NEW DELHI: Govt spending on healthcare has more than tripled from Rs 1.3 lakh crore in 2013-14 to Rs 4.1 lakh crore in 2023-24, while the share of medical expenses borne directly by households has fallen from 64.2% to 42.7% of total health expenditure over the decade. Despite the decline, families continue to shoulder a substantial burden, paying Rs 4 lakh crore out of their own pockets in 2023-24, according to the latest National Health Accounts (NHA) estimates.The share of govt health expenditure (GHE) in total health expenditure increased from 28.6% to 43.5% during the same period. Per capita govt health spending also rose more than two-and-a-half times, from Rs 1,042 to Rs 2,959, according to NHA 2023-24, which is the eleventh round of health expenditure estimates.
Where does the money go
The report, which tracks financial flows across the country’s healthcare system, estimates India’s total health expenditure at Rs 9.52 lakh crore in 2023-24, equivalent to 3.29% of GDP, or Rs 6,801 per person. Of this, current health expenditure accounted for Rs 8.37 lakh crore (87.9%), while capital expenditure stood at Rs 1.15 lakh crore (12.1%).State govts continued to be the largest contributors to public health spending, accounting for nearly 68% of total govt health expenditure, compared with around 32% contributed by Centre. GHE amounted to 1.43% of GDP during 2023-24, said the report prepared by NHA Technical Secretariat under National Health Systems Resource Centre (NHSRC).The estimates also show an increase in social security expenditure on health, which includes govt-funded health insurance schemes, medical reimbursements for govt employees and social health insurance programmes. Its share in total health expenditure rose from 6% in 2013-14 to 11% in 2023-24.Private health insurance expenditure stood at Rs 97,167 crore, accounting for 10.2% of total health expenditure. Expenditure under all govt-financed health insurance schemes combined was Rs 33,385 crore.An analysis of where healthcare money is spent shows that private hospitals accounted for 31.91% of current health expenditure, against 16.77% for govt hospitals. Pharmacies accounted for another 20.6%, with expenditure amounting to Rs 1.72 lakh crore.
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Pharmaceutical expenditure, including prescribed and over-the-counter medicines and drugs supplied during inpatient and outpatient treatment, accounted for 30.2% of current health expenditure.Primary care accounted for around 46% of current health expenditure, followed by secondary care at around 35% and tertiary care at 14%.
