Healthcare spend as percentage of GDP down in 15 years; out-of-pocket expenditure declines

An ambulance arrives as people stand at the entrance of the emergency department of a government-run hospital in New Delhi. (Representative image)

The National Health Accounts report for the year 2018-19, released by the Centre on September 12, has shown that the total health expenditure as percentage of the gross domestic product declined from 4.2 to 3.2 since 2004-05.

The same report, however, also showed that the out-of-pocket expenditure during the same period came down from 69.4 to 48.2 percent of the total health expenditure.

For 2018-19, the health expenditure for India was estimated to be Rs. 5,96,440 crore or Rs 4, 470 per capita and this constituted current and capital expenditures incurred by government and private sources including external and donor funds.

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As per the report, the current health expenditure for the year was Rs 5,40,246 crore or 90.58 percent, while the rest was capital expenditures.

Of the government health expenditure, the Union government’s share was 34.3 percent but the state governments spent the majority of the funds.

It also highlighted that the Centre’s expenditure on the National Health Mission was Rs 30,578 crore, defence medical services took Rs 12,852 crore, Railway health services took Rs 4,606 crore while Rs 4,060 crore were spent on the Central Government Health Scheme (CGHS).

Expenditures by all government-financed health insurance schemes combined were Rs 12,680 crore and households' out-of-pocket expenditure on health was Rs 2,87,573 crore, 1.52 percent of GDP or Rs 2,155 per capita.

The NHA report also showed that the private health insurance expenditure in the year was Rs 39,201 crore or 6.57 percent of the total health expenditure.

According to the document, the current health expenditure attributed to primary care was around 47.4 percent while 31.7 and 14.9 percent were spent on secondary and tertiary care respectively.