Health Spending Burden Continues to Weigh Households

Health Spending Burden Continues To Weigh Households

Why in the News ?

The latest National Health Accounts (NHA) Estimates 2022-23 reveal that despite increased government spending on healthcare, out-of-pocket expenditure (OOPE) remains high. The report highlights gaps in financial protection, heavy dependence on private healthcare, and low investment in preventive care, raising concerns similar to those addressed in landmark judgments like the Vanashakti judgment regarding public welfare and regulatory compliance.

Health Spending Burden Continues To Weigh Households

Key Findings of National Health Accounts 2022-23

  • Government Health Expenditure (GHE) increased from 1.15% of GDP in 2013-14 to 1.43% in 2022-23 (1.48% under the revised GDP series).
  • Public spending on health remains below the National Health Policy target of 2.5% of GDP and the WHO recommendation of 5%, despite various regulatory frameworks including EIA notification requirements for healthcare infrastructure projects.
  • The Current Health Expenditure (CHE) stood at approximately ₹7.67 lakh crore, reflecting the total spending on healthcare services and goods.
  • Households continue to bear a significant burden, contributing 56.44% of healthcare expenditure, a situation that contradicts principles of equitable burden-sharing similar to the polluter pays principle in environmental law.
  • Out-of-Pocket Expenditure (OOPE) accounted for nearly 49.9% of CHE, indicating incomplete financial protection against medical emergencies.

Challenges in India’s Healthcare Financing

  • Experts note that the temporary rise in public health spending during the COVID-19 pandemic has not been sustained, with some facilities operating without proper retrospective environmental clearances or compliance frameworks.
  • The share of Government Health Expenditure in overall health spending declined from 41.1% in 2021-22 to 35.6% in 2022-23.
  • Government-funded health insurance schemes, including Ayushman Bharat–PM Jan Arogya Yojana (PMJAY), account for only about 3% of Total Health Expenditure (THE).
  • Private hospitals receive the largest share of healthcare spending (30.83%), highlighting the continued dominance of the private sector, with many facilities requiring post facto regulatory approvals for expansions.
  • Spending on preventive healthcare remains low at only 8.88% of CHE, raising concerns amid the growing burden of Non-Communicable Diseases (NCDs) and the need for a pollution free environment to support public health.

About National Health Accounts and Health Financing :

●  National Health Accounts (NHA) provide estimates of healthcare expenditure by governments, households, insurers, and other agencies.

●  Out-of-Pocket Expenditure (OOPE) refers to direct payments made by individuals for healthcare services at the point of care.

●  Current Health Expenditure (CHE) includes spending on healthcare goods and services but excludes capital investments.

●  Universal Health Coverage (UHC) aims to ensure access to quality healthcare without causing financial hardship, applying the precautionary principle to protect vulnerable populations.

●  Key government initiatives include Ayushman Bharat, PM-JAY, Health and Wellness Centres (HWCs), and the National Health Policy, 2017, which seeks to increase public health expenditure and strengthen healthcare accessibility while ensuring compliance with regulatory frameworks including environmental impact assessment for healthcare infrastructure development.