In the most recent National Health Accounts projections for 2018–19, the government emphasised “an promising trend” in health spending indicators. Even so, the overall healthcare spending as a share of GDP decreased by one percentage point.
Between 2004-05 and 2018-19, the total health expenditure as a percentage of Gross Domestic Product (GDP) fell from 4.2% to 3.2%. The total health spending for each individual in the nation, calculated at current prices, went from 3,638 in 2013–14 to 4,470 in 2018–19.
Additionally, the government’s expenditure on health declined from 1.35 percent of GDP in 2017–18 to 1.28 percent in 2018–19. However, it increased 0.13 percentage points from 1.15 percent in comparison to 2013–14. Government health spending, which includes capital spending, increased by 5% from the previous fiscal year to 2,42,219 crores in 2018–19.
The government’s share of total health spending climbed by 12 percentage points, from 28.6% in 2013–14 to 40.6 percent in 2018–19. The Total Health Expenditure increased by 5% between 2017–18 and 2018–19, from 5,66,644 crores to 5,96,440 crores. The Total Health Expenditure includes both current and capital costs spent by the public and commercial sectors, as well as outside funding.
From 40.8 percent the year before to 34.3 percent in 2018–19, the Center’s proportion of government health spending decreased. On the other hand, the states’ share increased from 59.2% to 65.7% over the same time period.
Government healthcare spending per person increased from 2013–14 to 2018–19 by 74%, from $1,042 to $1,815 per person.
From 64.2 percent in 2013–14 to 48.2 percent in 2018–19, the per capita Out-of-Pocket Expenditure (OOPE) as a percentage of Total Health Expenditure fell by 16 percentage points. OOPE is the term used to describe payments made by a person to obtain medical treatments that are frequently not covered by health insurance. India’s OOPE is regarded as being extremely high in comparison to economically developed nations with strong social welfare systems.
Dr. VK Paul of Niti Aayog stated during the report’s release that reducing out-of-pocket health spending (OOPE), which forces individuals and families into poverty, has been the government’s guiding concept.
The social security expenditure on health—which includes the social health insurance programme, government-sponsored health insurance plans, and medical reimbursements to public employees—rose from 6% in 2013–14 to 9.6% in 2018–19. Additionally, between 2013–14 and 2018–19, government-financed health insurance spending surged by 167%, going from 4,757 crores to 12,680 crores.
According to the report, government spending on primary healthcare increased from 51.1% in 2013–14 to 55.2% in 2018–19. Primary healthcare, which consists of sub-centers and Primary Health centres, is the first tier of India’s healthcare infrastructure. According to Union Health Secretary Rajesh Bhushan, the increase in spending validates the Center’s choice to emphasise primary healthcare across the nation.
The study, despite demonstrating a significant improvement in some categories, reflected health spending in 2018–19, two years prior to the Covid–19 epidemic. Public health awareness brought on by the pandemic is anticipated to spur government spending. According to the 2021–22 economic assessment, “the current epidemic has demonstrated how a healthcare crisis can turn into an economic and social crisis.” It also noted a 73% increase in health spending from 2.73 lakh crore in 2019–20 (pre–Covid–19) to 4.72 lakh crore in 2021–22 (Budget Estimate).