) for India was estimated to be Rs. 6,55,822 crores (3.27 percent of GDP and Rs 4,863 per capita). THE constitutes current and capital expenditures incurred by Government and private sources including external/donor funds. The Current Health Expenditure (CHE) was Rs 5,93,659 crores (90.52 percent of THE) and capital expenditures was Rs 62,163 crores (9.48 percent of THE). Capital expenditures are reported for all sources of Government (Union Government is Rs 22,923 crores; State Government Rs 38,951 crores; external donors Rs 289 crores).

Government Health Expenditure (GHE) including capital expenditure is Rs 2,71,544 crores (41.41 percent of THE, 1.35 percent GDP, and Rs 2,014 per capita). This amounts to about 5.02 percent of General Government Expenditure in 2019-20. Of the GHE, Union Government’s share is 35.8 percent and State Governments’ share is 64.2 percent.

Union Government’s Expenditure on National Health Mission is Rs 40,482 crores, Defence Medical Services is Rs 14,690 crores, Railway Health Services is Rs 5,043 crores, Central Government Health Scheme (CGHS) is Rs 4,852 crores and Ex-Servicemen Contributory Health Scheme (ECHS) is Rs 5,180 crores. Expenditures by all Government Financed Health Insurance Schemes combined are Rs. 13,809 crores.

In the private health sector, expenditure on primary and secondary care has decreased while expenditure on tertiary care has increased over the years. National Health Accounts Technical Secretariat (NHATS) prepared the NHA estimates for 2019-20 with constant guidance and support from NHA Steering Committee and the NHA Expert Group for India.