Out-of-pocket health spend share falls, govt expenditure rises: NHA

The trend of private health insurance is also showing an upward trend, rising from 3.7 per cent in 2014-15 to 7 per cent in 2019-20

The share of out-of-pocket expenditure (OOPE) in total health expenditure declined from 62.6 per cent in 2014-15 to 47 per cent in 2019-20 due to a jump in the government’s share from 29 per cent to 41 per cent, according to the National Health Accounts estimates for 2019-20.

As a percentage of the gross domestic product (GDP), government health expenditure rose marginally from 1.13 per cent in 2014-15 to 1.35 per cent in 2019-20.

The coverage of private health insurance also showed an upward trend, rising from 3.7 per cent in 2014-15 to 7 per cent in 2019-20, which contributed to the decline in OOPE, alongside government schemes such as Ayushman Bharat.  

Government had set a target of raising health expenditure to 2.5 per cent of GDP by 2025. With two years to go, officials said the data showed that the country was moving in the right direction. As part of the GDP, the government health expenditure returned to the 2017-18 level after registering a dip in 2018-19 to 1.28 per cent.

“That we are in the direction of increased spending and our aim of universal health coverage is evident. The nation is making the best efforts towards this. We will be accounting for some of the recent expenditure that has been made on health as well,” said V K Paul, member-health, NITI Aayog.

The per capita health expenditure has nearly doubled from Rs 1,108 to Rs 2,014 from 2014-15 to 2019-20.

“You can see our journey towards reducing the hardships of citizens has been consistent despite competing priorities, with schemes such Ayushman Bharat,” said Paul.

The overall government health expenditure has increased by 12 per cent in 2019-20, compared to the previous year, while total health expenditure increased by 10 per cent.

“We want to use this data meaningfully to set our policies. States should do their own data to see how they can increase the share of health in their budget to 8 per cent,” Paul added.

At around 4.5-5 per cent, the average spend by states, Paul said, was way below the desired level of 8 per cent. “It is important that state governments continue in the right direction in their investments towards health and education. State is a health subject,” Paul said.

On whether the government is working to widen the scope of the Ayushman Bharat scheme, Paul said the government was holding internal discussions to ensure that the health cover is available to the people to achieve universal health coverage. He said that insurance products that the middle class could easily buy are also an important requirement.

Union Health Secretary Rajesh Bhushan said going forward there is a need to ramp up primary health care.